Abstract
<title>Abstract</title> <p> <bold>Background:</bold> Health professions education is shifting from time-based to competency-based models, but the perspectives of those most affected by this transition, particularly in optometry, an understudied discipline in Sub-Saharan Africa remain undocumented. This study examined the experiences and perceptions of students, lecturers, institutional leaders, and private clinic practitioners regarding the adoption of competency based education (CBE) in Nigerian optometry training. <bold>Methods:</bold> A qualitative descriptive design was employed, with data analyzed through reflexive thematic analysis.31 participants across four stakeholder groups:16 students, 7 lecturers, 2 institutional leaders, and 6 private clinic owners/employers, were purposively recruited from five anonymized Nigerian universities and private optometric practice settings. Individual semi-structured interviews, conducted predominantly by telephone, were the primary data collection method; a smaller subset provided structured written responses to the same guide, a variation disclosed and addressed in the methods. Transcripts were coded independently within and across stakeholder groups following six phases of reflexive thematic analysis. <bold>Results:</bold> Five themes emerged. First, competence was intended but inconsistently verified, as exam performance did not reliably reflect independent clinical competence. Second, participants across groups perceived an imbalance between strong theoretical grounding and uncertain practical skills, particularly in retinoscopy, ophthalmoscopy, and slit-lamp examination. Third, resource and workforce constraints, diagnostic equipment shortages, high student-to-lecturer ratios, and limited clinical space, were the central barriers to implementation, not opposition to CBE philosophy. Fourth, students and lecturers expressed cautious optimism, conditional on timing and faculty readiness for workplace-based assessment. Fifth, private clinic owners described providing an informal corrective function during new graduates' first months of employment, verifying competencies the formal system had not confirmed. <bold>Conclusions:</bold> Nigerian optometry stakeholders broadly support competency-based progression, with structural and funding constraints, not philosophical disagreement as the primary implementation barriers. Formalizing private practice's currently unrecognized verification role through structured externship partnerships could strengthen Nigeria's ongoing shift toward Core Curriculum </p>