Women are entering ophthalmology in greater numbers, yet still remain under-represented in senior leadership, academic and decision-making roles. Why does this matter? The gap is therefore not simply about getting women into ophthalmology: it is about ensuring that those who enter the profession can progress into positions where they lead departments, research, training, policy and institutions, in order to create greater representation that brings a wider range of perspectives to how eye-care systems are designed, delivered and governed .
Globally, women account for 55% of the 1.1 billion people living with vision loss, meaning 112 million more women than men live with vision loss, including blindness. Yet women represent only 25–30% of ophthalmologists and 35–45% of professionals-in-training worldwide.
These findings point to a progression problem rather than an entry problem. Women may complete specialist training and build strong clinical careers, yet advancement can become harder when opportunities for surgical volume, fellowships, research, professional networks and institutional leadership are unevenly distributed. A career break should not become a permanent penalty, nor should leadership depend on informal access to influential networks. Mentorship can help women navigate these barriers, but advice alone cannot close the leadership gap. Women also need sponsorship: senior professionals who actively recommend them for leadership roles, research collaborations, speaking opportunities, committees and other platforms where careers advance. The responsibility cannot rest entirely on women to adapt to systems that were not designed around the realities of their careers. Hospitals and academic institutions need transparent promotion criteria, equitable access to surgical opportunities and research funding, meaningful representation on committees and boards, and leadership pathways that account for career interruptions without diminishing professional potential. Community models led by women have demonstrated what changes when women are given responsibility and authority, not simply participation. But the same principle must extend upward through the profession, from community eye care to hospital departments, academic institutions and policy tables.
