Game Changers: View from the Present
Lucy Patchett talks to voices from practice and industry to find out what they think have been the biggest changes in their sectors and what the future holds
Author: Lucy Patchett
Peter Black, course lead for ophthalmic dispensing at the University of Central Lancashire.
Optician: What development in ophthalmic lenses do you consider the biggest game changer for the optical industry in the last century?
Peter Black: The biggest game changer that has been almost universally accepted is the computerised automatic focimeter. Unlike a manual focimeter, which needs calibrating each time the user changes so that one person cannot see what the other can, the automatic focimeter can be used by anyone without recalibration so it is more accurate and saves a huge amount of time in practice. The latest lens meters, such as those from Topcon, utilise robotics to ‘grab’ the spectacles and orient them correctly and can identify the position of progressive lens markings.
Optician: How have the rise of free form and progressive lenses impacted the industry?
PB: Although freeform technology dominates the production of surface lenses nowadays, I have been disappointed to see the slow uptake of personalised progressive and single vision lenses where this technology really comes into its own. It is disappointing to see older designs of lens manufactured using freeform technology rather than the sector offering individualised products that offer real visual improvements for the majority of patients.
Optician: What innovations can we expect for the future of frames and ophthalmic lenses?
PB: I’m really excited for the future and can see 3D scanning technology revolutionising how we dispense bespoke frames. This, linked to suitable robotic manufacturing, will enable opticians to design frames for their patients and make them on the premises. I’d also predict a surge in the use of Cadcam routing of acetate (eg the Optimaker) and the use of powder sintering technology for both plastic and metal frame components at a more bespoke level. For lenses, I doubt that ‘additive’ 3D printing will ever be high enough quality to displace the ‘reductive’ freeform technology even though it is less wasteful.
Jason Kirk, CEO at Kirk & Kirk eyewear, and Georgia Rae, optometrist and co-owner at Rae & Rae Opticians York.
Optician: What development in the making of frames do you cnsider the biggest game changer for the optical industry?
Georgia Rae: Concern for the environment and the move to seek out sustainable materials has had a huge impact on the way we make glasses. I actively look to work with brands who are eco-conscious and use materials such as wood, cork, plant fibres and bio-acetates. The use of bio-acetate is better for the environment and biodegradable, and, unlike traditional acetate frames, it’s made without the use of oil-based plasticisers.
Jason Kirk: New technology and materials have paved the way for lightweight frames such as horn and acrylic, allowing people to comfortably enjoy thicker looking frames, while frame virtual try-on technology has been very helpful when delivered with quality.
Simon Berry, owner of Durham-based practice Simon Berry Optometrist.
Optician: What development in instruments do you consider the biggest game changer for the optical industry in the last century?
Simon Berry: The invention of the Goldmann Tonometer in 1957. Before then, measuring intraocular pressure (IOP) was difficult in primary care, with some opticians relying on palpation as the only method. This enabled reliable, easy ways to check IOP and identify glaucoma cases that may have been missed otherwise. It has become the gold standard in eye hospitals worldwide and has standardised tonometry readings for a generation.
Optician: How were the development of OCTs and the slit lamps significant milestones?
SB: They allowed us to explore more of the eye’s anatomy, and that in turn helps us understand eye pathology in a much more detailed way. Before the slit lamp was invented, no one could guess what a cataract really looked like, or how keratoconus thinned the cornea. OCTs have done the same for the retina. We used to have to diagnose subtle cystoid macula oedema with a 90D lens, but now there’s a definitive diagnosis in seconds with very little effort.
Optician: What innovations can we expect for the future of eye care instrumentation?
SB: Avenues of growth in our equipment could facilitate that tantalising glimpse into diagnosing neurological conditions early in primary care. We could potentially find clues for a whole host of neurological conditions, such as Parkinson’s disease and Alzheimer’s, by examining parts of the retina.
Bhavin Shah, behavioural optometrist, myopia consultant and director at Central Vision Opticians.
Optician: What development in contact lenses (CLs) do you consider the biggest game changer for the optical industry in the last century?
Bhavin Shah: I believe the three top ones are soft lenses, daily disposables and lenses for myopia management. Daily disposables have made the biggest impact, however moving forward, CLs for myopia management will probably make the biggest change to the lives of our patients.
Optician: How were the development of soft lenses, hydrogels or silicon hydrogels significant milestones?
BS: The advent of soft lenses/hydrogels meant that CLs were easier to tolerate and to fit, enabling CLs to reach a wider market. Silicon hydrogels allowed the ideal amount of oxygen to permeate through the lens to reach the cornea (as defined by the Holden-Mertz criteria) in order to prevent hypoxia of the cornea, resulting in significantly reduced incidences of CL-related complications and much safer wear.
Optician: What innovations can we expect for the future of CLs?
BS: The developments that I am most excited about are contact lenses that have a built-in computer/phone display; lenses with the potential to measure IOP, blood sugar and other vital signs or disease; and have the potential to deliver drugs and medicines in a smart way.