Introduction

The year 2026 in ophthalmology will not be defined by a single “major breakthrough,” but rather by the maturation of several directions whose discoveries and innovations are now transitioning into everyday clinical practice. While just a few years ago innovations were often perceived as isolated technologies far removed from real-world care (a new drug, device, or piece of equipment), today entire ecosystems are being formed: from early detection to long-term monitoring, from the ophthalmologist’s office to optometric screening, from a single consultation to a longitudinal patient journey supported by digital tools.

The core logic of 2026 is a shift from reactive to proactive ophthalmology. Increasingly, the goal is to prevent disease at the stage of risk-factor modification, intervene in the earliest pathological changes, and track preclinical markers. This shift is visible across several dimensions: the growing role of telemedicine and portable diagnostics; autonomous AI becoming a public health tool; and oculomics, which enables ocular image analysis to serve as a source of early biomarkers for systemic conditions. At the same time, the treatment paradigm is evolving: where repeated procedures once dominated (for example, frequent intravitreal injections), 2026 brings a move toward extended-duration regimens, implant-based drug delivery platforms, and disease control with fewer clinic visits.

Another important axis is the alignment of patient expectations. Some new approaches (for example, in the management of dry AMD and geographic atrophy) do not promise to “restore vision,” but rather to buy time—slowing structural retinal damage and functional vision loss. As a result, in 2026, risk–benefit communication and shared decision-making become almost as important as the choice of molecule or device itself.

Below, we outline the key eye care trends of 2026: what is changing, why it matters, and how it will shape ophthalmic and optometric practice.

1. New Approaches to Treatment

1.1. Geographic Atrophy (GA): The Introduction of Active Treatment in eye care trends 2026

1.1.1. Injectable Therapies as Ophthalmology Trends 2026

Following the development of injectable therapies for geographic atrophy, clinical practice is entering a “second wave” phase—where the main questions are no longer whether therapy is possible for a disease historically considered untreatable, but how that therapy should be practically implemented. In 2026, the focus will be on patient selection, treatment initiation, dosing frequency and duration, as well as monitoring.

Currently, the FDA has approved the following injectable therapies for GA:

• Izervay (avacincaptad pegol) — a C5 complement inhibitor.
• Syfovre (pegcetacoplan) — a C3 complement inhibitor.

Their mechanism of action involves reducing chronic inflammation and cellular damage in the retina and—most importantly—slowing the rate of GA lesion expansion.

Because most available data focus on slowing atrophy progression (an anatomical endpoint) rather than guaranteed improvements in visual acuity, properly managing patient expectations becomes particularly critical in 2026. Clear discussions about therapeutic goals and limitations are emphasized in review publications addressing the first approved GA treatments.

1.1.2. Multiwavelength Photobiomodulation

Multiwavelength photobiomodulation is one of the most promising emerging approaches aimed at halting or slowing the progression of dry AMD through modulation of mitochondrial activity. The use of specific wavelengths (red and near-infrared light, approximately 590–850 nm) may reduce oxidative stress in retinal cells, inflammation, and apoptosis of retinal pigment epithelium cells.

Its appeal is clear: a non-invasive procedure with significantly better acceptability for some patients compared with regular injections.

Until recently, its effectiveness remained debated, with studies showing only temporary functional improvement and reduction in drusen volume. At ARVO 2025, updated results from the LIGHTSITE III study demonstrated that photobiomodulation can significantly slow visual acuity decline and reduce the rate of GA expansion.

In 2025, the FDA approved photobiomodulation for AMD, creating strong prospects for broader clinical adoption in 2026.

The 2026 trend is correct positioning and stratification:

• Use of photobiomodulation based on clear indications for specific dry AMD stages and patient profiles.
• Transparent communication of expectations, with goals focused on functional support and slowing GA progression rather than guaranteed vision restoration.

1.2. Extended Anti-VEGF Treatment Regimens

Another major trend is the shift toward regimens with reduced injection frequency. This is not merely about comfort, but primarily about preventing missed visits: patients with AMD and diabetic retinopathy with DME often fall out of treatment due to visit burden. Thus, 2026 reinforces the principle that treatment must be effective in real-world conditions, not only under ideal adherence.

The ranibizumab port delivery system (Susvimo, Port Delivery System) has become emblematic of this trend. In 2025, the FDA also approved Susvimo for the treatment of diabetic retinopathy.

