With potential changes to the affordable care act on the horizon, the US healthcare outlook is uncertain. However, no matter how the ACA shakes out, the ophthalmology market will be able to protect itself in large part due to several trends that optometrists, ophthamologists, surgeons and their practices can capitalize on.
TREND 1: The coming age of “Eye Health”
We are starting to see the “diseasification” of eye conditions. Reclassifiying conditions like glaucoma to diseases does three things:
- Raises the importance of screening and treatment
- Helps counter current downward reimbursement trends
- Elevates the role of the ophthalmologist / optometrist and increases overall
patient presentation rates
Most notable diseases are:
- Dry Eye Disease
- Infectious Keratitis
- Sjogren’s syndrome
TREND 2: The aesthetics of eyes
On the flip side, you have the cosmetology aspect of eye health where optometrist are more frequently performing more cosmetic procedures. MDs are educating themselves on fillers, injections, lash extensions and Latisse.
Optometry has always been involved in the cosmetic industry. We have had designer eyeglass frames for decades now. For those who did not like the aesthetics of eyeglasses, contact lenses became available, which evolved into cosmetically tinted contact lenses that even patients without visual problems desired. The initial lenses were color enhancing lenses, which eventually became iris color changing lenses. Then came the refractive surgeries, radial keratometry, PRK and LASIK, designed to free patients from the need to wear glasses.
Technology is now moving optometry into a new area of opportunity: “cosmetic optometry.” State laws regulate what procedures optometrists can perform. For instance, for Latisse (which increases lash length, thickness and darkness) there are four basic categories of scope of practice for ODs, which varies state-by-state:
- The optometrist can prescribe and dispense.
- The optometrist can only prescribe. The doctor cannot dispense or sell it on retail.
- With states with formularies, the state board of optometry may need to approve adding Latisse to the formulation before an optometrist can prescribe it.
- The optometrist cannot prescribe the drug.
Even though an optometrist can prescribe Lumigan, the glaucoma medication, which is the same formulation of Latisse, state law could forbid him or her from prescribing Latisse.
We fully expect to see optometry practices to continue pushing the field into cosmetics.
TREND 3: Cataract Surgery continues to be big business
Cataract Surgery is one of the most common surgeries in the US and is the most common performed by the ophthalmic surgeon. In 2015, 3.6M cataract procedures were performed in the US and 20M were performed worldwide. Cataract surgery is an outpatient procedure. To remove the cataract, the surgeon makes a circular incision around the eye's lens, and then uses ultrasound technology to break up and remove the cloudy lens. After that, a new lens is slipped into the eye.
Some surgeons still use a scalpel for the incision. But more and more, surgeons are using an ultra-short-pulse (femtosecond) laser as it allows physicians to make more precise incisions and ensure better centering of the implanted lens.
More people are having cataract surgery and they’re undergoing the knife earlier. In addition, costs of the intraocular lenses - and the procedure in general are coming down. Plus, advances in imaging, measuring, and lenses are making the procedure even better.