Event Horizon

By Derek N. Cunningham, OD

The rapid growth of managed care, unprecedented changes in federal health care, and endless new technologies are all demanding endless amounts of our attention within a finite amount of available time. Often, it can feel as though we, our practices, and even our entire profession are spiraling out of control toward an ominous unknown fate. Everything that our profession has known for the past century looks to be at risk of changing. For example, it is not uncommon to have the majority of our clinic time spent trying to master changing billing and coding rules rather than staying up to date on academics or clinical medicine.

During the past decade, we have seen virtually every component of the eye examination become automated. Even the highly skilled and subjective fundoscopic exam looks to have competition from artificial intelligence programs made to screen and identify retinal disease. Could we really be at risk of losing our 100-year-old phoropter to innovation? Is nothing sacred, to be spared from this recent evolutionary tornado? It looks like we could be standing at the edge of traditional optometric reality. I have dear friends, senior respected colleagues (long past retirement), who tell me the past 10 years of eye care would be enough to dissuade them from entering the profession if they were considering it now.

Do all the rules and laws of optometry break down moving forward? Yes and no. People will still be born with refractive errors, and people will still get sick. How we deal with these issues will never be the same. Technology, whether its use is in disease management or the science of public health, is an exponential curve. As we move along the curve, things speed up, and our profession will continue to change faster than it did before. Future planning based on long-term familiarity becomes the exception moving forward.

What should we do with so much future uncertainty? Embrace it. Great uncertainty brings endless opportunity, and never before has our profession been more ripe for innovative thinkers, progressive clinicians, and optometric visionaries. The great philosopher Joseph Dirté once said, “Life’s a garden. Dig it.” Now, we all have more control than ever on how we see patients, what technology we feel is important, and where our profession goes. Dig a little, and you can easily find endless amounts of information and options. Sure, there is a lot of fertilizer on the garden, but ultimately this will help the good ideas grow even better. Here at Advanced Ocular Care, we hope to help you shovel through the endless fertilizer and assist in your discovery of the ideas that can enable you as a clinician grow and adapt in this accelerated future.

We start 2015 with a redesign. The current trend in print publications is to shrink the size and lower the quality of the paper. In the typical fashion of AOC’s publisher Bryn Mawr Communications, we have decided to increase our dimensions to improve readers’ experiences by providing more room for images.

In this issue debuting our new look—and our new logo—we focus on innovation in contact lenses, cataract surgery, and pharmaceutical delivery. We are also kicking off “Modern Retina,” a column in which new advancements and technology in the retina world will be presented through collaborative care initiatives between optometrists and retina specialists. Evolving our relationships with ophthalmology and other health care providers will be equally as important as the new technology we embrace.

As we stand on the event horizon of our profession, there is no doubt in my mind that I too will eventually be one of the grumpy old Muppets in the balcony of optometry, lamenting the poor decisions and ill fate of my younger colleagues. Until then, I am going to run as fast as I can toward this exciting abyss. n

Derek N. Cunningham, OD
Chief Medical Editor