Clinical Perspectives on Current Trends in Optometry: Shaping the Future

Corresponding Author: Titas Dutta

Email: dr.duttatitas@gmail.com

Abstract

      Optometry and its aspects have evolved over the years, with the changing patterns in diseases; instrumentation has also developed rapidly. A clinical perspective in current trends allows the practitioner to bridge between scientific innovation and practical practice. Practitioners can investigate areas such as teleoptometry, myopia management, artificial intelligence, Contact Lens Advancements, Integration of Ocular and Systemic Health, ageing population, and Low Vision Rehabilitation.

Keywords: Tele-optometry, Myopia Management, Artificial Intelligence, Dry Eye Disease, Pediatric Optometry, Binocular Vision, Clinical Optometry Trends

Introduction:

As optometry enters a new era shaped by data-driven diagnostics, virtual care models, and public health needs. It traditionally used to focus on vision correction and related issues, is now at the intersection of technology and preventive care. A clinical perspective article helps

optometrists to contribute informed, experience-based insights on current trends, offering a bridge between research and private practice. Unlike traditional research articles, a clinical perspective is focused on interpretation, commentary, and translation of trends into real-world applications. A successful clinical perspective focuses on timely, impactful, and practical subjects. Examples include: The rising global burden of myopia among children, The transformation of practice through tele optometry, integration of AI in ocular diagnostics, Increasing awareness of ocular manifestations of systemic diseases, Advances in dry eye disease treatments and diagnostics here, we would focus more on the part of the rising global burden of myopia and the advancements, as this is widely being discussed about as the percentage grows day by day.  As we all know, the COVID-19 pandemic, increased screen time and the demand for diversified clinical services. This article explores key clinical trends and their impact on modern optometric care.

Myopia Control: epidemiological surge and preventive measures:

   The rise in childhood myopia is alarming; if projections hold, nearly one in two individuals could need myopia control strategies within 25 years. By 2050, it is projected that around 50% of the global population will be myopic  (Holden et al., 2023) Low-dose atropine (0.01% - 0.05%) and orthokeratology are now standard interventions with proven efficacy in slowing axial elongation. (Jonas et al., 2023) reviewed histomorphometry and clinical evidence to characterize structural changes associated with axial elongation in myopic eyes. In a two-year randomized study, children treated with 0.05% atropine showed 67% slower myopic progression compared to others. Lança and Pang’s in their systematic review, analyzed 12 randomized controlled trials conducted between 2019 and 2021, focusing on interventions such as highly aspherical lenslets (HAL), Mi Sight contact lenses, low-dose atropine, Biofinity +2.50 D, DIMS spectacle lenses, and orthokeratology. Just not this, Special Myopic lenses such as Myo smart, Mi Sight are showing promising results as well.( Yi et al., 2023) in their studies compared classrooms adorned with forest/sky wallpaper emulating high spatial frequencies versus standard classrooms. Subjective feedback revealed that 88–89% of teachers and 75–77% of students found the outdoor scene environment more enjoyable and efficient. A recent randomized clinical trial by (Lan et al., 2025) showed that children taught in outdoor-themed classrooms experienced a 0.22 D slower myopic shift compared to controls. So, we can summarize one thing for sure that there might be hundreds of trending treatment procedures available in myopia management, but Prevention still tops the list.

Dry Eye Disease: A Growing Clinical Burden:

TFOS DEWS II findings showcase that over 30% of adults in developed nations experience some forms of DEDs (Jones et al.,2023), which is quite evident, Widely used digital devices after COVID-19 are the real game changer here. The amount of time people invest using digital devices is massive these days. A multicenter study found a 28% rise in dry eye disease post-2020, primarily linked to digital fatigue.

In this UK-Ireland occupational health study, professionals averaging 9.7 hours/day on screens reported a 62.6% prevalence of digital eye strain (DES). Symptoms included ocular fatigue (89.5%) and neck/back pain (94.3%). The article emphasizes the need for optometrists to assess both visual and ergonomic risk factors in Dry eye management. (Sheppard & Wolffsohn, 2023) (Pucker, 2024) summarizes ocular surface pathophysiology in DES (Digital Eye Strain).

