Eyeworld

56 | EYEWORLD | SUMMER 2026 C ORNEA by Julie Schallhorn, MD Cornea Editor A few months ago, prompted by a request to give a talk on AI in refractive surgery, I delved down into the rabbit hole of generative AI. A few days later, I had made a fully functioning app. The last time I had pro- grammed was in graduate school, but this didn't matter—I was able to craft the app using plain English. That was my introduction to Claude Code—and more broadly, to the way AI has quietly collapsed the barrier between having an idea and executing it. Tools that once demanded specialized training are now within the reach of any curious user. It got me thinking about our own field. The expansion of digital technology in oph- thalmology is following a similar arc. Diagnos- tics and imaging that were once the province of well-resourced academic centers are becoming more accessible, more sophisticated, and in- creasingly capable of doing the heavy lifting for us. This issue's articles explore that evolution from multiple angles. The article on dry eye diagnostics, featur- ing Ashraf Ahmad, MD, Anat Galor, MD, and Melissa Toyos, MD, captures how far our toolkit has come—and also the persistent frustration that our ability to innovate outpaces our ability to get reimbursed for it. CPT codes lag behind technology, coverage is inconsistent across payers, and as Dr. Galor reminds us, "You can be a great diagnostician and clinician without any fancy equipment." True—and also a reminder that the proliferation of tools is outstripping the infrastructure to deploy them equitably. The article on corneal imaging tells a com- plementary story from the hardware side. Karo- linne Rocha, MD, PhD, Nandini Venkateswaran, MD, and Mitchell Weikert, MD, walk through the convergence happening in our imaging plat- forms, where topography, tomography, epithelial mapping, OCT, and biometry are increasingly collapsing into a single acquisition—with AI now helping to size ICLs and predict vault. In- traoperative OCT has gone from curiosity to, as Dr. Rocha puts it, "game changer." The direction is unmistakable: more data, faster, with less burden on patients. A final article, "Expanding applications for corneal tissue procedures," features commen- tary from Soosan Jacob, MD, Aylin Kiliç, MD, and Jack Parker, MD, PhD, on developments in techniques like CAIRS and CTAK and how these can help improve patients' vision and also offer an option that can be customized to the patient. What strikes me is that the pattern across articles—and in my own small adventure with Claude Code—is the same one we're seeing everywhere: Powerful technology is becoming accessible faster than our institutions can figure out how to accommodate it. For our patients, this is mostly good news—better diagnostics, more personalized treatment, and less trial and error. The challenge for us as a field is to advo- cate for reimbursement models that keep pace with innovation, for validation studies that justify adoption, for equitable access so these tools don't become boutique offerings, and for thoughtful integration so technology sharpens rather than replaces clinical judgment. I remain, as always, in awe of the pace at which our field evolves and optimistic that our patients will be the ultimate beneficiaries. The expansion of digital technology in ophthalmology I remain, as always, in awe of the pace at which our field evolves and optimistic that our patients will be the ultimate beneficiaries.

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