Part 4: Biggest innovations in ophthalmology in 50 years

In celebration of Ophthalmology Times 50th anniversary, we asked leading experts in the field what they see as the biggest innovation in ophthalmology in the last 5 decades.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Jessica Steen, OD, FAAO:

If we think 50 years ago, what the practice of optometry and ophthalmology were, you know, as we see where we are today, I truly think imaging strategies and technologies to best understand underlying pathology has changed the way that we think about posterior segment disease, glaucoma, and retinal pathology. We're able to evaluate tissue in ways that our colleagues and predecessors really only dreamed and imagined. We can dissect tissue non-invasively with OCT. We can evaluate imaging biomarkers that predict disease progression. Really, technology has been the core.

Eva Kim, MD:

I think, in the past 50 years, one of the most exciting innovations is really kind of what drives me in my practice, which is—cataract surgery has gone from a very medical procedure where we would just remove a cloudy cataract and replace that cataract with a lens. To what I like to call, when I explain to my patients, cataract surgery plus, which is the option to efficiently remove your cataract and correct your vision so that you have lots more independence from spectacles or contact lenses. So I love to be able to offer my patients a medical procedure that is incredibly quick and painless and combine that with the option to have spectacle-free vision with advanced technology, intraocular lenses. With femtosecond laser and, frankly, with corneal-based refractive surgery, if necessary, to kind of get them past the finish line. So just having that combination of technology, aborometers, lenses to lead your patients towards amazing, spectacle-free vision. I think that's just been the most exciting part about my practice.

Sherrol Reynolds, OD, FAAO:

So for me as an optometrist, what has really revolutionized our care in early detection management of our patient is multi-modal imaging technology development. For example, the OCT, the OCT-A, en face testing, EDI (enhanced depth imaging) fundus autofluorescence, and wide-field imaging. I mean, these technologies have really allowed us to capture disease pathology earlier. Not only can we use these technologies to educate our patients, show them what they have. A lot of times, if the patients see their condition, they're more inclined to be, you know, compliant with therapy and treatment and recommended care. And also, too to monitor the patient if they're having treatment, if they're getting better, we can show them that things are improving. So just having these multimodal imaging, including OCT, OCT-A enhanced depth imaging, wide-field imaging, you know, fundus autofluorescence, has really kind of changed the landscape in the last 50 years and even allowing us to understand pathology a lot better. So I'm excited for what's to come in the future, not just with new treatment modalities for patients, but more instrumentation to detect earlier. You know, artificial intelligence, it's coming, and some devices have that where we can better predict who's going to be impacted from disease pathology. So I'm excited about that as well in eye care. So just a lot that's emerging and coming through in the future that wasn't there when I was a student in school 30 years ago, that we see now, 30 years later, and even 50 years later.

Shivani Kamat, MD:

Oh, that's fascinating. So as a glaucoma specialist, for a long time, we only had incisional surgery, so trabeculectomy tube shunts; I actually think MiGs has been one of the biggest revolutions in glaucoma. And now MiGs and like sustained drug delivery and approaching the glaucoma with a more interventional approach, I think, is kind of what we're leaning into for, like, the next phase of treatment. But for the past, maybe 10 years, probably more. But around that time, I think MiGs has really changed the landscape. And I still do a lot of incisional surgery, but I think we're so fortunate to have so many tools in our tool kit now. Not just trabeculectomy and tube shunt on people who have really mild disease but have pressures that are hard to control, we can do all these other things that are less invasive and can be highly successful before having to go to a more invasive procedure. So in my opinion, for glaucoma, I think that's been revolutionary.