At the 2025 ASCRS meeting in Los Angeles, a concept was shared by AnnMarie Hipsley, DPT, PhD, for optometrists seeking to stay at the forefront of precision ocular care—the Digital Twin. More than a buzzword, a digital twin represents a virtual simulation of a real-world anatomical system, in this case, the human eye. Over the past decade, researchers have developed Virtual Eye Simulation Analyzer (VESA), a sophisticated AI- and physics-based model capable of simulating ocular anatomy and behavior with high fidelity.
VESA is not simply a generalized eye model. It can integrate refractive data, topography, biomechanical properties, and even simulate age-related changes in the eye—turning it into a predictive and diagnostic tool for clinicians managing complex conditions like presbyopia.
Tackling presbyopia with precision
Key Takeaways for Optometrists
- Digital Twin Technology is now viable for simulating the human eye and its aging process.
- VESA offers a personalized, AI-driven approach to managing presbyopia from early stages onward.
- Virtual simulations reduce the need for costly pre-clinical trials, supporting faster, safer innovation.
- Each patient can carry a secure 3D ID with predictive insights into future treatment needs.
- Ethical use, data privacy, and clinical validation remain central to integrating virtual models into practice.
Presbyopia remains a progressive and pervasive challenge, typically addressed only at later stages—think 52-year-olds with +2.25D reading adds. But what if we could intervene earlier and manage presbyopia through its entire lifecycle?
That’s the vision behind VESA. By building 3D IDs of individual patients, the system models ocular aging from age 40 to 65 and beyond. Using platforms like Ansys and proprietary algorithms, researchers replicated not just the optical changes in accommodation, but also biomechanical shifts in the lens, zonules, sclera, and Bruch’s membrane.
The result? VESA can simulate and output customized treatment patterns tailored to age and ocular condition, paving the way for personalized presbyopia management from onset through advanced stages.
The power of predictive simulation
Looking ahead, VESA is set to revolutionize eye care by enabling virtual clinical trials and fail-fast innovation. This means intraocular lenses and other innovations can be trialed virtually—bypassing costly early-stage animal and human testing. Each patient becomes a rich data source, generating thousands of simulations that refine and improve treatment algorithms in real-time.
Importantly, patient data is protected. Each digital twin is securely stored on a 3D ID “card,” enabling clinicians to access and update personalized treatment histories and predict future care needs. Think of it as a form of ocular Botox—patients will know when to return for treatment based on personalized aging simulations and digital guidance.
Ethical considerations and the road ahead
With such powerful technology comes ethical responsibility. VESA’s developers emphasized data privacy, algorithm transparency, and clinical validation. Human trials remain essential, but now, virtual models can run in parallel, drastically accelerating the pace and precision of innovation.
VESA and the digital twin approach mark a paradigm shift in how optometrists may soon diagnose, treat, and manage ocular conditions. The fusion of AI, biomechanics, and predictive modeling opens doors to individualized eye care that’s proactive, not just reactive—positioning the optometrist at the heart of next-generation visual health.
