At the 2025 American Glaucoma Society (AGS) Annual Meeting, a roundtable discussion brought together a panel of distinguished glaucoma experts to reflect on their personal journeys and professional insights. Moderated by Marlene R. Moster, MD, the session offered an honest and inspiring dialogue on the challenges and triumphs that women face in the specialty. Topics included navigating diverse career paths, building supportive mentorship networks, fostering inclusive leadership, and addressing ongoing disparities.

The following is an excerpt from this thought-provoking conversation, showcasing the perspectives and experiences of women who are helping to shape the future of glaucoma care.

CHOOSING A CAREER PATH

Marlene Moster, MD: After we completed our residency, we had three career options: academia, private practice, or potentially a hybrid approach that combined both. Dr. Piltz-Seymour, which option did you choose, and how did you navigate your career path from there?

• Jody Piltz-Seymour, MD: I began my career in academia, and I had intended to continue in academia. I started as an assistant professor at the Scheie Eye Institute of the University of Pennsylvania in Philadelphia. I stayed at Penn for 14 years, and it was wonderful for most of that time, but there were ways that I wanted to structure my life between work and home. While I would have preferred to stay in academia, I decided to look for a place in private practice where I could also continue as an academic.

I joined the faculty at Wills Eye Hospital in Philadelphia, which was very welcoming. Eventually, I found a good home in private practice, although it wasn’t the first or second place where I landed. I searched for a practice with a supportive, patient-centric culture and found a home at Valley Eye Professionals. Valley Eye is a lovely practice, allowing superb patient care, and it afforded me the camaraderie and lifestyle I was looking for. In fact, I just retired from Valley Eye after 10 years there.

If there’s a lesson from my experience, it’s that you should be able to find a practice that meets the needs of what you want in life and in your career. It might be difficult to find, and you might not get it right the first time, but it’s worth striving for.

Dr. Moster: Dr. Bedrood, you made an interesting transition. How did you navigate that journey?

• Sahar Bedrood, MD, PhD: Even before medical school, I knew I wanted to be an academic physician. I completed a medical science training program and earned an MD-PhD in protein chemistry and molecular biology. My vision was to work in an academic setting as a scientist, physician, and educator. After my fellowship at Johns Hopkins Wilmer Eye Institute, I accepted a full-time faculty position at another university.

I soon learned that the trifecta I envisioned is not always possible in every academic setting. Research requires grants, and in order to have grants, you have to have time to write them. You also need some support from the institution in the early years.

When I was assigned to the clinic full-time, I knew there would be no time for me to pursue research, so I decided to turn my attention to the educator part of my vision and focus on the residency program. Unfortunately, that also was not well supported, and I watched as men who were junior to me advanced to program director.

I wasn’t fulfilling my vision in that setting at that time, and I wanted more out of my career, so I decided to go into private practice. That was a major shift in my identity, as I’d spent a great deal of time earning a PhD, but the reality was that I loved surgery and the clinic. I was 100% okay with that move, because I could practice in a setting that was conducive not only to myself and my family but also to my overall vision of the type of doctor I wanted to be.

Dr. Moster: Dr. Rosdahl, you’re an academic physician, a tenured associate professor. How did you come to that decision? Are you happy with it?

• Jullia Rosdahl, MD, PhD: I loved hearing about Dr. Bedrood’s experience because I started out the same way. I also did an MD-PhD. My PhD is in developmental neuroscience. Even before I was a medical student and an MD-PhD student, I envisioned being that triple threat: a scientist, a doctor, and an educator. That’s what I was aiming for during my graduate work at Case Western Reserve University. My PhD led me to ophthalmology and my residency at Massachusetts Eye and Ear, and then I gravitated toward glaucoma.

I finished fellowship at Duke University, where we had a wonderful chairman, David Epstein, MD. He believed in the idea of the clinician-scientist and was comfortable with some of the inefficiencies needed in order to figure that out and get that going. That helped me build a strong foundation and to feel good about staying in academia.

Am I happy with this decision? That’s a resounding yes! I cannot imagine not being able to be an educator, researcher, and clinician—to share the intricacies of the optic nerve with my students; to collaborate with colleagues on research; and to take care of patients, which is why we do what we do.

Dr. Moster: Dr. Smith, you’ve had incredible experiences in various places. Please tell us where you began and what your decision-making process was like.

• Tosin Smith, MD: Most people don’t know it, but I’m a foreign medical graduate. I matched into ophthalmology at Howard University in Washington, D.C., while working in a surgical residency in the United Kingdom. My first day of work at the Washington Hospital Center in my intern year was the day after I arrived in the United States. Since then, I completed residency and fellowship at Wills Eye Hospital. My job search was limited by the fact that I held a J-1 visa and thus could accept only a J-1 waiver job. While navigating the system, one thing I decided—and what has driven me my whole life—is that whatever I do has to be impactful.

