From the high street: The robots are coming...

Paul Morris urges eye care professionals to do something about the patients who slip through the gaps

In 1992, I nagged my mum and stepdad to rent Terminator 2. I was probably a little young for it but all the other kids at school had seen it. The hype surrounding the film was huge, complete with Guns N’ Roses soundtrack and ground-breaking special effects.

The film captured my imagination. I remember thinking what the future would look like with robots to do every form of household labour, cooking, cleaning, and me generally living the easy life. That was provided I wasn’t living in a post-nuclear wasteland after the machines’ artificial intelligence had become sentient.

Of course, the world is easier thanks to technology. We have household appliances that our not-so-distant ancestors would have called witchcraft. But the adoption of large change is rarely as we foresee or fear. I’m still waiting for my flying car as promised by Tomorrow’s World in the early 1980s. I still mop the kitchen floor with a bucket, mainly because I’m too tight to buy a £500 automated version when I can use my existing method for free with 10 minutes of elbow grease.

This highlights how adoption and accessibility are huge factors when it comes to technology and change.

There are many advances that benefit us as registrants. Just think of the diagnostic technology now at our disposal compared to the past. But technology and advancement also bring threats to the model of eye care that, despite not being perfect, serves the public, and us as a profession, far better than the alternative.

There is an undeniable trend pointing towards the commoditisation of the refractive element of the sight test with the phone, tablet, computer and booth-led models that are successful in other markets.

This technology will only get better, more accurate and more accessible to the public with disruptive companies, backed by hedge funds and the like, eyeing up the UK market. They may see the Opticians Act as an inconvenience but accept any potential fines as a cost of doing business.

In terms of accessibility, search engines and consumer data are optimised to target the public. Glossy websites and applications seeking to persuade them that a non-traditional route is valid feature a small disclaimer that they should seek eye health checks with a registered professional.

Any adoption of this style of examination, devolved from the eye health element under a registered professional would be a disaster for public ocular health as you all know, with preventable eye disease manifesting as sight loss in record numbers.

This has become something I’ve been pleased to speak about on several occasions over the past five years or so, most recently at 100% Optical with Professor Anthony King, chair of Glaucoma UK, and my colleague Giles Edmonds. We discussed what our profession can do and has achieved, in terms of supporting our communities in the face of enormous challenges in ophthalmology with glaucoma.

A huge part of this is reaching people who don’t yet take up regular eye examinations (figures suggest one in five), so that we can monitor and safeguard their sight. I would argue that a bigger part of our challenge is to ensure that everyone who currently accesses our services keeps doing so. We need to educate them about the importance of what we do and the benefits to them in the long term; show them that we deliver a service that is so professional that they tell family, friends and anyone else in their sphere that regular eye tests are the only way to go when the alternative choices become ever more readily available.

To many readers, this seems obvious. I’m sure we would agree that these are the right things to be doing and that we’re already doing a great job of this. Some of you may be thinking ‘my patients would never do that’, and perhaps you’re right. If nothing else, reading this will cause you to pause, review how you engage and educate your patients about the importance of eye care in your clinics and assess how you can improve it.

Change over time is guaranteed. If we adopt the right mindset, it will present many opportunities for us as a profession. But we must safeguard the public by ensuring that we fight a rear-guard action in educating and engaging them. There are no downsides to this and in doing so we could make a huge dent into the one in five people who still don’t access regular care.

I’m not sure how long I’ll have the honour of continuing these segments and if I’ll be able to comment in five years about how this future has panned out. However, knowing I have some deadlines for articles already in the diary for later this year, and never being able to resist a cheesy sign off, as the Terminator would say… I’ll be back. 

  • Paul Morris is director of professional advancement at Specsavers UK & Ireland.