My Prediction: What Will UK Optometry Look Like in 2045?

This is a personal prediction rather than a statement of fact. It reflects one possible future based on current economic and technological trends, and I appreciate that others may reach different conclusions.

Every year, the cost of running an Optometry practice increases.

National Minimum Wage rises. Employer National Insurance and pension contributions increase. Utilities, insurance, business rates and rents all continue to climb. Meanwhile, NHS remuneration has struggled to keep pace with inflation, meaning that, in real terms, practices receive less funding for delivering the same clinical care.

Historically, practices could offset many of these pressures through spectacle sales. Today, online retailers and increasing competition make that difficult.

Businesses naturally look for ways to improve efficiency and reduce costs:

Greater efficiency through automation: autorefractors, automated focimeters, semi-automated glazing machines and digital systems.

Then support staff increasingly recruited around National Minimum Wage, which has continued to rise faster than NHS sight fees and faster than spectacle prices.

Buying groups were formed to increase purchasing power, negotiate bulk discounts and reduce the cost of frames, lenses and consumables.

Consulting rooms added to increase capacity.

Dispensing Opticians have also experienced increasing pressure on salaries in some parts of the profession.

As these pressures continue, economic considerations may increasingly extend to one of the remaining major costs: Optometrist salaries and locum rates.

Whether that happens remains to be seen, but if it does, I believe it could influence how some Optometrists choose to work.

NHS pathways continue to expand—hospitals to community care.

My prediction is that by 2045 we may see a resurgence of small, single-practitioner-led, home-based practices operating with low overheads.

Perhaps a consulting room attached to a practitioner's home, seeing perhaps five or six patients each day.

Possibly supported by virtual administration and AI agents: reception, telephone calls, appointment booking, ordering, bookkeeping — allowing the Optometrist to focus primarily on clinical care.

If clinicians can achieve a sustainable income while enjoying greater autonomy, flexibility and lower operating costs, this could become an attractive model for some practitioners.

In many ways, it would represent a return to the profession's roots.

The return of the Brass Plate Practice.

Of course, predictions are often wrong.

But if today's economic and technological trends continue, I would not be surprised if some independent Optometrists in 2045 work less like traditional practice owners or employees and more like community-based primary eye care clinicians.

Could this become one possible future for UK Optometry, or do you see the profession evolving in a different direction?

Haris is an Optometrist, Lecturer, hospital Optometrist, independent practice owner and Board Director.

He has a particular interest in community eye care, professional leadership and the future of the Optometry profession.

Connect with Haris on LinkedIn.