Ophthalmology Faces Serious Challenges

European ophthalmology is being reshaped by shifting demographics, rising patient expectations, and rapid advances in AI and digital health, according to Filomena Ribeiro MD, PhD, ESCRS president, who participated in the Global Ophthalmic Trends panel discussion at iNovation Day.

“Over the past few years, the field has moved from incremental innovation to a more transformative approach, with technology, sustainability, and equity of access now at the centre of the conversation,” she said.

Engaging representatives from regional and national ophthalmology societies, the iNovation programme focused on taking a proactive approach, Professor Ribeiro added. “We are bringing together the voices that can turn innovation into impact—defining how ophthalmology will look in the next ten years.”

Exciting though these transformations are, the field also faces significant challenges—such as declining reimbursement by both government and private insurers—that are affecting how and which services are delivered, Stephen McLeod MD said.

“Practice consolidation has been a significant factor over the last few years, largely driven by economic pressures related to increased practice costs in the face of stagnant or declining physician and practice reimbursement,” Dr McLeod explained. “The post-COVID inflation surge has never been fully absorbed into any meaningful adjustment to practice reimbursement, and costs continue to rise. Inevitably, this means that physicians are increasingly strained to meet their obligations to patients and are forced into difficult decisions regarding the services they can sustainably offer and the range of insurances they can absorb.”

Recent cuts in US government funding for ophthalmic research, as well as a proposal to merge the National Eye Institute (NEI) with other neurology-related fields, are major concerns, Dr McLeod added. “Eliminating NEI as an independent institute threatens to dismantle the progress made since its establishment by Congress in 1968. The Academy has urged Congress to continue its longstanding history of bipartisan support of NEI.”

Global ophthalmology must step up to meet these challenges, Prof Ribeiro said. “While reimbursement pressures and reduced research funding present ongoing challenges—particularly as cuts in the US reverberate globally—Europe’s collaborative research networks, strong academic-industry partnerships, and cross-border investment offer a pathway to mitigate these constraints and maintain momentum in innovation. The aim is to identify practical, scalable solutions that will shape the next decade of eye care.”

Filomena Ribeiro MD, PhD, FEBO is ESCRS president.

Stephen McLeod MD is CEO of the American Academy of Ophthalmology.