What does an optometrist do?

The majority of optometrists provide primary eye care. We are the first doctors you visit when your eyes bother you or when you just need a yearly check up. Optometrists thoroughly evaluate the health of your eyes and how well you see. Think of us as the family + emergency doctor specifically for your eyes and sight.

Medically, optometrists may catch systemic diseases (cancer, diabetes, thyroid disease, etc) by examining the eyes. Optometrists also check for cataracts, macular degeneration, glaucoma, and other eye diseases that cause vision loss. Additionally, optometrists confirm that your two eyes, twelve eye muscles, and internal focusing system work well together, providing you comfortable and efficient vision.

By evaluating the entire visual pathway and all of it’s moving parts, from the brain to tear film, optometrists assess multiple physiological systems to ensure your eyes are healthy and functioning well.

Visually, optometrists utilize optics and visual perception to determine your glasses prescription. In theory, our eyes work a lot like a camera, but everyone perceives what they see with nuance and subjectivity – this is where the art of optometry comes into play. Optometrists are the technical masters of prescribing prescriptions as well as the artists who refine them for each specific patient.

As you can see, there is so much more to an eye exam than "one or two".

The vast field of optometry encompasses rehabilitative care for the blind to those recovering from concussions or strokes. Other specialties include vision therapy, pediatrics, ocular disease, specialty contact lenses, and more. In three states, optometrists can perform laser eye surgeries.

Optometrists are eye doctors trained to care for the intricate and delicate visual system, from anatomical to neurological. Our education trains us to manage all eye care before and after the scalpel touches the eye.

What is the difference between an optometrist and ophthalmologist?

Optometrists (O.D.) are eye doctors who attend optometry school for four years after college. An optometrist's educational path is similar to dentistry and podiatry in that we start our medical training from day one. Optometry is a legislated profession, meaning the scope of practice changes from state to state. Despite this, every optometrist is trained to the highest level and maximum scope of practice.

Ophthalmologists (M.D. or D.O.) are eye surgeons who attend medical school for general medicine and later start their ophthalmic training in residency. They specialize in advanced diseases, procedures, and surgeries while in fellowship. Ophthalmologists don't all perform the same surgeries or see the same patients. A retinal surgeon will perform specific retinal surgeries while a cornea surgeon will perform specific cornea surgeries.

Increasingly, ophthalmologists are specializing in their own surgical niche, as optometrists also are specializing in specific areas adjunct to primary eye care.

Optometrists refer you to ophthalmologists, and ophthalmologists refer you to optometrists. Together, we are a healthcare team. For example, if you are a patient with keratoconus, any optometrist may refer you to a corneal specialist (ophthalmologist who specializes in the cornea and performs cornea surgeries) for corneal cross-linking. Additionally, any ophthalmologist may refer a keratoconus patient to a contact lens specialist (optometrist who fits specialty contact lenses) for gas permeable contact lenses. It all depends on the patient, disease status, and physician’s specialty.

In my case, I work alongside ophthalmologists to manage ocular diseases. I focus on the medical management of eyes and do not prescribe glasses. The contacts I prescribe are medically necessary for patients who are unable to see with glasses or needed for disease management. As such, I refer my patients to other optometrists for their refractive eye care needs.

Optometrists and ophthalmologists both play important roles in your eye care, and each physician brings a unique skill set to the table. The collaboration and respect between your doctors and you is what leads to successful outcomes.

Are there exceptions?

Absolutely. Eye care gets confusing as there are optometrists who solely do laser eye surgeries (in specific states) and general ophthalmologists who do not perform any surgeries. There are also optometrists who do not prescribe glasses or provide primary eye care. Instead, they work with ophthalmologists in surgical settings. Another example includes optometrists who only provide vision therapy and refer patients to other optometrists for contact lenses. There are even ophthalmologists who fit contact lenses!

Optometry encompasses so many aspects of eye care that some optometrists hone in on a very specific niche. While these practitioners are unique and excellent at what they do, the majority of optometrists and ophthalmologists are described in the question above.