A final thought

Technology’s role in transforming eye care

Optometrist, JVP at Millicans and Mansfield Opticians, and AOP Councillor representing franchisee/joint venture partnership optometrists, Rebecca Donnelly, discusses the impact and opportunities of advancing technology for optometry

4 min read

An illustration of an eye comprising on numbers

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Rebecca Donnelly

03 February 2026

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When I qualified 12 years ago, the most advanced piece of technology in the testing room was a digital fundus camera. At university, we were still examined on drawing our fundus findings. In my opinion, the introduction of a digital fundus camera into High Street practice has changed our ability, as optometrists, to monitor eye and vision changes over time, and how we can communicate our findings to the patient.

Interestingly, although my university did have an optical coherence tomography (OCT) device, at the time it felt almost mythical. The only person who I saw operate it was the clinic technician. I never saw a lecturer use it, which says a lot about where the profession was at that time – OCT existed, but it hadn’t yet become embedded in everyday practice.

Over the past decade I have seen optometry shift from being a largely observational and descriptive profession that detects and refers into one that is imaging-led, data-driven and preventative.

The biggest development that has enabled this change has been the normalisation of advanced imaging that allows optometrists to identify structural change in the eye earlier and to track the progression of change objectively. Alongside this, digital records and our ability to audit records has raised expectations. Overall, technology has not only made the eye examination more advanced, but it has also made optometrists more accountable, collaborative and clinical.

Where adaption can lag is in systems and incentives, with technology often advancing faster than commissioning models and remuneration structures. This means that optometrists can be expected to deliver advanced care without the funding or pathways in place to support it

Pace of adaption

When considering the rate of technology advancements and keeping apace as a practitioner, personally, I am quite deliberate about keeping my learning and use of technology clinically relevant rather than novelty driven. I focus on why technology matters, and how it changes diagnosis or patient outcomes.

As my role has evolved into practice leadership, keeping abreast of advancements has also meant embedding technology into everyday workflows, ensuring interpretation skills are up to scratch across a team of varying experiences, and learning through shared care and peer discussion. I’ve also found that teaching and discussing cases with colleagues keeps me sharp. Ultimately, I don’t think keeping up is about chasing every new development. It is about being critical and patient-centred, and adopting technology you genuinely believe in.

Across the profession, optometrists have generally embraced technology well and I see a clear appetite to use technology to improve patient care.

Where adaption can lag is in systems and incentives, with technology often advancing faster than commissioning models and remuneration structures. This means that optometrists can be expected to deliver advanced care without the funding or pathways in place to support it.

In England, as care models and remuneration structures are different across different postcodes, the gaps in patient access to eye care and how consistently technology is embedded in that care has widened. For the profession to fully realise the benefits of technological advances, commissioning and funding frameworks need to ensure that innovation leads to equitable access rather than increased variability.

Rebecca’s advice to optometrists preparing for a more technology-driven future

“Engage with technology thoughtfully and critically. Choose tools that enhance your decision making rather than just for the sake of it. Invest time in understanding the tools and ensure that you read around the relevant evidence base and translate it into practical clinical processes.

There are devices I have not invested in because although they are interesting, I’m not yet convinced by the evidence base; I don’t feel I can genuinely or ethically offer it to patients. That said, it is essential to educate my patients on options available to them outside of my practice so that they can make informed decisions. Prioritising patient experience is key and that ultimately means prioritising communication and engagement. Technology should support clearer conversations rather than replace conversations. Maintaining patient trust remains essential, with robust consent and data protection processes. Finally, be proactive about training and embrace change. Optometrists who thrive in the future won’t be those who resist technology.”

AI and safeguarding

In the practice that I work, in we are using artificial intelligence (AI) tools primarily for patient communication related tasks. I have used Ocumetra for myopia management and pre-myopia management consultations, which I have found helps translate what can be a complex conversation into an easy-to-understand bespoke report for families.

I have also used CSI dry eye software, which is a robust dry eye AI-based reporting tool. It supports both the diagnosis and management of patients by generating management recommendations based on diagnostic findings. These can be tailored to a practice’s specific offerings, ensuring a consistent quality of care within a large practice or a group of practices with multiple clinicians.

I haven’t personally used the Heidi AI scribe system yet, but I work in a private corneal and refractive ophthalmology clinic that uses it for patient letters and record-keeping – it seems to save a lot of time. When listing patients for complex procedures and often a series of staged procedures there are huge amounts of information that needs to be delivered by letter. Because each series of treatment is different for each patient, AI is immeasurably useful to ensure effective communication and note keeping.

When it comes to safeguarding, it is important for optometrists to remember that AI can be a support tool in diagnosis, but should not replace clinical judgement. The AI output should always be reviewed and validated by the clinician. AI tools are only as good as the data they are trained on, so optometrists should be mindful of bias or gaps in datasets.

Optometrists remain fully responsible for all diagnosis and management decisions. AI should not encourage clinicians to practise beyond their scope or rely on automated decisions. Robust compliance with data security standards is essential – we specifically obtain patient consent for using an AI tool such as when using Heidi for record-keeping and patient letters.

Future gazing

By the end of the decade, I believe OCT should be universally available in every High Street optometry practice. It should be used not only for confirming pathology, but as a standard of care for baseline and longitudinal care. Wide-field retinal imaging should also be routine, and AI tools should be embedded in these to improve detection of pathology and progression.

AI technologies could also be helpful with triaging urgency. This, combined with AI scribes for record-keeping and patient communication, would greatly reduce the clinicians’ administrative workload.

When I consider that the eye examination will look like in 10–20 years time, I think much of the data collection will occur before the patient sees the optometrist. Fully automated pre-testing will capture refraction, topography, axial length, OCT, wide-field retinal imaging, tear metrics, and functional vision measures. AI will pre-analyse this information, flagging risk, progression, or pathology, so the clinician can focus their time where it matters most.

Refraction will still matter, but it is becoming less of the centrepiece. AI will support personalised explanations, visual summaries, and written reports in real time. Patients will leave with clear, tailored information about their eye health. With better visuals and communication, patients will be more involved in the decision making. Plus, the value of the optometrist as a health care provider and advisor will increase.

What excites me most about emerging technology and the future of optometry right now is the integration of AI in OCT and wide-field imaging. So often we send or receive a message from a peer asking for an opinion on an image, and rightly so – we can’t be experts in everything. To have a system in place that is challenging my decision-making will be mutually beneficial for my clinical learning and also patient outcomes.

Used well, technology acts as a second set of eyes (excuse the pun) rather than a replacement of the optometrist.