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Optometrist vs. Ophthalmologist: Unveiling the Eye Care Baffle

Do you know the difference between an optometrist and an ophthalmologist? We’re here to help you out with this common question. Let’s take a look at what each of these eyecare professionals does every day and what sets the two of them apart.

What Is an Optometrist?

An optometrist isn’t a medical doctor, but they are a professional healthcare provider who holds a degree.

Optometrists are authorized for primary vision care, including vision tests, the diagnosis of eye diseases and vision disorders, and the management of patient treatment plans.

What Training Does an Optometrist Need?

If you want to become an optometrist, you’ll need a bachelor’s degree, most likely in pre-med. You’ll also need to go through four years of optometry school, giving you specialized training for your career.

You’ll need to graduate from optometry school with a Doctor of Optometry (OD) degree. After you graduate, you’ll need a certain number of hours of clinical training, which will set you up for success working in an eye clinic.

Some optometrists even go through medical residency, which helps give them specialized training to help treat and manage certain eye diseases, like glaucoma.

What Is an Ophthalmologist?

An ophthalmologist is an eye care provider authorized to do more than an optometrist can.

After completing medical school and a residency program, these eye care professionals can diagnose and treat diseases, perform eye surgeries like LASIK, and prescribe medications — all of which are responsibilities that aren’t included in an optometrist’s job description.

What Training Does an Ophthalmologist Need?

If you want to be an ophthalmologist, your education and training will generally be more intense. It starts the same way as the path to optometry: a bachelor’s degree.

However, you’ll go from your undergraduate studies into medical school, which takes four years and earns you a Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree.

You’ll also need a one-year internship in general medicine or surgery, followed by a three-year residency. Plus, if you want to specialize in a specific disease, you’ll need to add on a two-year fellowship, giving you specific training you won’t otherwise get.

When Should You See an Optometrist?

An optometrist is the first type of eye doctor you’ll visit for most vision-related concerns. Let’s take a look at everything your optometrist can do for you so that you know when to schedule an appointment.

Regular Eye Exams

During a standard eye exam, your optometrist will walk you through the visual acuity and refraction tests. The results will be used to determine whether your vision has changed since your last visit, and, if so, your optometrist will be able to pinpoint the right prescription for you (if any).

The standard eye exam also includes a checkup on your pupil function and a slit-lamp exam. The slit-lamp is a type of microscope that gives your optometrist a close-up look into the inner workings of your eyes. Through the microscope, they’ll be able to see your eyelids, cornea, iris, and eye lens up close, giving them the best chance of spotting the early development of cataracts and other vision problems.

Another main part of a comprehensive eye exam is the pressure measurement, which allows your optometrist to screen for early signs of glaucoma. With this information, they’ll know whether to have you back for other tests like pachymetry or corneal topography.

Vision Correction

Your optometrist can write you a prescription for glasses or contact lenses.

After your initial eye exam, you’ll be asked whether you want to be fitted for corrective lenses, which involves a few extra measurements by an optician. Otherwise, you’ll be provided with all the information you need to buy eyeglasses in-house or online (at Pair, we recommend the second option).

Mild Eye Issues

An optometrist can help with mild eye problems like dry eyes, irritation, or trouble with your glasses or contacts. They won’t prescribe you medication, but they can recommend over-the-counter relief. They’ll also probably ask you about your eye hygiene routine and help you identify specific areas of improvement.

Preventative Care

Your eye doctor uses special tests to help you avoid eye diseases like glaucoma and cataracts. These tests are standard parts of a routine exam, but you can also schedule an appointment focusing on preventative care. This visit to the optometrist might include more advanced eye testing, including specialized eye photography, optical coherence tomography (OCT), and more.

When Should You See an Ophthalmologist?

An ophthalmologist handles different aspects of eye care, severe eye conditions, situations that call for surgery, and care for people with diabetes or other conditions. They can also give you a second opinion if you’ve already seen an optometrist but aren’t sure about a diagnosis or evaluation they gave you.

Ophthalmologists treat conditions like cataracts, glaucoma, macular degeneration, diabetic retinopathy, retinal detachment, and more.

