Fair compensation needed to bolster glaucoma workforce
Key takeaways:
- Ophthalmology may experience a workforce inadequacy of 30% by 2035.
- Glaucoma fellows receive “excellent training” but may not perform enough trabeculectomies.
With the prevalence of glaucoma rising, the supply of specialists may not meet the demand for care, according to a speaker at the American Glaucoma Society meeting.
Kelly Muir, MD, of Duke Eye Center, said research estimated that 4.2 million people in the United States had glaucoma in 2022, and prevalence of glaucoma increases with advancing age.
Like other medical specialties, ophthalmology is expected to experience a decline in workforce between 2020 and 2035, Muir said. While the total demand is expected to increase by 24% over that period, the total ophthalmology workforce is expected to decrease by 12%, representing a workforce inadequacy of 30%.
“We don’t have subspecialty level data from [the Health Resources and Services Administration] to inform estimates of workforce adequacy specific to glaucoma, but we do have information from our society’s membership,” she said. “By my count, there are a little over 1,100 active and provisional members in the American Glaucoma Society, and those are the membership categories most likely to have active glaucoma practices in the U.S.”
In 2024, 72 glaucoma fellowship programs in the U.S. offered 106 positions.
It is reasonable to ask if enough glaucoma doctors are being trained, with Muir noting that specialists who go through glaucoma fellowships receive “excellent training.” However, there is a common concern that these programs are not teaching enough trabeculectomies.
The average number of procedures performed as primary surgeon went from 20.5 in the 2013-2014 academic year to 12.4 in the 2023-2024 academic year, and the range of procedures performed by the top and bottom quartile of surgeons remains wide. However, the number of procedures performed by the bottom quartile in 2023-2024 reached double digits for the first time in more than 10 years, Muir said.
Work needs to be done to ensure that the glaucoma workforce is prepared to handle the needs of patients, including providing glaucoma specialists with fair compensation for their work.
“We can expand efforts to expose students and residents early to all the awesomeness that it is being a glaucoma doctor, especially by supporting our younger members through programs such as [Young Glaucoma Specialists] and through the AGS INSPIRE program,” Muir said.
References:
- Berkowitz ST, et al. Ophthalmology. 2024;doi:10.1016/j.ophtha.2023.09.018.
- Ehrlich JR, et al. JAMA Ophthalmol. 2024;doi:10.1001/jamaophthalmol.2024.3884.
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Muir K. Glaucoma prevalence and workforce. Presented at: American Glaucoma Society meeting; Feb. 26-March 2, 2025; Washington. (hybrid).
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