The results by Reddy et al1 presented in this issue of JAMA Ophthalmology are startling, not because there is a gender gap in ophthalmology Medicare payments but because it is so wide. The authors report that in 2012 and 2013, the average female ophthalmologist collected $0.58 from Medicare for every dollar collected by male counterparts, which suggests that ophthalmology’s gender pay gap could be even larger than the US average. The existence of the pay gap is indisputable. Our challenge as an ophthalmic community—and as society in general—is to untangle the complex reasons for the gap and then remove the contributing institutional and unconscious barriers. This well-designed study by Reddy et al is a significant step toward understanding and deconstructing the issues.