What's the difference between optometrists and ophthalmologists?

Optometrist vs. opthamologist? Know the difference between these two professionals and choose the best professional when it comes to eye care.

Optometrist vs. opthamologist? Know the difference between these two professionals and choose the best professional when it comes to eye care.

Do you know the difference between an ophthalmologist and optometrist? More than 90 percent of respondents to a recent Angie’s List online poll say they do. Only 71 percent, however, correctly defined the distinctions between the two professions. Figuring out what the eye care providers can — and legally cannot — do can be complex.

To help clarify, optometrists are trained to provide routine eye care, such as exams and prescriptions for glasses and contacts, but they’re not medical doctors. Ophthalmologists are medical doctors educated and trained to provide the full spectrum of eye care, including the treatment of a wide array of diseases and performing complicated surgical procedures.

Muddying the waters even more, as our cover story discusses, is the push from optometrists in several states to expand their scope of practice to include various procedures that are currently limited to ophthalmologists. Some states have already passed laws allowing optometrists to perform certain surgical procedures, administer injections like local anesthesia and prescribe more medications.

Who you should see for certain procedures has sparked intense debate, with ophthalmologists arguing optometrists are not adequately educated and trained to deal with the risks and potential emergencies that can arise during high-tech laser surgeries and other procedures. But optometrists maintain they now go through sufficient preparation to safely and effectively perform more of these services and give patients the treatment needed.

While 100 percent of Angie’s List online poll respondents would go to an optometrist for an eye exam, only 2 percent say they’d have them administer an injection to treat macular degeneration or other problems; 4 percent would consider an optometrist for laser eye surgery; and 8 percent would see an optometrist to treat glaucoma. All together, 35 percent of members who took our poll saw an optometrist in the last year, 23 percent visited an ophthalmologist, and 14 percent went to both.

Your right as a prospective patient is to make an informed decision. With so many states at least considering proposals to expand optometrists’ scope of practice, it’s important you understand your state laws and regulations before seeking treatment for issues beyond basic eye care. Be sure to narrow your list of providers based on the type of services you need.

If you’re not sure whether to go with an optometrist or ophthalmologist, be conservative in your approach. Carefully research their background, training and experience. Both should be certified by an accredited institution and licensed to practice by your state optometry or medical board. Confirm credentials with your state or by emailing us at licensing@angieslist.com. The bottom line: Safety should always come first.

That’s how I see it.


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Optometrists, ophthalmologists fight over eye care rights

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Tulsa area resident Pam Odum hoped to ditch her glasses when she saw an optometrist for laser surgery. Instead, her vision got worse, and she now requires a stronger prescription. Photo by Jen Hoppa
Tulsa area resident Pam Odum hoped to ditch her glasses when she saw an optometrist for laser surgery. Instead, her vision got worse, and she now requires a stronger prescription. Photo by Jen Hoppa

Optometrists battle ophthalmologists as line blurs between levels of care

Comments

Having been in the industry for 33 years & working with both Optometry & Ophthalmology in referral centers - I will share insights. Private practice Optometrists are generally capable of handling 95-98% of all cases - including infections, glaucoma, pre & post cataract surgery evaluations, ulcers, pink eye & ocular complications of systemic diseases. The weak link in Optometry consists of the retail eyeglass sellers & big box stores who push staff Optometrists to generate eyeglass prescriptions as quickly as possible. Very similar to some HMO models that push primary care physicians to see patients in a matter of minutes. Few Ophthalmologist are good with contact lenses, nor eyeglasses, although most have in-office dispensaries nowadays. Best quality assurance factor with Optometry would be the doctors in private practice - not retail big box. I am diabetic & my eye doctor is a private Optometrists, because he spends more time & is more thorough. I will see the retinal specialist (not a general ophthalmologist) - if I ever need to.

