Optometrist showing patient eye drops.

New technology is disrupting the practice of optometry, just like it has radically changed how Americans watch movies, hail a ride, or purchase shoes.  The optical industry’s online sales have jumped 100% since 2011, and nearly one in 3 consumers surveyed said they will possibly or probably purchase eyewear directly online in the future. This trend will only intensify, with companies like Opternative, Eyenetra, GlassesOn, and Simple Contacts all beginning to offer online refractions. 

Optometrists naturally feel financially threatened by these changes — and concerned about their impact on patient outcomes. The good news is that technology is also providing powerful new tools that can also help optometric practices grow and expand in entirely new directions. This post offers advice for how to incorporate sports medicine, sensorimotor exams, reading assessments, concussion care, and other specialized services.  

Keep reading for more information on how to get started in a direction that fits with your interests, patient demographics, and local marketplace.  

1. Automated Sensorimotor Exams  

The opportunity

Studies show that 30% of patients have binocular vision issues or oculomotor dysfunction. Many times, these conditions are overlooked.  While all eye care providers understand the importance of running sensorimotor exams on their patients to identify these issues, traditional tests are time-consuming, not quantifiable, and lack visual reports that help lead to a diagnosis and treatment.  

How it fits into optometric practice

By automating sensorimotor exams, patients can be screened quickly and easily for binocular vision issues and oculomotor dysfunction right in the existing pre-test area. The simple 30-second screening, run by a technician, identifies patients where medical necessity exists to have a comprehensive examination.

The RightEye comprehensive sensorimotor exam is administered in just 5 to 10 minutes without adding non-billable time for the doctor. Both non-invasive screenings and exams can be administered by anyone in the practice helping to streamline and save time. The test administering devices are lightweight and portable making it easy to incorporate into am existing pre-test and exam lanes, even in small practices. In addition, vision care providers can submit the documentation for successful CPT code insurance claims to get reimbursed.

Bests for:

• All patient age demographics.

Services to consider:  
Vision trainer programs  

RightEye Sensorimotor was designed to integrate seamlessly into an eye care provider’s pre-test and exam lanes, By running RightEye Sensorimotor on every patient, eye care doctors are able to elevate their care and identify previously unaddressed binocular vision and oculomotor dysfunction.

Keith Smithson, OD,
Northern Virginia Doctors of Optometry

2. Concussion Care  

The opportunity  

Every year in the U.S., there are 2.8 million emergency department visits, hospitalizations, and deaths related to concussion or traumatic brain injury (TBI). For athletes of all ages in contact sports like football and soccer, the incidence of concussion is as high as 19% per season.  

How it fits into optometric practice  

Visual dysfunctions occur in 90% of TBIs, hindering patients’ ability to function effectively at work or school. On any given day, among the patients who present to an optometry office, there is probably at least one who has recently suffered a TBI.  

Best for:
• All patient age demographics, but especially kids and active adults 
• Doctors who are interested in the connections between eye and brain health

Services to consider:  
• Eye tracking tests to objectively evaluate how eye movement and teaming are affected  
• Computer-based training  
• Temporary reading glasses or prescription changes  
Vision therapy  
Neuro-optometric rehabilitation  
• Customized prism lenses  

Doctors of Optometry absolutely should have a place at the table in treating concussion patients. Eye tracking is a great tool for someone who wants to get involved in concussion care. Simply evaluating the impact of the concussion on convergence and accommodation as well as performing a sensory-motor exam using eye tracking is a start. From that point, you could consider therapy, offer computer- based exercises, or sometimes prescribe a little add power in a temporary prescription. We can have a huge impact  on getting that patient some relief and speeding up their return to school or work.   


Amanda Nanasy, OD, The Eye Center
Pembroke Pines, FL
Director, Florida Institute of Sports Vision

3. Reading Assessment  

The opportunity  

Only 1 in 3 students reads proficiently by the end of 3rd grade. Learning disabilities affect as many as 15 percent of otherwise able schoolchildren. Nearly 1 in 10 American children has been diagnosed with ADHD.    

How it fits into optometric practice  

Children with learning disorders, ADHD, and autism often have underlying visual processing disorders, but even neurotypical children can suffer from problems with eye movement or misalignment that affect their reading ability, according to developmental optometrist Cathy Stern.   

