Enablers and Barriers Among Women Ophthalmologists: A National Cross-Sectional Survey in Saudi Arabia.

PURPOSE: To evaluate the self-perceived enablers and barriers among female ophthalmologists practising in health centres nationwide across Saudi Arabia. It also reviews their work-life balance, psychological wellbeing, experience of workplace discrimination, maternity-related challenges, and the personal and institutional factors that facilitate or hinder their professional and maternal roles. PATIENTS AND METHODS: A cross-sectional, face-to-face survey was conducted among female ophthalmologists practising in health centres nationwide across Saudi Arabia over an eight-month period (October 2023 - June 2024). Participants were interviewed using a structured, piloted, and back-translated questionnaire. Self-perceived work-life balance (WLB), psychological wellbeing, happiness at home and at the workplace, experience of workplace discrimination, maternity-related challenges, and personal and institutional facilitating and impeding factors were assessed. Associations between WLB and demographic, family-related, and workplace variables were explored using non-parametric statistical tests. RESULTS: Fifty-five female ophthalmologists were enrolled in the study. Key enablers included strong family support (94.5%), spousal understanding (78.2%), and satisfactory WLB in 40 participants (72.7%). The predominant barriers were psychological unrest in 32 participants (58.2%), workplace discrimination in 27 (49.1%), and disproportionate childcare responsibility in 46 (83.6%). Median happiness scores were higher at home (9.0; IQR 8-9) than at the workplace (8.0; IQR 7-8). Most participants (61.8%) experienced their first birth during ophthalmology residency. The principal institutional barriers were workplace inflexibility (38.2%) and children's demands on maternal time (83.6%). No statistically significant associations were identified between WLB and age, number of children, or spouse's occupation (all P>0.05). CONCLUSION: Female ophthalmologists in health centres nationwide across Saudi Arabia navigate a dual reality of meaningful enablers - including strong family networks, high WLB satisfaction, and effective personal coping strategies - alongside significant barriers, most notably psychological unrest, workplace discrimination, and institutional inflexibility. Targeted institutional and policy-level interventions are urgently needed to strengthen the enablers while systematically reducing the barriers faced by this workforce.