1.3. Gene Therapy for Macular Telangiectasia Type 2 (MacTel 2)

MacTel 2 is a chronic, progressive neurodegenerative retinal disease that previously lacked active treatment.

In 2025, the first implantation of ENCELTO (revakinagene taroretcel)—the first and currently only FDA-approved gene therapy for MacTel 2—was performed in the United States. ENCELTO enables a shift from observation to active intervention, with the potential to preserve visual function in early-stage patients.

The device is based on encapsulated cell therapy technology: a capsule containing genetically modified cells that continuously secrete recombinant human ciliary neurotrophic factor (CNTF), acting as a neuroprotective agent that slows photoreceptor degeneration.

In 2026, the focus will move from “innovation storytelling” to routine clinical implementation, including defining early selection criteria, monitoring protocols (OCT biomarkers, functional testing), and accumulating real-world long-term data on photoreceptor preservation and visual function.

1.4. Gene Therapy for Neovascular AMD: Closest to Real Transformation

For neovascular AMD, gene therapy remains one of the most anticipated eye care trends 2026 directions, as it has the potential to fundamentally change treatment logic—from repeated injections to a single vector administration enabling long-term therapeutic protein expression. Reviews published in 2025 highlight active programs such as RGX-314, ADVM-022 (Ixo-vec), 4D-150, and others.

In 2026, the key questions shift from “does it work?” to “how does it work across different patient groups?” including:

• Stability and duration of expression;
• Inflammatory and immune response profiles;
• Need for supplemental anti-VEGF therapy;
• Patient selection criteria;

Injection centers and post-procedure monitoring standards.

2. Oculomics: The Eye as a “Window to the Body” and a Source of Digital Biomarkers

Oculomics is one of the most compelling trends of 2026, as it reshapes ophthalmology’s role within medicine as a whole. The concept is simple: the eye is the only structure where microvasculature, neurons, and signs of metabolic and inflammatory processes can be visualized non-invasively at high resolution. As a result, fundus and OCT/OCTA data may serve as biomarkers for systemic conditions—from cardiovascular risk to neurodegenerative diseases.

In contemporary research, oculomics is described as an approach that uses retinal images to assess systemic risks and conditions, with potential scalability for screening. In 2026, this “scale” becomes critical: data may originate not only from ophthalmology clinics, but also from optometric practices, mobile screening programs, and telemedicine.

What truly changes in 2026:

• A transition from “interesting correlations” to clinical utility, with models expected to demonstrate actionable impact on patient management.
• Data verification and management of false-positive risk, including the communication of systemic risk to patients.
• Integration with AI, as multidimensional patterns often exceed human interpretive capacity.

A major risk in 2026 is over-marketing, reinforcing the need for externally validated models with clear clinical context that do not generate unnecessary “medical noise.”

3. AI Technologies: From Decision Support to Autonomous Screening and Managed Patient Pathways

3.1. Autonomous Diabetic Retinopathy Screening as a Scalable Standard

In 2026, diabetic retinopathy remains the most studied use case for autonomous AI. In the United States, three FDA-approved autonomous DR screening systems are already described (LumineticsCore/IDx-DR, EyeArt, AEYE-DS). This positions AI as a practical tool capable of influencing large-scale screening programs, particularly in primary care, endocrinology clinics, and mobile settings.

The FDA approval of AEYE-DS as a fully autonomous solution (portable camera plus algorithm) underscores that in 2026, AI increasingly “works where the patient is,” not only where an ophthalmologist is present.

3.2. 2026 as the Year of Integration

Successful projects in 2026 will be distinguished by:

• Image quality standards and quality control;
• Clear referral rules and urgency levels;
• Mechanisms to ensure patient follow-through (scheduling, reminders, visit tracking);
• Transparent documentation for clinicians, patients, and audit purposes.

3.3. AI as “Invisible Infrastructure”

In 2026, AI increasingly functions as invisible infrastructure: highlighting high-risk cases, prioritizing queues, generating structured reports, and standardizing interpretation. The impact is reduced variability, faster routing, and fewer missed cases.

4. Telemedicine: From Video Calls to Retinal Screening and Remote Management

By 2026, telemedicine in ophthalmology is no longer synonymous with video consultations. Its foundation is tele-imaging: transmission and assessment of retinal images (fundus photos, sometimes OCT) with structured referral protocols.

