What is Optometry?

Optometry is a career field filled with possibilities. Optometry offers flexibility, variety, gratification, good income, and freedom in choosing a location to practice - all while doing meaningful work in healthcare. Doctors of optometry, the leaders in primary eye health care, help patients and their families take the first step toward healthier eyes and healthier bodies. If a disease or other conditions are detected, doctors of optometry can help navigate patients to the right prevention plans or the next steps in official diagnosis and treatment.

What is an Optometrist?

In the United States, an optometrist is an eye doctor who has earned the Doctor of Optometry (OD) degree. An optometrist generally must complete a four-year college degree program in the sciences, plus four years of post-graduate professional training in optometry school. In this regard, the educational requirements of an optometrist are similar to those of a dentist.

Optometrists take care of primary health care for the eye. After college, they spent 4 years in a professional program and got a doctor of optometry degree. Some optometrists get additional clinical training or complete a specialty fellowship after optometry school. They focus on regular vision care and they:

  • Perform eye exams and vision tests.
  • Prescribe and fit eyeglasses and contact lenses
  • Monitor medically related eye conditions related to diseases like diabetes
  • Manage and treat conditions like Dry Eye and glaucoma
  • Provide low-vision aids and vision therapy
  • Optometrists and ophthalmologists often work together

What does an Optometrist do?

In the United States, Optometrists examine eyes for both vision and health problems, and correct refractive errors by prescribing eyeglasses and contact lenses. Some optometrists also provide low vision care and vision therapy.

Optometrists in the United States also are licensed to prescribe medications to treat certain eye problems and diseases. The scope of medical care that can be provided by optometrists is determined by state law. (For details about the scope of practice of optometrists where you live, visit the website of your state's board of optometry.)

Types of Optometry

As stated above, in the USA all optometrists have a license granted by the state. This sets the limits or scope of what the optometrist may treat. Over time, the optometry field has expanded and grown to include specialization or a focus in a certain aspect of care. An optometrist may focus on:

  • Pediatrics
  • Vision therapy/binocular vision
  • Neuro-optometry
  • Specialty contact lenses (usually hard-to-fit contact lens patients)
  • Ocular disease

A focus on the first 3, pediatrics, vision therapy/binocular vision, and neuro-optometry have a significant amount of overlap. Optometrists that work in this field are sometimes referred to as a developmental optometrist, vision therapy optometrist (VTOD), or neuro-optometrist. The type of patient addressed by optometrists in this field is quite diverse - but often these patients struggle with binocular vision for some reason or another. This could be due to amblyopia, strabismus, vergence disorders, a traumatic brain injury, visual processing disorder, and others.

Optometrists that focus on specialty contact lenses often work with difficult contact lens cases. Quite often their patients have some sort of irregularity to the cornea, the front, clear window tissue of the eye. This could be due to a disorder such as keratoconus, pellucid degeneration, or other corneal diseases, or could be due to trauma from an accident or surgery. Although the vast majority of optometrists fit contact lenses, optometrists that work with patients such these often use specialty-made lenses called scleral or semi-scleral. These are really large, hard contact lenses that are fit to vault (or rise over) the damaged tissue and fit on the white part of the eye (the sclera). The lens is filled with saline, which is then mixed with tears over the course of wear. This, in essence, creates a new surface for the visual system when the patient is wearing the lens and can make a big difference in some patient's vision.

Many optometrists are capable of diagnosing, managing, and treating disorders of the eye. Some optometrists work in clinics that focus primarily on ocular disease - and as you can imagine, geriatric care. Many of these optometrists work together with ophthalmologists, or may work in hospital or Veteran's Affairs clinics that treat a higher proportion of sick eyes.

What Makes an Optometrist a "Specialist"

In short, there's no one test that makes an optometrist a specialist. Sometimes all it takes is years of experience! However, in recent years optometry has adopted a medical-model of additional training after 4-years of optometry school. This extra training is often a one-year long residency in a specific focus as listed above.

You may also see some additional letters behind an optometrist's name (besides the OD that stands for doctor of optometry). Some common additional letters are:

  • PC: profession corporation - this is purely a business designation
  • FAAO: a fellow of the American Academy of Optometry - these optometrists have completed fellowing with the American Academy of Optometry, which consists of case presentations, review, and an oral examination
  • FCOVD: a fellow of the College of Optometrists in Vision Development - these optometrists have completed a fellowship with the College of Optometrists in Vision Development, which consists of case presentations, review, and an oral examination; often these optometrists work within a vision therapy/binocular vision/neuro-optometry setting

  • FNORA: a fellow of the Neuro-Optometric Rehabilitation Association - these optometrists have completed a fellowship with the Neuro-Optometric Rehabilitation Association, which consists of case presentations, review, and an oral examination; often these optometrists work within a vision therapy/binocular vision/neuro-optometry setting

  • Other countries may have country-specific fellowship group associations, examples:
  • BABO - British Association of Behavioural Optometrists
  • BOAF - Behavioral Optometry Academy Foundation (European)
  • ACBO - Australian College of Behavioural Optometrists

How to Choose an Eye Doctor

One type isn’t automatically better than the other. The right choice depends on your needs. The best eye doctor for you should be:

  • Recommended by your doctor, friends, or family
  • Someone you like and trust
  • A good rule of thumb would be:

For primary eye care, you may wish to start with an Optometrist. From there, they may refer you to an Ophthalmologist if needed. If you think you need eye surgery for cataracts, glaucoma or another eye disease, an ophthalmologist with the appropriate specialty would be a good place to start.

References

https://www.webmd.com/eye-health/eye-doctors-optometrists-ophthalmologists https://www.neco.edu/admissions/explore-optometry https://www.aoa.org/healthy-eyes/whats-a-doctor-of-optometry?sso=y

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