New figures show almost 12,500 people were waiting for eye procedures at the end of August in Ireland.
That is the largest inpatient waiting list of any medical speciality.
More than 3,000 of these people are waiting more than a year, with 800 waiting more than 18 months.
A further 38,000 are on outpatient waiting lists, waiting to receive appointments.
This is up from 32,000 at the end of 2016 - an almost 20% increase within eight months.
The Association of Optometrists (AOI) says the "crisis-level" delays are compromising health, and services need to change urgently to meet demand.
AOI is calling for immediate reform which would see community and hospital based services work more closely together.
It says routine care should be provided in the community and only specialist or complex cases referred to hospital eye departments.
"Discussions with the HSE"
AOI chief executive Sean McCrave says: "Hospital eye departments cannot and will not meet patient ever-growing demand.
"In the UK and across Europe there has been an increasing move towards community based eye-care - and that is where Ireland needs to go to.
"We estimate that €32m can be saved while at the same time delivering a better and quicker service.
"This is because it is 50% less expensive to treat via the local optometrist than in the hospital system."
Mr McCrave suggests the Health Service Executive (HSE) could solve the problem quickly by reviewing optometrists' contracts and sanctioning them to provide an increased volume of routine public services.
"We have 600 optometrists across the country who are trained, highly-skilled, have the necessary equipment and want to solve the crisis.
"AOI is calling for discussions with the HSE to begin immediately".