Confused About When to See an Optometrist versus an Ophthalmologist? We Clear It Up for You.

One of the most confusing parts of vision and eye care for many patients is understanding the difference between optometrists and ophthalmologists. Add opticians into the mix and people become even more perplexed. So figuring out where you should start when it comes to vision care and eye health can be tricky.

Fortunately, once you understand the differences between an optometrist and an ophthalmologist, it’s pretty easy to know where you should go, when, and for what. There is considerable overlap in certain areas between the two, but there are also several striking differences.

Let’s start with optometrists.

What Is an Optometrist?

Traditionally, Optometrists (also known as O.D.s or Doctors of Optometry) were trained to diagnose and treat vision conditions like farsightedness, nearsightedness and astigmatism, as well as fit and prescribe contact lenses and prescription eyeglass lenses. A large part of their job was (and still is) to perform “refractions” — or vision correction exams.

Today’s Optometrist: Trained in Disease Diagnosis & Treatment

However, over the past 20 years, optometry training has become much more medically-oriented than in the past, and optometrists now receive rigorous and comprehensive training in not just optics and refractions, but also the diagnosis and treatment of eye disease, as well as other systemic conditions that can effect vision and eye health.

Although optometrists are not M.D.s, most current optometrists can prescribe certain medications, as well as diagnose and treat a broad-range of medical conditions that impact the eye, including glaucoma, macular degeneration, cataracts, retinal disease and ocular disorders associated with diabetes and high blood pressure.

In fact, it’s not unusual for a skilled optometrist to be the first health care professional to spot developing systemic conditions like diabetes during routine eye exams.

Optometrist Education & Training

Most optometrists will undergo four years of undergraduate training — usually a pre-med type curriculum — and then four years of post-graduate doctoral training. Coursework will typically include pharmacology, ocular disease diagnosis and treatment, vision therapy, optics, physiology and anatomy, and countless hours of hands-on clinical work.

All optometrists must pass a series of rigorous nationally-administered exams to earn their license to practice. Some optometrists will also complete a one-year post-graduate residency to gain more specialized expertise in a particular area.

All of this is done to prepare optometrists to serve as the “front-line” for day-to-day vision care.

Optometrist Services

Today, most optometrists provide a broad range of vision care services, including:

• General vision services like eye exams, and treatment of conditions like strabismus and amblyopia
• Diagnosis and basic treatment of eye conditions like glaucoma, cataracts, macular degeneration, diabetic retinopathy and conjunctivitis (pink eye.)
• Prescribing medications for certain eye conditions (for example, antibiotics for eye infections)
• Eye disease and injury-prevention
• Prescribing and fitting eyeglasses and contact lenses
• Vision therapy services, such as eye exercises and low-vision aids
• Pre- and postoperative care for people who have had eye surgery or Lasik surgery.

Not all optometrists will have specialized training in these areas, especially if they graduated prior to 2000, so it’s always a good idea when choosing an optometrist to ask questions about their specific training and specialties – especially when it comes to ocular disease diagnosis and treatment.

What’s an Ophthalmologist?

An ophthalmologist is a medical doctor (M.D.) that specializes in the eye.

While the training between ophthalmologists and optometrists is now very similar (especially around ocular disease diagnosis and treatment,) there are some marked differences between the two.

First, ophthalmologists are trained to perform surgery, which optometrists are not. This includes things like Lasik vision correction as well as removal of cataracts, or surgery related to eye trauma, burns or detachments of retina.

Second, ophthalmologists have additional specialized training in diagnosing and treating more complex medical eye conditions. So it is not unusual for optometrists and ophthalmologists to work closely-together on hard-to-diagnose conditions or ongoing disease treatment and management.

Third, as M.D.s, ophthalmologists are allowed to prescribe a broader-range of prescription drugs than optometrists.

Ophthalmologist Education & Training

Ophthalmologists will receive four or more years of premedical undergraduate education, four years of medical school, and then one year of internship to get their doctorate degrees. Once they become licensed physicians, they will then undergo a residency of three or more years, with medical and surgical training in eye care.

Ophthalmologist Services

While all ophthalmologists are trained in vision services such as eye exams, refraction, vision correction and lens prescription, not all ophthalmologists will choose to practice vision correction as a primary service.

Performing eye surgery is more profitable than refractions, so although ophthalmologists by training must be able to perform these services, they will often leave these day-to-day vision services to optometrists to perform instead.

Also, optometrists tend to have more eyewear product (like eyeglass frames and prescription sunglasses), so most primary vision correction is performed not by ophthalmologists, but by optometrists (and often technicians.) It is also not unusual for ophthalmologists and optometrists to work in the same office and co-treat patients.

What About Opticians?

Although opticians have a similar-sounding name to optometrists and ophthalmologists, they are very different from eye doctors: Opticians specialize in filling the lens prescriptions that optometrists and ophthalmologists prescribe.

Opticians will typically receive a one or two-year degree or certification. In a typical optometry practice, the optician will:

• Evaluate the lens prescriptions written by the eye doctor
• Dispense, repair, adjust and replace eyeglass frames, lenses and contacts
• Take measurements of a patient’s face in order to match them up with glasses that are appropriate for their facial structure
• Assist in determining which lenses are appropriate for a patient
• Provide guidance on how to match eyeglass frames with a patient’s personal fashion style or lifestyle

Should I See an Optometrist or an Ophthalmologist?

For most day-to-day eye and vision-care needs, an optometrist will generally be your best choice. Optometrists typically have better appointment availability than ophthalmologists and will often have more eyeglass frame stock options, as well.

Like ophthalmologists, optometrists are trained to perform thorough eye examinations and refractions, as well as vision therapy for things like lazy eye. Some argue that optometrists are actually more skilled at vision correction because they typically perform many more refractions on a day-to-day basis than ophthalmologists. So practice makes perfect … or so the theory goes.

And, because optometrists now have more specialized education in ocular disease diagnosis and management, they are trained to spot many of the same diseases and conditions that in the past only an ophthalmologist was trained to diagnose.

If more serious eye health conditions are found by an optometrist, the optometrist will then refer you out to an ophthalmologist for a more detailed examination or ongoing treatment.