The technologic advancements in ophthalmology are truly amazing. I completed my residency training almost 20 years ago, and since that time I have witnessed an incredible amount of change in the way we diagnose and treat our patients with eye disease.
Not only do we have a better understanding of many ocular disorders, but we also have new and improved ways of helping those who suffer from them. The most notable examples include advances in cataract and refractive surgery, glaucoma, macular degeneration, and dry eye disease, all of which have benefited from revolutionary diagnostic devices, medications, and surgical products. One common trend is combination technologies:
Surgical Systems:
The combination of diagnostic and surgical devices into fully integrated systems that can share information and streamline the surgical process is the new trend in cataract surgery.
The best example of this is Alcon’s Cataract Refractive Suite, which is comprised of the VERION Image Guided System, LenSx laser, LuxOR LX3 microscope, and CENTURION Vision System phaco machine.
Another approach is a collaboration among various companies: Cassini Corneal Topographer from i-Optics, LensAR laser, and TrueGuide system from TrueVision Systems; CALLISTO eye from Zeiss and TrueVision 3D Surgical system from TrueVision Systems; and intraoperative wavefront aberrometers such as the ORA System with VerifEye+ from Alcon and the Holos IntraOp from Clarity Medical Systems are also technologies that are likely to be integrated with other products.
Anterior Segment Analysis:
The iTrace from Tracey Technologies is a unique ray-tracing device that combines topography and aberrometry to analyze the refractive parameters of the cornea, lens, and entire eye. Specifically, this machine measures refraction, corneal topography, ray tracing aberrometry, pupillometry, keratometry, accommodation, angle alpha (the distance between the visual axis and the center of the limbus), angle kappa (the distance between the visual axis and the center of the pupil), dysfunctional lens index (an objective metric of the crystalline lens performance), quality of vision and visual function. It also contains toric IOL planning software to aid in the surgical correction of astigmatism.
The IOLMaster 700from Zeiss is a next generation optical biometer that utilizes SWEPT source optical coherence tomography (OCT). In addition to faster acquisition times, the reproducibility of the measurements has improved and the measurements are directly verifiable by the OCT scans. The device also calculates cornea and lens thickness, and more data points are acquired with the keratometry feature.
Electrophysiology:
Diopsys has developed an in-office electrophysiology device that simplifies what was once a complicated battery of tests traditionally performed and interpreted at academic centers. The device captures proprietary VEP and ERG (pattern and flicker) tests that are simple for the patient to undergo and easy for the physician to interpret. These objective tests have been shown to be effective for detecting early stages (i.e., preperimetric) as well as progression of glaucoma, and they can also be used for diagnosing and following a variety of other retinal and visual pathway abnormalities.
Retinal Imaging:
Many devices now allow us to obtain high-resolution scans and photos of the posterior segment. The newest addition to this group of devices is the AngioVue Imaging System from Optovue, an OCT Angiography (OCTA) technology that just received FDA 510(k) clearance. 
AngioAnalytics is an algorithm that quantifies blood flow in the retinal microcirculation. This noninvasive technology can dramatically change the way retinal angiography is performed; no longer will needles and dye be required as is currently used with fluorescein angiography.
Other products include the TRC NW400 from Topcon which is an automatic, non-mydriatic retinal camera that can acquire photos of the posterior as well as the anterior segment, the Eidon from CenterVue is a non-mydriatic confocal scanning device for obtaining wide field color and infrared images, and the iScan from Optovue is an automated OCT that allows for an improved patient experience.