OPHTHALMIC

The ophthalmic market is large and growing. The forecast calls for a market worth over 50 billion dollars in 2024. The space is fairly large with ophthalmic drugs, medical devices, vision care devices as well as retail operations 

MARKET PLAYERS

Traditionally, the market has been divided across the world between independent retailers and larger retail chains managing between a couple hundred stores to a couple thousands. In certain countries, the market is extremely saturated. Our consulting firm is solicited regularly to help those players grow their business past their own borders. Of note, the market is changing with online retailers becoming part of the competition landscape , as well as new brands geared towards millennials disrupting the industry. Niche markets are created for instance for high end demographics, fashion brands as well as pediatric glasses shops. Some major players are trying to expand internationally with M&A. Some of them face difficulties stemming from a lack of understanding of market specificities. While visual needs might be the same, consumer habits and needs can differ tremendously depending on the region.
New trends in ophthalmic surgery call for less invasive procedures allowing patients a better recovery time. This is particularly the case for Minimally Invasive Glaucoma Surgery devices that change the way glaucoma surgeons approach their cases. New devices are being developed to allow for drug delivery such as medicated punctal plugs. LASIK, once thought to end the glasses business doesn’t show any recent breakthrough. With that said, blade-less LASIK has allowed for better outcomes and reliability in refractive surgery procedures. An ophthalmic surgical device allowing to compensate for presbyopia would be a game changer. Several companies are currently in clinical studies stages.

In recent years, there has not been a true revolution in new category of drugs available to eye care providers. A few new glaucoma drugs reached the market. While they may be a bit more efficient, they are not disrupting the industry. One new dry eye disease drug appeared on the US market recently offering competitive challenges to the historical drug of choice. 

Of note, old drugs with new clinical applications are being used such as atropine or doxycycline. The true revolution currently in the pipeline will certainly be Complement-System modulators in the treatment of macular degeneration.

Telemedicine is generally seen as a way to improve patient’s access to medical care, mostly in case they live in areas with low doctor density. Insurance companies see them as a way to lower cost of care. Ophthalmology is a specialty with its own challenges for an easy implementation of telemedicine. Equipment is both expensive and requires a trained operator to assist patients. Resolution of cameras, both for anterior and posterior segment could limit accuracy of diagnosis. On the topic of retinal imaging, traditionally cameras required the patient to be dilated, which in itself can be a challenge. Newer technologies allow for good resolution and field of imaging without dilation. Remote reading of retinal pictures is certainly a hot topic given the increasing prevalence of diabetes.

Several companies have developed technical solutions to allow consumers to self determine their glasses prescription either through the use of a phone application or with minimal equipment in the comfort of their home. While the idea is appealing, professionals are very concerned with the lack of disease screening. Traditionally when a patient undergoes a refraction, the eye doctor also performs an exam of the eye which includes eye pressures and anatomical structures visualization. Many progressive losses of vision are not refractive in nature. Use of such tele refraction technology could hinder visual prognosis and patient’s opportunity for treatment. Those technologies, however might have a role in between eye exams by an eye care professional to diminish work load, specially in markets with poor access to eye doctors. 

Digital devices are everywhere and used across all demographics bringing some challenges and opportunities. Ophthalmic lens manufacturers seized the opportunity to market blue light blocking technologies to concerned customers. What is more concerning is the use of screens at an increasingly young age, which invariably will lead to more patients suffering from myopia. Myopia can be associated with potentially sight threatening disease such as glaucoma and retinal detachment. This in itself creates a market for myopia control solutions. They include Orthokeratology lenses, soft multifocal contact lenses as well as low dose atropine. In Asia low dose atropine is commercially available. In Western Europe and in North America it still needs to be compounded by a pharmacist leading to access difficulties and increased costs.