Quadrant Eye Co-Founder, Dr. Quinn Wang breaks down the impact of an increasing need for more accessible eyecare and how QE is helping to fill the gap with patient-powered at-home eyecare.
With the remote work boom, we’ve gotten lots of questions about the visual impacts of increased screen time (spoiler alert: digital eye strain is very real.) The proliferation of blue light glasses (which btw probably don’t work) is another indication that folks are becoming more concerned about eye health.
Importantly, as large portions of our workforce disperses across the country, we’re seeing more of the stark geographical differences in eyecare access. It’s hard enough getting ophthalmology appointments in major metropolitan cities… but did you know that 24% of U.S. counties have no optometrists or ophthalmologists at all?
QE’s mission is to bring high-quality eyecare to everyone, and we’re bullish about telemedicine’s potential to improve eyecare access.
Specifically, QE believes that at-home eyecare — the patient-powered collection of important eye data such as visual acuity and visual symptoms — is a promising and powerful way to bring high-quality eyecare to everyone.
We need to first acknowledge that ophthalmology and optometry are hardware intensive fields. A typical eye clinic, for instance, is filled to the brim with expensive and highly-specialized equipment such as fundus cameras, Humphrey Field Analysers, and phoropters (agent of the infamously anxiety-provoking “which is better, 1 or 2?” question.)
Of these, the workhorse of eyecare is the slit lamp biomicroscope, which is an unwieldy thing that takes years to master. Not surprising, as ocular structures are microscopic; things like the posterior capsule of the lens, for example, are mere microns thick.
Therefore, one might argue that modern telemedicine capabilities fall far short of true remote eyecare needs. To some extent, this is true: we don’t really have the portable* hardware needed to capture eye vitals such like eye pressure and eye pathology such as retinal holes /tears /neovascularization /etc.
But traditional hardware development is lengthy and costly, and we can’t afford to wait: per HRSA, the US is on track to reach its peak ophthalmologist shortage in 2025.
Of note, this HRSA report was from 2016; given that the pandemic forced many ophthalmologists into early retirement, this timeline has most likely been accelerated.
In answer to this urgent eyecare access problem, QE is using software as a first pass solution. We know that true at-home eyecare can’t yet be powered by software alone, but we strongly believe that a few well executed digital tests can form a powerful foundation.
Let’s use online eye exams** as an example. At its core, an online eye exam is a very basic piece of software that crudely checks a patient’s vision. Yet despite this limited functionality, online eye exams can still be incredibly high impact. Specifically, they can and have been enabling the more than 164 million glasses wearers in the US to renew their corrective eyewear prescriptions online.
These exams not only lower the barrier to getting new corrective eyewear (particularly when folks are faced with broken glasses or run out of contact lenses,) but they can also free up precious chair time for eye doctors to manage common and vision threatening eye problems like diabetic retinopathy and glaucoma. These diseases alone cost Americans billions of dollars in direct eyecare expenditures as well as indirect productivity losses.
Simple preventative screening and aggressive early intervention can alleviate a lot of eye-related financial and emotional suffering. So when it comes to improving eyecare access, there’s really no time to waste.
Eye health is a critical part of having good vision, and good vision is often a critical component of professional and personal happiness. High-quality eyecare, therefore, is a basic healthcare necessity.
QE is taking immediate action by amplifying the power of existing software. For one, we think that it’s possible to use relatively rudimentary maneuvers — done in the comfort of one’s own home — to flag serious eye problems that may have otherwise gone undetected.
QE is committed to making at-home eyecare a reality. We’re starting small to go big, and we want to deliver the eyecare patients need as soon as possible.
Ultimately, we’re working hard to prove to everyone, ourselves included, that eyecare can and will be better.
*There are “portable” products like the TopCon Robotic Non-Mydriatic Retinal Camera on the market, but their cost, size, and weight make them hard to scale. This may also be part of the reason awesome technology like IDX-Dr, which is anchored to TopCon hardware, hasn’t quite taken off in the way we had all hoped.
