Estimated number of ophthalmologists worldwide (International Council of Ophthalmology update): will we meet the needs?

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Abstract

Background/aims

To estimate 2015 global ophthalmologist data and analyse their relationship to income groups, prevalence rates of blindness and visual impairment and gross domestic product (GDP) per capita.

Methods

Online surveys were emailed to presidents/chairpersons of national societies of ophthalmology and Ministry of Health representatives from all 194 countries to capture the number and density (per million population) of ophthalmologists, the number/density performing cataract surgery and refraction, and annual ophthalmologist population growth trends. Correlations between these data and income group, GDP per capita and prevalence rates of blindness and visual impairment were analysed.

Results

In 2015, there were an estimated 232 866 ophthalmologists in 194 countries. Income was positively associated with ophthalmologist density (a mean 3.7 per million population in low-income countries vs a mean 76.2 in high-income countries). Most countries reported positive growth (94/156; 60.3%). There was a weak, inverse correlation between the prevalence of blindness and the ophthalmologist density. There were weak, positive correlations between the density of ophthalmologists performing cataract surgery and GDP per capita and the prevalence of blindness, as well as between GDP per capita and the density of ophthalmologists doing refractions.

Conclusions

Although the estimated global ophthalmologist workforce appears to be growing, the appropriate distribution of the eye care workforce and the development of comprehensive eye care delivery systems are needed to ensure that eye care needs are universally met.

Related collections

Most cited references 9

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The number of ophthalmologists in practice and training worldwide: a growing gap despite more than 200,000 practitioners.

Bruce Spivey, William Felch, Marie-Krystel Gauthier … (2012)

To assess the current number of ophthalmologists practicing worldwide in 2010 and to create a system for maintaining, collecting and improving the accuracy of data on ophthalmologists per population, ophthalmologists performing surgery, growth rate of the profession, and the number of residents in training. Between March 2010 and April 2010, the International Council of Ophthalmology emailed a standardised survey of 12 questions to 213 global ophthalmic societies. Missing data and additional information were gathered from direct correspondences with ophthalmologist contacts. The total number of ophthalmologists reported was 204,909. Data are presented for 193 countries. Information was obtained from 67 countries on the number of ophthalmologists doing surgery, entering practice, leaving practice, rate of growth and resident training. The survey results show that despite over 200,000 ophthalmologists worldwide, there is currently a significant shortfall of ophthalmologists in developing countries. Furthermore, although the number of practitioners is increasing in developed countries, the population aged 60+ is growing at twice the rate of the profession. To meet this widening gap between need and supply, it is necessary to aggressively train eye care teams now to alleviate the current and anticipated deficit of ophthalmologists worldwide.

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Integrated model of primary and secondary eye care for underserved rural areas: The L V Prasad Eye Institute experience

Gullapalli N. Rao, Rohit C. Khanna, Sashi Athota … (2012)

Blindness is a major global public health problem and recent estimates from World Health Organization (WHO) showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS) provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (AP). It also highlighted that uptake of services was also an issue, predominantly among lower socio-economic groups, women, and rural populations. On the basis of this analysis, L V Prasad Eye Institute (LVPEI) developed a pyramidal model of eye care delivery. This article describes the LVPEI eye care delivery model. The article discusses infrastructure development, human resource development, and service delivery (including prevention and promotion) in the context of primary and secondary care service delivery in rural areas. The article also alludes to opportunities for research at these levels of service delivery and the amenability of the evidence generated at these levels of the LVPEI eye health pyramid for advocacy and policy planning. In addition, management issues related to the sustainability of service delivery in rural areas are discussed. The article highlights the key factors required for the success of the LVPEI rural service delivery model and discusses challenges that need to be overcome to replicate the model. The article concludes by noting the potential to convert these challenges into opportunities by integrating certain aspects of the existing healthcare system into the model. Examples include screening of diabetes and diabetic retinopathy in order to promote higher community participation. The results of such integration can serve as evidence for advocacy and policy.

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Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020

Jennifer J. Palmer, Farai Chinanayi, Alice Gilbert … (2014)

Background Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Methods Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. Results HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed (CSR P = 0.0042, ophthalmologists P = 0.0034, cataract surgeons, ophthalmic nurses and optometrists 0.1 > P > 0.05). Conclusions With only a minority of countries in our sample having reached suggested ophthalmic cadre targets and none having reached targets for refractionists in 2011, substantially more targeted investment in HReH may be needed for VISION 2020 aims to be achieved in sub-Saharan Africa.

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Author and article information

Journal

Journal ID (nlm-ta): Br J Ophthalmol

Journal ID (iso-abbrev): Br J Ophthalmol

Journal ID (hwp): bjophthalmol

Journal ID (publisher-id): bjo

Title: The British Journal of Ophthalmology

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Print): 0007-1161

ISSN (Electronic): 1468-2079

Publication date (Print): April 2020

Publication date (Electronic): 2 July 2019

Volume: 104

Issue: 4

Pages: 588-592

Affiliations

[1 ] Brien Holden Vision Institute , Sydney, New South Wales, Australia

[2 ] Help Me See, Instituto Mexicano de Oftalmologia , Queretaro, Mexico

[3 ] International Council of Ophthalmology , San Francisco, California, USA

[4 ] departmentMelbourne School of Population Health, Faculty of Medicine, Dentistry and Health Sciences , The University of Melbourne , Melbourne, Victoria, Australia

[5 ] Independent Consultant , San Antonio Tlayacapan, Mexico

[6 ] American Academy of Ophthalmology , San Francisco, California, USA

Author notes

[Correspondence to ] Professor Serge Resnikoff, Brien Holden Vision Institute, Sydney, NSW 2052, Australia; serge.resnikoff@ 123456gmail.com

Author information

Serge Resnikoff http://orcid.org/0000-0002-5866-4446

Article

Publisher ID: bjophthalmol-2019-314336

DOI: 10.1136/bjophthalmol-2019-314336

PMC ID: 7147181

PubMed ID: 31266774

SO-VID: 8353e50a-9f4a-4fe5-a0aa-241e8afd7450

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.