My optometric journey has been a very different career path than I expected, but it has been fulfilling in ways I never envisioned.
My career began as a Peace Corps volunteer and has since led me to clinical practice across a range of settings, leadership roles in the development and implementation of education programs, hands-on provider training, technical consultation for various community-based programs, and optometric writing.
These experiences have allowed me to live in Nepal, Kenya, Vietnam, Moldova, and Israel—broadening my perspective on the world, deepening my understanding of optometry’s role on a global scale, and enhancing my skills as a clinician both at home and abroad.
While it hasn’t been without challenges, I wouldn’t change anything if I could do it all over again.
Where to look for international optometry opportunities
International opportunities vary drastically in terms of scope, time commitment, and earning potential. The possibilities are endless, but it is important to find the right fit.
Clinical opportunities in global optometry
Military bases
Military bases provide opportunities abroad that are most similar to US clinical practices. These offices are overseen by the Army and Air Force Exchange Service (AFFES) and offer eyecare services to military personnel and their families. Inquiries can be made to an AFFES regional general manager for your preferred location(s).
Hospitals and international clinics
Being an optometrist in a hospital or international clinic provides the opportunity to practice at a local level with strong organizational support. You will see local and expatriate patients while working within a local provider network.
Some facilities will have established optometric services, and others are open to expanding with a new department. You can find a list of reliable, reputable in-country medical facilities in the US Citizen Services section of the US embassy website as a starting point.
Additionally, an internet search for international clinics and hospitals in the city (or country) where you would like to live can provide other options. There are often expat guides and forums (here is a good example from Vietnam) that list the top clinics for an area.
Local private practices
Private practice is another option and can be very rewarding, although these opportunities may be challenging to find. These are usually smaller offices without as much network support.
If you can provide services in the local language, this could be a perfect opportunity with a lot of growth potential.
Volunteer opportunities
Volunteering is usually a short-term commitment with mobile clinics. Multiple organizations coordinate international efforts. Volunteer Optometric Services to Humanity (VOSH) International, VOSH disaster relief reserves, Unite For Sight, Orbis, and OneSight are all great organizations to start your search.
Non-clinical global optometry opportunities
Most non-clinical opportunities focus on public health programs and eyecare provider education/training to expand high-quality eyecare services through optometry—a proven approach to maximize limited resources and improve eyecare accessibility.
Many non-governmental organizations (NGOs) and non-profit organizations strive to help address the estimated 1+ billion cases of avoidable vision impairment and blindness around the world.1 Uncorrected refractive error and presbyopia, a hallmark of optometric practice, account for over 900 million of these cases.
Figure 1 illustrates the global cases with leading causes of avoidable vision impairment.2
Figure 1: Data adapted from World Report on Vision.
Addressing the global shortage of optometrists
The global shortage of optometrists largely contributes to the problem. Most middle and low-income countries have inadequate optometrist-to-patient ratios to meet the world’s growing eyecare needs. For example, there are 156 optometrists per million people in high-income countries vs. as low as two optometrists per million people in Sub-Saharan Africa.3
Table 1 represents the current global workforce of optometrists based on median ODs per million by global burden of disease (GBD) super region.3
| GBD Super Region | Median Optometrists Per Million |
|---|---|
| High Income | 156 |
| Latin America and the Caribbean | 31 |
| Central Europe, Eastern Europe, and Central Asia | 48 |
| North Africa and the Middle East | 34 |
| Sub-Saharan Africa | 2 |
| South Asia | 10 |
| Southeast Asia, East Asia, and Oceania | 5 |
| Global | 18 |
Table 1: Courtesy of The International Agency for the Prevention of Blindness.
Top 5 organizations for non-clinical global optometry opportunities
- Hellen Keller International (HKI): HKI supports community-based programs and achieves great success in improving access to eye care, providing medical care, and improving access to nutrition in remote areas of 20 countries in Asia, Africa, and Europe.
- Brien Holden Foundation: The Brien Holden Foundation is based in Australia and has local and international programs. Some are clinic-based, while others are provider training and education to establish and strengthen community eyecare services.
- World Council of Optometry (WCO): The WCO offers a grant program supported by the World Optometry Foundation (WOF) designed to foster eyecare delivery and optometry professional development with long-term sustainable results worldwide.
- Sightsavers: Sightsavers aims to address uncorrected refractive errors, improve ocular health, and advocate for the rights of people with vision loss and other disabilities in 30 countries around the world.
- VOSH Corps: VOSH Corps offers short- and long-term options for getting involved in optometric education on an international level. Optometrists receive compensation for each 1-year assignment they’re able to commit to.
