Eye Care Professional
Their Education, Training, and Practice

Many patients and consumers are confused about the qualifications of the eye care professionals who serve them.

Perhaps the greatest area of confusion is the distinction between an optometrist and an ophthalmologist. In the simplest of terms, an ophthalmologist is a medical doctor who specializes in treating the eye. An optometrist is a non-medical practitioner who has completed a post-graduate study program to provide a variety of eye care services.

Differences in the education and training of health care professionals are important because they affect the quality and level of care patients receive. However, state-level lawmakers frequently determine the scope of practice - the variety of services a health care practitioner can provide, the range of drugs, therapies, and surgery, etc. Therefore, when considering their healthcare/eye care options, patients should be mindful of their provider’s training and qualifications.

The following are more detailed descriptions drawn from the U.S. Department of Labor, Bureau of Labor Statistics (BLS), of the education, training and areas of practice of ophthalmologists, optometrists, and opticians.

Ophthalmologists

Premedical students must complete undergraduate work in physics, biology, mathematics, English, and inorganic and organic chemistry. Students also take courses in the humanities and the social sciences.

The minimum educational requirement for entry into a medical school is 3 years of college; most applicants, however, have at least a bachelor’s degree. Acceptance to medical school is highly competitive.

Students spend most of the first 2 years of medical school in laboratories and classrooms, taking courses such as anatomy, biochemistry, physiology, pharmacology, psychology, microbiology, pathology, medical ethics, and laws governing medicine.

Ophthalmologists also learn to take medical histories, examine patients, and diagnose illnesses. During their last 2 years, students work with patients under the supervision of experienced physicians in hospitals and clinics, learning acute, chronic, preventive, and rehabilitative care. Through rotations in internal medicine, family practice, obstetrics and gynecology, pediatrics, psychiatry, and surgery, they gain experience in the diagnosis and treatment of illness.

Following medical school, almost all M.D.s enter a residency-graduate medical education in a specialty that takes the form of paid on-the-job training, usually in a hospital.

Physicians are licensed by the states. To be licensed, physicians must graduate from an accredited medical school, pass a licensing examination, and complete 1 to 7 years of graduate medical education. To maintain their license, they must fulfill continuing medical education requirements each year.

M.D.s seeking board certification in a specialty may spend up to 7 years in residency training, depending on the specialty. A final examination immediately after residency or after 1 or 2 years of practice also is necessary for certification by the American Board of Medical Specialists. There are 24 specialty boards, one of which is in ophthalmology. For certification in a subspecialty, physicians usually need another 1 to 2 years of residency.

Surgeons are physicians who specialize in the treatment of injury, disease, and deformity through operations. Using a variety of instruments, and with patients under general or local anesthesia, a surgeon corrects physical deformities, repairs tissue after injuries, or performs preventive surgeries on patients with debilitating diseases or disorders.

Although a large number perform general surgery, many surgeons choose to specialize in a specific area, one of which is ophthalmology. Like primary care and other specialist physicians, surgeons also examine patients, perform and interpret diagnostic tests, and counsel patients on preventive health care.

Optometrists:

Optometrists examine people’s eyes to diagnose vision problems and eye diseases, and they test patients’ visual acuity, depth and color perception, and ability to focus and coordinate their eyes. Optometrists prescribe eyeglasses and contact lenses and provide vision therapy and low-vision rehabilitation. Optometrists analyze test results and develop a treatment plan. Optometrists often provide preoperative and postoperative care to cataract patients, as well as patients who have had laser vision correction or other eye surgery. They also diagnose conditions due to systemic diseases such as diabetes and high blood pressure, referring patients to other health practitioners as needed. Most optometrists are in general practice, according to the BLS.

Optometrists administer drugs for diagnostic and therapeutic purposes, privileges they have obtained largely through legislative efforts over the past two decades. Some of their professional societies are seeking permission from state regulatory authorities to perform surgical therapies.

Opticians

Employers usually hire individuals with no eye care educational background as an optician or those who have worked as ophthalmic laboratory technicians. The employers then provide the required training.

Most dispensing opticians receive training on the job or through apprenticeships lasting 2 or more years. Some employers seek people with postsecondary (beyond high school) training in the field. In the 21 States that require dispensing opticians to be licensed, individuals without postsecondary training work from 2 to 4 years as apprentices. Apprenticeship or formal training is offered in most States as well. Formal training in the field is offered in community colleges and a few colleges and universities.

Dispensing opticians may apply to the American Board of Opticianry (ABO) and the National Contact Lens Examiners (NCLE) for certification, which must be renewed every 3 years through continuing education.

Training usually includes instruction in optical mathematics, optical physics, and the use of precision measuring instruments and other machinery and tools.

Under the supervision of an experienced optician, optometrist, or ophthalmologist, apprentices work directly with patients, fitting eyeglasses and contact lenses.