A Vision for Growth

If you were invited to indulge your wildest dreams about the future of ophthalmology, what would you envision?

Perhaps you’d imagine novel treatments for dry age-related macular degeneration (AMD), a way to stem the rising global tide of myopia, or even a toolbox of gene therapies for the inherited eye diseases that cause so much devastation for patients?

The good news is that these innovations – plus many others – have already made the move from pipe dream to pipeline, fueling our belief that standard-changing medications and devices will continue to flow into ophthalmologists’ offices in the year ahead.

Admittedly, the outlook for ophthalmic innovation has been a bit shaky over the past year, with the life sciences sector lagging the S&P 500 Index by 30% (1). Yet, there’s plenty of evidence suggesting that the ophthalmology market has stabilized, creating a healthy ecosystem for new investments.

For instance, since December 2024 eye care’s biotech indices have outperformed biotechnology’s indices overall, with leading drugs selling extremely well and innovative new medical technologies continuing to be adopted. At the same time, ophthalmic diseases are becoming more common and attracting more attention, intensifying competition among drug developers and investors to get into the game (1).

The result? Decision-makers in the life sciences, venture capital, private equity, and adjacent industries are working hard to bring novel products to market, with a particular focus on treatments for AMD/geographic atrophy (GA) and diabetic retinopathy (DR)/diabetic macular edema (DME) in the posterior segment, as well as dry eye disease in the anterior sector.

Their goal is one we all share: to serve the patients who need our help – including over 20 million adults with retinal disease and seven million people with uncorrectable loss of visual acuity in the United States alone (2, 3). That makes this an exciting moment for everyone who is passionate about ophthalmology, and the perfect time to take stock of the milestones we can anticipate in 2026.

Attracting investment

It’s no secret that the life sciences market faced some challenges in 2025, from tariffs and an oversupply of real estate to regulatory changes and limited employment growth. But strong positive signals in the marketplace have convinced us that the sector is headed in a productive direction.

Driven by companies that are household names and have generated blockbuster drugs, the value of the global ophthalmology drug market stood at $38 billion in 2024 and is projected to reach $62 billion by 2030 (4). That makes the field a highly competitive specialty, similar in size and impact to the markets for HIV antivirals and antibody-drug conjugates for cancer treatment.

In roughly descending order, here’s a look at the main categories contributing to ophthalmology’s market value (4):

●       Anti-VEGF agents for wet AMD, DME and DR

●       Glaucoma treatments

●       Therapies for infection, allergy, refractive disorders, post-surgical care and rare indications

●       Interventions for dry eye disease

●       Treatments for inflammatory diseases (although it’s currently the smallest, watch this category, as it’s expected to demonstrate the fastest expansion, with a compound annual growth rate of 9.4% anticipated between 2024 and 2030) (1).

Investment in ophthalmology remains strong; in the second quarter of 2025 alone, 13 transactions attracted a total of $620 million. Although that amount was lower than in other recent quarters, continued funding in the form of large series B investments indicates investor certainty (5).

Just as reassuring is that venture capital rounds have grown each year in ophthalmology since 2022, with at least marginal growth expected to continue through the end of 2025, especially in medtech (1). With a good portion of that investment supporting later-stage assets, we’re seeing more commercial-ready products receive additional equity infusions.

Finally, rising demand for ophthalmology clinical trials is very encouraging. Between 2023 and 2030, the ophthalmology clinical trials market is expected to reach $2.5 billion, with a compound annual growth rate of 6.6% (6).

Novel treatments to change the world

So, what’s hot and new in translational ophthalmology? Cell and gene therapies are a huge focus because they offer the potential to create one-and-done treatments for sight-threatening conditions that currently require surgery or monthly injections.

Interestingly, the first gene therapy ever approved by the US Food and Drug Administration for an inherited disease was for an ophthalmic indication: Leber's congenital amaurosis. Since the 2017 approval of that medication, Luxturna, an array of investigational gene therapies have moved into the clinic for evaluation in retinitis pigmentosa, AMD, glaucoma, DR/DME, and inherited retinal conditions, including choroideremia and Stargardt disease. Meanwhile, in Fuchs endothelial corneal dystrophy, gene therapy is currently in the preclinical stage.

A host of other innovations are also brewing in the clinic. In anterior ophthalmology, investigators are evaluating novel ways to treat:

●       Myopia. It's astounding that this condition is expected to affect more than 5 billion people within just 25 years, which will not only impact sight in these individuals but increase their risk of cataracts, glaucoma, and macular degeneration (7, 8). If we can do something to stem the tide of nearsightedness through innovations such as atropine-based pharmaceutical approaches and defocus techniques using contact lenses and spectacles, we’ll be providing a global service.

●       Presbyopia. Sooner or later, we’ll all suffer from difficulty focusing at close range, which makes presbyopia an excellent candidate for novel treatments. Along with drops designed to modify the pupils, researchers are now testing devices such as novel intraocular lenses that offer extended depth of focus or multifocality.

●       Dry eye. Rather than trying to improve lubricating drops, investigators are developing targeted medications intended to treat the disease based on whether it’s inflammatory, infectious, or autoimmune.

In the posterior segment space, one of the biggest hopes is that we’ll soon be able to treat our “bread-and-butter" diseases, such as neovascular AMD and DME, with tyrosine kinase inhibitors and bi- and tri-specific small antibodies, whose novel mechanisms of action could extend the durability of outcomes, and through innovative delivery systems such as slow-eluting polymer stents injected into the vitreous.

Stakeholders collaborating to support success

It would be difficult for any of these efforts to succeed without support from a host of stakeholders, and that’s being fostered through consortia such as the Ocular Diseases Forum, the Mary Tyler Moore Vision Initiative, and the Collaborative Community on Ophthalmic Innovation.

Through these collaborations, stakeholders are working to align clinical trial endpoints with regulatory and real-world needs. Selecting endpoints that matter to regulators, payers, physicians, and patients will help ensure that the data produced in clinical trials are relevant, reproducible, approvable, and reimbursable.

Novel endpoints are often functional, anatomic or based on the patient perspective and can include GA lesion size, low-luminance visual acuity, ellipsoid zone at the photoreceptor level, quantitative contrast sensitivity. and patient-reported outcomes.

Artificial intelligence is also contributing to the success of ophthalmology drug development by searching investigators’ databases to find eligible patients for trials; gathering and analyzing real-world evidence, sometimes with the goal of expanding labeling after a treatment’s approval; and using algorithms, rather than human evaluators, to determine whether endpoints have been met.

Ultimately, the efforts most likely to succeed will address unmet needs in novel ways. And, of course, interventions with the potential to accumulate a range of indications will have an advantage.

With strong sales and continued investment in innovations that hold the potential to improve visual outcomes for billions of people worldwide, the ophthalmology market contains immense promise. As today’s investigations move closer to fruition, we look forward to watching novel therapies transform the field of ophthalmology, creating new opportunities for both doctors and the patients who entrust them with their sight.