Increased prevalence of ophthalmic diseases due to continued population growth and aging requires an increase in the number of ophthalmologists nationwide. Multiple sources, including the National Eye Institute (NEI) and the American Academy of Ophthalmology (AAO), report that the number of people with the most common eye diseases will double between 2010 and 2050. This includes the elderly suffering from long-term eye diseases such as cataracts, age-related macular degeneration (AMD), diabetic retinopathy, dry eye disease, and glaucoma.
As per the 2010 statistics by the NEI, age-related macular degeneration (AMD), which is most common among older white Americans, affects more than 14 percent of white Americans of age > 80. Starting at age 40, the risk of cataracts increases with every decade of life, and by age 75, half of white Americans develop cataracts. 53 percent of blacks, 61 percent of Hispanic Americans, and 70 percent of whites have cataracts by age 80. Diabetic retinopathy is most common among Hispanic Americans by age > 50, and by age 75, 19 percent of Hispanic Americans have this disease. On the other hand, black Americans of age > 40 have the highest prevalence rate for glaucoma, and by age 80, 12 percent of blacks have glaucoma.
Thus, the estimated prediction of the total number of people with visual impairment is growing due to a rapidly growing elderly population. According to the Association of American Medical Colleges (AAMC), people over the age of 65 currently account for 34 percent of the demand for physicians, while they will account for 42 percent of the demand by the year 2034. 2.71 million people in the United States were diagnosed with primary open-angle glaucoma (POAG) in 2011, and it is estimated that 7.32 million people in the U.S. will develop POAG by the year 2050. The highest per capita POAG burden is estimated to double in Florida, Texas, and New Mexico in the next 40 years.
Consequently, there is an enormous need for ophthalmologists throughout the nation, and while this need is increasing, around a quarter of current ophthalmologists are reaching retirement age. Within the next decade, more than 2 out of every 5 current physicians will be of age 65 or older, according to the AAMC. Data shows physicians are already suffering high levels of burnout before the COVID-19 pandemic, and with this pandemic, the additional physician depression and burnout could convince physicians to expedite their retirement.
Data presented by the International Council of Ophthalmology shows that there were 18,805 total ophthalmologists in 2012 in the United States and 59 ophthalmologists per million population. In 2021, 498 medical students matched into ophthalmology. There has been an increase from 458 matches in 2012 to 498 in 2021. Although the need for ophthalmologists has continued to increase during this time, the training of future ophthalmologists has only increased by 40 in this timeframe.
Therefore, a current number of active ophthalmologists is insufficient to treat the growing elderly population and the increasing eye diseases in the nation. This challenge of not having enough ophthalmic workforce will become even more alarming in the future with the added stress from COVID-19. It is important to take the initiative now to encourage the growth of more training programs and increase exposure to the field in medical school to meet this growing need. The top three reasons why medical students did not choose a career in ophthalmology were insufficient interest, lack of exposure in the field, and the feeling by medical students that the field is too specialized. The same study also suggests that increased exposure to the field early in medical school could be an effective strategy to increase interest among students. Thus, more robust data is necessary to further evaluate our growing need for ophthalmologists in the U.S. and how to appropriately respond to this need.
Eyesight is a beautiful gift, and ophthalmologists as the protectors of this gift are needed now more than ever to preserve eyesight and treat eye conditions for as many people as possible.
Jeslin Kera is a medical student.
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