The State of Ophthalmology & Optometry Hiring in 2025: Gaps, Regions, Specializations

Introduction

As we close out 2025 and look ahead to 2026, both ophthalmology and optometry are at a crossroads. Patient demand for eye care services is surging, yet employers continue to face significant challenges filling open roles. The aging U.S. population, growth in chronic diseases such as diabetes, and a nationwide shortage of specialists are all colliding to create one of the most competitive recruiting markets in healthcare. For clinicians, this presents new career opportunities and more leverage in negotiations. For employers, it means that the way you recruit, compensate, and retain talent can make or break your growth strategy.
 

Rising Demand Meets Workforce Shortages

The U.S. Bureau of Labor Statistics projects that employment of optometrists will grow by 10% between 2022 and 2032, adding thousands of new roles each year (BLS). Ophthalmology faces even greater pressure: by 2035, demand for eye surgeons is expected to outpace supply by as much as 20%, according to the American Academy of Ophthalmology (AAO). Aging demographics, chronic disease prevalence, and pipeline limitations are fueling this gap. By 2030, one in five Americans will be over age 65, driving demand for cataract and macular degeneration care. Meanwhile, more than 38 million Americans currently live with diabetes (CDC), contributing to surging diabetic retinopathy cases. Training programs for both optometry and ophthalmology have not expanded quickly enough to keep pace.
 

Regional Hotspots: Where the Shortages Are Most Severe

Shortages are not evenly distributed. In rural America, more than 15% of counties lack sufficient vision care services (HRSA), creating long wait times and forcing patients to travel for care. Recruiting into rural clinics is especially difficult given geographic isolation, limited spousal job opportunities, and concerns about career progression. By contrast, urban and suburban hubs have more clinicians but see fierce competition among employers. Corporate groups and hospital-affiliated practices can often outspend private clinics. Regionally, the Vision Council notes that salaries are higher in California, Texas, and New York, but retention is weaker in these states due to cost-of-living pressures and burnout.
 

Specializations in Highest Demand

Demand isn’t evenly spread across specialties either. Retina and glaucoma remain the hardest subspecialties to staff, with wait times for fellowship-trained physicians continuing to grow. Cornea and refractive surgery roles are expanding as elective procedures rebound post-pandemic. Pediatric optometry and myopia control are emerging as fast-growth specialties, driven by the doubling of childhood myopia rates globally. Low vision and geriatrics are increasingly important as Americans live longer, while dry eye and ocular surface disease represent lucrative niches for practices investing in diagnostics and therapies.

Compensation Pressures in 2025

Compensation continues to rise. The BLS reports the median annual wage for optometrists at $134,830 in 2024, with top earners surpassing $200,000. Ophthalmologists earn substantially more, with median compensation ranging between $350,000 and $400,000 depending on subspecialty (AAO). Signing bonuses are now standard, especially in underserved areas. A Review of Optometry survey showed that 42% of practices offer new-hire bonuses, typically between $10,000 and $50,000. Relocation stipends and student loan repayment programs are also increasingly common.

Employer Challenges in Recruiting

Employers report three consistent challenges. First, corporate players and private equity–backed groups can offer bigger paychecks and slicker benefits, leaving independent practices at a disadvantage. Second, retention issues drive up costs. Ophthalmology Management estimates it costs clinics $50,000–$75,000 to replace a single OD, factoring in lost productivity and onboarding. Finally, pipeline delays in residency and fellowship slots limit the availability of ophthalmologists, keeping supply tight for years to come.

What Candidates Should Know

For candidates, the current market offers leverage. Flexibility on location and willingness to take on underserved geographies can unlock significant financial incentives. Specialization pays: optometrists with advanced training in ocular disease, myopia management, or dry eye can command higher salaries. Beyond money, culture matters. A recent AAO survey found 70% of ophthalmologists ranked culture and growth opportunities as their top job satisfaction factors, above salary.

Strategic Recommendations for Employers

Employers can adapt by benchmarking salaries quarterly, not annually, to remain competitive. Culture is crucial — mentorship, CE stipends, and predictable scheduling all influence retention. Showcasing advanced technology such as OCT or AI integration helps attract younger clinicians eager to work with cutting-edge tools. Finally, partnering with specialized recruiting firms such as Hëda Global’s vision practice can help clinics tap into passive candidate pools and speed up hiring.

Conclusion

The U.S. vision care workforce is under strain, and both opportunities and challenges lie ahead. For clinicians, the shortage translates into more negotiating power and diverse career paths. For employers, success requires more than just competitive pay; it demands a holistic value proposition of culture, career growth, and mission. As 2026 begins, the organizations that adapt fastest to these new realities will be the ones best positioned to thrive.

References

• Bureau of Labor Statistics — Optometrists

• American Academy of Ophthalmology — Workforce Studies

• CDC — Diabetes Statistics

• HRSA Vision Access Data

• Vision Council Market Insights

• Review of Optometry Compensation Data

• Ophthalmology Management Workforce Report