March 8 this year marked half a century since International Women’s Day was formally recognised by the United Nations (UN). This milestone presents an opportunity to reflect on the evolving role of women within the ophthalmic workforce of Aotearoa New Zealand and to assess both the progress made and the challenges that remain in achieving gender equity in the field.
New Zealand has a strong history of gender equality, being the first self-governing country to grant women the right to vote in 1893, thanks to the efforts of suffrage campaigners led by Kate Sheppard. Since then, the country has made significant strides in gender equality including the election of three female prime ministers and the introduction of policies supporting pay transparency and parental leave. New Zealand now ranks among the top 10 countries for gender parity in the 2024 Global Gender Gap Report¹, with a gender pay gap of 8.2% as of June 2024. However, it is important to acknowledge that wāhine Māori, Pasifika, ethnic and disabled women continue to face significantly higher pay disparities. While progress has been made, true gender equality remains a work in progress and, to achieve this in the workforce, equitable measures are required.
Gender issues in the ophthalmic workforce
The gender landscape within New Zealand’s ophthalmic workforce has seen notable shifts. As of 2023, 62% of optometrists were female, with the majority aged 55 years or younger, indicating a growing female presence. In contrast, in 2023, female ophthalmologists made up just 27% of the workforce. However, this is projected to rise to 38% by 2050², with the growth reassuringly supported by an increase in female RANZCO trainees, who comprised 36% of new intakes in 2023³.
While gender representation in optometry has surpassed parity and is gradually improving in ophthalmology, this progress has not translated into senior academic roles or research authorships. Female optometrists remain underrepresented in leadership positions such as editors-in-chief and editorial board members of leading optometry journals (as seen in the top five leading optometry journals included in the ophthalmology category of Journal Citation Reports⁴). Female optometrists are also less frequently listed as last (anchor/senior) authors, though first-author roles are approaching gender parity⁴. This suggests that, while more women are entering the field and contributing to research, the transition to senior leadership remains a challenge.
For female ophthalmologists, pervasive gender disparities persist at all career stages. Despite the growing number of women entering the profession over the past three decades, this was not associated with an increase in female representation in clinical or academic leadership positions⁵,⁶, first-author research publications⁷ or pay parity⁸. In fact, within ophthalmology trainees, females performed fewer cataract operations and total procedures than their male counterparts, despite no association between complication rate and gender of operating surgeon⁹,¹⁰. Beyond surgical training disparities, female ophthalmologists within Australasia reported additional obstacles in career advancement, including difficulty receiving mentorship (despite gender-specific mentorship being crucial for female professionals), travel difficulties due to family responsibilities, greater child-rearing responsibilities, rigid timelines for promotion/tenure and gender-based discrimination¹¹-¹³.
Targeted initiatives and institutional policies promoting equity in training opportunities are helping bridge these gaps but they are not perfect and are ever-evolving. Expanding mentorship programmes and advocating for flexible career pathways will be crucial in achieving greater gender balance in the field.
Pioneers in New Zealand and Australia
Despite these challenges, recent years have witnessed significant progress for female ophthalmologists in leadership roles in Australasia. In 2018, Associate Professor Heather Mack became the first female president of the Royal Australia New Zealand College of Ophthalmologists (RANZCO).
In 2023, Dr Liz Insull became the first female elected as the New Zealand branch Chair for RANZCO, following in the footsteps of the late Dr Dorothy Potter, who led the New Zealand Ophthalmological Society (established in 1946) from 1984. Professor Helen Danesh-Meyer, the first female surgeon elected as a Fellow of the Royal Society Te Apārangi and New Zealand’s first woman named to The Ophthalmologist’s Power List, has been recognised among the world’s Top 100 most influential ophthalmologists from 2021 through 2025. In 2020, Professor Justine Smith became the first woman to serve as editor-in-chief of Clinical and Experimental Ophthalmology, a leading Q1-ranked ophthalmology journal and the official journal of RANZCO. Most recently, she commissioned a 'Women in Ophthalmology' special issue of Clin Exp Ophthalmol for 2024, featuring women-led review articles¹⁴.
Notably, the University of Auckland has been leading the way in regard to equity over the last 25 years. Of the 10 current professorial-level positions in the Department of Ophthalmology, three professors (Profs Danesh-Meyer, Jennifer Craig and Ilva Rupenthal) and three associate professors (A/Profs Andrea Vincent, Stuti Misra and Jie Zhang) are female.
Greenlane Clinical Centre, New Zealand’s largest public clinical and surgical ophthalmology service, is also approaching gender equity, with clinical director Dr Sarah Welch and 20 of the 50 specialist ophthalmologists being female.
These trailblazers have paved the way for future generations of women in ophthalmology, demonstrating that leadership and excellence are achievable despite systemic and inherent challenges. Their achievements highlight the importance of continued advocacy and institutional support to sustain this momentum.
