Ophthalmic – An Evolving Industry

Ophthalmic equipment are medical devices which are designed for vision correction and surgical diagnosis, purposes and help to prevent disorders such as, dry eye, cataract glaucoma etc. This story takes our readers to the industry analysis and innovations in the ophthalmic equipment industry.

Carl Zeiss - Visumaxsa

Ophthalmic devices are utilised in the detection and treatment of ocular defects or deficiencies and eye disorders. The increasing incidence of loss of vision and eye disorders continue to accelerate the demand for ophthalmic devices. Ophthalmology industry is witnessing a rapid pace of technological advances in order to accomplish efficient diagnosis and treatment.

India is considered to be a home to around 30 per cent of the world’s blind people. A huge part of the Indian population suffers from glaucoma and the country has over 10 million blind citizens. It is reported that 60 per cent of blindness is caused by cataract and about 13 per cent from glaucoma. Indian ophthalmologist surgeons conduct approximately five million cataract surgeries annually.

Industry Analysis

According to Persistence Market Research, “Asia is the fastest budding market for ophthalmology equipment because of the hastening number of eye surgeries for diagnostics of ophthalmic conditions. Moreover, there are several government steps that are supporting the growth of ophthalmology devices market in the Asian countries.” Tarun Jaggi, CEO, Optitech Eyecare says, “The dry eye disease is one of the most frequent ocular morbidities. The rapidly increasing incidence rate of keratoconjunctivitis sicca due to pollution and changing environmental conditions is a rising health concern imposing a significant economic burden globally. Ophthalmic strips are used as a diagnostic tool for the detection of dry eye disease.”

Rise in demand for safe and non-invasive diagnosis of dry eye disease, rise in prevalence of dry eye disease globally, improvements in health care infrastructure in developing countries, rise in incidence rate of lifestyle-related disorders, and increase in number of new market entrants that are establishing strong local distribution network owing to aggressive marketing strategy are some of the major factors expected to drive the global ophthalmic strips market during the forecast period. Jaggi said, “However, intensified pricing pressure leading to reduced profit margins and limited availability of skilled eye care providers in rural areas, which results in delayed diagnosis of dry eye, are some of the factors expected to detain the global ophthalmic strips market between 2018 and 2026.”

Carl Zeiss – Visumax Hr

Similarly, Zeiss has been at the forefront of ophthalmology and optics right from inception. Deepak Singhal, National Manager-Sales and Marketing, Refractive Lasers, Medical Technology, Carl Zeiss India shares, “The Medical division at Zeiss has been consistently contributing to help the doctors in improving the patient outcomes through its continuous innovations in ophthalmology and microsurgery. Zeiss technology is so dominant in ophthalmic patient care that around 75 per cent of all cataract patients worldwide come into contact with Zeiss product at least once during their treatment.”

Refractive care is yet another sphere that saw its evolution and growth with parallel contribution from Zeiss. “MEL Excimer lasers from Zeiss have been used widely to perform LASIK on millions of patients worldwide. However, a new benchmark was set in 2011 when Zeiss launched ReLEx SMILE commercially. The ground-breaking technology redefined the way refractive procedures were performed and has gained wide spread interest in ophthalmology community. Performed on VisuMax by Zeiss, SMILE is the only minimally invasive procedure available today in refractive segment that does not need creation of flap. It works on intact cornea and is totally painless,” Singhal shared.

An estimated 58 per cent of individuals worldwide suffer from a type of ametropia. Fortunately, refractive surgery procedures can correct the natural limitations of the human eye while enhancing vision and providing better quality of life for those affected individuals.

Innovations in the Market

Ophthalmic equipment market in India has vast opportunities as ophthalmic services are offered all across major cities in India. The number of practicing ophthalmologist in India is increasing day-by-day. There are few ophthalmologists who work in solo practices while few ophthalmic surgeons are attached to hospitals. There are several prominent ophthalmic hospitals spread all over India.

It has been observed that there has been a tremendous rise in the prevalence of eye-related conditions such as glaucoma, cataract, refractive errors, age-related macular degeneration which has driven the Indian ophthalmic devices market towards a progressive growth. Further, the role of few more drivers have been observed in boosting the growth of ophthalmic device market such as rapid growth in the geriatric population, high demand for efficient diagnostic platforms, augmenting government investment towards research activities, continuous technological advancements in developing novel ophthalmic devices, persistent product modifications, use of mobile smartphone applications for eye visualisation, increasing demand for minimally invasive eye surgeries, growing adoption of contact lenses and spectacles, and increasing government initiatives to control visual impairment. It is also viewed that the subsequent increase in the number of ophthalmologists is also a vital factor which is escalating the demand for ophthalmic diagnostic devices.

Singhal says, “With the VisuMax, Zeiss is expressively shaping the world of refractive surgery. This innovative laser system employs high-performance femtosecond laser technology and is characterised by its outstanding cutting precision, unsurpassed speed and gentle treatment technique.”

