Ophthalmologists
Official title Ophthalmologists, Except Pediatric (SOC 29-1241)
Also called Eye surgeon, Eye physician, Cataract surgeon, Retina specialist, Retinal surgeon
In brief
In May 2025, BLS counted 8,950 US ophthalmologists, with median pay of $300,080 a year. Of the BLS counts since 2021, the highest was 12,580, in May 2022. The earliest figure here is an estimate of 8,616 from 1968, not measured the same way as today's count. The last full technology era for ophthalmologists: Optical coherence tomography and digital retinal imaging, 1991 to 2018. OCT made ophthalmology data-intensive in ways that positioned it uniquely for AI augmentation: the retinal images are standardized, high-volume, and amenable to pattern recognition.
What the sources say
Official outlook
BLS projects employment to grow 4.5% from 2025 to 2035.
AI exposure studies
- 33.8% of this job's tasks are exposed to large language models. Not a forecast of job losses. Eloundou and others, 2023
Data as of BLS OEWS May 2025; BLS Employment Projections 2025-35. BLS publishes these counts as yearly survey snapshots and cautions against reading them as a precise trend.
Last updated .
Cite this page
Future History. (2026, October 11). Ophthalmologists: jobs and pay since 1968 [Data set; data as of BLS OEWS May 2025; BLS Employment Projections 2025-35]. https://futurehistory.earth/timeline/29-1241
Future History. "Ophthalmologists: jobs and pay since 1968." Data as of BLS OEWS May 2025; BLS Employment Projections 2025-35. Last modified October 11, 2026. https://futurehistory.earth/timeline/29-1241.
@misc{futurehistory_29_1241, author = {{Future History}}, title = {Ophthalmologists: jobs and pay since 1968}, year = {2026}, month = oct, howpublished = {\url{https://futurehistory.earth/timeline/29-1241}}, note = {Last updated 2026-10-11. Data as of BLS OEWS May 2025; BLS Employment Projections 2025-35}, }
The access date is today's date on your device.
≈ $292,387 in 2024 prices (derived by us, CPI-adjusted)
The American Ophthalmological Society was founded on June 7, 1864, by eighteen physicians, most trained in Vienna, Paris, and London. It was the second medical specialty society in US history and the first that survives intact. The proximate cause was outrage over a dubious eye journal that the founders felt was polluting their nascent field. Edward Delafield, first president, had also co-founded the New York Eye and Ear Infirmary. The founding marked the beginning of ophthalmology's recognition as a distinct specialty rather than a subspecialty of general surgery.
The American Board of Ophthalmology was established in 1916, the first specialty board in American medicine. Members of the American Ophthalmological Society, the American Academy of Ophthalmology, and the Eye Section of the AMA created it to establish a standardized examination and credentialing system for the specialty. The ABO predates the American Board of Medical Specialties, which was not founded until 1933. Board certification transformed ophthalmology from a self-declared specialty into a credentialed profession with defined training requirements.
Medicare and Medicaid were enacted in July 1965, extending insurance coverage for cataract surgery to the elderly and low-income populations who had previously been unable to afford it. The effect on ophthalmology was immediate and large: cataract surgery volume grew substantially through the late 1960s and 1970s as the backlog of untreated cataracts among the elderly was addressed. Medicare's coverage of IOL implantation (approved 1980) further accelerated demand. The combination of phacoemulsification technique and Medicare reimbursement made cataract surgery the highest-volume elective procedure in the US healthcare system by the 1990s.
The Medicare Resource-Based Relative Value Scale (RBRVS) was enacted in 1989 and took effect in 1992, fundamentally restructuring physician fee schedules. Surgical procedures, which had historically been the most reimbursed, were cut sharply; cataract surgery reimbursement fell by roughly 60-70% over the following decade as CMS repeatedly reduced the RVU values for phacoemulsification. Ophthalmology adapted by increasing surgical volume -- higher throughput per surgeon hour in ambulatory surgery centers -- rather than reducing case counts. The financial model shifted from high per-procedure fees to high-volume ASC efficiency, which reshaped practice structure: solo and small-group practices increasingly partnered with or owned ASCs to capture facility fees.