Key mechanisms include tear film instability, increased osmolarity, elevation of inflammatory markers, and dysfunction of the meibomian glands. Patients using screens for extended hours report blurry vision, burning sensations, and ocular fatigue. Clinical management includes blue light–filtering lenses, artificial tears, and, in advanced cases, in-office therapies like intense pulsed light.

(Storås et al., 2021) show Artificial Intelligence in Dry Eye Disease (arXiv) Surveys deep-learning algorithms for dry eye detection using meibography and tear-film imaging, discussing diagnostic consistency and future clinical use cases.

Technological Inventions in Imaging and Diagnostics:

OCT, OCT Angiography, and VFA have become vital for the early detection of glaucoma and retinal pathologies; technological inventions are making life easier, and optometry holds very evident proof for that. Tools like IDx-DR have achieved 87% sensitivity and 90% specificity in autonomous diabetic retinopathy detection (Gulshan et al, 2024).More than 60% of optometric clinics in developed regions have adopted some form of digital retinal imaging. (Spaide, R. F. , 2023) discusses how OCTA enables non-invasive visualization of the retinal and choroidal microvasculature, without dye injection. Modern optometry has embraced a wide array of technological tools that enhance diagnostic precision, therapeutic outcomes, and patient access. From imaging technologies like OCT to contact lens innovations, these tools significantly shape the future of eye care. However, Certain tools (e.g., contact-based tonometer, long imaging sessions) may be uncomfortable, especially for children, the elderly, or patients with disabilities; other than that, rural practices may struggle to invest in or access these tools, creating disparities in care delivery.

The Rise of Teleoptometry:

Teleoptometry refers to the remote delivery of optometric care using digital platforms, including video consultations, mobile applications, and image-based diagnostics. It has emerged as a vital extension of traditional eye care, particularly in improving accessibility and continuity of services across underserved and rural populations.

The use of remote optometric services increased by 400% from 2020 to 2022 (Chiang et al ., 2023). (Jo & Pasquale, 2024) – Advances in telemedicine for glaucoma Reviews remote visual field testing, tonometry, and monitoring platforms for glaucoma management, with outcomes comparable to clinic-based assessments. `(Ramamurthy et al., 2024) introduced Smart Devices in Optometry  Reviews, wearable, smartphone-based, and augmented-reality devices for remote monitoring of ocular function and visual symptoms, especially in low-resource settings.(Goldschmidt & Stanimirovic,  2020/2023) show a Teleophthalmology practice overview. Highlights cost-effective rural retina screening via fundus/OCT imaging by trained technicians with remote specialist evaluation—ideal for diabetic retinopathy and AMD screening. Remote refraction, ocular history intake, and follow-up management have shown less than 85 % satisfaction rates in the urban population, but are still limited in in-person diagnostics, like intraocular pressure measurement, and anterior segment assessment remains a challenge. Remote vision assessments and tele-refractions have demonstrated comparable accuracy to in-person examinations when using validated protocols and trained facilitators. However, certain procedures—such as intraocular pressure measurement, slit-lamp examination, or contact lens fittings—require in-person evaluation. Challenges also persist around technology access, digital literacy, and data privacy, which must be addressed to ensure equity and safety in care delivery.

USE OF AI : 

The integration of Artificial Intelligence (AI) into optometric practice is one of the most rapidly adopted for tasks such as automated image analysis, predictive diagnostics, and clinically significant current trends shaping the future of eye care. AI technologies are being decision support. (Wang et al., 2023) used Advances in AI models and algorithms in optometry.

A comprehensive review of AI applications in optometry, covering myopia, amblyopia, keratoconus, and strabismus, with discussion of opportunities and limitations. While AI is promising, it still has several challenges, including bias in results, high costs, and difficulty integrating into everyday clinical use.

(Scanzera et al., 2022) Surveyed optometrists and found that over 60% were hesitant to adopt AI due to workflow disruption. (Zangwill et al., 2024) emphasized the lack of legal clarity and patient consent pathways for AI-involved diagnoses.

