A workforce study once suggested that an oversupply of optometrists would exist for some 20 years before it would begin to shrink, and even then, it would take 12 years before the supply reached equilibrium. But, the demand may actually outweigh supply when considering changing demographics and the relation to ocular disease.

In 1999, an AOA-commissioned study conducted by Abt Associates, of Cambridge, Mass., predicted an oversupply of O.D.s through 2020. Specifically, the study estimated that within the following five years, about 550 O.D.s would retire each year, while more than 1,100 O.D.s would enter practice annually.

But, those projections are almost 10 years old. If anything, theres going to be a real crunch on the demand for eye-care services, says Richard Edlow, O.D., chair of the AOAs Information and Data Committee. Just last month, a report in Archives of Ophthalmology found that about half of U.S. adults age 20 and older have refractive errors or eye problems that result in less than 20/20 vision.

An analysis of data from the National Health and Nutrition Examination Survey (NHANES), an ongoing survey conducted by the Centers for Disease Control and Prevention (CDC), found that, of the 12,010 participants age 20 and older who completed the survey between 1999 and 2004, 3.6% were farsighted, 33.1% were nearsighted and 36.2% had astigmatism.

Perhaps more significantly, the Abt Study did not consider a shift in demographics in the United States. Consider: Latest estimates from the Census Bureau show that the Hispanic population is projected to nearly triple from 46.7 million to 132.8 million between 2008 and 2050changing from 15% to 30% of the population. The black population is projected to increase from 41.1 million, or 14% of the population in 2008, to 65.7 million, or 15% by 2050.

Thats going to have a dramatic impact on the demand for services, Dr. Edlow says. The reason I say that is with both glaucoma and diabetic retinopathy having a much higher prevalence in the Hispanic and African-American populations, the demand for services is going to increase at a much more rapid rate than the Abt study predicted.

Furthermore, as the first baby boomers turn 65 in 2010, there will likely be a greater prevalence of age-related eye disease.

While the Abt survey predicts that the number of providers will increase by 1.5% each year, Dr. Edlow estimates that the demand for services will likely increase anywhere from 4% to 10%.

So, we need to be very careful not to have this sense of complacency that we have too many optometrists, Dr. Edlow says.

Vitale S, Ellwein L, Cotch MF, et al. Prevalence of refractive error in the United States, 1999-2004. Arch Ophthalmol 2008 Aug;126(8):1111-9.