April 11, 2018: the FDA granted De Novo marketing authorization to LumineticsCore (then IDx-DR), the first autonomous AI diagnostic system authorized for any medical condition in US history. The authorization explicitly permits the system to issue diagnostic interpretations -- "More than mild DR detected: refer to an eye care professional" -- without a licensed clinician reviewing the image. This is the furthest any medical AI has advanced into autonomous diagnostic decision-making under FDA clearance. The approval was widely discussed in medical AI circles as a precedent for subsequent autonomous diagnostic systems in radiology, dermatology, and cardiology.
The AAO-commissioned workforce projections published in the journal Ophthalmology in 2023 quantified a looming structural shortage: supply of ophthalmologist FTEs was projected to fall 12% by 2035 while demand rises 24%, yielding a 30% gap between supply and demand. The study ranked ophthalmology as the second-worst-projected specialty for workforce adequacy among 38 US medical specialties. Rural adequacy was projected at 29% by 2035, meaning fewer than 1-in-3 of the needed ophthalmologists would be available in nonmetro areas. The projections galvanized AAO advocacy for expanded residency positions and scope-of-practice models using optometrists and ophthalmic medical technicians to extend ophthalmologist reach.
Will AI replace ophthalmologists? What the research says
Each figure is stated by the named source; we publish no forecasts of our own. Where sources disagree, we show the disagreement rather than an average.
Each figure is stated by the named source; we publish no forecasts of our own. Where sources disagree, the spread is the honest signal.
What's changing day to day for ophthalmologists
Three parts of your work where AI is already doing real lifting, and what stays yours.
AI is sitting alongside you hereTriage autonomous AI diabetic retinopathy screening results from primary-care upstream sites, reviewing LumineticsCore (IDx-DR) or EyeArt flags routed from primary care practices and federally qualified health centers
Triage autonomous AI diabetic retinopathy screening results from primary-care upstream sites, reviewing LumineticsCore (IDx-DR) or EyeArt flags routed from primary care practices and federally qualified health centers; confirming referable DR cases by correlating fundus image quality and severity grade with the patient's glycemic control history (HbA1c trend), medication list, and time since last dilated exam; scheduling urgent vs. routine ophthalmology referrals; and identifying cases where image quality failure or comorbidities (dense cataract, poor dilation) require repeat imaging rather than AI classification.[3],[4],[11],[10]
LumineticsCore (formerly IDx-DR) is the first FDA-cleared autonomous AI diagnostic system in the United States: it issues binary "refer / rescreen" interpretations without an eye care professional present, and is reimbursed under CPT 92229 at 1,000+ primary care sites. EyeArt (FDA-cleared 2020) achieves 96% sensitivity for more-than-mild DR and 92% for vision-threatening DR across multiple fundus camera brands. The AAO 2024 DR Preferred Practice Pattern formally recognizes all three cleared systems as effective detection methods. Your irreplaceable contribution at the ophthalmology end of this workflow is the clinical triage decision: confirming image quality, correlating the AI flag against the patient's actual glycemic trajectory, identifying the subgroup with moderate NPDR who warrant near-term pan-retinal photocoagulation vs. observation, and managing the cases the autonomous AI cannot handle (dense media opacity, prior laser, combined DR + AMD). Ophthalmologists who build AI-augmented retinal screening programs can effectively extend their clinical reach to tens of thousands of primary care patients rather than only those who self-refer.
AI is sitting alongside you hereDocument clinic encounters, surgical cases, and post-operative care using ambient AI scribing: using Dragon Copilot or Abridge to capture new patient consultations, post-op visits, and injection clinic encounters from ambient audio
Document clinic encounters, surgical cases, and post-operative care using ambient AI scribing: using Dragon Copilot or Abridge to capture new patient consultations, post-op visits, and injection clinic encounters from ambient audio; reviewing and attesting AI-drafted operative reports for cataract, vitreoretinal, glaucoma, and refractive procedures including device model/lot documentation; generating AI-assisted prior authorization letters for premium IOLs (toric, extended depth of focus), anti-VEGF injections, and glaucoma surgical procedures (trabeculectomy, MIGS); and completing structured documentation required for IRIS Registry data submission and MIPS quality measure reporting.[12],[13],[1]
Ophthalmology generates unusually high documentation volume relative to appointment length: a high-volume cataract practice may perform many injections in a half-day session, each requiring individual procedure note, drug/lot documentation, and visit attestation. Dragon Copilot and Abridge (KLAS Best in KLAS Ambient AI 2025 and 2026) meaningfully reduce this burden by capturing the encounter narrative from ambient audio and generating a structured note. The critical accuracy verification in ophthalmology documentation is device and implant specificity: IOL model, catalog number, dioptric power, axis (for toric lenses), and intravitreal drug lot number are patient safety and regulatory compliance requirements that ambient AI must capture explicitly with specialty-specific templates. Verify all implant-specific fields against the operative device log before attest: this is not delegatable to ambient AI verification alone.