Angie's List can be very helpful in many situations, but this article still has much work to do and still does not "explain" the differences between Optometry and Ophthalmology. The differences are really linked to the training that is provided for each profession. An Optometrist does not a hold a Doctorate of Medicine degree, but a Doctorate of Optometry degree (4 years beyond bachelor's degree). This doctor has spent the most time learning and performing refractions (determining your eyeglasses prescription), it is the core of what they do best. They are also highly trained to fit contact lenses. They can also treat minor eye conditions and injuries. They are also trained to detect eye diseases and provide the proper referral to a specialist (Ophthalmologist). An Optometrist can be considered your "primary eye care" doctor much in line with "primary health care" doctor and are best suited for "routine eye care". They typically have had very little training in performing surgeries, using lasers, or injections. An Ophthalmologist is a medical doctor who specializes in the eye. Ophthalmologists have a Doctorate of Medicine degree and has completed an additional fellowship in Ophthalmology (8 total years beyond bachelor's degree). They typically perform surgery and treat complicated eye diseases. Ophthalmologists spend very little training performing refractions or fitting contact lenses (2 to 3 week courses). However, many Opthalmology practices are now providing one stop shop that includes an optical. These are business decisions to capture the retail side of the market as well as the medical side. Truth be told, if you are at one of these Ophthalmology offices and require refraction services, you will likely be seeing an Optometrist working for the Ophthalmologist or Opthalmic Technician (least trained) performing that aspect of your eye exam. So, the recommendation should be this: For your routine eye care for glasses, contact lenses, and minor eye conditions, see an Optometrist. If you have a documented eye disease that requires a higher level of expertise, you should be seeing an Ophthalmologist. In conclusion, consumers often get confused with the most highly trained aspect while choosing the proper doctor. The most highly trained doctor getting your eyeglasses prescription correct and fitting your contacts are Optometrists. The most highly trained doctor to treat your complicated eye diseases are Opthalmologists.

I'm a healthy 45 year old female with a strong family history of diabetes (juvenile and type 2) myself pre-diabetic for several years-not due to weight gain (I'm only 100lbs. on my fat days.) Anyway my vision is getting progressively blurry from very close to about 6ft in front of me. I I used to have HD vision now it's old school fuzzy :( WHO WOULD FIX MY VISION PROBLEM MORE SUCCESSFULLY, AN OPTOMETRIST OR AN OPTHALMOLOGIST? I don't want contacts, just glasses. And I don't want to have to go to both initially.Any advice??? Thanks!

I'm sure you've heard of macular degeneration in diabetics. Ophthalmologists have much more training than optometrists. If you could find one who specializes in diabetic retinopathy, I think that would be your best bet. I have a new eye problem (I'm 71, not diabetic), and I wouldn't consider going to an optometrist about it. Plus when it's time to get your cataracts replaced, optometrists can't do surgery. I'll have to say, though, that I had an A+ optometrist in Sacramento. He could tell that I was raised in the midwest by how my retinas looked. I asked how he knew & he said he'd noticed over the years that people raised inland had some retinal characteristics that were different from those of people who were raised on or near the coasts. I don't remember what he said - I do remember it was something about the amount of oxygen in the air. It sounds kooky, but he was right about me.

I would recommend seeing an optometrist vs an ophthalmologist for your concerns. I am friends with an optometrist and they are great with vision problems. During the exam, they also check for eye health problems such as cataracts, glaucoma, and diabetic eye problems. You can also be seen a lot quicker at an optometrist, usually same day, where as an ophthalmologist will have a few weeks wait.

To all that are not sure what an optometrist is, I am sorry to say you are all uneducated and very stupid. You should all read what an optometrist does. THey are more qualified than most OPHTHALMOLOGISTS ! My optometrist saved my life. She not only told me that I have high cholesterol, but she also told me that I should get my blood sugar checked. My cholesterol was 400 and my Blood sugar was 597. If it wouldn't be for her, I would have been dead. The people on this forum are uneducated, and idiotic.

Geez dude calm down. Being derogitory, calling people stupid is not constructive. Hopefully those words are not used towards your family.

I prefer an opthamologist. I am a registered nurse, and I simply have more confidence in a physician. I feel he/she would best be qualified to deal with any problems regarding surgery (should I ever require it). This is strictly my personal preference.

For myself, I feel most comfortable with an opthamologist due to my many systemic illnesses. I, too, am a health professional. A couple of my diseases are rare & one can directly effect my vision, and meds I'm taking can, also, effect my vision. I have a tiny freckle that has to be watched carefully & I didn't find out about it until I went to opthamologist. 1 ~ the optometrist didn't see it, or 2~ the optometrist didn't think it important enough to disclose (bad choice)

So you had a freckle...? So what? 99%+ of freckles stay the exact same way for ones entire life. If the Ophthalmologist tried to tell you that the Optometrist should have referred you to him/her for further evaluation, that is an unwarranted bashing on Optometry. Nonetheless, I understand your comfort going to an Ophthalmologist given your systemic conditions

I have used only opthamologists since an optometrist told me I was losing sight in my right eye, so I went to an ophthamologist to see what needed to be done and I found out that my eye was fine. That was about 40 years ago and, other than corrective lenses for my aging eyes,my sight is great. It costs very little more and I know the advice I'm getting is correct. I have gone to Dr Diana Hampton in Edmond since moving back to Oklahoma in 1996, and I would recommend her to anyone.

