The three “O’s” in eye care are important for anyone to understand, especially since sight is one of our most precious senses. Our eyes are responsible for 80% of the information our brain receives and processes, so choosing an eye care provider is a critical step in safeguarding your vision over your lifetime. We’re here to explain the differences behind the three “O’s” so you know just who to go to for your vision care needs.
Optometrists are the primary-care physicians of the eye responsible for diagnosing, treating and managing disorders that affect the eye or vision. An optometrist is an eye care professional who has earned a Doctor of Optometry degree from an accredited school of optometry (ASCO, 2017). Doctors of optometry spend the same amount of time in professional school as medical doctors and dentists but are not required to complete residency training, although this option is available in several specialty practice areas. Optometrists are trained in general health and systemic disease detection making them often the first to identify critical health issues including diabetes, hypertension, certain cancers and neurological disorders. Their role encompasses prescribing glasses and contact lenses, providing vision therapy and low vision services, treating eye diseases such as glaucoma and infections of the eye, and delivering pre-and post-operative care to patients undergoing ophthalmologic surgery. In some states, optometrists perform minor surgical procedures. The scope of medical practice for optometrist is determined by individual state laws.
Ophthalmologiests are your “specialty care” eye doctors. An ophthalmologist is a medical doctor (MD) or doctor of osteopathic medicine (DO) who specializes in eye surgery and general medical eye health. Ophthalmologists complete four years of medical school before entering a residency program in ophthalmology. The first year of residency is an internship year followed by a minimum of three years’ hospital-based residency in ophthalmology. Further specialization is obtained through fellowship training in one of the following disciplines: retina, cornea, oculoplastics, pediatrics, neurology and glaucoma. Specialty educated ophthalmologists perform advanced surgical and medical procedures to preserve and restore eyesight.
Opticians are not eye doctors but are the refractive correction experts of the eye care team. Opticians like pharmacists fill prescriptions written by an optometrist or ophthalmologist for eyeglasses, contact lenses and specialty lenses. Opticians complete a training program usually lasting a few months to become licensed, however many are trained in-office without completing a formal training program. Depending on the state, some opticians can also fit contact lenses after completing a certification program.
Now that you know the differences, which eye doctor should you see?
If you already have an annual eye exam to update glasses or contacts you are most likely seeing an optometrist (simply because there are more optometrists than ophthalmologists in the US). Most optometrists and general ophthalmologists perform routine eye exams unless they specialize in a specific area. After a routine eye exam, either an optometrist or general ophthalmologist will refer more complex medical or surgical problems to ophthalmology specialists. For instance, if you are diagnosed with cataracts and your vision cannot be fully corrected with glasses, you will likely be referred to an ophthalmologist who performs cataract surgeries. Likewise, should an eye care provider find a retinal condition that could threaten your vision, you will be referred to a retinal specialist for treatment. In some cases, if medical treatment for a condition like glaucoma is no longer manageable with topical medications, you will be referred to a glaucoma specialist for surgical treatment of your glaucoma.
Co-management between ophthalmologists and optometrists is a common practice especially for pre- and post-surgical cataract, Lasik and other eye surgeries. In this case, your primary eye care provider will refer you for surgical treatment and resume care after the surgery.
In summary, inquiring about the services an eye doctor provides is an important first step in scheduling an eye exam. Often this information can be found on their website along with a personal bio of their specialty area of practice. Group practices with both optometrists and ophthalmologists is another option, especially if you have an existing eye condition that may need further attention.