AI is sitting alongside you hereManage neovascular AMD patients using AI-powered home OCT monitoring, prescribing Notal Vision SCANLY Home OCT to high-risk nAMD patients
Manage neovascular AMD patients using AI-powered home OCT monitoring, prescribing Notal Vision SCANLY Home OCT to high-risk nAMD patients; reviewing AI-flagged hypo-reflective space (HRS) volume changes transmitted nightly from patients' homes to the Notal Health Cloud; triaging urgent portal notifications indicating significant HRS increase (biomarker for subretinal fluid accumulation signaling wet AMD activity); adjusting anti-VEGF injection schedules (bevacizumab, ranibizumab, aflibercept, faricimab) based on AI-quantified biomarker trajectory rather than fixed-interval dosing; and identifying patients on treat-and-extend protocols whose interval can be safely extended vs. those requiring immediate retreatment.[5],[10],[14]
Notal Vision SCANLY received FDA De Novo authorization in May 2024: the first patient self-operated OCT device and the first FDA clearance of any AI algorithm applied to OCT images. The pivotal study demonstrated reliable AI segmentation of HRS biomarkers across diverse imaging conditions. ForeseeHome (FDA-cleared, Medicare-covered) detected wet AMD conversion a median of several months earlier than standard care in the HOME Study, with patients losing median a few letters. Your irreplaceable contribution is the anti-VEGF management decision: the AI flags HRS volume change but cannot determine whether the observed change is clinically significant given this patient's RPE integrity, prior response to bevacizumab vs. aflibercept, cataract interference with OCT penetration, or systemic cardiovascular risk that makes aggressive anti-VEGF dosing suboptimal. Retina specialists who build competency interpreting home OCT biomarker streams will manage larger AMD patient panels with better visual outcomes than those relying on fixed-interval office OCT alone.
Where ophthalmologists go next
Natural next steps for someone with your foundation: not exits, evolutions.
- Medical and Health Services Managers
- US median pay
- $123,860 (May 2025)
- BLS outlook 2025-35
- +24.2%
- Bioengineers and Biomedical Engineers
- US median pay
- $109,370 (May 2025)
- BLS outlook 2025-35
- +7.6%
- Neurologists
- US median pay
- $248,560 (May 2025)
- BLS outlook 2025-35
- +6.4%
What each move takes
Medical and Health Services Managers
Ophthalmologists with departmental or ambulatory surgery center leadership experience are well positioned for Medical and Health Services Manager roles including ophthalmology department chief, CMO, VP of Eye Care, and ASC medical director. As autonomous DR screening AI (LumineticsCore, EyeArt), home OCT monitoring (SCANLY), and ophthalmic registry analytics (IRIS Registry / Verana Health) proliferate, health systems and large ophthalmology practice groups need physician executives who understand AI procurement, population-level screening program design, quality metric compliance, and value-based contracting for cataract and retina episodes of care. Ophthalmology is the highest-volume elective surgical specialty in ambulatory settings: CMO and executive medical director roles at ophthalmology-dominant ASC networks are among the best-compensated physician executive positions in ambulatory care.
- · Ambulatory surgery center operations: surgical block time optimization, OASIS accreditation standards for ASCs, ophthalmic device cost benchmarking (IOL implant cost negotiations, phaco consumables), same-day bilateral cataract surgery program design
- · Value-based eye care: Medicare Advantage ophthalmology network quality metrics (refraction outcome benchmarks, DR screening rates, cataract surgical threshold appropriateness), direct contracting models for ophthalmic care episodes
- · AI governance for ophthalmic screening programs: evaluating LumineticsCore vs. EyeArt deployment economics, IRIS Registry MIPS reporting integration, home OCT monitoring program design for AMD population
- · Healthcare executive credentials: MBA (healthcare management focus), ACHE healthcare executive certification, AAO Leadership Development Program, or ASCRS practice management curriculum
How has the work of ophthalmologists changed since 1851?
