The ophthalmoscope heralded the twentieth century, known as the golden age of eye care. Early in the century, schools of optometry and ophthalmology proliferated. Eye surgery became safer, more effective as a treatment and more accessible to middle class patients. And by the 1960s, there were several internationally recognized eye institutes in America. These facilities were devoted exclusively to vision care, and they functioned as freestanding hospitals and research and training centers. The National Eye Institute was founded in order to coordinate the research that was making eye care so progressive. Many professional organizations, like the American Ophthalmologic Association, were founded to establish standards for certifying practitioners.
There is no doubt that eye care has evolved into a very complex system. It offers patients a wide range of choices. There are many types of professionals who are trained to administer care at various prices and in many locations. The scope of practices has also expanded to include not only care of the eye itself, but also parts of the body that interact with the eye to create vision. In other words, patients have to be good consumers. They have to know which doctor to see for a specific problem, where to locate good quality care, and how to pay for it.
In recent years, there has been some concern about the direction that eye care has taken. While eye care became a multifaceted form of health care, it also became a multi-billion dollar industry. In response to concerns about the corporatization of eye care, the American Academy of Ophthalmologists proposed a seven-point National Eye Care Plan, including the establishment of a patient information and referral service. The plan addresses three major dilemmas facing eye care professionals and their patients.
- Access. Patients should be able to get eye care services without knowing the complexities of the system. And providers, whether they are family doctors or specialists, should monitor the visual health of their patients and be prepared to make appropriate referrals to specialists.
- Quality. Eye care patients should be assured that they are going to receive the best care possible and that providers are well trained to administer state-of-the-art care.
- Cost. Every American should be able to get quality eye care regardless of his or her ability to pay. Eye care is a right, not a privilege for only those who can afford it.
A Glimpse Into The Future
How will technology affect the future of eye care? Will eye care workers be replaced by robots? These are valid questions for the aspiring eye care professional who is about to invest a great deal of time and training in a rapidly changing occupation.
Today our ideas about the future manifest themselves in movies and television shows like Star Trek. In these futuristic scripts, people live to be hundreds of years old and solve their eye problems in ways that are unheard of today. One of the major characters on the television shows is blind, but he sees better than most humans with the use of an "eye band" that transmits images to his brain. The ship's doctors diagnose and treat their patients using small, handheld devices. All medical and surgical procedures are noninvasive—simply waving this device over the patient produces both the diagnosis and the cure.
These scenes from Star Trek may seem futuristic, but soon there will be very new and different careers in eye care. In almost every job, people will be able to accomplish a wide range of functions with the aid of computers and genetic engineering. High technology is becoming a part of everyday life, and the trend extends to eye care. New jobs in researching and applying new forms of automation to eye care will develop. There will be more research into the causes of blindness.
You might wonder why there is so much research into the causes of blindness and ocular diseases. It is because knowing the cause is the basis of finding the cure. For this reason, a great deal of the research that is being conducted now and in the future is focused on genetics and the manipulation of genetic material to overcome inherited diseases and conditions such as retinitis pigmentosa. As the life expectancy of the average person increases, more research will focus on slowing all of the debilitating aspects of growing older, such as glaucoma. Perhaps one of the most fascinating prospects for the future is the combining of computer microchip technology with genetic engineering. Scientists speculate that some day we may swallow what looks like a pill, but is really a tiny microprocessor that seeks out genetic defects and corrects them. The ethics of what is a genetic "defect" may be more of a barrier to scientists than the technology.
Another barrier to progress is shrinking government and private funding to research projects. Although most people understand that our health care improves because of scientific research, a study conducted by the National Science Foundation showed that 98 percent of the people polled did not know where the money for research comes from. As a future eye care researcher, provider, or patient, it is important to be an activist for improved funding to this valuable endeavor.
Whatever the future holds, robots will never totally replace humans as eye care workers. We can be confident that there will always be a need for human contact. Even in the high-tech "sick bay" on Star Trek the patient always holds the doctor's hand, even if the patient's hand is green! There is no replacement for the reassuring touch of a compassionate caretaker.
