Disruptive Innovation and Optometry

The constant of change can add a bounce in your practice income while “wowing” patients.



Disruptive Innovation and Optometry

The constant of change can add a bounce in your practice income while “wowing” patients.


When confronting change, the easiest thing to do is nothing. Do the same thing everyone else is doing. Pretend that nothing will affect your practice or livelihoods while the world changes around you. After all, you perform a good refraction, take credit cards, patients like you, and like that you are on their low-paying vision plans. Right? Wrong! There is a better way.

Times of “VUCA”

Business thought leaders have emphasized that we live in times of VUCA, a military and business acronym for Volatility, Uncertainty, Complexity and Ambiguity. Though I previously wrote about developing a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis during the strategic planning process (OM December 2013), the truth is that competition does not wait for you to publish your strategy document before it tries to assault it. Patients don’t wait to shift their preferences, and new technology introductions can speed past you before your strategy cycle completes and begs to be analyzed. VUCA is the new normal. Welcome to Disruptive Innovation.

Disruptive Innovation

Harvard Professor Clayton Christensen first coined the term Disruptive Innovation to describe how innovation creates new markets and upends existing ones. The new products come to market quickly, usually at a lower price point and claim to be just “good enough.”

We have all seen it, as disposable contact lenses came to replace relatively expensive vialed conventional lenses; as digital cameras have all but replaced film, etc.

True, the legacy technologies still exist and seek even more upscale markets that desire the performance advantages of more highly differentiated products. Even Toyota’s cheap and disruptive Corolla eventually went upscale to become Lexus.

Growth opportunities

Before we address how disruptive changes influence eye care, we must be prepared to consider the opportunities before us. We must also look at current disruptive innovations that will help us provide better care and provide for additional pillars of income.

In truth, disruptive technologies can act both like missiles aimed to destroy your business or rockets designed to launch it to new heights. Your ability to quickly survey the landscape and make decisions about where to play and how to win — sometimes with an incomplete set of decision-making data — can greatly improve your practice’s odds of success. Over-analysis and the fears of failure and financial risk in taking on new technologies can work to your detriment.

These opportunities exist all around us. Every aspect of our practice can be impacted.

Dry eye disease, MGD, and blepharitis

The area of dry eye disease has progressed from the days of just handing a patient a fist full of drops and asking her to report which work best.

Today, technologies like tear osmolarity, slit lamp photography, meibomian gland interferometry and inflammatory marker analysis have changed the process of disease differential diagnosis. Treatment devices have also changed the way many ocular surface diseases are treated.

For example, a treatment that applies precisely controlled heat and gentle pressure to the eyelids effectively clears blocked glands. This is a fast and significant treatment for sufferers of DED who can appreciate its value proposition and are able to pay for it.

Macular degeneration

Gone are the days when we tell patients with a family history of AMD that there is nothing we can do to prevent their genetic destiny with blindness. Technologies such as genetic testing and measurements of macular pigment are enabling clinicians to more accurately diagnosis early stage disease, which, in turn, allows patients to proactively treat their disease and make other lifestyle decisions that will hopefully positively impact their visual status through their lifetime.


New companies are espousing that we approach our patient’s health on a more individual basis, taking into account epigenetic changes that influence the methylation pathway. Based on the analysis of a cheek-swabbed DNA sample, we can now recommend a customized nutritional regimen and supplementation. One goal for nutrigenomics in eye care is to prevent age-related diseases, such as AMD and dementia. These technologies are causing disruption in the way we diagnose and treat various ocular and systemic conditions.

Contact lenses and corneal reshaping

Proponents of ortho-k are now entering the exciting domain of myopia prevention. Topographical advances and optical wave path measurements are altering not only the way specialty lenses are fit, but also the way we look at things like myopia control and corneal surface reshaping. Contact lenses with center distance multifocal correction and reverse geometry curves are slowing the progression of myopia. In the future, technologies, such as corneal crosslinking will also alter treatment of these, visually devastating diseases.

Wearable tech

There are also many new technologies coming to eye care that will disrupt not only our visual assessment, but dramatically impact our opticals. Variable-focus eyewear can be used as an emergency pair for spherical powers of +3.00 to -6.00. This has implications for patients who wear contact lenses but need glasses in times of infection, lost glasses, post-op temporary correction, as well as an inexpensive option for third-world populations who just need something to get by in the absence of modern exams and glasses.

Technologies, such as Google Glass, and new 3D technologies will likely not only impact binocularity assessment and treatment but also change the consumer experience in terms of information access and visual assessment. There are technologies that have an incredible consumer demand, and eyecare must stay on the forefront of these consumer offerings.

Time to execute

By this time, some readers will be thinking, “That’s okay for someone else’s practice, but not for mine.”

Change is not for every patient, provider, nor staff member. If, however, you choose to embrace change as the new normal and try to benefit from it, the rewards could be very ample.

Implementation of these disruptive innovations can serve to add a bounce in your practice income while “wowing” patients, as you again enjoy the competitive journey of everyday practice. This means acceptance of change and investing dollars and energy where others may not. It also means taking a leadership position in optometry and your community, a role that can be very rewarding in more ways than one. OM

Dr. Brill attended Illinois College of Optometry and received his Executive M.B.A. from the Henry Bloch School of Management. He founded Brill Eye Center in 1983, where he enjoys all aspects of optometry and is an early adapter of technology. E-mail him at, or send comments to