**More on online eye exams here.
Taking good care of your eyes and your overall health can go a long way toward preventing age-related eye conditions. Eating an eye-healthy diet that includes lots of antioxidant-rich fruits and vegetables slows down the formation of cataracts and reduces your risk of macular degeneration. Getting plenty of exercise and maintaining a healthy weight can prevent diseases like diabetes and high blood pressure--both of which affect vision and eye health. And while you may not be able to prevent the presbyopia (and need for reading glasses) that comes with getting older, your eyecare professional can make sure you get the correct vision correction to see clearly.
The sun’s rays contain damaging ultraviolet (UV) light. The same UV rays that burn your skin and lead to skin cancer also affect your eyes. Staring directly into strong sunlight can damage the retina. And repeated sun exposure over time can lead to cataracts, benign growths on the eyes and even eye cancer. Protect your eyes anytime you’re in the sun by wearing sunglasses that block both UVA and UVB rays.
Some people claim that by correcting your vision with prescription glasses or contacts, you’re weakening your eyes—which then leads to worse vision. Their “proof” is that after wearing your corrective prescription for a while, your vision appears blurrier when you’re not wearing it. But that’s likely because you’re now used to seeing the world in clear, crisp detail—and in contrast, your uncorrected vision appears fuzzier. Getting the proper vision correction for your eyes is essential for your eye health. Don’t try to tough it out if you can’t see clearly. Visit your eyecare professional for an in-person or virtual vision screening.
Not having a bright enough light may make it harder to clearly see the words on the page, but it won’t damage your eyes or permanently impact your vision. Because you’re straining to see, you might get a headache or other symptoms of eyestrain. If you want to read in bed without illuminating the entire bedroom, get a reading light that provides just enough brightness to see your book clearly.
LASIK surgery corrects your distance vision only, so people who are nearsighted benefit most from it. But LASIK doesn’t affect the lens of the eye, the part that helps you focus up close. As you get older, changes to the lens impact your ability to see close up. So even if you have LASIK in your 20s or 30s, you’ll most likely still need reading glasses by the time you hit your 40s or 50s.
Having your face right up next to the bright screen may give you a headache or even cause some temporary eyestrain or fatigue, but it won’t damage your vision. Children are more prone to this behavior than adults—which may be because children can focus close up better than adults can. But if your child can only see the television clearly when sitting close (and has to hold other things close to see them clearly), they may be nearsighted. Taking your child to an eyecare professional for a vision exam will help determine if they need glasses to see clearly.
Most eyecare professionals recommend removing—and thoroughly cleaning—your contacts every night. Even if you use extend-wear lenses that are approved for use a week or month at a time, it’s always safer to give your eyes a nightly break. Your contacts are more likely to accumulate bacteria when you leave them in 24/7, and that can lead to eye infections. Sleeping in your contacts also prevents essential oxygen from getting to your corneas. If you must sleep in your contacts, make it a once-in-a-while event and ask your eyecare provider about contacts that are specially formulated to let more oxygen through.
Carrots (along with other vegetables like sweet potatoes and dark leafy greens) contain high amounts of beta-carotene, which the body converts to vitamin A. Vitamin A is essential for eye health, and a deficiency of the nutrient is the leading cause of childhood blindness in developing countries. In the U.S., vitamin A deficiency is rare, and few people get so little it could impact their eyesight. Also, there’s no evidence that beta-carotene affects the sharpness of your vision or can prevent near or farsightedness. So while getting lots of beta-carotene in your diet may help keep your eyes healthy, no amount of carrots is going to actually improve your vision and allow you to toss out your glasses or contacts.
The jury is still out on how effective blue light glasses are for eyestrain. One recent study found they made no difference in eyestrain symptoms during a two-hour-long computer task. But some experts feel they may help alleviate eyestrain and fatigue during prolonged, cumulative screen time. Either way, blue glasses alone won’t solve the problem of too much screen time. The best way to reduce eyestrain is to limit screen time and take frequent breaks when you do need to spend several hours at your computer.
The jury is still out on how effective blue light glasses are for eyestrain. One recent study found they made no difference in eyestrain symptoms during a two-hour-long computer task. But some experts feel they may help alleviate eyestrain and fatigue during prolonged, cumulative screen time. Either way, blue glasses alone won’t solve the problem of too much screen time. The best way to reduce eyestrain is to limit screen time and take frequent breaks when you do need to spend several hours at your computer.
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