My decision to go to the University of Mississippi was reinforced by what my chairman at Howard and my mentors at Wills always told me, “Trust your training.” Here I was, just out of fellowship and going to work in Mississippi, which has a large population of people with glaucoma, at an institution where there had never been a glaucoma department. They had not had a full-time glaucoma doctor on staff in 40 years.

I dove in at the deep end and started that department. It was challenging and gratifying. It was just me, south of Memphis and north of New Orleans, with nobody to call upon for support or backup.

After six and a half years, my husband and I moved to Texas. I contacted every glaucoma specialist in the Dallas-Fort Worth area to find out if they were hiring. I joined Glaucoma Associates of Texas, and that was 15 years ago. It was the right fit.

INDEPENDENCE AND A PATH TO PARTNERSHIP

Dr. Moster: Dr. Bedrood, how important were your independence and your partnership process in our decision to transition from academics to private practice?

• Dr. Bedrood: One of the main reasons I transitioned from academia to private practice was for independence and flexibility. I wanted to own my career trajectory. Partnership wasn’t the first thing on my mind. I focused more on creating the best daily situation for myself. In the next phase of my professional life, I might think about partnership, but that was secondary to having a sense of independence.

Dr. Moster: Dr. Smith, how about you?

• Dr. Smith: I joined an existing group, and looking back now, I wouldn’t have done it differently. Having partners in a nurturing practice can be a good thing. The group supports you, so that you can spend a day with your child, go on a trip, or attend a meeting and know that your patients will be taken care of.

When I joined the practice, I wasn’t thinking so much about partnership. I was more concerned about the environment, because there are different types of private practice. There are those where you’ll just see patients and that’s fine, but there are others that create an environment where you also can teach or do clinical research. To be able to do that, you need a certain type of group to support you.

VALUE OF MENTORS

Dr. Moster: Each of us has had at least one mentor, someone we looked up to, someone who helped us forge our way. How crucial was this in your development and your success, and how important is it that we mentor others to become the best they can be?

• Dr. Smith: When I trained at Wills Eye Hospital, I had 8 attendings: 7 men and 1 woman. That woman was Dr. Marlene Moster. When I think back to that experience, I realize that year could easily have been different if all of my attendings were men.

As I watched Dr. Moster, I recognized not only what she did for us as her fellows but also how well she navigated being the only woman in the department. She was confident in her skills and fully in charge. This experience told me that not only was I capable in what I had learned but also literally anything was possible.

If you have a mentor who shows you what the possibilities are, it changes your outlook when you reach beyond wherever you are. Being a mentor to other people becomes really important. For me, it’s clear what my mission is: I’m here to help people in any way that I can. I mentor medical students, and I mentor minorities. I mentor my colleagues, and they mentor me. Treasure your mentors, not only for what they teach you directly, but also in how they live their lives, and then be there to provide the same guidance for others.

• Dr. Bedrood: I think there can be many different types of mentorship. Some people have been mentors to me, and they didn’t even know it. Just by observing them, I saw that they could be amazing surgeons and have a thriving career while also having a family. I know that nobody can really do it all, but seeing people doing any of these can be really inspiring.

I also want to mention that some of the most impactful mentors for my career have been men. When I was at Doheny Eye Institute for residency, 2 or 3 men who were senior attendings were true mentors to me. I think it’s crucial that it’s not just women mentoring women, but men mentoring women as well and bringing them into the fold.

• Dr. Rosdahl: I would encourage all of our younger glaucoma physicians to ask for help. When you see something that you’re interested in, or you want help with something, ask a colleague, whether it’s a man or a woman. Don’t be afraid to ask for help.

FINDING YOUR NICHE IN GLAUCOMA

Dr. Moster: A key aspect of success as a glaucoma physician is ensuring that your skills are recognized by other physicians. How have you established a niche for yourself in either academia or the private sector?

• Dr. Rosdahl: People often try to find a niche by looking for a place where they can fit in, where there’s a gap, even if it’s not doing something they love. My advice is to start by doing something that you’re passionate about.

I always look for a place where I’ll bring value with my training, passions, and skills. That’s what led me to patient education as a research topic and to some of the wellness activities that I’m involved with, because these are things that I really care about. My background gives me a perspective that might be useful. Even though some people around me were saying, “I don’t think that’s important or scholarly,” 14 years later, I can say I was right.

• Dr. Piltz-Seymour: The niche that I tried to fill when I was in academia involved large-scale, multicenter clinical trials. That’s a wonderful entry point into clinical research. Being part of various trials over the years, including the Ocular Hypertension Treatment Study and the Collaborative Initial Glaucoma Treatment Study, provided opportunities for me to collaborate with and learn from exceptional clinicians and researchers. For me, that was very important.

When I went into private practice, I was able to bring those skills with me to perform clinical trials in the office. There’s a real sense of freedom when you leave academia, knowing that you can design a clinical trial and make your own decisions. I learned that I could pilot the ship.

• Dr. Smith: I definitely agree that you should do what you’re passionate about. While I was at the University of Mississippi, I took care of children who had glaucoma because there was nowhere else for them to go. Over the years, I’ve become that eye doctor who sees all of the kids. It’s challenging, but it’s absolutely rewarding.

I’m also involved in global outreach. It’s my passion to reach out to the world to train other doctors. When you’re in an environment that nurtures and allows you to follow your passion, run with it.

• Dr. Bedrood: All of these comments resonate with me. When you find something that you really want to do, whether it’s the business aspect of practice or research or education, you should focus on it during your first
few years.

If you’re in a setting where you’re not doing the thing that you want to do, that tells you everything you need to know to move on. As for me, I doubled down on the things that I thought were really fun, such as speaking panels, conferences, and consulting. I would not necessarily have done those things if I’d stayed in academia.

BECOMING A LEADER

Dr. Moster: Leadership roles in glaucoma can influence your standing within your department or practice. How can women identify leadership opportunities, and how can young doctors be recruited into leadership positions to ensure that women in glaucoma continue to advance?

• Dr. Smith: There are two aspects to leadership. First, as an individual, if you want to be in leadership, you have to acquire skills that demonstrate your capabilities. Second, it’s important to be in an environment that will nurture that desire.

Shortly after I arrived at the University of Mississippi, I took ownership of the glaucoma department and put it together, which demonstrated to my chairman that I could be the medical director for the department. When they needed someone to lead a new committee, the chairman volunteered me. I didn’t ask for those positions, but I took what was given to me, and I performed so well that my leadership potential showed through. Anyone seeking a leadership role should also have mentors who know them well and volunteer them for certain positions.

Finally, whatever you do, do it brilliantly. Don’t be shy about showing off the good that you’re doing, because people will see it and put you forward for the next leadership position.

Dr. Moster: Dr. Piltz-Seymour, you are a strong leader; it’s part of your fabric. How do you inspire younger people to follow in your footsteps? How do you guide them while being both nurturing and assertive in your vision of “going for the top”?

• Dr. Piltz-Seymour: When you’ve reached a leadership position, it’s important not to go it alone. Remember that there were people who helped you get where you are, and now it’s your turn to bring others along with you.

As we advance in the field, it’s important to pull everyone along with us. There are so many women who are capable, and it’s wonderful for them to know that you’re there to encourage them to put themselves out there.

Every year, the American Glaucoma Society calls for volunteers to serve on various committees. I recommend that those wanting to become more involved just say yes. Talk to the heads of committees and the leaders of the societies and make your desires known. It’s important for us to remain a community and be supportive of each other.

WOMEN SUPPORTING WOMEN

Dr. Moster: Women in glaucoma are like a sisterhood. We share our complications readily and our successes quite easily. How can we guarantee that other women are involved at every stage of their careers, from medical school to professional development to leadership roles? How do we support other women on the journey alongside us?

• Dr. Piltz-Seymour: Take every opportunity to connect. At a Women in Ophthalmology meeting last year, I was relaxing in the hot tub at my condo, listening to a group of young people chatting, and I realized they were medical students. I started talking to them, and I wound up giving them my contact information. Sometimes you can make a difference in unexpected places.

• Dr. Bedrood: I recently was contacted by an undergraduate who had read a Women in Glaucoma article from a few years ago when I happened to be on the panel. I invited her to come in and shadow me in the clinic. Who knows where that could lead? Perhaps to a letter of recommendation? Attendance at a Women in Ophthalmology meeting? Women helping women started with that student’s decision to reach out to me and with my willingness to reach over and invite her in.

• Dr. Rosdahl: Supporting other women can be as simple as answering emails, having a welcoming smile, and not being afraid to connect. I have a low threshold for scheduling a Zoom when a medical student reaches out to me. You just don’t know who you’re going to help with a short conversation and how you might be able to connect them with other people who might be able to help them in their careers, too.

• Dr. Smith: I think we’ve done a better job of making sure we provide places for women to engage. When I first started, there was no Women in Ophthalmology or Women in Glaucoma, and there were very few mentoring programs. Now, there are many programs available, but the programs don’t just happen. You have to engage. Attend Women in Ophthalmology events. Engage at the American Academy of Ophthalmology, where we also need women. We can’t complain if we’re not stepping up to the plate. We need to make sure we’re there to encourage the next generation.

