Scott A. Edmonds, OD, FAAO, focuses his blog on the role of the optometrist in health care reform – moving from primary eye care to primary health care. He is the chief medical officer of MARCH Vision Care, the co-director of the Low Vision/Contact Lens Service at Wills Eye Institute in Philadelphia and a member of the Primary Care Optometry News Editorial Board. 

Disclosure: Edmonds is a consultant for March Vision and OcuHub.

BLOG: Leveraging technology

I have just returned from an inspirational week at Vision Expo East. There were a number of themes that emerged from this event that can be very positive for the profession of optometry if one is open to new ways to provide patient care.

The first theme for me was the advancement in telehealth and the practicality of virtual optometry services. What seemed like science fiction not long ago is quickly becoming reality. We know that many of the technical aspects of optometry have been automated, and most of us employ autorefractors, autokeratometers and autolensometers in our office locations. Add to that digital fundus photography, video slit lamp technology and the Internet, and you can quickly see that all of the critical information can be gathered remotely.

The key role of the optometrist is now just twofold. First is the assimilation of all of the data for the proper diagnosis and management. This is a skill that requires a good basic optometric education combined with a commitment to lifelong learning and some practical experience. The second role is the one that I have been highlighting throughout my blog series and something that I strive to teach all of my students: Doctoring!

The doctoring of the optometrist is what separates us from all of the technical professions and what has evolved us into essential primary health care providers. When done well, it combines optical data, eye health data, systemic medical data, the functional needs and the individual personality of each patient. It then blends in into a cogent treatment and long-term management plan that a patient can understand and implement.

I have always thought that this element required a personal face-to-face session with the patient. I learned in New York, however, that this perception is just a Baby Boomer thing and that the Millennials don't need or even want this type of interaction. Millennials, who I also learned are now the largest population in America, prefer a text over a phone call and a video chat over a live interaction. Who knew? With this in mind, however, it is clear that tele-optometry with real-time video “doctoring” is going to be a rapidly growing segment of optometric care.

The second major theme for me at this annual meeting in the Big Apple is that the technology available to improve the optometric management of diabetes has taken several leaps forward. Between optical coherence tomography angiography and high-resolution wide-angle digital photography, we can visualize and diagnose subclinical diabetic retinopathy years earlier than ever before. The optometric examination can be the most effective element in the decision to treat borderline elevated blood sugars and to increase the treatment in cases with single-drug treatment or otherwise undertreated people with diabetes.

These technologies have the potential to catapult optometry into the mainstream of diabetic care and open up the scope of practice to the treatment of diabetes and other chronic health problems in many more states. The eye can show the earliest signs of end organ damage, and this new technology can allow the optometrist to study the retinal vasculature in a noninvasive, cost-effective manner.

The optometrists that can master and implement the new technology that was introduced at this industry meeting will be leading the way to improving health care in America. We now have the tools for broad access to patients and high-quality assessment that can improve the lives of millions of people.