At the same time, limitations become more openly discussed. Certain conditions and components of assessment may be less accurately captured remotely, requiring clear protocols to define which patients can be managed remotely and which require in-person examination.

The 2026 trend is a shift from “tool” to “pathway”:

• Tele-screening as the first step;
• Automated or semi-automated reporting;
• Referral and follow-up control;

Remote reassessment for ongoing risk monitoring.

5. New Devices and Portable Diagnostics: Closer, Faster, More Scalable Care

5.1. Portable Diagnostics as the Foundation of Coverage

Portable fundus cameras and compact diagnostic systems represent one of the most practical changes of 2026. Their value lies not only in technology, but in enabling large-scale screening in locations without full ophthalmic infrastructure.

Synergy with autonomous AI (such as AEYE-DS) is especially strong here, supporting new partnership models:

• Endocrinology and primary care clinics;
• Optical stores and optometric practices;
• Mobile programs for workplaces or regions.

5.2. Devices Deliver Value Only with Quality Protocols

Success depends not just on acquiring devices, but on defined protocols:

• Staff training in image acquisition;
• Minimum quality criteria;
• Retake rules;
• Handling ungradable cases.

In 2026, image quality becomes decisive, as AI and telemedicine depend on it.

5.3. Home and Remote Monitoring for Extended Treatment Regimens as eye care trends 2026

As treatment intervals lengthen, the risk of between-visit deterioration increases. Thus, 2026 strengthens the role of:

• Home functional monitoring;
• Digital questionnaires and symptom trackers;

Remote checkpoints signaling the need for earlier recall.

6. 2026 as the Year of Standardized Myopia Control and Greater Risk Awareness

By 2026, myopia control is no longer debated but formalized, grounded in consensus documents and systematic reviews. Myopia is increasingly recognized as a chronic disease with stages, phenotypes, and potentially blinding complications.

Implications for practice:

1. Focus on preventing progression to high myopia.
2. Combined strategies integrating behavioral, optical, and pharmacologic interventions with monitoring.
3. A shared language between optometrists and ophthalmologists, with coordinated patient pathways.
4. Support from AI and telemedicine for risk detection and personalized care.

Myopia control in 2026 becomes a structured, long-term risk-reduction process.

7. Optogenetics: Expanding the Evidence Horizon in Inherited Retinal Degenerations

In 2026, optogenetics moves beyond concept into longer-term observation. Publications from 2025 highlight functional stabilization or improvement in retinitis pigmentosa, emphasizing pragmatic success criteria.

For patients with severe vision loss, meaningful outcomes extend beyond visual acuity charts to spatial orientation, object recognition, and contrast sensitivity. In 2026, discussions increasingly focus on realistic endpoints and honest communication of limitations.

8. Less Invasive Interventions and Patient Comfort as Components of Clinical Effectiveness

Another key eye care trends 2026 is less traumatic technology that preserves efficacy while improving patient experience. A notable example is the FDA approval of Epioxa (epi-on) for keratoconus in 2025, preserving corneal epithelium and potentially reducing pain and recovery time.

This trend spans refractive surgery, ocular surface disease, and chronic condition management, reinforcing that patient experience is integral to adherence and clinical outcomes.

Conclusion

The ophthalmology trends 2026 clearly demonstrate that ophthalmology and optometry are entering a phase of mature transformation, where success is driven not by isolated innovations but by their integration into coherent clinical pathways. The focus is shifting from treating consequences to early detection, slowing progression, and long-term management of chronic eye disease.

Active treatment of geographic atrophy, photobiomodulation, extended anti-VEGF regimens, and the emergence of gene therapies for MacTel 2 and neovascular AMD fundamentally reshape patient management—from observation or frequent procedures to strategies aimed at preserving retinal structure and function with minimal procedural burden. These approaches require careful patient stratification and responsible expectation management, as the goal increasingly becomes slowing neurodegeneration rather than restoring vision.

At the diagnostic level, 2026 reinforces decentralization: portable devices, telemedicine, and autonomous AI bring screening closer to patients and enable coverage of much broader populations. Oculomics and AI transform ocular images into sources of digital biomarkers that may influence not only ophthalmic but also general clinical management. At the same time, it becomes clear that technological value is defined not by algorithms or devices, but by data quality, model validation, and clearly structured patient pathways—from screening to treatment.