(Coan et al., 2022) noted that most AI models for glaucoma screening were not validated across ethnically diverse populations, limiting reliability. (Du et al., 2024) also summarize

Current AI research and technologies used for diagnosis in optometry, related to myopia, strabismus, amblyopia, optical glasses, contact lenses, and other aspects.

Limitations:

While this review attempts to summarize the clinical implications of the emerging trends in optometry, several limitations can be seen.

First, many of the studies on AI and tele-optometry are based on preliminary data; hence their applicability to diversify in real-world clinical settings is still challenging.

Second, there is a geographic bias, where most trials and technological evaluations are being conducted in high-income or urbanized regions. This limits the generalizability.

Lastly, rapid developments in both technology and clinical protocols mean that some referenced data may become outdated within a short period. The optometry field is evolving quickly, so practitioners need to keep updated now and then.

Conclusion:

  Clinical optometry is in its transformational era, where preventive care, digital health Integration and precision diagnostics define Modern-Day Optometry, providing quality eye care. The field of optometry is rapidly evolving, driven by advancements in technology and growing clinical demands. Innovations such as artificial intelligence, teleoptometry, and specialized interventions for pediatric and binocular vision care, inventions to manage and control DryEye Disease, Myopia, and in most of the sectors of optometry are transforming how optometrists diagnose and manage eye conditions. These tools are making eye care more accessible, efficient, and tailored to individual patient needs. However, these developments also present certain challenges. Issues such as cost, training requirements, integration into daily practice, and concerns about data privacy and accuracy must be addressed. In pediatric populations, especially, the rise in digital eye strain and binocular vision disorders calls for increased attention to early screening and management. strategies. Overall, while new technologies and approaches hold great promise for improving patient outcomes, optometrists need to maintain a balanced approach, combining innovative tools with evidence-based care and a strong patient-provider relationship. Continued education, research, and collaboration will be key to ensuring these advancements benefit both clinicians and the diverse communities they serve.

Reference:

Chia, A., Chua, W. H., Cheung, Y. B., Wong, W. L., Lingham, A., Fong, A., & Tan, D. (2012). Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2). Ophthalmology, 119(2), 347–354. https://doi.org/10.1016/j.ophtha.2011.07.031

Coan, L. J., Williams, B. M., Venkatesh, K. A., Upadhyaya, S., Alkafri, A. A., Czanner, S., Venkatesh, R., Willoughby, C. E., Kavitha, S., & Czanner, G. (2022). Automatic  detection of glaucoma via fundus imaging and artificial intelligence: A review. Survey of Ophthalmology, 68(1), 17–41. https://doi.org/10.1016/j.survophthal.2022.08.005

Du, H. Q., Dai, Q., Zhang, Z. H., Wang, C. C., Zhai, J., Yang, W. H., & Zhu, T. P. (2023). Artificial intelligence–aided diagnosis and treatment in the field of optometry. International Journal of Ophthalmology, 16(9), 1406–1416. https://doi.org/10.18240/ijo.2023.09.06

Holden, B. A., Fricke, T. R., Wilson, D. A., Jong, M., Naidoo, K. S., Sankaridurg, P., Wong, T. Y., Naduvilath, T. J., & Resnikoff, S. (2016). Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology, 123(5), 1036–1042. https://doi.org/10.1016/j.ophtha.2016.01.006

Jo, J. J., & Pasquale, L. R. (2024). Recent developments of telemedicine in glaucoma: Advances in remote tonometry, perimetry, and imaging. Current Opinion in Ophthalmology, 35(2), 116–123. https://doi.org/10.1097/ICU.0000000000001019

Jonas, J. B., Bikbov, M. M., Wang, Y. X., Jonas, R. A., & Panda-Jonas, S. (2023). Anatomic peculiarities associated with axial elongation of the myopic eye. Journal of Clinical Medicine, 12(4), 1317. https://doi.org/10.3390/jcm12041317

Lança, C., & Pang, C. P. (2023). Effectiveness of myopia control interventions: A systematic review of 12 randomized control trials published between 2019 and 2021. Frontiers in Public Health, 11, 1125000. https://doi.org/10.3389/fpubh.2023.1125000

