Ophthalmologist workforce gaps persist in rural United States counties
Unequal distribution of the eye care workforce can contribute to disparities in access to eye care services. A cross-sectional study by Shah et al. examined workforce density across 3,218 counties in the United States, measured annually from 2010 to 2021.
Key Findings:
- The study examined ophthalmologist and optometrist density across 472 large metropolitan counties, 763 small/medium metropolitan counties, and 1,983 rural counties.
- Median ophthalmologist density was 2.5, 2.6, and 0.0 per 100,000 persons in large metropolitan, small/medium metropolitan, and rural counties, respectively; corresponding optometrist densities were 12.9, 12.3 and 10.2.
- Overall, ophthalmologist density decreased by a mean of 0.09 per 100,000 persons, while optometrist density increased by a mean of 2.3 per 100,000 persons, indicating divergent trends in the eye care workforce.
- The proportion of counties with no practising nonfederal ophthalmologists (“dead zones”) increased modestly from 60.7% in 2010 to 62.7% in 2021, with these counties disproportionately concentrated in rural areas.
- In 2021, 78.6% of rural counties had no practising ophthalmologists, compared with 76.2% in 2010, highlighting persistent geographic gaps in specialist workforce availability.
Reference: Shah J, Ahmed H, Weiss MB, et al. Eye care workforce density by provider type in urban and rural counties in the United States, 2010 to 2021. Graefe’s Arch Clin Exp Ophthalmol. Published online July 2, 2026. doi:10.1007/s00417-026-07356-4
