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Purpose: To evaluate the incidence of burnout in chairs of academic departments of ophthalmology, identify stressors, and propose methods for reducing and preventing burnout in our academic leaders., Design: Cross-sectional study., Participants: One-hundred thirty-one chairs of academic departments of ophthalmology in the United States and Canada., Methods: Confidential surveys mailed to ophthalmology chairs., Main Outcome Measures: Questionnaires assessed demographics, potential stressors, satisfaction with personal life, self-efficacy, burnout as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and quality of life., Results: Questionnaires were returned from 101 chairs, a response rate of 77%. Each chair had served an average of 9.4 years. They worked an average of 62 hours each week, spending 41% on patient care, 36% on administrative duties, 13% on teaching, and 9% on research. There was no difference in hours worked each week in chairs who had served >10 years from those who had been chair <5 years. The most frequently identified stressors were faculty retention, Residency Review Committee/Accreditation Council for Graduate Medical Education issues, department or hospital budgets, and compliance issues. Seventy percent of chairs reported they are currently satisfied with their positions compared with 79% who reported feeling that way 5 years ago. Nine chairs (9%) were considered to have burnout based on their MBI-HSS surveys, and 9 (9%) chair's scores showed no characteristics of burnout. Fifty-six percent had scores consistent with low personal achievement, the highest risk factor for burnout. Overall, the MBI-HSS revealed moderate subscale scores for emotional exhaustion, low for depersonalization, and low for personal accomplishment., Conclusions: The overall prevalence of burnout in chairs of academic departments of ophthalmology is similar to burnout rates seen in chairs of other academic departments. The MBI-HSS scores for ophthalmology chairs showed high levels of emotional exhaustion, moderate levels of depersonalization, and moderate levels of personal accomplishment. Because the cost of burnout can be high, both in terms of a chair's psychological well-being and the actual cost associated with replacing a chair, it is important that strategies are put in place to reduce burnout in our academic leaders.