• Dr. Bedrood: There’s another aspect to consider. There is this sentiment that women should help each other, but when there’s only one spot available on a panel, for instance, how do we create more collegiality among women so that it doesn’t feel so competitive?

• Dr. Smith: I have two suggestions. First, if I’m asked to do something—serve on a panel, for example—but I’m unable to do it, I’ll say, “Sorry, I can’t, but I know several other women who would do a fantastic job.” When I get a positive response from the organizers, I send them a list of names. I always recommend my replacement.

• Dr. Moster: That’s important. I always make it a point to fill my replacements with powerful people, preferably women.

• Dr. Smith: And second, whenever you serve on a program committee, you have the opportunity to compile a list of the people you want to participate. That becomes your responsibility to ensure a diverse program and that there’s enough representation.

THE IMPACT OF PARTICIPATING IN CLINICAL TRIALS

Dr. Moster: The future management of glaucoma will be guided by scientific research. We will need unbiased clinical trials to support our decision-making. Due to the high cost of multicenter prospective clinical trials, they are typically funded by industry and often mandated by the FDA. How can a glaucoma specialist participate in clinical trials? What impact will this participation have on your career growth?

• Dr. Smith: First, you have to be interested in research, and then you must prepare yourself. Attend seminars such as those offered by Women in Ophthalmology to learn what you need, staffing-wise, in your office. Engage with industry and let them know about your interests. Talk to people who are active in clinical trials to find out how to become involved. You may not be invited right away to participate in some of the larger trials, but you can do investigator-initiated trials in the office to establish yourself and become accustomed to the routines.

By preparing yourself, your staff, and your office and then engaging with industry and collaborating at meetings, you’ll make your interest known. Find a mentor who will sponsor you and let them know that you’re ready and able to do a clinical trial.

• Dr. Piltz-Seymour: What Dr. Smith just said is absolutely perfect. Not only is it important to make connections to get involved in trials, but you also need to demonstrate that you have the infrastructure and the staff who are willing to take this on. Otherwise, you’ll be working 24/7, filling all of the roles yourself. I once had a clinical trial staff who refused to use the telephone. I ended up staying at night to make all of the phone calls. You also have to think about the various waivers, equipment, and training that you’ll need for your clinic. There’s a lot that goes into setting up your practice before you take on a clinical trial. The Women in Ophthalmology course is an excellent place to gain the insight needed into starting clinical trials in your practice.

Dr. Moster: What advice would you give to someone who’s interested in clinical trials?

• Dr. Bedrood: In academia, the bureaucracy made it difficult to get a trial through. In private practice, though, I had the freedom to make connections directly with industry. That meant I had to speak with people, and I had to be good at the thing they wanted me to study—a medical device, for example. You have to do the legwork, talk to people, and showcase your skills. It’s worth the effort. The trials that I’ve been involved with have helped me grow as a physician and in my career.

Dr. Moster: Dr. Rosdahl, you have the gold standard of clinical trials being at Duke. Is there anything you would like to add?

• Dr. Rosdahl: I would encourage people to develop their clinical skills, because you can’t be on a clinical trial without being an excellent clinician and surgeon. Also, develop your patient base so you’re ready to perform these studies.

ADVICE TO YOUR YOUNGER SELF

Dr. Moster: What career advice would you give yourself if you were just starting out right now?  What do you wish you had known then?

• Dr. Bedrood: I’d tell myself, “Don’t be afraid to evolve and change. Don’t be so rigid with the idea of how something should be. The beauty in life comes from that evolution, being flexible and meeting and learning from new people.” When I was just entering practice, I was very rigid about certain things. Being able to shift that mindset was revolutionary for me.

• Dr. Rosdahl: I’ve dealt with anxiety and lack of self-confidence in my life, and I think many women feel that way, too. I would tell my younger self, “You’re great. You’re awesome. You have good ideas. You deserve to be where you are. Enjoy it.” I’d say those same things to all of the women starting out in medicine today.

• Dr. Smith: I’d tell my younger self, “Get good training and trust it. Then step out there and be bold.”

• Dr. Piltz-Seymour: I’d say, “This is not a dress rehearsal. This is your life, and you have to live it the way you want to live it. If you can’t do that where you are, you can try to fight for it in your current situation, but if you’re butting your head against a wall, then you need to move on. You deserve to live the life that you want to live and balance your life the way you want to. Keep searching and fighting to achieve your goals.”

• Dr. Moster: Speaking to all of you now, it’s clear how you became successful and why you continue in this role. You are an inspiration not only to each other, but also to everyone who is just starting this journey and wants to follow in your footsteps. I think you are key to making this happen. Thank you so much for your participation.

Scan the QR code or click here to watch the roundtable discussion.