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Dr. Mali's top 5 predictions for ophthalmology in 2021


In light of an unprecedented year filled with technological advancements and pivots, Joshua Mali, MD, offers his top 5 predictions in ophthalmology for 2021.

Joshua Mali, MD


Editor's Note: Welcome to Let's Chat, a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Joshua Mali, MD, a vitreoretinal surgeon at The Eye Associates, a private multispecialty ophthalmology practice in Sarasota, FL. The views expressed in these blogs are those of their respective contributors and do not represent the views of
Ophthalmology Times® or MJH Life Sciences.™️

Watch Dr. Mali's interview on what ophthalmologists should expect from the new year.

It is that exciting time of the year when I once again reveal my top 5 predictions in ophthalmology for 2021.

1. While COVID-19 will continue to dominate the headlines in 2021, the human spirit and innovation will ultimately achieve victory and prevail.

It is obvious that COVID-19 will likely continue to be the dominant story well into 2021. This virus has impacted every part of our society.

However, I strongly believe in humanity’s ability to defeat this challenge through our unity in spirit and incredible ingenuity in innovation. It has been amazing to see the speed, efficiency, and potency of the worldwide efforts in clinical research and the pharmaceutical industry to fight and crush this virus. It is really an industry-wide team effort, with companies both big and small joining the battle.

For example, as of this writing, pharmaceutical giant Pfizer distributing its COVID-19 vaccine with a massive distribution plan unseen in our country’s history. While possibly equally as impressive, small biotech company — Sorrento Therapeutics — has rapidly developed a tremendous pipeline of promising COVID-19 antibody treatments, vaccine candidates, and diagnostic tests that could hold the key to next generational management and a potential cure for this disease.

Our unity as a society with unshakeable will and determination is what will win the battle against COVID-19, and this takes the top spot in my predictions for 2021.

2. The competition battle lines will be drawn in 2021 for ocular therapeutics in the most common eye disease markets

While COVID-19 did impact the vast majority of our society, surprisingly. clinical research in ophthalmology did not stop. In fact, it continues to grow at a record pace with incredible amounts of data to analyze and interpret for clinical application in ophthalmology.

With that as a backdrop, 2021 will see product launches and regulatory approvals for ocular treatments in all the major disease states in ophthalmology: dry eye, glaucoma, cataract/intraocular lens implants, and macular degeneration.

We have never seen such innovation in multiple common ocular disease states simultaneously until now.

A few potentially impactful players in 2021 to keep your eye on are Genentech and Kala Pharmaceuticals. Genentech delivers significant optimism with two exciting products: its Port Delivery System with ranibizumab (PDS) for exudative age-related macular degeneration (AMD) to provide a revolutionary sustained drug delivery system; and faricimab, the first bispecific antibody designed for intraocular use that can simultaneously bind and neutralize Ang-2 and VEGF-A, which appears to be a very effective treatment for wet AMD and diabetic macular edema (DME).

Both these products will likely be game-changers in the retina therapeutic space. Kala’s recently FDA-approved EYSUVIS (loteprednol etabonate ophthalmic suspension) 0.25%, for the short-term treatment of the signs and symptoms of dry eye disease, will certainly be a major player in the dry eye market in 2021.

Related: Dr. Mali's top 5 stories in ophthalmology for 2019

3. Artificial intelligence will continue its rise and application in clinical ophthalmology

I have been writing about artificial intelligence (AI) and its great potential for years — and rightfully so. This technology is designed to improve efficiency and data analysis, which has been strategically and successfully implemented into ophthalmology and, frankly, all of medicine.

One particular device to keep your eye on is Notal Vision’s Home Optical Coherence Tomography (OCT) System. A new platform for monitoring wet AMD patients with its pioneering patient-operated design, it is utilized to identify intraretinal and/or subretinal fluid in the central 10° of eyes diagnosed with wet AMD.

It will allow patients to complete the test at home while the machine-learning algorithm (Notal OCT Analyzer) performs an automated analysis, which generates a report and transmits the information to a physician.

This innovation represents the symbiotic relationship between AI and telemedicine that could revolutionize the way we monitor and determine treatment intervals for patients receiving intravitreal anti-VEGF injections. The Home OCT system will inevitably be the new standard of care in wet AMD management.1

4. Telemedicine platforms will still play a role in ophthalmology

Telemedicine visits and utilization spiked in 2020 due to COVID-19 practice restrictions and temporary shutdowns. However, it really was only an acceleration of an early trend that has been gaining traction over the past several years.

While telemedicine will never replace a physical exam (especially in ophthalmology), I believe that telemedicine can be a helpful adjunct and service that ophthalmology practices can provide to benefit patients and patients will expect to have it available as an option in certain circumstances going forward.

5. Virtual ophthalmology conference options will be present for the majority of 2021

The adaptability of ophthalmology conferences and professional organizations in 2020 has been incredible.

I have been so impressed by organizations such as the American Academy of Ophthalmology (AAO) and the American Society of Retina Specialists (ASRS), which put together successful and informative virtual annual meetings in such a short amount of time has been nothing short of amazing.

The strong leadership of these organizations should be applauded for their ability to adapt and pivot during this challenging time to deliver stellar meetings.

Due to this success, my prediction is that the major meetings in ophthalmology in 2021 and beyond will continue to have a virtual option to allow flexibility and more widespread participation for future meetings.

In addition, meetings that take place during the end of 2021 will likely have a hybrid model: a live in-person meeting (with limited number of registered participants) and a simultaneous virtual meeting platform for those unable to attend the live event.

The constant exchange and flow of ideas and knowledge is the lifeblood of our profession and will continue to thrive successfully.

With 2020 behind us, 2021 is shaping up to be an amazing year. I look forward to keeping you updated throughout 2021 and beyond.

About the author
Joshua Mali, MD, is a board-certified ophthalmologist and award-winning vitreoretinal surgeon at The Eye Associates, a private multispecialty ophthalmology practice in Sarasota, Florida. He is also the founder & CEO of Mali Enterprises.He can be reached at malienterprisesglobal@gmail.com. Dr. Mali’s relevant financial disclosures include Genentech/Roche (consultant, speaker), Notal Vision Inc. (consultant, speaker), Sorrento Therapeutics (Nasdaq:SRNE) equity stock shareholder, Kala Pharmaceuticals (consultant, speaker).



1. Mali, Joshua. Dr. Mali’s Top 5 Predictions in Ophthalmology for 2019. Ophthalmology Times. March 2019.

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