Glad someone explained the difference

In IA I went to Wolf Clinic and they were excelente . Saw Dr. Barns , very caring Dr.

Always use MD since bad experience with an optometrist.

I'm scheduled for eye surgery in August 2011. Price V

Because a discipline is licensed for various "skills" in a state does not guarantee quality and depends a lot on which state. I live in Oklahoma..if that tells you anything.

I have been looking at some of these post from people who know absolutely nothing about Optometrist. Claiming that they are only equip to handle glasses and contact lenses. Most patients end up seeing ophthalmology b/c optometrist diagnose surgical problems and correctly refer them. The retinal detachment post is ridiculous b/c most retinal detachment surgeries are performed by RETINAL SPECIALIST not any old ophthalmologist. Obviously optometrists are not claiming to be able to perform retinal surgeries in any capacity. Optometrists in some states are being licensed to perform small surgical procedures (including laser, and some injections to the eyelid.) As an optometrist I feel that Optometrist should not be performing any surgery in their office. I you can't deal with possible complications then you should not be doing any surgery. An optometrist should be able to perform a complete eye exam and should refer when needed. Those who say that an optometrist is only good for glasses or contact lenses has no idea what level of education an optometrist has and are probably just repeating what other people are saying.BOTH OPTOMETRIST AND OPHTHALMOLOGISTS HAVE THERE PLACES.

An optometrists' education does not only include ophthalmic optics and visual function with respect to glass and contact lenses. An optometrist spends 4 years learning everything ranging from neuroanatomy to systemic disease. The difference is that an optometrist is geared to primary eye diseases/treatment and systemic disease and how that effects the eyes. To claim that an optometrist is no more than a technician is absolutely ridiculous. Optometrists do carry malpractice insurance, albeit not as expensive as an ophthalmologist, b/c they are not doing surgery. An optometrist must know their place in the scheme of eye care. An optometrist is the primary entrance for eye care in this country. An optometrist have been trained to diagnose treat and manage certain eye diseases, including glaucoma (there are certain forms of glaucoma that optometrists should defer to a glaucoma specialist that may need surgical intervention). An optometrist have the education to monitor diabetics and patients with macular degeneration that does not need surgical intervention. An optometrist can treat eye disease that lead to diagnosis of systemic disease. The most important thing is that optometrists must know their place and must know when to work with other medical specialties and to refer to specific ophthalmology specialties. An optometrist is not a surgeon nor should they try to be in anyway, but they are more than capable to treat and diagnose eye diseases.

After 40 years of this you'd think I would just be able to laugh it off as ignorance and let it go, but I cannot. Many OMDs aren't any better than their MD cosmetic surgeon counterpart: it's all about the cash on the barrelhead. LASIK is the cashcow. And those that purport to be strabismus surgeons make my blood boil. They treat the eyeball as a separate entity, apart from the brain (the very thing that controls the eyes) and may cosmetically 'fix' some people but far more are harmed. I cannot tell you how many botched muscle surgeries I've seen in my career. The last one, a sweet little 5 yr old boy with an intermittent floating eye went under the knife at a prestigious regional dept of ophthalmology at a medical school and ended up with double vision. He is now VERY cross-eyed. The surgeon was like "Oh, it'll go away in about 6 months." WHAT?? Yeah, right. That's competence and caring at it's best in that field. Arrogant, greedy, egotistical & narcissistic...synonyms for OMDs! As for taking a 6 week course...most MDs learn new procedures in a weekend in a hotel....how many of you knew THAT?

Many years ago I went to an Optometrist and I was told I needed tinted glasses because I was color blind and needed my glasses tinted. Subsequently I visited an ophthalmologist who asked me why I wanted my glasses tinted and I repeated what the optometrist told me. He assured me I was not colored blind so it is obvious which doctor I now see. As I have aged I acquired cataracts and have had surgery. I definitely would trust only an ophthalmologist to operate on my eyes.

To MAS's comment above. Optometrists complete 7-8 years of school. 3-4 years undergraduate & 4 years specialized optometry school. We are qualified to prescribe glasses & contact lenses as well as treat ocular disease. Because we treat patients medically, we must also carry medical liability insurance. I feel that there is a lot of misinformation given to consumers on the OD/MD subject, and this article really did nothing to help clear that up.

Dr. