Disruption and Innovation: Challenges and Opportunities in Ophthalmology: Synopsis: Two types of innovation, defined as "the use of a new idea or method", have been described. The first, sustaining innovation, makes something bigger or better. The second is disruptive innovation, which disrupts the bigger-and-better cycle, bringing to market a product or service that is more affordable and easier to use, allowing a whole new population of consumers to access a product or service that was historically only accessible to consumers with more money or greater skill. The introduction of affordable intraocular lenses for patients in developing countries, as championed by Professor Fred Hollows, is an example of a disruptive innovation that has had a profound impact on eye health globally. The year 2020 will be remembered for the global disruption caused by a pandemic that that will have ramifications for decades to come. 2020 also marked the culmination of a global initiative for the elimination of avoidable blindness, VISION 2020: The Right to Sight. Despite the global prevalence of blindness falling by 28 in the past 30 years, in 2020, 43.3 million people were blind and 553 million had vision impairment, with evidence of significant inequities. The COVID-19 pandemic has impacted eye health; however, innovations that address this disruption may present opportunities to improve eye health even after the pandemic is under control. A systems approach is required, with innovation not only in eye care delivery but in policy, workforce planning and education. Of course, we should promote sustaining innovations, but also be looking for truly transformative (disruptive) innovations that provide opportunities for improving eye health in ways not previously considered.
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