Women in Optometry: Then and Now

In optometry, women have come a long way from the days when they were grossly underrepresented due to social and gender barriers.

Historically, a woman’s path to pursuing a career in optometry was hampered by many barriers. This included social pressure and stereotypical opinions, unequal access to participate in social organizations, discriminatory experiences, concerns with practice patterns, as well as discrimination in placements upon graduation.

Today as women gain more equality in academic and career opportunities, the numbers and the positions occupied by women optometrists are not only increasing — and in some parts of the world, they have outnumbered their male counterparts.

The American History

The March 2019 edition of Optometric Education¹ documented the historical trends of women in optometry and celebrated contributions by women to the profession in the United States. 

Around 1899, Gertrude Stanton was reported to become the first licensed female optometrist.  She was soon followed by Millie Armstrong.  In 1898, two women were charter members of the American Association of Opticians, which later became the American Optometric Association (AOA).  In the past 50 years, women in optometry have made huge strides. By 1968, only 368 women were optometrists in the United States, representing 2.1% of active optometrists in the country at the time. In the 1970s, women still accounted for a very small percentage of practicing optometrists. Then, the percentage of women enrollees in optometry school began to grow in the 1980s: from 19% in 1980 to 44% by 1989. This decade also saw women benefiting from fading stereotypes regarding which careers they should pursue. In particular, 1992-93 was a pivotal academic year when women became the majority of students enrolled in optometry schools. This shift in the profession’s demographics toward women has continued to grow. In 2014, women made up 38% of the profession and 39% of AOA members. 

From an AOA Focus² article in March 2019, the Association of Schools and Colleges of Optometry (ASCO) data show that female optometry students have outnumbered males for at least the past decade. In the 2017-18 academic year, there were 4,830 females and 2,294 males enrolled as full-time doctor of optometry students at U.S. schools and colleges of optometry. And according to the data from AOA’s Survey of Optometric Practice, in 2016, female doctors accounted for 43% of practicing doctors of optometry, up from about 29% in 2009. And many more women doctors owned practices in 2016 (39.1%) than in 2009 (20.5%).

In recent years, 65 to 75% of optometry students have been women. While male ODs (Doctor of Optometry) tend to be practice owners with 74% of owner/optometrists are men, the number of female practice owners is also growing. Indeed, from optometry schools to private optometric practices, to the AOA Board of Trustees, women are better represented in optometry than ever before.

Today, more women are also members of optometric professional organizations. The 2018 annual report of the American Academy of Optometry (AAO) noted that approximately 40% of fellows and approximately 63% of candidates for fellowship are female.  Dr. Joan Exford became the first female president of the AAO in 1993 and in the last decade, more women leaders have become role models and continue to inspire other women leadership roles. Dr. Karla Zadnik was the president of the AAO in 2011, followed seven years later by Dr. Barbara Caffrey in 2018. Dr. Dori Carlson became the first female president of AOA in 2011, and Dr. Andrea Thau was elected to the role in 2016.

To learn more, COOKIE magazine spoke to two luminous women optometrists from the United Kingdom and the United States on their professions and aspirations. 

Famous Firsts

In 2001, Professor Shahina Pardhan became the first woman to be appointed as a professor of optometry at Anglia Ruskin University in the U.K. Born in Tanzania, Dr. Pardhan moved to Yorkshire when she was 18 and went on to graduate with a first-class degree in optometry from the University of Bradford. After receiving a scholarship from the College of Optometrists, she completed her doctorate in 1989. She joined the University of Bradford in 1994 where she was the only Asian female lecturer.

“My parents were not educated — my mother had no schooling and my father had only four years of primary school. However, they believed in education and worked extremely hard so that we could all go to school and university. “Out of eight children, seven of us have university degrees and some have postgraduate degrees. We have doctors, pharmacists, optometrists and accountants in our family,” shared Dr. Pardhan.

Now, as Director of Vision and Eye Research Institute at the School of Medicine at Anglia Ruskin University, Dr. Pardhan is responsible for leading the Institute’s direction, as well as its activities. The Institute was awarded world-class scores at the Research Excellence Framework (REF2014), which is a national exercise that grades the research profile of all universities in the U.K. Dr. Pardhan wore glasses from an early age and she knew people who lost sight from reversible blindness — and she wanted to try to redress that, in any way she could. Among others, her fields of specialization include working on factors that influence the risk of sight-threatening retinopathy in different parts of the world. 

“We have designed culturally and linguistically appropriate training to reduce the barriers affecting good diabetic control and to increase the uptake of retinal screening. I also work on how visual impairment impacts activities of daily living —  especially gait, and reaching and grasping; and how auditory cues are used by people with low vision,” she said. Dr. Pardhan also loves research. She likes designing new projects and the brainstorming behind them, including the “good challenges” like when data does not fit the hypothesis and leads to a thorough rethinking.

