A Student’s Perspective on the
Changing Landscape of Optometry

Since I started optometry school at the University of Houston College of Optometry, the world of optometry has changed significantly. Then again, so have the lives, perspectives, and opportunities of its optometry students, as well as those of optometry students elsewhere.

In this article, I will share with you what has happened since you were last in optometry school and what has shaped the optometry students of today.

WE SURVIVED A PANDEMIC

The COVID-19 pandemic disrupted our programs in ways we never could have imagined. Schools shut down abruptly, and classes went a year without meeting in person. We were thrust into a new world of remote learning, electronic exams, and awful mask fog (Figure 1). No amount of Starbucks incentives could cure our Zoom fatigue, and the lack of in-person interaction initially made learning and socializing difficult.

Despite the challenges, we persevered and adapted to new norms. In doing so, we learned a lot about ourselves. We studied together and found that sometimes, a Zoom meeting is the most efficient way to get things done. We taped our masks to our faces, found the most sweat-resistant scrubs, and upgraded our home Wi-Fi capabilities. Although the world felt vast and isolated, we created virtual hangout spaces to connect with students across the country whom we never would have otherwise met. Cats, dogs, partners, and home decor allowed us to connect more as individuals and strengthened our bonds as an optometry community.

WE LEARNED ABOUT SELF-CARE

As we grappled with the challenges posed by the pandemic, we came to truly appreciate the importance of self-care and compassion. We developed new routines, learned to seek help when needed, and recognized that we were all doing the best we could in an unprecedented situation. We learned to extend kindness and compassion to ourselves and to others and in doing so, we discovered that self-care is not a one-time event. Instead, it requires ongoing practice, attention, and care. For some of us, this meant closing our textbooks and turning on the TV; for others, it meant logging off of social media and spending time outside. Whatever our means of disconnecting and tuning into our own needs, we were all able to reflect on who we were outside of clinic. We learned to nurture the humanistic part of ourselves and found that it made us better clinicians. Our ability to connect with our patients on a personal level was enhanced, whether it was through a mutual love for the Avengers or catching up with the latest football stats.

WE WOKE UP

We woke up to a new reality, one in which diversity, equity, and inclusion (DEI) initiatives were gaining traction everywhere (Figure 2). We acknowledged that our campus communities were not representative of our local communities, and we knew we could do more to bring about systemic change. Across our campuses, we saw a renewed commitment to creating a more equitable and inclusive environment. This commitment included the implementation of new programs and policies designed to promote DEI, such as bias training, mentorship programs, and opportunities to reflect on how institutional policies and practices may have contributed to this lack of diversity. We began to speak up and be heard (Figure 3).

WE PAID THE PREMIUM

Optometry school is a worthy investment in our future, but it comes with a hefty price tag. With student debts often exceeding $200,000 upon graduation, we are facing a long road toward financial stability. Virtual learning may have saved us from the costs of commuting, but tuition prices have not changed. There were also additional expenses associated with studying from home, such as better desk chairs, higher-quality monitors, and whatever else we felt we needed to convert our homes into classrooms. It all added up. Also, there were other school-related expenses to consider, such as externships and the National Board of Examiners in Optometry (NBEO) examinations. All of this makes it challenging to plan for our financial futures in a profession known for its high debt-to-income ratio.¹

WE (STILL) CONQUERED BOARDS

Despite all the challenges we faced, one thing remains constant: We still have to pass our boards. As students prepare for their boards, they are faced with a disheartening reality: Board passage rates have not improved, and prices have increased significantly.

Optometry students are spending more than $1,000 on board preparation courses, such as those from KMK Educational Services and Optoprep. Additionally, NBEO has raised board exam prices by a staggering 30% this year alone. The total cost is now more than $4,000 (or $1,380 per part), not including a new subscription test bank service offered by NBEO at $200 per month. With Part I first-time passage rates at 73% and total passage rates at 87% as of 2021, students are feeling the financial burden and demanding greater transparency from NBEO.²

WE TOOK ADVANTAGE OF OPPORTUNITIES

The optometric profession is constantly evolving, with new modalities, technologies, companies, and brands emerging, and students have a myriad of exciting opportunities from which to expand their knowledge and skill set. From private practice to private equity to corporate optometry, students can choose from a range of career paths that offer their own set of advantages and challenges, allowing them to find the right fit for their goals and interests. I would consider myself an example. I have a passion for artificial intelligence (AI) and other emerging technologies. In exploring those passions, I have had opportunities to work alongside incredible people in eye care on products such as custom 3D-printed glasses and computer vision retina assessment tools (Figure 4).

We also discovered that our role as students goes beyond simply learning the basics of our profession. We have the unique opportunity to shape the future of optometry through advocacy, leadership, and networking. With the pandemic as a backdrop, we’ve realized the importance of getting involved and participating in professional organizations. This has empowered us to advocate for expanded scope of practice laws and to appreciate the contributions of doctors in advancing our profession.

WE ADOPTED TECHNOLOGY

With the profession rapidly evolving, optometry students are eager to explore the latest technological advances. Telehealth, AI, and virtual and augmented reality will be increasingly commonplace in our careers, leveraged to provide better care for patients. No-code tools allow practice-specific software to be built on demand, enabling the creation of custom applications for managing patient data or streamlining appointment scheduling in a way that best fits the provider.

Meanwhile, 3D printing allows customization of eyewear and optical devices, promoting personalized care at a fraction of the cost. For example, 3D-printed eyeglasses can be tailored to an individual’s facial measurements, ensuring a perfect fit and optimal comfort. Other AI tools such as ChatGPT (OpenAI) will transform communication in the field, providing real-time answers to clinical questions and patient concerns. This technology will likely influence the way we and our patients interact with all-text information, as AI-generated responses could replace traditional pamphlets, providing patients with personalized and easily digestible information on eye care and treatment options.

Finally, as we continue to shape the way we practice with technology, we are increasingly harnessing the power of social media platforms to engage, educate, and share insights about the optometry profession with a global audience.

WE CELEBRATED INDIVIDUALITY

Optometry students have come to value their individuality, recognizing the significance of personal needs and interests while forging their career paths. Beyond financial gains and large practices, factors such as job satisfaction, clinical variety, and location have become critical in determining the success of our careers. Work-life balance is not a suggestion to us; it’s a priority.

Although relatively few, programs are learning to adapt to these changing priorities by introducing specialized programs such as OD/MBA and 5-year tracks, catering to the personalized interests of students.^3-6 Now more than ever before, student preference is somewhere between finding the perceived best job and the best job for us. We know that, regardless, we will have the power to make a positive impact on our profession and community in our own unique way.

WE ARE THE FUTURE

As we prepare to become optometrists, we are eager to take on the mantle of leadership, drive innovation, shape policy, and ensure that every patient has access to the highest quality care. The road ahead may be challenging, but we began our schooling and careers in tumultuous times. Today’s optometry students are up to the task. For better or worse, we have practiced resilience each day, and we will rise to meet challenges with passion, dedication, and an unwavering commitment to leave a lasting impression on our profession and shape the future of eye care.