Lan, W., Pan, W., Wen, L., Luo, Z., Flitcroft, D. I., Yang, Z., & Yi, X. (2024). Effect of outdoor scene classrooms on myopia prevention and control: One-year result from a randomized clinical trial. Investigative Ophthalmology & Visual Science, 65(7), 129.  https://iovs.arvojournals.org/article.aspx?articleid=2795180

Li, D. L., Dong, X. X., Yang, J. L., Lanca, C., Grzybowski, A., & Pan, C. W. (2025). Lower indoor spatial frequency increases the risk of myopia in children. The British journal of ophthalmology, 109(2), 250–256. https://doi.org/10.1136/bjo-2024-325888

Pucker, A. D., Kerr, A. M., Sanderson, J., & Lievens, C. (2024). Digital Eye Strain: Updated Perspectives. Clinical optometry, 16, 233–246. https://doi.org/10.2147/OPTO.S412382

Ramamurthy D, Srinivasan S, Chamarty S, Velappan T, Verkicharla PK, Samuel Paulraj AK. Smart Devices in Optometry: Current and Future Perspectives to Clinical Optometry. Clin Optom (Auckl). 2024 Jul 29;16:169-190. doi: 10.2147/OPTO.S447554. PMID: 39100732; PMCID: PMC11296370.

Scanzera, A. C., Shorter, E., Kinnaird, C., Valikodath, N., Al Khaled, T., Cole, E., Kravets, S., Hallak, J. A., McMahon, T., & Chan, R. V. P. (2022). Optometrists’ perspectives on artificial intelligence in eye care: A survey study. Journal of Optometry, 15(Suppl 1), S91–S97. https://doi.org/10.1016/j.optom.2022.06.006

Scheiman, M., Rouse, M., & Cotter, S. (2023). Binocular vision disorders in the digital age: Emerging patterns in clinical optometry. Optometry and Vision Science, 100(7), 789–797.                  https://doi.org/10.1097/OPX.0000000000002105

Sheppard, A. L., & Wolffsohn, J. S. (2018). Digital eye strain: prevalence, measurement and amelioration. BMJ open ophthalmology, 3(1), e000146. https://doi.org/10.1136/bmjophth-2018-000146

Spaide, R. F., Fujimoto, J. G., Waheed, N. K., Sadda, S. R., & Staurenghi, G. (2018). Optical coherence tomography angiography. Progress in retinal and eye research, 64, 1–55. https://doi.org/10.1016/j.preteyeres.2017.11.003

Storås, A. M., Strümke, I., Riegler, M. A., Grauslund, J., Hammer, H. L., Yazidi, A., Halvorsen, P., Gundersen, K. G., Utheim, T. P., & Jackson, C. J. (2022). Artificial intelligence in dry eye disease. The ocular surface, 23, 74–86. https://doi.org/10.1016/j.jtos.2021.11.004

Storås, A. M., Strümke, I., Riegler, M. A., Grauslund, J., Hammer, H. L., Yazidi, A., Halvorsen, P., Gundersen, K. G., Utheim, T. P., & Jackson, C. J. (2022). Artificial intelligence in dry eye disease. The ocular surface, 23, 74–86. https://doi.org/10.1016/j.jtos.2021.11.004

Li, F., Wang, D., Yang, Z., Zhang, Y., Jiang, J., Liu, X., Kong, K., Zhou, F., Tham, C. C., Medeiros, F., Han, Y., Grzybowski, A., Zangwill, L. M., Lam, D. S. C., & Zhang, X. (2024). The AI revolution in glaucoma: Bridging challenges with opportunities. Progress in retinal and eye research, 103, 101291. https://doi.org/10.1016/j.preteyeres.2024.101291

Krishnan A, Dutta A, Srivastava A, Konda N, Prakasam RK. Artificial Intelligence in Optometry: Current and Future Perspectives. Clin Optom (Auckl). 2025 Mar 12;17:83-114. doi: 10.2147/OPTO.S494911. PMID: 40094103; PMCID: PMC11910921.

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