Arthur Cummings: Power List Perspectives

What industry trends are catching your attention right now?
 

It appears that multiple companies are diversifying, i.e., trying to broaden their portfolios to include diagnostic devices, IOLs, phaco and vitrectomy machines, consumables, vision care, pharma, etc. Companies are realizing that they need more than one product to survive and thrive.

The EU Medical Device Regulation (MDR) is slowing down innovation in Europe and I think we will see a shift to Asia and back to the USA to lead ophthalmic innovation. Some of my colleagues in this space think I am wrong and I hope I am.

Reversible procedures are going to flourish. Procedures such as implantable collamer lenses (ICLs) for refractive error or Allotex for the correction of presbyopia are going to continue growing in popularity. One of the reasons is that of reversibility.

Many patients fear the permanence of laser vision correction and lens replacement surgery in case they get an unwanted result. With the option of reversibility (removing the ICL or corneal inlay), things return to the preoperative state. I have seen this personally, where someone is contemplating surgery but not quite sure about how to proceed and as soon as a reversible procedure is mentioned, they commit.

What is a little-known fact about you?
 

I was born and raised in South Africa where I trained and practiced as an ophthalmologist doing mostly vitreoretinal, refractive, and cataract surgery. We moved to Ireland in 1998 and for eight years I could only do laser vision correction surgery. Once I got back to doing intraocular surgery, I had developed a performance-based mindset rather than a pathology-based mindset. It has set me up to have a refractive mindset since then.

I am a big believer in the teams we have around us. Without my team I would achieve much less. Building a great team is crucial to delivering a great service and patient experience.

Make a bold prediction for the future of ophthalmology.
 

Ophthalmology will remain the queen of specialties for a long time to come yet.

If you weren’t an ophthalmologist, what would you be doing instead?
 

I have often thought about this and even though I have many interests outside of ophthalmology, there is nothing that I would like to do professionally other than ophthalmology.

How do you think AI and machine learning will impact ophthalmology?
 

Much of our image-based work will be performed by artificial intelligence (AI), and will likely be more accurate than it was before, e.g., AI will do a better job of detecting glaucoma progression from analyzing OCT images and visual fields. Ophthalmology will truly become the window to the health of an individual with AI analysis of the fundus being able to detect health issues like cardiac disease, risk of myocardial infarction or stroke and likelihood of dementia. AI will increase IOL power predictably, ICL vault, further enhance refractive nomograms etc. AI will be able to help us better select the best fit IOL for an individual's lifestyle.

What global trends in eye health should ophthalmologists be aware of?
 

Myopia continues to increase, in incidence and grade. We are relatively up to date taking care of pathological conditions (cataract, AMD, glaucoma) but are falling further and further behind in terms of taking care of uncorrected refractive error, especially in the developing world. We have the opportunity to change people's lives for the better by correcting these refractive errors at a young age (18-21 years) and providing these individuals and their families a better life for the rest of their lives.

The relative shortage of ophthalmologists is only going to get worse for the foreseeable future. With no immediate robotic surgery solution on the horizon, we are going to be faced with a growing cataract epidemic.

Arthur Cummings is Medical Director, Wellington Eye Clinic, Consultant Ophthalmic Surgeon, Beacon Hospital, Non-Executive Director, Alcon, Associate Clinical Professor, University College Dublin, Ireland.