Mirror, Mirror on the Wall

I strongly believe that the biggest challenge we face in ophthalmology is inequality – in gender and diversity. And perhaps our biggest opportunity lies in actively addressing the problem, which exists for historical reasons but nevertheless persists across all aspects of ophthalmology – from the most senior executives to patients of all ages. The representation of women amongst consultant-level staff in the UK is still less than 40 percent (1), and only 1.8 percent of all consultants are of Black ethnicity (2). This lack of diversity negatively impacts on our discovery, advancement of ophthalmology, and – most importantly – the care patients receive.

In previous years, I felt disappointed that the Power List was so male-dominated, with only 17 percent of the 2020 list made up by women, and only one woman featured in the Top 10. And yet, there are brilliant female ophthalmologists working alongside us every day, making great contributions to our field. Why are they not getting the same recognition as their male counterparts? Although there was an entire Power List devoted to women in 2021, I think we need to ensure that there is equal representation in the joint Power List. We have a responsibility to address this imbalance, otherwise we are condoning inequality.

In my own field of genomic ophthalmology, there is a well-recognized dearth of genomic data from Black ethnic populations. And it decreases the interpretation accuracy of genetic tests for patients from those backgrounds; the majority of large databases used to interrogate patient genomes are from European ancestry and that’s why we struggle to determine whether a potential variant is common in a population or causes a certain disease.

In academic ophthalmology, there are still few female and ethnic minority senior role models despite greater diversity at junior levels. We see a physical representation of senior leadership, but it is not reflected in the mirror. Our views, approach, contribution, and methodologies need to be integrated at the highest levels to ensure that large strides are taken to tackle diversity and pave the way for clinical and research excellence.

I am proud to lead Women in Vision UK, which has 350 members spanning the country’s ophthalmology sector. We have forged strong international networks, but we cannot achieve significant change on our own. We must all work together to dispel the conventional stereotypes and embrace new ways of thinking and acting. We must welcome equality for all – at every level.

Mariya Moosajee

Professor of Molecular Ophthalmology at UCL Institute of Ophthalmology,
Group Leader of Ocular Genomics and Therapeutics at the Francis Crick Institute, Consultant Ophthalmologist specializing in Genetic Eye Disease at Moorfields Eye Hospital NHS Foundation Trust, London, UK