The median age of a practicing ophthalmologist in the United States is 55 years old according to data compiled by Dr. Richard Lindstrom and reported in Healio. Among solo practitioners specifically, two-thirds are already in the succession window, with 1,807 aged 55 to 64, 1,983 aged 65 to 74, and 1,950 who are 75 or older and still actively registered according to Verdira's Q1 2026 CMS NPPES analysis. Projected cumulative exits for solo ophthalmologists will exceed 5,500 by 2035, which is more than 60% of the current solo pool gone in under a decade. Everyone in ophthalmology knows this retirement wave is coming, but very few people are talking about what happens to the patients, the practices, and the communities that depend on them when it actually arrives.
The Ophthalmology Workforce Math Doesn't Work
Approximately 500 new ophthalmologists complete residency each year, while 650 to 700 retire annually, creating a net loss of 150 to 200 ophthalmologists every single year according to Lindstrom's analysis in Healio. The total number of practicing ophthalmologists was essentially flat from 2015 to 2022, going from 17,656 to 17,615, while the number of practices decreased 18% from 7,149 to 5,890 according to Smith et al. in the journal Ophthalmology. Supply is stagnant and consolidating while demand is accelerating. HRSA projects a shortfall of 7,290 ophthalmologists by 2038, representing only 72% workforce adequacy. That makes ophthalmology the second worst workforce adequacy projection of 38 medical and surgical specialties studied, better only than thoracic surgery at 69%.
Ophthalmology Disease Prevalence Is Accelerating Into the Gap
The 65 and older population in the United States will grow 35% by 2035, and the 85 and older population will more than double from 6.7 million to 14.4 million by 2040 according to Census data and MedCity News. These are the highest utilizers of eye care. Cataract surgery volume is growing 3 to 4% annually and will reach 6 million procedures by 2030, performed by a slightly smaller group of surgeons. Glaucoma affected 4.22 million Americans in 2022 according to Ehrlich et al. in JAMA Ophthalmology, higher than previous estimates. Diabetic retinopathy prevalence among people with diabetes nearly doubled from 10.9% in 2007 to 20.8% in 2021 according to a study published in Ophthalmology in 2025. AMD affects approximately 20 million Americans and is projected to reach 22 million by 2050. The CDC projects that vision-threatening disease costs will reach $373 billion by 2050, a 157% increase from current levels.
Why the Ophthalmology Residency Pipeline Can't Close the Gap
There are 126 accredited ophthalmology residency programs in the United States producing 518 new trainees per year, and that number increases only 1 to 2% annually. Neutralizing attrition alone would require an immediate 33% expansion in residency positions according to an editorial in Glaucoma Today, and there's no evidence that expansion is coming any time soon. Applicant interest has never been the problem because the ophthalmology match remains one of the most competitive in medicine. What's missing is funded residency slots, which are capped by Medicare GME funding that Congress hasn't meaningfully expanded in decades.
We've Already Seen This Play Out in Other Ophthalmology-Adjacent Specialties
Dentistry provides the clearest warning of what's coming for ophthalmology. As of March 2025, there are 7,054 Dental Health Professional Shortage Areas impacting 59.7 million Americans according to HRSA. In Alabama, three counties have zero dentists, and one county has a single dentist who is 60 years old and practices only two days per week. In Florida, more than 146,000 residents sought emergency department care for dental pain in 2024, a 25% increase since 2021, resulting in 4,012 hospitalizations and $281.7 million in hospital charges that grew 77% over three years.
Dermatology shows what the wait time spiral looks like when it accelerates unchecked. Average dermatology appointment waits reached 36.5 days in 2025 according to AMN Healthcare, up 50% since 2004, and in Boston those waits exceed 8 months. Nurse practitioners and physician assistants now account for over 40% of dermatology prescribers because there aren't enough dermatologists to see the patients.
The pattern across every specialty is the same. Retirements outpace the pipeline, wait times increase, rural communities lose providers entirely, patients shift to emergency departments for conditions that should've been caught in an office visit, and mid-level providers fill gaps that were never supposed to exist. Ophthalmology is on the same trajectory, and the numbers suggest it'll be worse because the subspecialization rate among graduating residents has climbed from 34% in 1996 to 68% today, meaning fewer comprehensive ophthalmologists entering the workforce to replace the ones leaving.
Rural ophthalmology is already deep in crisis and the numbers make it hard to see how that reverses. Approximately 800 U.S. counties had zero practicing optometrist or ophthalmologist performing Medicare eye exams as of 2019 according to Baylor College of Medicine. Only 5.6% of ophthalmic subspecialty surgeons practice in rural areas despite 17.4% of their patients residing there according to JAMA Ophthalmology. Rural workforce adequacy by 2035 will reach just 29%. We can keep treating this like a future problem, but the patients who can't get an appointment this month would probably disagree.
This article is for general educational purposes and is not legal or financial advice.
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