I n 1904, the American Academy of Ophthalmology (AAO) welcomed its first woman as a member of the newly formed professional society. Since that time, the proportion of women practicing as ophthalmologists has grown significantly, but the disparity persists; in 2024, over 50% of U.S. medical students were women. Of the practicing ophthalmologists in the United States, 26.2% are women; this number has been bolstered by the growing number of women choosing ophthalmology as a career, now measuring 38.6% of ophthalmology residents.
This Perspective traces the historical roots of the critically important professional group Women in Ophthalmology (WIO) that supports career growth for women ophthalmologists today. The value of specific groups in supporting underrepresented populations in organizations has been documented. , Such groups are well positioned to create a sense of community and provide a platform for mentorship and advocacy. WIO began when the number of women ophthalmologists who attended the AAO could be counted on 2 hands, and many of these early women leaders are currently semiretired, retired, or deceased. Thus, documenting the humble beginning of this organization is not only long overdue but also important to recognize the courage and efforts of these early founders.
The context of this historical account dates to the 1970s, a time that exemplifies enormous change and upheaval in the United States. This was the period following the passage of the Civil Rights Act in 1964, a significant increase in the numbers of women in the professional workforce, and an emergence of an empowering culture that was fundamentally shaped by protests against the Vietnam War across campuses in the United States. This historical journey of WIO began with Marjorie Mosier, an ophthalmologist who completed her residency in the early 1970s, more than 50 years ago. She realized that gender equity in an academic setting would be a cultural challenge, and, undoubtedly, in those early times of reflection, she would never have envisioned the birth of a thriving national organization that would carry her energy for generations beyond her own career journey. This early saga may illuminate a path toward opportunity and a transformed environment of objective meritocracy for women, as well as leadership accountability. Currently, progress is still needed to achieve fairness without gender discrimination.
EARLY CHALLENGES
In 1976, Marjorie Mosier, a retina specialist, was a junior tenure-track faculty member in the Division of Ophthalmology, Department of Surgery at the University of California, Irvine (UCI) (M. Mosier, personal communication, May 10, 2024). She had not experienced gender bias during her training. By her account, the Stein Eye Institute, University of California, Los Angeles (UCLA) where she completed her residency and fellowship treated her fairly. However, this was not her observation at UCI. Within several years, it became apparent to her that she was being treated differently from the male faculty members in the Division. She was the only woman in a group of 3 male full-time ophthalmologists and realized that there were no other women in the tenure-track faculty in any of the other surgical specialties. Discussing the inequities with ophthalmology decision-makers, the Dean of Academic Affairs, and the University Ombudsman led to no changes. The differences in staff support, assigned space, research support, and travel support underscored systemic inequities. One egregious issue involved a higher salary for a new, junior male member, which was discovered accidentally. It took several months for the pay inequity to be resolved.
In her UCI university-based practice, Marjorie Mosier saw a number of women faculty as patients and heard unbelievable stories of unfair treatment. It was then that she decided that remaining silent about her observations was not an option. A few brave women had previously attempted to bring change to the University of California system before Marjorie Mosier’s time but with unsatisfactory results. She learned that when women left a campus and applied for teaching positions at other institutions, they would not be hired. The administrative network among universities and departments was the basis. These actions resulted in personal challenges in many instances; some of these women were single heads of households, frequently with children and mortgages, and were in an untenable situation.
Marjorie Mosier’s individual travails, which worsened over time, led to legal action. By 1979, she had heard enough stories of unfair and illegal treatment of women faculty members to convince her that it was a widespread problem at UCI and at other institutions. She was curious to know the extent of gender bias in other academic departments of ophthalmology across the country and became committed to change the environment in which women build their professional careers.
There were very few women in academic ophthalmology at that time, and Marjorie Mosier contacted the ones that she knew, thinking that it might be productive to get together at the annual AAO meeting. For the 1979 meeting in San Francisco, she invited these women to gather for a luncheon at Trader Vic’s restaurant. All 7 invitees, Bronwyn Bateman, Moira Jeanne Burke, Karen Fallis, Ann Barker-Griffith, Jane Kivlin, Sheila Margolis, and Elise Torczynski, attended the luncheon and were excited to gather and discuss challenges ( Figure 1 ). There was considerable interest in continuing to meet and discuss careers as well as the observed widespread biases in academia. Marjorie Mosier continued to organize lunches at the annual AAO meetings to discuss common concerns.
For the first year or 2, the invitees were all in academics, but there was a sentiment that such a group would be of interest to women ophthalmologists in other professional settings. Bronwyn Bateman, a UCLA Stein Eye Institute resident when Marjorie Mosier was a retina fellow, suggested that all women ophthalmologists and trainees be included, an appealing idea. The number of women attending her events continued to increase and the group named itself “Women in Ophthalmology.”
Discussion topics included the need for equal recognition, equal pay, and equal opportunity. During the first approximately 8 to 10 years, Marjorie Mosier organized and managed the arrangements, and she was, ipso facto, the founder and initial organizer of WIO. Although she does not recall the year in which formal elections were finally held, Marjorie Mosier’s role as President of WIO was established in the 1980s.
In the early 1980s, Marjorie Mosier was involved in the creation of “We Advocate Gender Equity” (WAGE). Its purpose was to “…to end gender bias and achieve gender equity in the hiring, retention, promotion and compensation of academic women within the University of California System.” At the meetings, usually on the UCI campus, illegal and unfair personnel actions were discussed. We learned that Northern California harbored the same sorts of problems and merged the 2 groups of activists. News media in both the north and south, and other states quickly reported on our issues.
Marjorie Mosier passed the leadership baton to Bernice Brown, then in private practice and affiliated with the Doheny Eye Institute and the University of Southern California. She arranged for the WIO events at the AAO meetings to be held in clubs affiliated with the Los Angeles Athletic Club of which she was a member. The number of attendees continued to increase. There was clearly a need for women ophthalmologists to share their experiences and discuss ways to improve the professional environment. At the time, this forum provided an important platform for many women who were considering changing positions or even leaving the field.
GOVERNANCE AND EARLY ACTIVITIES
WIO quickly developed a formal infrastructure for governance, establishing a Board of Directors under the leadership of Penny Asbell, then of Mount Sinai School of Medicine, New York, who was elected to lead the organization in 1988. The organization was incorporated in 1989 and received tax exempt status (Section 501(c)(3)) in 1994. These legal transactions generated the impetus for a formal governance structure with bylaws, elected officers and Board of Directors, formal membership, and annual programming, all of which continues to this day. In 1989, Penny Asbell corresponded with Bruce Spivey, Executive Vice President of AAO, and determined that approximately 8% of practicing ophthalmologists were women; he also provided a list of women who participated in AAO activities (P. Asbell, personal communication, January 4, 2025) ( Figure 2 ). The first Board of Directors meeting was held in 1990 in New Orleans at the AAO. Members included Penny Asbell, Jane Kivlin, Bernice Brown, Marilyn Miller, Suzanne Veroneau-Troutman, Marjorie Mosier, Gail Summers, Eve Higginbotham, Nancy Ronsheim, Mary Stefanyzyn, and Kimberly Neely. The WIO Board developed a plan to provide speakers for an annual course at the AAO meeting. Early programs included Bruce Spivey; Marilyn Miller; Perri Klass, a pediatrician and author of Are Women Better Physicians ?; Frances Conley, a neurosurgeon who had threatened to resign from Stanford Medical School over biased treatment of herself and female faculty; George Garcia, President of AAO; Susan C. Stewart, President of the American Medical Women’s Association; and Deborah Tannen, a linguist and author of You Just Don’t Understand: Women and Men in Conversation.
