Ophthalmologists and Optometrists – What’s the Difference?

The difference between optometrists and ophthalmologists is quite significant. Importantly, ophthalmologists have gone to medical school: they are physicians. Optometrists go to schools of Optometry. Ophthalmologists do internships in hospitals (as do virtually all physicians after medical school), they do residencies, many do fellowships, and then sit for their board exams. Optometrists attend four years of optometry school, take a licensing exam, and then begin their practice.

Ophthalmologists have far greater knowledge of the medical implications of eye disease and the ophthalmic implications of medical disease. They have significantly more experience in treating diseases of the eye. Typically, optometrists have more interest and expertise in fitting/prescribing glasses and especially contact lenses. Ophthalmologists – with some exceptions – prefer to use their medical education and experience for more serious matters, such as diagnosis and treatment of blinding conditions such as glaucoma, macular degeneration, diabetic eye disease, uveitis, thyroid-related eye disease, etc.

Surgery is another arena where the two fields differ. Though there are some states that have granted optometrists the right to perform laser surgery, ophthalmologists generally are the only providers who do eye surgery. The fact is however, that optometry has made many inroads into ophthalmology, gaining privileges for optometrists to treat medical conditions and even prescribe potent drugs with potentially lethal side-effects. This is a political issue and has largely been the result of strong lobbying efforts by a powerful optometric lobby. There is roughly ten times the number of Optometrists in this country compared to Ophthalmologists. The extra lobbying force and political action budgets of the optometric associations simply overwhelm the ability of Ophthalmology and its academy to resist. The battle between Optometry and Ophthalmology has been waged in every state senate and universally won by optometry, despite active resistance by organized ophthalmology. It is very likely that this will result in inappropriate care, missed diagnoses, and potentially even deaths due to prescribing errors on the part of newly empowered optometrists.

The bottom line is, go to an optometrist if you want to have glasses or contacts made. If you want a medical doctor to examine your eyes, evaluate the presence of significant medical eye disease and then institute appropriate testing and possible treatment, go to an ophthalmologist.

What about Opticians — what are they? Opticians are skilled technical personnel who fit glasses to a person’s face. They measure the physical arrangement of the face and eyes and manufacture appropriate frames and lenses for proper visual correction.