She admits that her career journey has been hard work and frustrating at times. “When I was younger, there were patients who said they wanted to be tested by an older experienced man. Occasionally, I used to think that I have to be better to be an equal, but much less so now as things are improving,” she continued. 

In a December 2017 issue of Optometry Today³, Dr. Pardhan shared that gender imbalance still exists within academia in the U.K., although in 2015–16, there were more female doctoral students than males. “However, less than half of female doctoral students go on to take up research positions”, she said. “Of the nine optometry schools in the U.K., 83% of professors are male, while only 17% are female.” On her first day as a lecturer at the University of Bradford,  Dr. Pardhan was told that she “couldn’t go into the staff common room because secretaries weren’t allowed.”

“Yes, it was one of the examples of unconscious bias that we all have to be aware of,” says Dr. Pardhan. “ As it is ‘unconscious’ it is difficult for the person to know that they are engaging with it. Self-awareness and training can help.” Among the accolades that she’s received are the famous Asian Woman of Achievement Award in 2001 and the  Asian Jewel Award in 2005. 

“I think Asian women have a much better profile than previously, but there may be some who still have not been recognized for the wonderful and meaningful work they do,” she said. She believes that the challenges women optometrists face are the same across the world — primarily, balancing the demands of a job and home life/childcare. 

“This is why it is so important to take into account the time taken off from work to bring up children when promotions are being considered,” she said, adding that there shouldn’t be any limitations in career fields for women. Women are just as capable as men in whatever they choose to specialize in.  And she believes that the future of women in optometry is bright — very bright indeed.

Forward-Thinking Futures

Dr. Kristie Nguyen, an optometrist based in Orlando, Florida, USA, wears many hats. She is an independent consultant with Rodan + Fields, and serves as a contract Doctor of Optometry for Perez and Associates, Phan-Tastic Eye Care and Dr. David Feenstra. The latest feather in her cap is brand ambassador for Kazoku Lunettes, a Japanese eyewear company. Her passion for eye care began because she wanted to help people see clearly to enhance their day to day life. The eldest of seven children, Dr. Nguyen graduated in the top 10 of her high school and finished college with a Bachelor in Science from the University of Houston. She obtained her Doctorate in Optometry in 2005. 

“During graduate school, I envisioned opening my own office after I graduated. But the reality was that I needed money after graduation to get married and pay my student loans,” she shared. “I worked instead as a contractor at multiple locations. I quickly learned that private practice wasn’t for me. The cost to break even for most doctors was five years at the time. I preferred the flexibility of contracting and I have never looked back.”

She says her consultant role is similar as that of  an optometrist, except Rodan +Fields is all about skincare and helping people feel more confident in their skin. “My focus is to help curate a special skincare regimen to target the concerns my customers have and to obtain healthy, beautiful skin to make them feel and look confident. I also help empower men and women who want to earn extra income to share in this business opportunity,” she explained. 

Meanwhile in optometry practice, pediatrics and contact lenses are her passion. “I’ve worked 7.5 years with special needs kids. Each patient’s visual demand is different, therefore each patient who I fit with contact lenses is unique. Listening and learning what they need for their visual system on a day-to-day basis allows me to better select the best combination of contacts for them,” she explained.

Dr. Nguyen met Michael Nicolas, head designer and CEO of Kazoku Lanettes, at the Vision Expo East in New York in 2019; he approached her a few months later and asked her to be their brand ambassador. “This is due to my large following on social media, especially LinkedIn. I loved his bold and beautiful collection so I was happy to accept the role,” said Dr. Nguyen.

As a working mom, she has had to learn to prioritize her time each day and make the most of what she has. “When I’m physically at work, I use any pockets of free time to work on all of my other businesses. When I get home, I try to maximize the time I have with my family. Sometimes it can’t be helped, for example if I have an hour-long Zoom presentation, but now I actually have more free time with my family than when I was working only as an optometrist,” she said.

Some challenges include having big corporations pushing doctors for more hours or more patient numbers.  “Quantity often reduces quality due to lack of sufficient time spent per exam. Insurance is another problem. Changes in a patient’s benefits often lead to them having a poor understanding of their coverage,” she said. She admits that female optometrists don’t get paid the same as their male counterparts, and it’s the same for other professions.

“We still don’t get the same level of respect. A few of my male patients would inappropriately address me as hun, honey or darling,” said Dr. Nguyen. “But I can only count a handful of times in my 15-year career when a patient refused to see me because I was a woman, but never because I was Asian. I’m grateful in this regard,” she said. In the U.S., dry eye, specialty contact lenses, myopia control and aesthetics are a few fields that female optometrists can specialize in, she says. However, she thinks that there aren’t any real advantages for one gender.

“Currently, I think there are just as many female optometrists as men, if not more. The stats shifted years ago.  The profession is also becoming younger and more female. So, women are very much the future of optometry,” she concluded.

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