This article is an excerpt from the Changes & Challenges report.
The narrative that optometry is an oversaturated profession is a persistent one. Many optometrists voice concerns that the workforce has become overcrowded, and the conversation intensifies every time that a plan for a new optometry school is announced. However, a starkly different story emerges when industry data expert Richard Edlow, OD, widely known as the Eyeconomist, takes a closer look at the data. “Far from being overpopulated, optometry faces a looming shortage—a challenge that could evolve into a full-blown public health crisis, particularly in rural areas and in meeting the needs of an aging population,” he says.
AGING POPULATION AND A GROWING DEMAND
The aging of America is no longer a future prediction but a statistical reality. Baby boomers, now all at least in their 60s, comprise 21% of the U.S. population. As a result, the demand for age-related eye care is increasing rapidly, with a tenfold growth in demand outpacing the supply of ophthalmologists and optometrists.
Compounding this issue, the ophthalmologist workforce is largely static, says Dr. Edlow. He finds an annual net growth of only 0.4% due to minimal additions from residency pro- grams and steady retirement rates. In 2024, for instance, 498 new ophthalmologists entered the workforce. With retirements, there was an estimated net increase of just 67 ophthalmologists nationwide, he says.
Meanwhile, the current optometric workforce is just under 49,000 ODs, according to Dr. Edlow. He updates his numbers annually based on graduations and anticipated retirements. For example, optometry adds about 1,770 new graduates annually. After accounting for attrition, the profession sees a net gain of approximately 552 practitioners each year, growing the workforce by 1.3% annually in terms of headcount and 1% in full-time equivalent (FTE) positions. These gains are barely enough to keep pace with rising demand, he says.
Additionally, optometric schools face a 10% attrition rate, which he calls a “dilemma for optometry schools.” Roughly 1,906 students enter each year and about 1,702 graduate. This attrition represents a significant loss of potential workforce and underscores the importance of supporting students through to graduation.
PUBLIC HEALTH CRISIS LOOMING?
The bottleneck created by the flat growth in ophthalmology and limited optometric workforce expansion is already evident. For nonsurgical care, patients often face waits of three to four months. This delay is especially critical as age-related eye conditions like cataracts, macular degeneration and glaucoma rise in prevalence. While cataract surgeries—an ophthalmologic priority are generally scheduled promptly, other essential eye care services face significant backlogs.
“We are already in the midst of a supply crisis,” Dr. Edlow says. “The demand for age-related eye care that’s not being met presents an opportunity for state legislators and the health care system to mitigate a growing public health challenge. Optometry is uniquely positioned to fill this gap with its ability to provide nonsurgical eye care and free up ophthalmologists for surgical procedures.”
Optometrists are increasingly recognized as the key to addressing these challenges. By taking on noninvasive and routine eye care, optometrists can alleviate the burden on ophthalmologists. This shift is vital as the increasing demand for cataract surgery alone will require an additional 3,500 surgeons from 2020 to 2030, says Dr. Edlow. However, a net of fewer than 600 will enter the workforce. “Cataract surgeons will need to spend more time in surgery and significantly less time providing office-based care. Developments in robotics and artificial intelligence may help mitigate some of the shortfall, but one would assume help is years away.”
The data also shows room for optometry to expand its Medicare billing footprint. Currently, only 66% of optometrists bill Medicare, Dr. Edlow’s analysis finds. This leaves a significant percentage of the profession underutilized in the Medicare system, which could help address unmet needs in elderly care.
LOOKING AHEAD
Projections for the optometric workforce in 2027 estimate 50,345 practitioners at the beginning of the year, increasing to 51,055 by year’s end after accounting for attrition and new graduates. However, the average retirement age for optometrists and ophthalmologists remains around 66 to 67, signaling ongoing workforce attrition that will need to be offset by new entrants.
Whether ODs are retiring at this rate is not entirely clear. Since optometry is a flexible profession, some ODs are continuing to work in some capacity well beyond age 67. A Women In Optometry analysis of HealthGrades data gathered in October 2024 indicates an upcoming wave of retirements, which will shift the gender balance in the profession considerably. Among ODs age 60 and younger, 11,929 were female and 9,598 were male. How- ever, for ODs 61 and older, 3,283 were female and 14,364 were male. Not all ODs reported an age.
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Dr. Edlow’s research underscores the stability of optometry’s growth but highlights the profession’s role as a critical player in addressing a health care crisis. As demand continues to grow exponentially, optometry must step up to fill the void left by an overstretched and static ophthalmology workforce.
In the end, the narrative of oversaturation gives way to a reality of opportunity: a profession poised to lead the way in meeting America’s burgeoning eye care needs.
The Changes & Challenges report is supported by Alcon.
