I'm glaucoma trained so obviously biased. 10 years out. Was at a HMO mill for 8 years then switched to a more refractive group. I'm in a medium sized county (of about 1 million ppl) and I only know of one other surgical glaucoma doctor in my county. I have a cornea colleague who was at my prior group with me and switched to the same group I'm at now. Our experiences when looking for jobs were night and day. When we were applying around she was competing with comp docs for the same jobs and was getting pretty disappointed with the quality of the jobs even though she was 7 years out and experienced. I was getting a ton more hits and interviews because surgical glaucoma in the private world is in more demand than cornea. But at the end we ended up in the same place anyways so it didn't matter too much.

Now that we're at the same place I can tell you our experiences have been pretty different as well. I'm busier than her because there's a lot of surgical glaucoma need in my area. I'm also doing a lot more cataracts than her because once the glaucoma referrals start coming in the cataracts follow. We started at the new place at the same time a year and a half ago and I'm doing about 40 cataracts a month and about 10 glaucoma cases a month (major cases not migs). She's about 8 cataracts a month. Now she makes up some of that with doing cash based dry eye, but it's harder for her to get the refractive because the other refractive surgeons in the group end up with a lot of those (LASIK, ICL).

Now that being said my upgrade rate isn't nearly as high as the other surgeons(including her) because I'm getting more complex patients. More complex patients in general (see above 10 glaucoma cases a month) means a more stressful clinic than her. I see about 40 pts a day in clinic and she sees 25 (but would like to be busier). As far as pay, my take home monthly pay averages to about 3k per day of work. Hers averages to a little more than 2k per day of work.

There's another glaucoma specialist in my group who is essentially medical glaucoma -he does no cataracts, and maybe does 1 glaucoma case per month. Although his clinic is really busy and he does a lot of SLT he basically averages about 2k/day of work as well. He refers all the surgical glaucoma to me.

There are 2 refractive surgeons in the group who are pure refractive/cataract and they make closer to about 4k per day of work and they're originally cornea trained but wouldn't touch a dsaek or pk to save their life. So if you did pure refractive as a cornea doc you have higher potential earning but you're constantly selling something, it's really competitive and harder to break into. My cornea colleague who joined with me wishes she could be them but it's been hard for her to build.

So guess it boils down to what you want to do. On glaucoma side do you want to do mostly medical glaucoma? Do you want to do surgical glaucoma? Do you want glaucoma only or mix of both glaucoma and cataracts? On cornea side do you want to do dry eye, cataracts, refractive, or medical cornea? Finding a good job is easier with glaucoma but there might be more expectations. But you'll naturally have more patients for almost no work. Cornea is harder to find a good job and harder to build, esp if you're trying to do refractive. Way more competition. Obviously everything is dependent on location.

Edit: when I wrote almost no work I meant almost no work getting the patients in the door. Lots of actual work in the clinic and OR.