The tools that defined the work, one line per era. Select an era to see how it reshaped the work.
Ophthalmoscope (Helmholtz 1851): the founding instrument of modern ophthalmology
Before 1851 there was no way to see inside the living eye. Helmholtz's ophthalmoscope -- a mirror with a hole in it held at the right angle -- illuminated the retina with reflected light for the first time. Von Graefe immediately used it to document glaucomatous optic nerve cupping, retinal detachment, and the retinal hemorrhages of diabetic eye disease. By the 1860s the ophthalmoscope was the defining instrument of the new specialty: a physician who owned and could use one was, by that fact, an ophthalmologist. The retinoscope (invented 1873) added objective measurement of refractive error. By 1900 US ophthalmologists could diagnose more conditions than they could treat, but the diagnostic foundation had been laid.
Effect on the workThe ophthalmoscope created the specialty. Before its invention, ophthalmology as a distinct medical discipline did not exist in the United States. Within two decades of Helmholtz's publication, dedicated eye infirmaries had opened in every major American city and the first specialty society had been founded.
Slit lamp biomicroscope (Gullstrand 1911) and standardized clinical examination
Swedish ophthalmologist Allvar Gullstrand received the Nobel Prize in 1911 for his work on the dioptrics of the eye; that same year he introduced the slit lamp, which combined a high-intensity narrow beam of light with a binocular microscope to allow magnified examination of the cornea, lens, and anterior chamber in living patients. Carl Zeiss commercialized the instrument and by the 1920s the slit lamp had become the central piece of equipment in every ophthalmology office. The standardized comprehensive eye examination, still recognizable today (visual acuity, slit-lamp biomicroscopy, tonometry, dilated funduscopy), took its modern form during this era. Tonometry for glaucoma screening (Goldmann applanation tonometer, 1954) and Goldmann perimetry for visual field testing completed the diagnostic toolkit.
Effect on the workThe slit lamp made the comprehensive ophthalmic examination a reproducible, standardized procedure that could be performed in a private office rather than a hospital, enabling the growth of the community-based ophthalmology practice model that dominates the specialty today.
Intraocular lens implant (Harold Ridley 1949) and extracapsular cataract extraction
On November 29, 1949, British ophthalmologist Harold Ridley implanted the first intraocular lens (IOL) at St. Thomas's Hospital in London. His insight came from World War II pilots: polymethyl methacrylate (PMMA) shards from shattered aircraft canopies lodging in pilots' eyes caused no rejection or inflammation. If the eye tolerated inert acrylic, an artificial lens could replace the cataract. Ridley faced decades of resistance from the surgical establishment, but by the 1970s IOLs were becoming the standard of care. The IOL transformed cataract surgery from a procedure that left patients in thick "Coke bottle" glasses to one that restored near-normal vision -- changing ophthalmology's value proposition from managing a chronic disability to reliably restoring function.
Effect on the workThe IOL created the modern cataract surgery market. With post-operative vision restoration as the expected outcome rather than spectacle correction, patient demand for cataract surgery grew dramatically through the 1970s-1990s. Medicare coverage of cataract surgery (1965) and the IOL became the financial engine of US ophthalmology.
Phacoemulsification (Charles Kelman 1967): cataract surgery as outpatient procedure
In 1967, New York ophthalmologist Charles Kelman, inspired by his dentist's ultrasonic cleaning probe, performed the first phacoemulsification cataract surgery on a human patient. It transformed a hospital stay with bilateral patching and bed rest into an outpatient procedure with same-day recovery. Resistance from the surgical establishment was fierce: Kelman's early case series had a high complication rate, and established surgeons had built careers on the existing technique. By 1978 phacoemulsification had become the standard of care and by 1990 it was performed in ambulatory surgery centers on hundreds of thousands of patients per year.
Effect on the workPhacoemulsification is the highest-volume elective surgical procedure in the United States, with approximately 4 million cases per year. It transformed the economics of ophthalmology: a surgeon who performs several phaco cases in a morning ASC session generates more revenue than a full day of office visits. The procedure became the dominant financial driver of the specialty and the reason ophthalmology consistently ranks among the highest-earning surgical specialties despite relatively short training.