Further giving the details of VisuMax, Sinhal shares, “The VisuMax is thus the ideal platform for therapeutic and refractive applications of cutting-edge corneal surgery including:

  • Flap – for precise flap cutting for Femto-LASIK
  • Keratoplasty – for a broad spectrum of corneal transplant procedures
  • Incision for ICR – for tailor-made intracorneal tunnel segments
  • SMILE – the step towards minimally invasive laser vision correction

With SMILE, VisuMax heralds a paradigm shift in refractive surgery: minimally invasive laser vision correction. It completes the unparalleled range of innovative surgical possibilities and creates the ideal preconditions for tapping into new patient groups. VisuMax is the logical enhancement of the product range for refractive surgeons – and marks another step into the future of corneal surgery, the progress of which Zeiss has been shaping for more than 20 years.”

Singhal adds, “Owing to its painless nature and quick recovery benefits, SMILE is now highly preferred by patients. More than two million eyes have been already treated globally and around 45 installations of SMILE are functioning in India alone. All the premium institutes of ophthalmology in India including RP Centre of Ophthalmology, AIIMS have installed VisuMax and offer SMILE to their patients.”

SMILE enables the fusion of cutting-edge femtosecond technology and precise lenticule extraction to provide minimally invasive vision correction. A refractive lenticule is formed in the intact cornea and detached via a small incision. Without ablation. Without a flap. This solution made way for additional treatment opportunities – like Small Incision Lenticule Extraction.

Jaggi explains, “The ophthalmic strips market can be classified based on product, usage, application, end-user, and region. Based on product, the global ophthalmic strips market can be divided into schirmer strips, fluorescein strips, phenol red strips, rose bengal strips and lissamine green strips. In terms of usage, the global ophthalmic strips market can be divided into human and veterinary.” Based on application, the global ophthalmic strips market can be classified into diagnosis of IgE identification and dry eye (keratoconjunctivitis sicca). “In terms of end-user, the global ophthalmic strips market can be categorised into hospitals, ophthalmic clinics, research institutes, diagnostic laboratories, and ambulatory surgical centers,” Jaggi adds.

Another innovation that Jaggi shares is Ophthalmic knives. “Ophthalmic knives market size is expected to grow significantly from 2019 to 2025. Ophthalmic knives market will grow significantly over the forthcoming years,” Jaagi said. “The growth is mainly attributable to rising incidence of ophthalmic diseases including keratosis, cataracts among others. According to World Health Organisation published data in October 2018, around 1.3 billion individuals worldwide live with some type of vison impairment and the major cause for vision impairment is uncorrected refractive errors as well as cataracts. Also, majority of individuals with vision impairment are above the age of 50 years. Such huge patient pool of vision impairment is anticipated to boost ophthalmic knives industry growth,” Jaggi added.

Crescent knives segment accounted for substantial revenue share in 2018 and is expected to grow with a robust CAGR over the analysis period. Jaggi says, “The growth is primarily attributable to various advantages associated with crescent knives such as sharp edges that help in smooth tunnel incision, and well-rounded tip. Reusable segment is anticipated to witness considerable growth during the forecast timeline owing to increasing preference for reusable knives among ophthalmic surgeons.” The factors such as efficacy, durability, and sharpness increase the preference of reusable knives, thereby, propels segmental growth.


Asia Pacific ophthalmic knives industry is expected to grow substantially during the estimated timeline. The growth is attributed to factors such as increasing incidence of ophthalmic diseases coupled with improving healthcare infrastructure. Moreover, industry players focusing on emerging economies to increase their market share in the region should further boost regional growth.

With the rising rate of ophthalmic disorders, there surely arises a need for technologically advanced ophthalmic equipment. Ophthalmic equipment industry does necessitate to continue to progress at a rapid pace for not only technologically advanced devices but also for quality products. Thus, there is an enormous opportunity for the growth of quality ophthalmic equipment market in India.

Highlights of SMILE:

  • Small incision of less than 4 mm
  • Side-cut length up to 80 per cent shorter and cap incision area up to 30 per cent smaller than for a Femto-LASIK flap
  • Potentially lower incidence of transient dry eye syndrome and less nerve transection thanks to smallest of incisions without flaps
  • Less risk of infections and epithelial ingrowths reproducibility of the lenticule, irrespective of individual corneal characteristics and ambient conditions
  • Excellent predictability, particularly for higher refraction values
  • Efficient treatment process without patient having to switch places.

Highlights of VisuMax:

  • Maximum cutting precision: High-precision optics from Zeiss provide an extremely focused laser beam. The result: minimum laser pulse energy at a high pulse frequency for unsurpassed incision control – at precisely the desired depth in the cornea, even with three-dimensional, curved incisions.
  • Brilliant visual control: The combined, high-quality Zeiss surgical microscope, including digital video camera for live recording of the surgical procedure ensures precise and complete control of each treatment step.
  • A smart unit: The ergonomically pivoting patient supporting system ensures maximum comfort. The patient’s position is endlessly monitored during treatment and the robust yet comfortable patient supporting system is robotically adjusted during surgery.
  • Efficiency paying off: With a laser pulse frequency of 500 kHz, the VisuMax realises short treatment times. This means more comfort for both physician and patient. In addition, the user benefits from a more efficient workflow and a higher throughput of satisfied patients.

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