Cornea Specialists Lacking in Low-Socioeconomic, Rural Areas

A recent study sought to understand how the distribution of cornea specialists in the US correlates with various demographic factors, including median income and educational attainment. Its findings highlight significant disparities in access to cornea care, particularly in low socioeconomic regions.The researchers used the "Find an Ophthalmologist" tool provided by the American Academy of Ophthalmology to gather data on practicing cornea-specializing ophthalmologists in the US. In June 2024, they collected data on a total of 1,665 office addresses from the database. To ensure thoroughness, any potential gaps in the database were filled by conducting additional searches for cornea specialists. Data analysis involved independent samples t-tests comparing counties with and without cornea ophthalmologists across multiple socioeconomic factors. A recent study analyzing the geographic distribution of cornea ophthalmologists in the US found that more than 85% of US counties have no practicing cornea specialists. These regions were more likely to have low household income and education rates and high poverty rates. The above map from the study shows how the location of cornea specialists (in optometry as well as ophthalmology) generally tracks with higher income regions of the country. Photo: Patel RH, et al. Am J Ophthalmol. May 28, 2025. Click image to enlarge. Findings revealed that a staggering 85.6% of US counties (2,688 counties) do not have a practicing cornea ophthalmologist, while only 14.3% (447 counties) had at least one of these specialists. Furthermore, there was an average of just 5.02 cornea specialists for every one million people in the US.Notably, counties with access to at least one cornea ophthalmologist reported significantly higher median incomes ($77,444 vs. $60,872), educational attainment rates (35.5% vs. 21.4%) and health insurance coverage (98.6% vs. 97.5%) compared with their counterparts lacking such specialists. Poverty rates were also lower in counties with cornea specialists (12.0%) than those without (14.2%).In their paper on the findings, the study authors noted that “the states with the fewest cornea ophthalmologists’ office locations per million people tend to be more rural in the West and South United States (i.e., North Dakota, Indiana and Arkansas), indicating limited coverage of cornea care in these regions.” Rural states like these also have more expansive land area and limited transportation infrastructure, increasing travel time and distance to the nearest cornea ophthalmologists, they pointed out. Other studies have reported similar disparities in access to ophthalmologists in other subspecialties, including pediatric ophthalmology and neuroophthalmology.The authors outlined several possible solutions to address the disparities in corneal eye care access, the first being improving incentives for ophthalmologists to practice in rural areas. Tele-ophthalmology may also present an opportunity to extend specialized corneal care to rural areas that lack sufficient provider coverage by facilitating remote consultations, diagnostics and follow-up care. Furthermore, the authors suggested a redistribution of public health resources in underserved communities and a greater emphasis on collaborative models between ophthalmologists and optometrists could help bridge this care gap.“Future research should focus on understanding how clinical outcomes of corneal conditions may vary with geographic distribution of cornea eye care provers and US population demographics as well as characterize specific barriers to cornea care such as travel distance and insurance coverage,” the authors suggested. They stand hopeful that these findings can help “guide future policy for improving provider access in these regions and ensuring equitable cornea eye care.”Click here for the journal source. Patel RH, Mothy D, Choudhry HS, Grinberg A, Bhasin J, Dastjerdi MH. Cornea eye care coverage based on geographic distribution and population demographics in the United States. Am J Ophthalmol. May 28, 2025. [Epub ahead of print].