Optician India

This is a personal opinion and does not reflect the views of any organisation I represent or work for these are the views of no-one but the author.

The UK optical market today is still remarkably similar to how it has always been with the addition of better diagnostic tools and more accurate measurements –OCT, Biometry and auto-refraction being the main new additions. However from a patient perspective most individuals still visit bricks and mortar practices and are served by opticians on a one to one basis.

New technology is introduced every week and it usually makes our job quicker, easier and more accurate so we have a duty of care to our patients to embrace it, however the end user, our patients still rely on us to guide them through the process of identifying what they most need, facilitating its procurement, whether it be an extended clinical procedure or a bespoke product and ultimately supplyingthem with it for a price.

The areas we need to keep in mind are technology, sustainability, consumer trends, AI and the general trend in the healthcare professions towards globalisation.

Lens technology

The improvement in lens manufacture means lenses can be made more complex, individualised and uniquely while at the same time being made faster and thus more efficiently. Innovative technologies from Freeform progressives to myopia management products, new thin film technology in photochromic, anti-reflective surface coatings and tints like polarising filters are being made differently with more variety than ever before – but not always better.Some smart tech is making its way to the market although not at a large scale yet. Contact lenses that monitor you intra-occular pressure, spectacle lenses that incorporate head up displays are just breaking into the high street.

Frames are enjoying their own innovations, new materials are continually introduced and while the majority are newly formulated polyamides (Nylon) they are less expensive and injection moulded so made with less waste than traditional plastics and made faster, I would however suggest that some of these plastics are chemically very sensitive, very fast to market and while I am reassured by the manufacturers that all frame production, including 3D printing has to be safety tested to “standard 100 OEKO_TEX” there is little opportunity to witness or confirm this. I have been assured by market influencers that 3D printing and smart eyewear is coming down the line to meet us and is apparently travelling at some speed, as yet I see truly negligible impact in the UK.

Personalised frame fitting following 3D facial scans are often talked about but its not going to be a 3D printer in the practice that delivers this, the scanner will have to be mobile phone based (our facial recognition technology is not far removed from a 3D Scan) but the quality of 3D printer needed to make such products would not be sustainable by an individual practice so the data will have to be transmitted to a large scale printer serving multiple users.

The use of data to enhance optical performance and comfort is stationary because opticians are so precious about their customers data, this is an area where we need some industry trust, the amount of products now available is insane, the optical suppliers association in the UK tells me there are now more than 1000 different progressive power lens designs available! No optician can memorise all these lens features and benefits, if we had a lifestyle questionnaire at the beginning of a consultation, input the prescription found at refraction and facial measurements taken for position of wear, followed up with a satisfaction survey after the event allowing time for adaption, that data could be AI analysed and dispensing recommendations could be spontaneous and better serve our customers!

It is arguably in the patients best interest to do this but I do not see it happening any time soon in the UK. If however you look beyond the UK to our esteemed colleagues in Spain, IOT have already done this, it is called Evolens!

Sustainability and carbon neutral manufacturing is talked about a lot, we have suppliers who maintain a high profile on their “green” credentials with biodegradable plastics, reused and recycled plastics, there is even a company that will call into a practice on request and for a fee tell you how to make your practice more environmentally friendly and where you can’t achieve carbon neutral, again for a fee, will help you offset your carbon footprint by paying them to plant trees or similar. We all know injection moulding and 3D printing is a much lower waste process compared to traditional frame manufacture and we all know the nightmare of ensuring all our products are ethically manufactured without the use of slave or child labour. The acetate market in particular gives us the same dilemma as the clothing industry as acetate is a cotton based plastic and cotton production worldwide is often unethically produced.

Our dispensing practices are easier to control and we have made timely progress with these in the UK, reduced packaging, more environmentally friendly packaging with one of our more ethical suppliers setting up a recycling service for dummy lenses which, as far as I know, is an industry first? There is another company who grinds second hand prescription lenses I do chunks that can be incorporated into road surfaces.

Does the customer care? The truth is some do and some wish they could afford to! While we do have some customers who are very focussed on the social, ethical and environmental aspects of where and on what they spend their money there are still people in the UK who buy on price and price alone. As a business I like to try to provide good service, good products and an awareness of sustainability and of course part of sustainability is to remain in business so we can provide the same service next time which means we too must make a profit, the aim is for everyone to thrive not just survive.

Our customers/patients are changing, everything is changing, availability of online cheap specs is starting to be seen in every town, the ability to try frames on virtually is still not good enough to threaten retail in a real way, the phone apps that perform a sort of refraction are still not robust but this will change.What of patient loyalty? It is nice if you can afford it but loyalty is being seen increasingly as an indulgence we have to be ever mindful that these people have a choice and everyone looks online for a bargain. This is not helped by the fact that our own suppliers own the companies that sell online! Who knew? There is no doubt there is an appetite from within the industry to bypass traditional opticians and serve the public direct without the need for optometrists or opticians, mark my words.

Then there is the aging demographic that is the UK population and all that goes with it, more ARMD, more glaucoma, more low vision. The UK high street optician is more involved than ever with these people, the hospitals cannot cope and the skill set needed is available, we have shared care pathways for diabetes, glaucoma, post op. Cataract patients even minor eye condition pathways developed by and paid for by the local hospital to reduce their onerous back log of patients waiting for simple procedures.Then at the other end of the market we have young, tech savvy, generation Z wanting specs with head up displays and cameras and microphones and speakers all built in, and yes they are available but not being adopted quickly due to price but we all know this will change. It has not gone un noticed that all the big players have research going on into vision, AR, VR, smart specs – it feels like we are on the edge of a revolution!

So what are UK opticians going to be doing in ten years time? Well I do not think AI is going to close us down, I think opticians who embrace AI will close down those that do not! If AI analyses retinal photographs and OCT images better than we can, we are duty bound to do what’s in the best interest of the patient and use them, if our patient can afford and have available to them remote monitoring devices that maybe monitor their IOP’s or their AMD and their blood sugars, they still have to send that data somewhere? I wear a blood pressure monitor on my wrist but the result still gets sent to my GP, not direct to the pharmacy for an AI generated prescription (yet)! We balance and embrace new responsibilities while AI does what we ask quicker than we could our time is diverted to holistic patient care, advice and guidance on lifestyle, recomending different self care, all of which has to be rewarded for the business model to be sustainable. We must learn from those who have gone before us and get our faces out of the computer and communicate better with our patients. When I see my GP he types in my symptoms to a computer, confirms a diagnosis and then selects from a list of suggestions which medication to prescribe from a list that has already been screened for contra indications with any existing medication I may be on, if he is only selecting a medication from that list based on cost, why do I need a doctor?

As with all of these innovative technologies while I can see their merit the question I most want an answer to is this; While AI is delivering my job quicker, more accurately and more reliably than me, what is it I am going to be doing with my time!

In conclusion, I think there will be progress to make high street optometry more automated, there will be a general trend towards AI analysis and I predict an additional fee to have your images/scans analysed by both a person and a computer. The really big threat is the big global corporations who are buying up independent opticians at an alarming rate and as has happened with medicine , dentistry and Vetinary medicine over the last few years soon we will have little choice on who we deal with or what we buy because they will all be owned by two men! Look inwards optical sector, your demise is from the very people who tell you they are there to support you!