Here’s a quick rundown of what these diseases are and how an ophthalmologist might approach treatment:

Cataracts

Cataracts cloud the lens of the eye, which can have a lifelong negative impact on vision. An ophthalmologist can perform surgery to replace the lens with an artificial one, helping a patient see clearly again.

Your optometrist might spot the early signs of a cataract during a routine visit, but they’ll most likely refer you to an ophthalmologist for further treatment; optometrists can’t fully treat cataracts because they can’t perform cataract surgery.

Glaucoma

Glaucoma is an umbrella term that eye care pros use for conditions that damage your optic nerve. The main cause of glaucoma is high pressure in your eyes, which your eye doctor tests for with that little puff of air.

If you have glaucoma, your eye doctor will refer you to an ophthalmologist, who can treat the disease with medications or surgical eye care — often a combination of both.

Because an ophthalmologist can prescribe medication and perform surgery, the bulk of glaucoma care will fall on them. However, your eye doctor and ophthalmologist will most likely act as part of your care team to give you the best possible treatment.

Macular Degeneration

This disease causes vision loss by breaking down the innermost part of the retina, called the macula. There are 2 types of Macular Degeneration, they are wet AMD (age-related macular degeneration) and dry AMD. Although no one wants either condition, dry AMD progresses slowly (over several years) and responds well to treatment, whereas wet AMD happens very quickly (in a few weeks or months) and the damage is irreversible.

Your optometrist can identify early signs of the condition through specialized testing and the slit-test exam, but they’ll need to refer you to an ophthalmologist for more extensive treatment.

Treatment for macular degeneration usually involves a combination of laser therapy, injections, and surgery. Some vitamins (Preservision / AREDS) can be taken by patients to help slow the progression or minimize the chances of getting macular degeneration. It’s an ongoing process that can be expensive, but it also has the potential to change your life and stop the condition from progressing.

Diabetic Retinopathy

Ophthalmologists often handle eye care for folks with diabetes, as the condition often requires special treatment and more frequent check-ups.

Diabetes sometimes causes an eye disease called diabetic retinopathy, which damages the blood vessels in the retina and can lead to blurry vision, distortion, trouble seeing colors, and sometimes vision loss. Dilated eye exams can sometimes catch diabetes, along with other health conditions, before the patient is even diagnosed by their PCP — which is why annual dilated exams are important.

Ophthalmologists sometimes use surgery to treat diabetic retinopathy, but they may also recommend lifestyle changes to patients and prescribe medications like steroids or VEGFR inhibitors.

Retinal Detachment

Ophthalmologists sometimes need to perform emergency surgeries, especially in the case of a retinal detachment. This occurs when a person’s retina is pulled away from the back of the eye, and it’s a medical crisis that requires immediate attention.

Using a special surgical procedure, an ophthalmologist reattaches the eye to the retina and provides aftercare support as the patient recovers.

Eye Infections

While optometrists can treat infections and can sometimes prescribe medications, if the infection lingers or drops are not helping, the optometrist may refer the patient to an ophthalmologist for further evaluation.

Treatment for eye infections often involves a combination of several meds, including an antibiotic, a steroid, and sometimes prescription eye drops.

Ocular Tumors

Sometimes, tumors develop in a person’s eye or around it. Some of the most common forms of ocular tumors are melanoma (skin cancer) and retinoblastoma (retinal cancer).

An ophthalmologist might be able to remove a tumor surgically, but that isn’t possible in some cases — especially when the cancer spreads or progresses beyond a certain point. If that’s the case, an ophthalmologist will make a treatment plan that usually involves chemotherapy or other radiation therapy.

Make sure you visit your eye doctor often to catch early signs of cancer and start treatment as soon as possible.

Wrapping Up

Optometrists and ophthalmologists both take care of our eyes, but they play different roles. You’ll probably spend more of your time in the optometrist’s office than the ophthalmologist’s unless you have a condition requiring specialized treatment.

Has it been a while since you scheduled an eye exam? Your optometrist can help you manage your eye health and spot certain diseases before they impact your life.

Sources:

Diabetic Retinopathy | National Eye Institute

Retinoblastoma - Symptoms and causes | Mayo Clinic

What Is Glaucoma? Symptoms, Causes, Diagnosis, Treatment | American Academy of Ophthalmology

Retinal Detachment | National Eye Institute