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The following projection (net changes from 2020 to 2030) reveals a unique opportunity for the growth of optometric practice over the next 10 to 20 years. An aging population, the prevalence of age-related eye conditions and a relative shrinking supply of ophthalmologists presents a oncein-a-lifetime open window to embrace medical eye care. GROWING DEMAND & MARKET SIZE The US population is expected to grow 6.7% this decade. Of greater significance: projected growth among those age 64 and under is only 1.9%, while the 65-and-older increase is 30.5%. The demand for medical eye care services will grow 20 times more rapidly than the demand for vision exams. The latter are defined as ICD-10 refractive diagnosis codes, while medical eye care exams are those that have a medical diagnosis. Eye care providers (ECPs) will need to collectively deliver two million additional vision exams per year, 10.8 million additional diagnostic tests per year, 16 million additional medical eye exams per year and 1.4 million additional cataract surgeries per year—all above and beyond what we are providing today in 2020. For perspective, current levels are 111.4 million vision exams, 64 million diagnostic tests, 60.4 million medical eye exams and 4.2 million cataract surgeries. SUPPLY OF ECPs The supply of optometrists will increase at a pace somewhat greater than overall population growth but much slower than the 65 and older demographic. The game-changer is that the supply of ophthalmologists is almost flat. Ophthalmology residency programs will produce approximately 460 new entrants each year, and 420 practitioners will be exiting, for a net increase of 400 ophthalmologists over the entire decade—just 40 each year for the entire country. To just provide for the increase in cataract surgical procedures, we would require 3,500 surgeons. Ophthalmologists will find themselves more and more in the operating room, less and less in the office setting. The message is clear: Optometry must rapidly embrace providing medical eye care services in their practices. If one uses Medicare Provider Utilization & Payment data as a proxy for how engaged optometry is in providing medical eye care, it is at a very low level—less than 28% of optometrists provide any level of care. It is incumbent upon the entire eye care industry to rapidly increase optometry’s involvement in medical services and turbocharge practices, regardless of practice setting. n Dr. Edlow, AKA “The Eyeconomist,” practices in Catonsville, MD, and is known for strategic trend analysis. STRATEGIES FOR SUCCESS SAFETY OF PHENYLEPHRINE “Phenylephrine 2.5% leads to no clinically meaningful change in blood pressure or heart rate and can be considered safe to use in clinical routine.
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