Ophthalmic nursing is an emerging specialty that plays a critical role in eye care services, particularly in preventing vision impairment and blindness. While many countries recognize ophthalmic nursing as a distinct specialty, Oman lacks formal education programs and structured career pathways in this field. This study explores the key drivers and barriers to the establishment of an Advanced Ophthalmic Nursing (APON) specialty in Oman. A qualitative thematic analysis was conducted using semi-structured interviews with nurses and administrators across three governmental hospitals. Findings reveal that nurses are highly motivated to specialize due to career advancement, improved patient care, and professional sustainability. However, significant barriers such as the lack of educational programs, policy constraints, and workplace stress hinder specialization efforts. A theoretical framework is proposed to facilitate the development of APON, incorporating education, policy support, and healthcare system integration. These findings emphasize the need for urgent reform in nursing education and policy to support specialized ophthalmic nursing in Oman.