AOA members carry the message of #2020EyeExam into the future

Excerpted from pages 26-27 of the September/October 2019 edition of AOA Focus.

The Year of the Eye Exam is in full swing, and AOA members are thinking about how they can carry the momentum of this important AOA awareness campaign forward into the future. Here's what doctors, students and paraoptometrics forecast for optometry's future.

Responsibility of students today

"Our profession's ability to positively impact the public has improved from simply providing glasses to now being able to manage sight-threatening diseases," says Bibin Cherian, American Optometric Student Association president and a student at Northeastern State University Oklahoma College of Optometry. "Optometry students, such as me, are being taught surgical and laser procedures in school-an outcome considered unfathomable decades ago.

"Looking forward to the next 20 years, today's students have a responsibility to build upon the work of the giants who came before us. I envision by 2040, doctors of optometry across the country will have the ability to treat glaucoma, prescribe orals and perform minor injections. Laser procedures including YAG, SLT and laser-assisted cataract surgery will have a more prominent role in our medical model, allowing practitioners to better serve the growing needs of patients. More importantly, our message to the public will have solidified the importance of annual, comprehensive eye exams and demonstrate the value doctors of optometry provide to health care."

Eye exams—a lifetime of good vision

"Considering how far we have come communications-wise in this country in the past 20 years, it's almost mind-blowing to try and imagine where we will be 20 years from now," says Andrea P. Thau, O.D., AOA past president and chair of the AOA's Leadership Development Committee. "How much further will we go? I hope that 20 years from now AOA and its member doctors of optometry will be firmly established as the leading source for all information regarding vision and eye health. Our role as primary eye care providers and primary health care providers would be firmly entrenched in the public's mind, and the AOA will find a way to help disseminate patient education information in whatever the most popular modality will be at that time in the most targeted way. We would direct the public to seek out the outstanding care of our member doctors of optometry to protect, enhance, preserve and rehabilitate their vision. I would love to see the public educated, so they would no longer take their vision for granted.

"Today, the Centers for Disease Control and Prevention reports that fewer than 15% of preschool children receive eye exams. In 20 years, my dream would be that, in accordance with the AOA's clinical practice guidelines, everyone enjoys a lifetime of good vision by receiving a comprehensive, in-person eye examination in the first year of life, at age 3, age 5 and every year thereafter."

Driven by more data

"Data, particularly aggregate from registries such as AOA MORE, has the power to reshape clinical trials and investigations into new therapies," says Zachary McCarty, O.D., chair of the AOA's Quality Improvement and Registries Committee. "Instead of recruiting 100, 500 or 1,000 people to study a new drug or material, there will be real-world feedback from thousands of patients. We will have better glimpses into pathology progression such as myopia, and this may lead to faster discovery of interventions that work. There may even be the inclusion of genomics, that when coupled with AI (artificial intelligence), may lead to better detection of patients at risk for particular diseases and initiation of earlier interventions.

"We are on the early wave of true precision health care with better selection of the appropriate treatment that is tailored to each individual patient."

More office-based surgical procedures

"In my crystal ball, I continue to see optometry grabbing ahold of the medical model; the demand for services is going to be there for optometry," says Nathan Lighthizer, O.D., assistant dean of clinical care services and director of continuing education at Northeastern State University Oklahoma College of Optometry. "The demand will be there for optometry to treat topically, to treat orally and to treat surgically as well with injections, with lump and bump removal and laser procedures."

In my opinion, the writing is on the wall. Twenty years from now, instead of five states that allow doctors of optometry to perform office-based surgical procedures, it's going to be 25 states. That's my hope and personal opinion. It's going to follow what happened with diagnostics and therapeutics. It started with just a handful of states back then, and now it's all of them. I think 20 years from now we're going to look back and say it's hard to believe it was once only a few states that would allow doctors of optometry to perform office-based surgeries, and now it's dozens. Twenty years from now, many states could have laws similar to what we have in Oklahoma, Kentucky and Louisiana. We have the proper training in school and are well qualified to care for our patients in these manners. With an aging population, it is more critical than ever to have optometry shoulder the load of office-based surgical and laser procedures."

Training for technology

"Our world in 20 years? For paraoptometrics, the main change in our work would be improved technology," says Jennifer Jacquez, CPOA, CPOC. "When I started as a paraoptometric eight years ago, we had paper charts instead of the electronic health record we have today. When I first started, we sent postcards to patients to remind them they needed to schedule their annual eye exam. Today, patients are able to request appointments online. We send automated text messages or emails that go out when their eye examinations are due. And we're implementing a program so that patients can look at their medical records online.

"In 2013, I helped implement the EHR in our practice, and it has made it easier to assign diagnostic codes for billing insurance companies. To meet these technological advances, paraoptometrics will need to keep up with their education, certification and training (for instance, setting up for office-based surgical procedures). I enjoy learning something different every day."

Staying optical, growing medical

"I am very fortunate to practice in Kentucky," says Josiah Young, O.D., M.S. "I'm practicing a stone's throw from the state I grew up in (Ohio) and yet, in Kentucky, we can do so much more scope-wise. The state association has accomplished so much in Kentucky, which affords the citizens of the state the best eye care in the country, I think. I've heard the occasional doom and gloom regarding our profession. But I'm an optimistic person. I think optometry definitely has a future in medical eye care. I don't want to call it a paradigm shift-medical eye care has been around for a while due to expanded scope in certain states. And medical optometry is certainly where the profession continues to be headed. I just hope that we continue to stay at the top of the profession, optically, as well. When we combine our medical optometry with our prescribing of glasses and contact lenses and medical breakthroughs, there are some neat opportunities in optometry's pipeline. They're developing contact lens for drug delivery, and some day we might be measuring diabetics' blood sugar with contact lenses. So, we need to stay both medical and optical, and we've got to be good to help the public see better."