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Al Cleinman: Reality Check




Fall is here and new classes of optometry students have begun work toward their degrees. They’re going to invest a significant sum of money in their education — and many are already worried about their future.

Optometry students face a field with big-box retail and Internet competition, increasing penetration of vertically integrated vision plans and the still-uncertain effects of Obamacare. Meanwhile, many practicing optometrists feel worn out from fighting vision plans and retail competition. They’re working harder than ever, and many see their desire for the new car, new house and all the trappings of being a doctor going unfulfilled.

But optometry isn’t dying. Indeed, the need for optometrists is going to be greater than ever in the coming decade. Our current population of 315 million will swell to almost 350 million by 2025. More important, the percentage of people age 65 or older will increase by 50 percent, adding 25 million people to optometry’s primary demographic. That’s another 700 patients for every licensed optometrist. That’s more progressives; more glaucoma patients; more diabetics. Success is virtually guaranteed … or is it?

&#8220An estimated one in four
Americans don’t use our
services at all. &#8221

The reality is that while older patients continue to need more advanced services, younger Americans have a very different view of the purchasing process and what they enjoy and dislike. And our industry, as a whole, hasn’t enticed them into the market.
Consumers spend more on shoes than they do on eyecare. An estimated one in four Americans don’t use our services at all! We haven’t been effective enough at helping people know why they ought to invest in their vision.

But I believe these market conditions are ripe for change. We’ll see disruptive, consumer-friendly technologies that force us to defend optometry as a necessary profession. We’ll see consolidation of retail, new entrepreneurial activities, and ever-increasing competition from inside and outside our industry.


For some optometrists, this decade will be their last in practice; their businesses will not survive in their present form. For others, the near future will be full of opportunity. But it certainly won’t be business as usual. Out of this turmoil will emerge a profession with a wider scope and deeper services. Optometrists will help people access new technologies and achieve better overall health.

Optometry isn’t dying, it’s evolving. It’s time to expand your thinking. What new technologies can you adopt? What new learning, outside of optometry, must you engage?

Change in our profession reminds me of Yellowstone in 1988, when vast wildfires prompted a global debate over whether or not to intervene. What’s fascinating about the event — and I was in Yellowstone in 1990 to witness this — is that without big fires, many types of pine cones do not release their seeds. It is because of fire that new growth occurs. Out of the ashes of destruction comes renewed vibrancy.

Is the same not true for optometry — that real change never occurs without crisis? I think so. It’s not about survival of the fittest, but survival of the adaptive.

The real question is whether you’re ready for the challenges … and the opportunities. Will you adapt fast enough?


This article originally appeared in the September 2014 edition of INVISION.

Longtime vision industry leader Al Cleinman is a popular speaker and author with decades of experience in all aspects of the eyecare business. Read more from him at, where he first wrote on this topic, and contact him at


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