Dr. Young and Colleague Highlight Shortage of Certified Ophthalmic Personnel

*This article originally appeared in the Association of University Professors of Ophthalmology News & Views Fall 2021 Newsletter

-by Terri Young, MD, MBA, and Lynne Anderson, PhD

As the needs of ophthalmic patients increase, there remains a crucial shortage of well-trained, certified Allied Ophthalmic Personnel (AOP) globally. Access to skilled eye care technicians is a major need for Ophthalmology’s expansion and continued provision of quality eye care.

In 1969, the International Joint Commission of Allied Health Personnel in Ophthalmology (formally the International JCAHPO or IJCAHPO®) was established to develop, train, and certify ophthalmic technicians in the U.S. and Canada.1 One of IJCAHPO’s six founding organizational supporters, AUPO, appoints a department chair representative every three years. Together, AUPO and IJCAHPO share in efforts to achieve human resource capacity-building goals.

The Bureau of Labor Statistics reports healthcare occupations and medical assisting account for 13 of the 30 fastest-growing occupations between 2019 and 2029, expecting to create over 139,000 new jobs.2 Healthcare occupations are projected to be in greater demand as team-based models are increasingly used to deliver healthcare services.

The American Academy of Ophthalmology (AAO) and IJCAHPO’s benchmark studies indicate an average clinic ratio technicians to ophthalmologists is 3:1.3,4 Utilizing web site reports of the AAO (19,216 U.S. ophthalmologists) and the Canadian Medical Association (approximately 1,200 ophthalmologists) in conjunction with this ratio, the projected calculation of technicians needed totals 57,648 (U.S) and 3,600 (Canada).5,6 IJCAHPO’s active database of technician numbers is approximately 50,000, leaving a gap of 10,000 technicians.

In IJCAHPO’s 2020 Salary and Benefits Study, over 7,000 certified and non-certified technicians reported an employment average of 12-14 years in ophthalmology, with certified technicians staying longer both in the profession (15-25 years) and with current employers (8-12 years) than non-certified personnel (6 years).7 Entry into the professions include academic training programs and on-the-job training, with over 85% indicating this latter pathway.7,8 Accredited training programs are limited to 6 Canadian and 30 U.S.-based programs. The International Council of Accreditation reported approximately 300 graduates per year, falling far short of projected needs.9

IJCAHPO’s national technician competencies and job analysis research underscores the need for a trained and assessed workforce to meet job requirements. Four of 5 ophthalmologists indicated certified AOP are better trained and more productive than non-certified technicians.3,4,9,10

IJCAHPO’s recruitment strategies include national career fairs, partnership with student health profession organizations, social and print media, employers, and job seekers’ resources such as a recruitment toolkit, Career Center and Jobs Posting site, job descriptions, career materials, and complimentary new hire online courses. Additionally, IJCAHPO is strengthening its training and certification initiatives.

Human resource capacity building ensures fulfillment of our workforce needs. A well-staffed eye care team is important for effective eye healthcare delivery.8 Strategies for AUPO’s support of IJCAHPO and workforce development include:

  • Establishing new AOP training programs – Universities with residency training programs are prime candidates.
  • Having the AUPO work directly with area technical colleges that provide ophthalmic technician certification.
  • Encouraging AUPO members to participate in instruction sessions for IJCAHPO and training programs.
  • Advocating training and assessment protocols for certification of technicians by AUPO members.


1.  www.jcahpo.org/about-jcahpo August 30, 2021.
2.  www.bls.gov/ooh/healthcare/home.htm?view_full
3.  Astle WF, et al. Survey on allied health personnel in Canadian ophthalmology: the scalpel for change. Can J Ophthalmol 2011;46:28–34.
4.  Woodworth KE, et al. A comparative study of the impact of certified and noncertified ophthalmic medical personnel on practice quality and productivity. Eye and Contact Lens 2008;34(1): 28-34.
5.  www.aao.org/newsroom/eye-health- August 30, 2021.
6.  www.cma.ca/sites/default/files/2019-01/ophthalmology-e.pdf August 30, 2021.
7.  store.jcahpo.org/?PROMO=jcahpoweb August 30, 2021.
8.  Astle WF, et al. A workforce in crisis: a case study to expand allied ophthalmic personnel. Can J Ophthalmol 2016; 51(4): 288-293.
9.  International Council of Accreditation Annual Report. July 2021. www.icaccreditation.org/accreditation/get_accredited.html. Unpublished.
10.  International Commission on Allied Health Personnel in Ophthalmology. Job Task Analysis. Criteria for Certification and Recertification. 2015, 2019.