9 steps to get started in global optometry
1. Have your passport ready.
You should have a valid passport for 6 months beyond your planned stay. The current processing time is 7 to 10 weeks to apply for or renew a current passport.4 Passports can be renewed abroad, if needed, at the US Embassy or Consulate.
2. Inquire about a work visa.
A work visa allows you to live and work in a foreign country. It is important to understand the general application process, which takes 3 to 6 months.5 Discuss this with the hiring employer, as they usually submit the application on the employee’s behalf.
3. Make an appointment with your PCP.
Discuss health concerns, current prescriptions, routine vaccines, and all country-specific recommended vaccines with your primary care physician (PCP) to ensure you are fully prepared.
If necessary, find a clinic for any vaccines not readily available through your regular office.
4. Locate the US embassy or consulate abroad.
Familiarize yourself with the US embassy website and physical location(s). Save the contact information for US Citizen Services for emergency assistance and find various local resources (medical, legal, etc.) and other valuable information.
5. Enroll in the Smart Traveler Enrollment Program.
The Smart Traveler Enrollment Program (STEP) enables the embassy to contact you with important safety information in the case of an emergency (natural disaster, civil unrest, etc.), as well as help family and friends get in touch with you in case of an emergency at home.
6. Find a place to live.
It is important to have local input and/or a guide to help you find the perfect abode. Your employer, future colleagues, and online expat forums are great places to start and can give valuable insight into housing and real estate agents.
7. Research the local cost of living to plan your budget.
Websites like Nimbeo break down overall expenses on local economies and give a realistic idea of what to expect in terms of a monthly budget.6
8. Prepare your digital and electronic devices.
Know the local current and socket type, verify compatible voltage range for each device on plug (often 100 to 240V), and purchase appropriate adapters and/or transformers, if necessary, for large appliances.
An adapter or compatible plug is adequate for most digital devices. These are often readily available locally but be prepared for immediate use upon arrival.
9. Manage student loans.
Educational debt can hinder ambitions of practicing internationally. It is important to have a game plan for handling student loans when practicing abroad.
Organizations like MedSend can help doctors pay for their student loans while practicing internationally.
What to expect from international optometry opportunities
Living and working abroad has its share of challenges but provides opportunities for personal and professional growth that far outweigh the difficulties. You will find yourself on adventures you never thought you’d have, building bonds with people you wouldn’t have otherwise met, and missing things from home you never knew you liked.
It is a time for exploration and discovery while developing a deep appreciation for home.
Potential obstacles to living and working overseas
Incompatible banking systems
Some employers may not have the capacity to deposit money into a foreign account, and US banks often have foreign transaction fees, which can add up. Discuss payment methods and consider opening a local bank account and a no-fee credit card.
Confusing tax implications
While you should not have to pay taxes in the country you reside as a US citizen, you must file US tax returns if you meet a threshold. Be aware of what that means for you.
Culture shock
Living in a different country and learning the ins and outs of a new job can be challenging. Adapting to a new way of life, forging new friendships, and establishing a personal daily routine all require time and effort.
Difficulties in communication
Cultural and language barriers add complexity to effective communication, professionally and personally. Be patient and give it time.
Customs
If traveling with ophthalmic supplies, equipment, glasses, etc., be prepared to present all necessary customs forms upon arrival. These forms should be completed weeks in advance of your arrival.
There is nothing worse than having valuable equipment and supplies confiscated at customs because a form wasn’t filled out properly.
4 tips to thrive in foreign settings
- Learn the language: Make an effort to acquire some language skills, people will appreciate your effort. Even a few common phrases will go a long way.
- Embrace the culture: Gain a basic understanding of the local culture. Continually ask questions as opportunities arise, this will help deepen your understanding and provide insight into the local culture and perspective.
- Be versatile: Things will rarely go as planned, and your ability to adapt is crucial. Creative problem-solving allows you to adjust your clinical routines to the environment without sacrificing quality and accuracy.
- Seek out fellow expats: Fellow expats can relate to your experiences and the challenges you encounter, offering a sense of camaraderie. This helps you create social connections, enhances your experience, and potentially provides networking opportunities.
Final thoughts
Venturing into the world unknown is challenging, both personally and professionally. While compensation may not be equivalent to practicing in the US, international optometry can provide invaluable experiences in character development.
It forces you out of your comfort zone and changes how you see the world, yourself, and your profession. It’s a leap of faith, but with preparation and the right attitude, it will be the experience of a lifetime.