Best for:   

• Practices with young families or large pediatric population  
• Doctors interested in and comfortable working with children  

Services to consider:  
• Eye tracking evaluation focused on reading  
Vision trainer programs  
• School screenings  
• After-school or weekend appointments and child-friendly  
office  
• Computer-based vision training  
• Therapeutic prism lenses  
Vision therapy  
• Neuro-optometric rehabilitation  

Vision-related learning issues are often hidden. Parents and other doctors assume that if a child has good vision, there isn’t a problem. School struggles may be chalked up to attention or behavior issues, or even a lack of intelligence. Optometrists who offer reading or learning assessments can provide a critical service in validating the child’s experience and educating parents and other professionals. Objective, computer-based assessments not only give us better and more accurate information with which to proceed clinically, but they also convey a cutting-edge impression that is important for practice success.


Cathy Stern, OD, FCSO, FCOVD, FNORA,
Canton, MA

4. Sports Vision  

The opportunity 

Ninety million Americans of all ages avidly participate in at least one sport, according to the Sporting Goods Manufacturing Association. 80% of perceptual input in sports is visual.  

How it fits into optometric practice  

Optometrists can offer a range of services, from objective testing of visual performance skills with a single device to multiple diagnostic tools and advanced skills training programs. According to Dr. Adam Clarin, opportunities exist to work with individual athletes, training facilities, and teams from Little League up to the professional levels. 

Best for:  

• All ages, but especially children to young adults 
• Doctors who are athletes or have a connection to a sports community 
• Affluent areas where parents have resources to invest in kids’ sports 
• Cities with professional teams or elite training facilities  

Services to consider:  

• Sport-specific filters and protective 
eyewear 
• Sports vision evaluations 
• Eye-tracking technology 
• Balance and motor skill technology 
• Contrast sensitivity testing 
• Concussion care 
• Performance training 
• Sports vision training 

As a young doctor in a well-established practice, I was looking ways to offer new services that would help differentiate our practice. I began marketing sports vision evaluations to local athletes, trainers, and coaches. In addition to standard vision tests, the evaluation includes sensory skill and eye-tracking tests to evaluate pursuits and saccades, dynamic
visual acuity, reaction time, eye dominance, and ability to see contrast. They get a customized report that measures strengths and weaknesses and compares their performance to peers and elite athletes. Over time, I’ve added computer-based, video and virtual reality vision training equipment. Sports vision has been a new source of revenue and it has boosted our patient retention and referrals.


Adam Clarin, OD,
Clarin Eye Care Miami, FL

5. Digital Device Strain 

The opportunity  

American adults now spend more than 9 hours a day on digital devices. More than 65% of U.S. adults complain of headaches, neck/shoulder pain and eyestrain when using digital devices

How it fits into optometric practice  

Heavy near to intermediate vision demands can place new stresses on vision, overwhelming previously successful compensatory mechanisms, especially if presbyopia or ocular dryness are compounding the problem. Optometrist Stephen Glasser emphasizes computer and digital eyecare in his practice and says a simple shift in perspective helps him address these patients’ visual needs. 

Best for:  

• Patient population in their 30s – 60s with busy lives 
• Doctors who appreciate the challenges of presbyopia 
onset 

Services to consider:  

• Computer glasses 
• Multifocal CLs and progressive spectacles 
• Dry eye testing and treatment protocols 
• Blink and lid closure evaluation 
• Eye tracking technology to identify sources of strain, reading problems, and/or 
lingering effects of mild TBIs 
• Eye misalignment measurement technology and contoured prism lenses 
• Ergonomics evaluations 

6. Aging Eye Health   

The opportunity  

By 2030 one out of every five Americans — approximately 72 million people — will be 65   
years or older, and the 85+ segment is the fastest-growing age group. The number of licensed older drivers (65+) is up 56% since 1999, and drivers age 70+ are most at risk of fatal crashes, according to the Center for Disease Control. By 2050, the number of people with age-related macular degeneration (AMD) is expected to more than double from 2.1M to 5.4M and the number of people with diabetic retinopathy (DR) will nearly double, from 7.7M to 14.6M.  

How it fits into optometric practice 

More patients than ever are prone to age-related eye conditions, including cataract, AMD, glaucoma, DR, and ocular surface disease. Aging also brings ocular and cognitive changes that can affect visual performance. The need for care is increasing dramatically, while the number of ophthalmologists is static.   

Best for:  

• Medical model practices  

Services to consider:  

• Screening questionnaires for dry eye and meibomian gland dysfunction (MGD)  
• Evaluation of ocular scatter  
• Advanced dry eye diagnostics  
• Meibomian gland  
• Ultra-widefield retinal imaging  
• Dynamic Vision health evaluation through  eye tracking  
• Older patient demographic  
• OCT of the macula and/or retinal nervefiber layer (RNFL)  
• “Eye spa” treatments such as thermal pulsation or intense pulsed laser  
• Vision or neuro-rehabilitation  
• Co-management of cataract or MIGS surgery