Optics and Rurality: what models in underserved areas?

In France, territorial inequalities in access to healthcare are a well-known reality, and optical care is no exception. While large cities concentrate the majority of services, many rural areas suffer from limited access to eye care, sometimes marking a dividing line between optical and rural areas. Few ophthalmology practices, sometimes no opticians within several dozen kilometers, and waiting times incompatible with effective follow-up. Faced with this observation, how can optical players rethink their model to better serve these areas? Several avenues are emerging, combining innovation, cooperation and local adaptation.

Optics and rurality: Identifying the specific obstacles of rural areas

Rural areas face a dual structural handicap that weighs heavily on access to vision care: a deficient medical demographic and significant geographical constraints. According to the DREES (Regional Directorate for Health and Social Affairs), in 2022, some rural regions did not even have four ophthalmologists per 100,000 inhabitants, while urban areas had more than double that number. This unequal distribution translates concretely into waiting times that can exceed six months for a simple appointment, lengthening the care pathway.

Adding to this shortage of specialists is the remoteness of retail outlets. Opticians are mostly located in urban centers, forcing many rural residents to travel long distances to reach a store. In some cases, the round trip takes more than an hour, a significant obstacle, especially for the elderly or those in precarious situations.

These logistical and medical difficulties reveal a real social and economic challenge. For the most vulnerable populations, distance, delays, and travel costs add to budgetary issues, contributing to the foregone conclusion of vision care. The gap between regions is thus widening, to the detriment of equal access to quality vision.

Explore alternative models to open up supply

To address these shortcomings, several initiatives are being developed. They offer concrete avenues for rethinking access to optical services in rural areas.

Thus, mobile optics is experiencing phenomenal and growing success . Companies such as Les Opticiens Mobiles and l'Opticien qui Bouge provide a service that contributes to offering a new model for the optical sector. Some of them have joined forces to form ROAD , a collective whose objective is to promote this model in order to "bring prevention to the heart of the regions." Building on its success, this model has inspired large groups of opticians, such as Optic 2000 and Optimal Center, which now offer a home service.

Furthermore, as part of the 100% Health program, projects are bringing together rural opticians and urban ophthalmologists via teleconsultation . The optician takes measurements (refraction, eye exam), and the diagnosis is made remotely. This model of urban-rural cooperation makes it possible to accelerate the care pathway, while respecting the legal framework (2016 decree) governing in-store eye exams.

Multi-professional health centers (MSP), which have been growing rapidly for the past decade, bring together various healthcare professionals. Integrating an optician into these structures facilitates coordination with general practitioners and orthoptists, while benefiting from shared rents and a captive patient pool. This is a sustainable solution, often supported by local authorities or regional health agencies (ARS). Some brands offer eyeglass rentals or subscription plans, making optical care more accessible in economically fragile areas.

The role of communities, brands and local initiatives

Rural optics cannot rely solely on a market logic. Faced with the challenges faced by residents of underserved areas, the involvement of local authorities, community networks, and professional groups is proving decisive. Some municipalities, aware of the medical desertification and its consequences on the visual health of their citizens, are implementing support schemes for setting up, similar to what is already done for doctors.

This support takes the form of subsidies, premises made available or tax exemptions, in order to make setting up in rural areas more attractive for optical professionals.

At the same time, the community network is playing an increasingly active role. Organizations such as UNADEV (National Union of the Blind and Visually Impaired) are working on the ground, notably by organizing screening campaigns in isolated villages. By reaching out directly to the population, they provide an initial awareness of unmet visual needs and facilitate referrals to appropriate follow-up care.

Finally, collective dynamics are developing within the profession itself. Groups of independent opticians are choosing to pool their human and logistical resources to cover multiple territories. These cooperative networks, more flexible than large retailers, are experimenting with hybrid models—between occasional physical presence, shared equipment, and mobility—to address the realities of rural areas without sacrificing quality of service. By building relationships between professionals, local elected officials, and citizens, these initiatives are paving the way for more equitable access to optical care across the country.

Meeting the challenges of rural opticians requires thinking outside the box. Solutions exist, ranging from mobile innovation to local partnerships and new business models, but require collective commitment. For opticians, this represents a public health issue, a lever for social impact, and an opportunity for diversification. At a time when vision health is becoming a growing concern, it's time to put rural areas back at the heart of healthcare access strategies.