Optical coherence tomography (OCT) and digital retinal imaging: the eye as a data-rich organ
Optical coherence tomography, introduced clinically in 1991 by James Fujimoto and colleagues at MIT, uses light interferometry to generate cross-sectional images of retinal tissue at micron resolution without contact. For ophthalmology the impact was transformative: for the first time, a physician could see the individual cell layers of the living retina, measure their thickness with precision, and track changes over time with serial scans. OCT made ophthalmology the most imaging-dense medical specialty relative to its size: a single retina practice generates more imaging data per patient per year than a radiology department of equivalent throughput. The Zeiss Stratus OCT (1996), the high-speed spectral-domain devices (Zeiss CIRRUS, Heidelberg Spectralis, 2006-2008), and the integrated OCT-A (angiography, 2014) each expanded the diagnostic surface area of the specialty.
Effect on the workOCT made ophthalmology data-intensive in ways that positioned it uniquely for AI augmentation: the retinal images are standardized, high-volume, and amenable to pattern recognition. The same data richness that created the diagnostic revolution of the 1990s-2000s became the training corpus for the AI diagnostic systems of the 2010s-2020s.
Autonomous AI diagnostics (LumineticsCore FDA-cleared 2018; EyeArt 2020; home OCT 2024)
On April 11, 2018, the FDA granted De Novo authorization to LumineticsCore (then IDx-DR), the first autonomous AI diagnostic system cleared by the FDA for any medical condition. It detects referable diabetic retinopathy from fundus photographs in primary care settings without an eye care professional present, issuing binary "refer / rescreen" interpretations. EyeArt (FDA-cleared 2020) followed with multi-camera compatibility and 96% sensitivity for vision-threatening DR. Notal Vision SCANLY Home OCT received FDA De Novo authorization in May 2024 as the first patient self-operated OCT device and the first AI algorithm cleared on OCT images. These are not theoretical futures: they are deployed at thousands of primary care sites, reimbursed under CPT codes, and recognized in the AAO 2024 Diabetic Retinopathy Preferred Practice Pattern. The result is a two-tier structure: autonomous AI handles population screening and early detection in primary care settings; ophthalmologists manage confirmed disease, complex cases, and all surgical care that autonomous AI cannot approach. Rather than displacing ophthalmologists, these tools are routing more confirmed-disease patients to ophthalmology referral -- arriving pre-screened, with imaging already interpreted -- which increases the clinical density of the ophthalmology workload rather than reducing it.
Effect on the workThe AAO / HRSA workforce projections (2023) project a 30% shortage of ophthalmologist FTEs relative to demand by 2035, with projected supply declining by thousands of FTE and demand increasing by thousands of FTE over the same period. This is a workforce facing growing demand driven by demographic aging, not displacement by AI. AI diagnostic tools expand patient identification but do not substitute for the ophthalmologist who treats the identified patients.
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Browse all rolesOphthalmologists, Except Pediatric employment and pay by year
View all 9 years of cited US data, each linked to its source
| Year | US employment | Annual pay (median unless marked) | Source | Report |
|---|---|---|---|---|
| 1968 | 8,616 | $37,000 | Est., National Center for Health Statistics (employment) Researched contextEst., AMA Socioeconomic Monitoring System (pay) Researched context | Report |
| 1983 | 12,400 | n/a | Est., AAO Ophthalmology Manpower Studies Part… Researched context | Report |
| 2000 | n/a | $210,000 | Est., BLS OOH Researched context | Report |
| 2003 | 15,800 | n/a | Est., AAMC 2022 Physician Specialty Data… Researched context | Report |
| 2021 | 11,610 | n/a | BLS OEWS May 2021 Official statistic | Report |
| 2022 | 12,580 | $219,810 | BLS OEWS May 2022 Official statistic | Report |
| 2023 | 11,530 | n/a | BLS OEWS May 2023 Official statistic | Report |
| 2024 | 12,110 | n/a | BLS OEWS May 2024 Official statistic | Report |
| 2025 | 8,950 | $300,080 | BLS OEWS May 2025 Official statistic | Report |