Optometrists and ophthalmologists are both eye care professionals, but what's the difference between them?
Ophthalmologist and Optometrist Training
Ophthalmologists have completed four years of post-graduate training in ophthalmology after obtaining their MD or DO degree. Many train for another three to four years in a subspecialty like retina or glaucoma and are excellent surgeons.
Optometrists complete a four year graduate program in optometry after completing a four-year undergraduate program. Many will train for another year or two in a related specialty such as binocular vision or contact lenses. Optometrists, like ophthalmologists, continue their education with CE lectures that cover all aspects of eye care including diagnosing all eye diseases and their medical and surgical management.
There are about 58,000 practicing optometrists in the United States. There are about 24,000 ophthalmologists currently practicing in the United States. Many years ago there were much larger differences between how the two professions practiced. Today there is much greater overlap leading to much patient confusion as to who the best eye doctor is to visit.
Let's start with training. While it's true that all ophthalmologists are "real doctors" and graduated medical school, the four years spent in medical school and internship did not involve any significant training in ophthalmology or optometry. The real training of ophthalmologists begins in residency, which is three years long and ends with specialized fellowship training lasting one to two more years. Ophthalmology is a highly specialized and advanced area of medicine with many different specialties and sub specialties.
Optometrists spend four years in optometry school studying ophthalmology and optometry. The entire four year program is dedicated to studying eyes and everything related including optics, vision science, eye disease, pharmacology, low vision, pediatric optometry, glasses and contact lenses.
The major difference in training is that the ophthalmologist has more extensive training in a subspecialty and in surgery. One of the most common surgical procedures performed by ophthalmologists is cataract surgery. Not all ophthalmologists are surgeons, but all eye related surgeons are ophthalmologists.
Optometrists have a broader education in all thing eye related with more emphasis on primary care, providing eye exams for glasses and contact lens fittings. In recent years many more optometrists are being employed by ophthalmologists to see most patients for routine care such as basic eye disease management and spectacle and contact lens work and refer those patients needing surgery, or advanced medical treatments, to the ophthalmologist.
Scope of Practice
In many states, the scope of practice for optometry has been expanded allowing optometrists to write prescriptions for almost all eye drops and many oral medications needed to treat eye diseases. It would not make any sense for you to see a retina or glaucoma specialist to get glasses or contact lenses and it would make no sense to visit an optometrist to repair a retinal detachment or have cataract surgery.
There are still many ophthalmologists in general practice that do prescribe glasses and contacts and are not specialists. Their practical training and experience in these areas is comparable to an experienced optometrist with the same number of years in practice.
Most ophthalmologists work in solo private practices or in large groups. Many of the larger ophthalmology practices employ optometrists. You should be aware that even if you are visiting an ophthalmology practice, you may be examined and treated by an optometrist. If the optometrist determines you need surgery or a more advanced diagnostic work up, you'll be referred to an appropriate ophthalmologist in the practice.
Most optometrists in the US still work in private practice, but this is rapidly changing as these practices are being consolidated into larger groups and are often being merged with larger ophthalmology practices.
Many optometrists also work for large chain stores that are found in malls and shopping centers. These practices focus mainly on routine eye care with prescriptions for glasses and contact lenses.
Finding the Best Eye care Professional
In seeking eye care you should be concerned mostly with finding the most appropriate professional for your needs.
Optometry is an excellent choice for eyeglass prescriptions and contact lenses. It's even an excellent choice for medical eye care such as red eyes, dry eyes and many other common eye ailments. You will always be referred to an appropriate specialist if a condition requires further care or is potentially sight or life threatening.
You should visit an ophthalmologist if you need eye surgery, or are considering eye surgery, or if you have a sight threatening eye diseases such as advanced glaucoma, advanced cataracts, retina disease or any other condition requiring the expertise and training of a specialist.