Women in Vision
Women in Vision Aotearoa New Zealand (WIV NZ) was founded in 2022 to foster a supportive and inclusive environment for women in vision research, clinical practice and ophthalmic innovation. Our mission is to build a strong interconnected network of women across the field – advocating for gender equity in funding, leadership and professional development, while also driving research initiatives that address the unique challenges faced by women in eye health.
Central to our mission is the creation of a safe and empowering forum where women can engage in open dialogue around professional challenges, whether navigating career progression, achieving work-life balance, or managing the intersecting demands of family and clinical or academic responsibilities.
Recent WIV NZ conference attendees, comprising ophthalmologists, registrars, optometrists and medical and optometry students
Since its inception, WIV NZ has organised conferences and networking events, bringing together researchers, clinicians and industry leaders to discuss advances and challenges in the field. Our November 2024 conference fostered collaboration between ophthalmology and optometry, as well as medical students – a move that saw us breaking down hierarchical barriers while promoting empowerment. This collaboration is now a key part of the WIV NZ’s mission, with our advocacy helping spark meaningful conversations around gender bias in both professions. Through ongoing mentorship initiatives and support for women-led innovation, WIV NZ is making tangible strides toward a more inclusive future in vision science.
While gender disparities persist in ophthalmology and optometry leadership, the momentum for change is undeniable. With continued support and commitment from the broader ophthalmic community, we can continue to empower women in the ophthalmic workforce to take their stand. As former UN secretary-general Ban Ki-moon said, “Achieving gender equality requires the engagement of women and men, girls and boys. It is everyone’s responsibility.” And, as US social-political activist Gloria Steinem reminds us, “The story of women's struggle for equality belongs to no single feminist nor to any one organisation, but to the collective efforts of all who care about human rights.”
References
1. World Economic Forum (2024) Global gender gap report 2024. Available at: https://www.weforum.org/publications/global-gender-gap-report-2024/in-full/ (Accessed: 08 March 2025).
2. Yen Hong C, Merriman M, Wilson G, Chiong Hong S. Update and projections for New Zealand's ophthalmology workforce. N Z Med J. 2024;137(1599):27-36. Published 2024 Jul 19.
3. https://ranzco.edu/news/ranzco-2023-2024-annual-report/
4. Cardona G, Herrera A. Gender distribution in publishing in five leading optometry journals. Ophthalmic Physiol Opt. 2024;44(3):634-640.
5. Rousta N, Hussein IM, Kohly RP. Sex Disparities in Ophthalmology From Training Through Practice: A Systematic Review. JAMA Ophthalmol. 2024;142(2):146-154.
6. Vought R, Vought V, Lin M, et al. Gender Representation Among Ophthalmology Fellowship Directors in 2022. Am J Ophthalmol. 2024;259:166-171.
7. Heng Wong MY, Tan NYQ, Sabanayagam C. Time trends, disease patterns and gender imbalance in the top 100 most cited articles in ophthalmology. Br J Ophthalmol. 2019;103(1):18-25.
8. Gill HK, Niederer RL, Shriver EM, Gordon LK, Coleman AL, Danesh-Meyer HV. An Eye on Gender Equality: A Review of the Evolving Role and Representation of Women in Ophthalmology. Am J Ophthalmol. 2022;236:232-240.
9. Gong D, Winn BJ, Beal CJ, et al. Gender Differences in Case Volume Among Ophthalmology Residents. JAMA Ophthalmol. 2019;137(9):1015-1020.
10. Gill HK, Niederer RL, Danesh-Meyer HV. Gender differences in surgical case volume among ophthalmology trainees. Clin Exp Ophthalmol. 2021;49(7):664-671.
11. Jain NS, Kersten HM, Watson SL, Danesh-Meyer HV. Gender differences in Australasian ophthalmologists' experiences of the workplace. Clin Exp Ophthalmol. 2019;47(6):706-712.
12. Paul M, Dweck M, Chadha N. Ophthalmology Education Leadership Attitudes Toward Mentorship of Female Medical Students. Am J Ophthalmol. 2022;243:149-157.
13. Danesh-Meyer HV, Deva NC, Ku JY, Carroll SC, Tan YW, Gamble G. Differences in practice and personal profiles between male and female ophthalmologists. Clin Exp Ophthalmol. 2007;35(4):318-323.
14. Cartwright, V.A. and Smith, J.R. (2024), Women in ophthalmology. Clin Exp Ophthalmol, 52: 133-134.
Dr Joevy Lim is a RANZCO trainee in Auckland and was a recipient of an HRC clinical research training fellowship for her PhD, A contemporary appraisal of ocular melanoma in Aotearoa New Zealand.
Professor Helen Danesh-Meyer is an international authority in glaucoma and neuro-ophthalmology. She is one of the most highly regarded specialists in her field, having published more than 120 articles.