Access to Glaucoma Specialist Limited by Location in US

The nationwide shortage of ophthalmologists disproportionately burdens rural communities, as doctors (of all varieties) tend to concentrate in urban areas. North Dakota faces the longest drive times in the nation. Photo: Getty Images. Click image to enlarge. Limited access to specialty eye care has long been recognized as a national challenge, and a recent study published in Ophthalmology Glaucoma measured geographic accessibility to glaucoma specialists across the United States by estimating county-level drive times to the nearest practicing glaucoma specialist and summarizing these findings by state, US Census region and rural-vs-urban designation.Across the contiguous United States, county-level drive times to the nearest practicing glaucoma specialist demonstrated substantial geographic variability. Median county-level drive times ranged from 10 minutes in highly accessible New England counties in Connecticut and Massachusetts to over four hours in sparsely populated regions of the northern Great Plains, including North Dakota (median: 4 hours 24 minutes) and South Dakota (median: 2 hours 35 minutes). “Workforce projections suggest that these disparities may worsen as demand for eye care increases and the ophthalmic workforce ages,” the study authors wrote in their paper. “For glaucoma, a chronic, progressive disease that requires longitudinal monitoring and timely intervention, limited availability of subspecialists may contribute to delays in diagnosis, poorer disease control and ultimately higher rates of irreversible vision loss.”This analysis was conducted using US Census Bureau county-level data and practice locations of glaucoma specialists obtained from the American Glaucoma Society, limited to those with provisional or active membership practicing in the United States. County geographic centers were linked to the nearest specialist practice location across county and state boundaries. Approximate drive times to the closest specialist were computed.Drive-time estimates demonstrated a clear gradient by region, state and rurality, with the Northeast showing the shortest travel times and the West having the longest, often exceeding several hours in sparsely populated counties. State-level analyses revealed wide intrastate heterogeneity, particularly in geographically large states such as Texas, Montana and North Dakota. Counties in the Northeast had the shortest median drive time of 40 minutes, followed by the South with 1 hour 14 minutes and the Midwest with 1 hour 23 minutes, while counties in the West had the longest median drive time of 1 hour 45 minutes.The proportion of counties with drive times shorter than their state’s mean also varied widely, from 2% in Delaware and Rhode Island to roughly 80% in Georgia. When stratified by rural or urban status, metro core counties had the lowest median drive time (0.23 hours), whereas small town cores and rural counties experienced considerably longer medians (1.16 hours and 1.02, respectively).County population size also emerged as an important structural determinant of geographic access. More populous counties were consistently associated with shorter drive times to glaucoma specialists, supporting the interpretation that specialist clustering aligns strongly with population density. However, the strength of this association was modest and slightly weaker than that observed for median household income, suggesting that socioeconomic context may play an equally important, or potentially greater, role in shaping subspecialty distribution.“These findings suggest that while longer drive times in sparsely populated regions may partly reflect expected geographic dispersion, population density alone does not fully explain the observed regional and socioeconomic gradients in access,” the researchers noted.“Addressing these disparities will require coordinated strategies, including telehealth expansion, targeted workforce incentives, strengthened referral networks and support for high-need communities to ensure that early detection and longitudinal management of glaucoma are available regardless of geography,” the study concluded. “Improving access to subspecialty care will be essential to reducing preventable vision loss and advancing equity in eye health nationwide.”Click here for the journal source. Wang J, Adomfeh, Owete AC, et al. Geographic distribution and drive times to glaucoma specialists in the United States a national geospatial access analysis and drive-time study. Ophthalmol Glaucoma. April 22, 2026. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.