The eye care industry is facing a critical moment. Across the country, patients are struggling to access timely vision and medical eye care due to a growing imbalance between provider supply and patient demand. This disparity underscores a truth that can no longer be ignored: we need more optometrists. With a shrinking number of ophthalmologists and rising healthcare needs of an aging population, optometrists are increasingly vital in bridging the gap and improving access to care. As Dr. Richard Edlow, widely known as the “Eyeconomist,” reveals in a powerful discussion with Dr. Darryl Glover on Defocus Media, the future of eye care depends on bold collaboration and an expanded optometric workforce.

The data paints a sobering picture of the eye care workforce crisis in the United States. At the heart of this issue is a severe shortage of ophthalmologists and an inadequate rate of growth in the number of practicing optometrists. The numbers are clear:

• By 2025, there will be a shortage of 6,180 ophthalmologists in the U.S. according to Health and Human Services.
• From 2020 to 2035, the 65+ population will grow by 35%, significantly increasing demand for age-related eye care services.
• Conditions such as cataracts, glaucoma, and macular degeneration are expected to rise annually by 2.5%, equating to over 1 million additional patients per condition each year.
• Cataract procedures alone will jump from 4.2 million in 2020 to 5.6 million by 2035, requiring 3,500 additional cataract surgeons.

At the same time, the optometric workforce is struggling to keep pace:

• Only 1,700–1,800 new optometrists graduate annually.
• Approximately 1,200–1,300 optometrists exit the workforce each year.
• Net gain: just 500–600 new optometrists yearly, or about 1.2% growth.

Compounding the problem is that many new graduates work part-time, with the average optometrist now operating at just 83% of a full-time schedule.

These statistics clearly demonstrate the urgent need for more optometrists and greater investment in solutions that expand access to care. Without meaningful intervention, the shortage of ophthalmologists and underutilization of optometrists will lead to longer wait times, missed diagnoses, and increased public health strain.

Dr. Edlow highlights the practical impact of these trends, noting that the average cataract surgeon performs around 400 procedures a year. With demand expected to rise by 1.4 million additional cataract surgeries annually by 2035, the U.S. would need 3,500 more cataract surgeons just to meet this need—yet the supply is shrinking.

This reality presents a massive opportunity for optometry. By embracing both routine vision and medical eye care, optometrists can fill critical gaps in care delivery and improve access to care. Practices that invest in diagnostic equipment and train staff to handle urgent eye issues can expand their scope and serve patients more comprehensively.

Despite the clear need, only 28% of optometrists bill Medicare for any diagnostic testing such as OCT or visual field assessments. This reveals a significant underutilization of optometric potential in the medical care space.

There are several barriers to full engagement:

• Some optometrists continue to focus solely on routine vision care.
• Limited access to diagnostic tools in certain practice settings.
• Lack of public awareness about optometry’s full scope.
• Variability in state laws regarding the scope of practice.

Additionally, today’s graduates prioritize work-life balance more than past generations. Most new optometrists prefer 2–4 day work weeks, reducing their full-time equivalency to about 83% compared to a traditional 5-day schedule. These shifts affect the total care capacity, further amplifying the need for more optometrists and raising concerns about access to care.

The number of optometry schools in the U.S. has increased in recent years, with new programs aiming to meet rising demand. However, some professionals express concern about the quality and motivation of applicants, citing that many students consider optometry as a second or third option rather than a calling.

This perception highlights the need for stronger recruitment strategies and public education about the value and impact of a career in optometry. Schools must work closely with industry stakeholders to ensure students can handle clinical and medical demands. Scholarships, mentorships, and early exposure to full-scope practice are critical to maintaining a robust pipeline of committed optometrists.

Collaboration with policymakers is essential to truly resolve the shortage of ophthalmologists and enhance access to care. Dr. Edlow has created custom state-level presentations to help optometrists advocate for expanded scope laws, better reimbursement structures, and state-supported workforce initiatives.

Policymakers can play a vital role in:

• Supporting expanded practice privileges for optometrists.
• Funding loan forgiveness for those working in underserved areas.
• Promoting programs that integrate optometry more fully into primary healthcare networks.

These changes not only help optometry schools attract talent but also position optometrists to meet the growing population’s needs.

For optometry students and early-career doctors, this evolving landscape represents both a challenge and an immense opportunity. There’s never been a better time to enter the field. With the shortage of ophthalmologists and the rapid growth of the aging population, optometrists have the chance to lead transformative care models and enhance access to care.

Moreover, as more optometry schools open, the profession has a unique chance to shape future doctors through stronger mentorship, technological integration, and exposure to full-scope practice. Programs that offer tuition reimbursement, similar to military service programs, are also helping to offset the financial burden of education—especially for doctors entering underserved areas where access to care is limited.

Dr. Edlow advocates for expanded collaboration, not only within eye care but across legislative and educational institutions. He’s created PowerPoint templates for 20 states, helping practitioners present the data to state legislators and push for expanded scope laws, better workforce planning, and increased support for optometry schools to meet the need for more optometrists.

The message is clear: to meet the demands of today—and tomorrow—we need more optometrists. The profession stands at a pivotal intersection of opportunity and responsibility. With a growing patient population, a worsening shortage of ophthalmologists, and increased access to care concerns, optometrists must rise to the occasion.

Optometry has the tools, training, and passion to lead. By embracing full-scope care, advocating for legislative change, and mentoring the next generation, optometrists can ensure a future where no patient is left behind due to a lack of access.