Part 6: Biggest innovations in ophthalmology in 50 years

In celebration of Ophthalmology Times' 50th anniversary, we asked leading experts in the field what they see as the biggest innovation in ophthalmology in the past 5 decades.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Bonnie Henderson, MD:

So the history of ophthalmology is fascinating because we are such a technology-driven field, and if you look back even 50 years, so much has changed in those 5 decades.

So if you can imagine, 50 years ago, we didn't have all these different types of intraocular lenses, for example, for cataract surgery. So...I think about all the things that have changed, especially as an anterior segment specialist. Of course, I always think about cataract surgery as my first and foremost; it is the bread and butter of what we do. So all the changes in the diagnostic tools that we can actually now look at, I mean, the invention of OCT [optical coherence tomography], so that we can actually evaluate the parts of the eye without invasive or radiologic detriments to the patient, as well as all the specific different types of lenses, all the different medications, and glaucoma treatment. Wow, that's been a huge explosion of the different types of medications, eye drops, [and] all the MiGs [microinvasive glaucoma surgery] and the devices that can now be treated.

And then retina, oh my goodness. I mean, we didn't even know what an injection in the vitreous was until just very recently. So the disease of macular degeneration has really evolved in terms of the treatment options that are available. So it's really great to see patients who, you know, having been diagnosed with macular degeneration,...probably thought that this really was almost like a death sentence for their vision. But now we have so many treatments that we could...give them, and they can also say, "Wow, this is not the end of my vision." It gives them hope so that they can actually have new treatments and continue their life in a very active way.

Lucy Shen, MD:

So I think when I was in fellowship training, which was not 50 years ago, of course, but when we were in fellowship training, most of our training was based on incisional surgery. So traps and tubes. And it wasn't until after I was done with fellowship that I got more involved with MiGs, and I think now most of our patients who have glaucoma will be first considered for MiGs surgery—not saying they are all candidates for it, but that is often an option that we offer to patients who are undergoing cataract surgery. And I think that really helped to prevent things like postop complications from incisional surgery but also to help with the patient's quality of life. Because the MiGs often reduces the number of glaucoma eye drops that the patient will be using after cataract surgery.

Geeta Lalwani, MD:

For me, it'd be anti-VEGF. I mean, wow, anti-VEGF is a game changer. It started when I was in residency. We did not have anti-VEGFs, and you'd watch people go blind, and then all of a sudden I started...fellowship and anti-VEGFs; we're just...literally...seeping into the general population. And all these patients [who] were previously going blind, we are saving and maintaining,...so easily, anti-VEGF has been the game changer for me.

Majda Hadziahmetovic, MD:

I have to echo that as well, but the AI is the future, and probably we're going to be hearing much, much more about the AI involvement in ophthalmology. Disease progression, prediction,...treatment responses, clinical trials, and everything else.

Ollya Fromal, MD:

Well, I'm probably biased as a retina surgeon, but I would definitely say anti-VEGF injections have revolutionized our practice, and I would be very interested to see the answer to this question in the next 50 years, as I'm guessing that it may be the gene therapy that's going to take us to the future.