Background: Orthoptists play a critical role diagnosing and managing vision disorders such as amblyopia, strabismus, and diplopia, which are common in Canada. While there is a lack of prevalence data nationally, Newfoundland and Labrador reported amblyopia prevalence at 4.7% while strabismus was 4.3% (Drover et al., 2008). In Northern Canada, 5.9% of Nunavik Inuit patients were at risk for refractive amblyopia (Tousignant et al., 2022). Globally, the prevalence of these disorders varies: a meta-analysis found higher prevalence of amblyopia in Europe (2.90%) and North America (2.41%) than Asia (1.09%) and Africa (0.72%), with global numbers projected to rise from 99.2 million in 2019 to 221.9 million by 2040 (Fu et al., 2020). Despite the increasing need for orthoptists in Canada, their distribution may not meet population health demands. Previous studies highlighted uneven distribution of ophthalmologists and optometrists across the country, especially in rural areas (Al Ali et al., 2015; Shah et al., 2020; Micieli, 2014), but no data is currently available on orthoptist distribution. 

Objective: This study aims to assess orthoptist distribution in Canada relative to population needs of vision services, address workforce shortages, and project educational needs to meet demand, informing workforce planning and ensuring equitable access to vision care across Canada.

Methods: A list of registered orthoptists practicing in Canada was generated from the Canadian Orthoptic Council member database, representing > 95% of orthoptists practicing nationally. The information was reviewed for services provided, area of work, and location; and the total number of orthoptists was compared to population growth and needs. Using statistical area classification, we categorized census subdivisions into metropolitan and metropolitan influence zones (categorised based on employed residents’ proportion), then, current orthoptist ratios estimated at health regions were mapped.

Key Insights and Implications: Canada faces a critical shortage of orthoptists, with uneven distribution favoring urban areas; similarly to ophthalmologists and optometrists (op. cit.). A key factor driving this is the dependence of orthoptist jobs on ophthalmology services, which are predominantly city-based. Studies have also shown lesser utilization and funds of vision services rurally, which contributes to these discrepancies (Gold et al., 2006; Lam and Leat, 2016). This leaves rural populations underserved, leading to delayed diagnoses and health inequities. Policies to increase training, offer incentives for rural placements, and improve telehealth are essential to address these disparities. Long-term workforce monitoring and equitable care strategies are strongly recommended to meet population needs and reduce vision health services disparities.