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Business & Profession Business and Innovation, Cataract, Professional Development

A Robotic Revolution

Cataract is responsible for 51% of blindness worldwide, making it one of the most detrimental eye diseases globally (1). Affecting over 24 million people in the US, nearly five times more that amount in China, and with worldwide rates expected to double by 2050, cataracts disease has initiated a global public health emergency (2)(3). As the average life expectancy soars, a larger portion of the population is affected by cataracts despite the disease being highly preventable.

Ophthalmologists have to confront the question – what is at the core of this global public health emergency? The answer is complex and multifaceted but includes a worldwide shortage in skilled eye surgeons who are able to operate on patients, and therefore a lack of access to quality surgical eye care. Too many patients have simply been abandoned by the global healthcare industry. By neglecting an individual patient, the industry creates an unsustainable cycle that may have disastrous consequences on communities all around the globe.

A growing problem

There are over 28 million cataract surgeries performed every year around the world, placing cataract at the very top of the surgical procedures list (4). Despite the relatively simple surgical fix – a procedure lasting around twenty minutes, during which the clouded cataract lens is removed and a new clear lens inserted – patients are often forced to wait for months and sometimes years as their vision deteriorates before surgery is performed.

The growing gap between ophthalmologists entering the field and leaving is causing significant difficulties. In the US alone, there are at least 100 more surgeons retiring than entering the practice annually (5). Worldwide, an average of 31.7 ophthalmologists treat a population of one million, and when nearly 75% of a population is suffering from cataracts – as is the case in India, in adults over the age of 60 – it is clear that the demand for healthcare outweighs the capacity to provide it (6,7).

Societal burden

Beyond impacting a patient’s quality of life, cataracts also place a heavy burden on society with estimations showing that the worldwide economic and health burden from visual impairment costs $3 trillion annually in lost productivity (8). In China, despite approximately 80% of potential cataract patients living in rural areas, a shocking 70% of cataract surgery resources are located in urban centers (9). This lack of access to ophthalmic treatment leaves patients in a vicious cycle and indefinitely widens socioeconomic inequality.

Embracing robotics

As both the global shortage in cataract surgeons and the demand for cataract surgeries grow, it is clear that a purely human solution is no longer enough. The key to improving access to cataract surgery lies in integrating novel technologies like artificial intelligence and machine learning into surgical eye care. By embracing developments such as robotics, healthcare providers can improve the quality of eyecare, empower surgeons, and raise surgical efficiency and reach.

Implementing robotic surgery into cataract procedures – and other ophthalmic operations – can have a significant impact on both surgeons and patients. Improving both a surgeon’s career cycle and a patient’s clinical experience, robotics enhances ophthalmic efficiency and success, extending its reach to ensure that millions of patients who currently lack access to treatment are provided quality surgical eye care.

Implementing robotics

Whether a novice surgeon at the beginning of his career or a veteran physician with thirty years and 15,000 cases of operating experience, a robotic platform’s world-class methods can standardize ophthalmic procedures and enable surgeons to provide outstanding surgical care at every step. Robotic platforms – like ForSight Robotics’ ORYOM – combine a vast set of analytical data points to implement the finest operation. Observing thousands of procedures and studying the world’s leading ophthalmologists’ methodology, the robotic platform is built to give every surgeon the ability to perform the most high-quality procedure during every single operation.

More than just a tool, robotic surgery is a source of empowerment, ensuring a more precise and accurate performance than the human hand. Filtering out even a minor hand tremor, robotics can relieve surgeons of unnecessary cognitive stress while providing a streamlined guide during operations. Monitoring, highlighting tools, and alerting when needed are just a number of the ways that AI-based algorithms provide guidance and surgical support during operations.

Relieving physical stress

Today, two-thirds of ophthalmic surgeons experience work-related pain and nearly 15% plan to retire early due to poor ergonomics and medical issues that stem from prolonged poor posture (10). Surgical robotic platforms can be designed to alleviate the physical stress endured during surgeries, thus elongating ophthalmic careers and allowing surgeons to practice for a number of years beyond what is possible today.

A global impact

Enhancing operational performance with robotics begins before a surgeon even steps into an operating room. Robotic surgery allows physicians to learn from, observe, and experience procedures that are happening on the other side of the world. In a leap for the industry, this method of apprenticeship opens new opportunities for surgeons who otherwise would not have access to top-tier ophthalmologists or leading fellowship opportunities. Through increased access to the highest quality resources, surgeons in developing regions or with limited resources can be given a new tool to enhance their practice and serve their patients with the best techniques.

Bridging the gap

Although promising, the ultimate question is, how can surgical robotics provide a solution for the gap between the increasing number of patients needing surgical eye care and the decreasing number of ophthalmic surgeons? ForSight Robotics’ ORYOM is a prime example. Initially targeting cataract procedures, the surgical robotics platform is developed with 14 degrees of freedom, ensuring access to any point within the human eye. Surgical robotics need to pose a solution to more than one condition, and by allowing access to both retinal and subretinal regions, the robotic platform will be able to perform a wide variety of procedures. In turn, instead of focusing on one specific sub-specialty, this model will allow ophthalmic surgeons to expand their practice and treat a broad type of eye conditions and diseases – ultimately reaching a much wider patient population.

A new horizon

Opening up new horizons, robotic surgery allows surgeons to do what they love at the highest possible level with a broader reach than ever before. Early adopters of surgical robotic platforms have an opportunity to impact millions of people worldwide and redefine quality surgical eye care for generations to come. The healthcare industry must act now to promote the development and integration of novel technologies into ophthalmology. By democratizing surgical eye care, robotic surgery has the potential to disrupt the industry and, loudly, end today’s global public health emergency.

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  1. P Song et al., “The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis,” J Glob Health, [Published online] (2018). PMID: 29977532.
  2. National Eye Institute, “Cataract: NEI Looks Ahead”. 
  3. Y F Du et al., “Prevalence of cataract and cataract surgery in urban and rural Chinese populations over 50 years old: a systematic review and Meta-analysis,” Int J Ophthalmol, 15, 141 (2022). PMID: 35047369. 
  4. Eyewire, “Cataract Surgery Products Continue to be the Main Single-Use Surgical Device Sales Driver” (2019). Available at:
  5. Healio, “Supply and demand: Navigating the future of ophthalmology” (2021). Available at:
  6. S Resnikoff et al., “Estimated number of ophthalmologists worldwide (International Council of Ophthalmology update): will we meet the needs?,” Br J Ophthalmol, 104, 588 (2020). PMID: 31266774. 
  7. P Vashist et al., “Prevalence of cataract in an older population in India: the India study of age-related eye disease,” Ophthalmology, 118, 272 (2011). PMID: 20801514. 
  8. A Gordois, “An estimation of the worldwide economic and health burden of visual impairment,” Glob Public Health, 7, 465 (2012). PMID: 22136197. 
  9. J R Broyles, “Global Cataract Problem and Cataract Surgery Backlog,” Cataract Blindness and Simulation-Based Training for Cataract Surgeons: An Assessment of the HelpMeSee Approach, 5. RAND Corporation: 2012. 
  10. S A Schechet et al., “Survey of musculoskeletal disorders among US ophthalmologists,” 26, 36 (2020). PMID: 33867881.
About the Author
Dr. Joseph Nathan

Dr. Joseph Nathan is President, co-Founder and Chief Medical Officer of ForSight Robotics

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