Gender disparity/inequity is always an interesting debate; a timeless issue in most aspects of life. Women are stereotyped as the weaker sex, and less capable leaders. They often have to work harder to prove themselves in most professions including medicine. Sadly, women receive less pay and have to fight harder to get promotions at work.
Currently, the number of women in ophthalmology is on the rise as the number of female medical students increases. When I started my ophthalmology training 24 years ago, I was the only female trainee and the first female academician in the department. I was lucky, my male colleagues were wonderful, they made changes (less boisterous) and allowed me to grow. They provided me with abundant opportunities for advancement in my career.
Women in glaucoma
The popularity of ophthalmology as a specialty programme among women is perhaps due to the nature of the work, which allows women to balance their career and family. Glaucoma is a popular subspecialty. Again this is due to the practice: clinic-based and shorter surgical procedures compared to, say, vitreoretinal surgery.
However, they still face bias: there are less opportunities for them to be invited as speakers in conferences or to professional industry relationships and they receive less payments from the pharmaceutical industry compared to their male counterparts1,2. There are just a handful of them sitting in the international boards or any regulatory bodies. All of this boils down to their gender. Their involvement in publications has increased tremendously but is still outnumbered by men among the corresponding authors for published papers2. The disparity does not just lie in the lack of opportunity but perhaps women prefer, in the face of social norms and implicitly accepted roles, to step back rather than to lean in and lead. Women in the glaucoma fraternity need to increase their visibility. They have what it takes to be future leaders and prominent researchers.
Glaucoma in women
Glaucoma is always perceived as a disease of deprivation. The incidence of glaucoma differs between urban and rural areas. In developing countries, women lack access to education and health care, leading to poor awareness and late diagnosis. In general, women have a longer life expectancy, which increases their susceptibility to glaucoma. However, gender-based discrimination can override this advantage and reduce female life expectancy to lower than or equal to that of males.
Women are at a higher risk – 4:1–of developing Primary Angle Closure Disease (PACD)3. Apart from their inherent biological advantage of living longer, ocular biometry of women predisposes them to PACD. Their physical build predisposes them to Normal Tension Glaucoma (NTG) and they are at a higher risk of glaucoma once they reach menopause3. These combined with socioeconomic burden and deprivation in society increases the risk of glaucoma blindness in women, especially older adults.
How can we address these broader causes of glaucoma? Due to the complexity of gender roles, an interdisciplinary approach is needed. We need glaucoma specialists, experts in women’s health and public health specialists to strategize to prevent glaucoma blindness in women. But this is key: women in glaucoma have to increase their visibility to improve the care for women with glaucoma.
- Reddy AK, Bounds GW, Bakri SJ et al. Representation of Women With Industry Ties In Ophthalmology. JAMA Ophthalmol 2016;134(6):636-643. doi:10.1001/jamaophthalmol.2016.0552
- Mimouni M, Zayit-Soudry S, Segal O et al. Trends in Authorship of Articles in Major Ophthalmology Journals by Gender, 2002–2014. Ophthalmology 2016; 123(8): 1824-1828. https://doi.org/10.1016/j.ophtha.2016.04.034
- Vajaranant TS, Nayak S, Wilensky JT et al. Gender and glaucoma: what we know and what we need to know. Curr Opin Ophthalmol 2010; 21 (2): 91-99. doi:10.1097/ICU.0b013e3283360b7e.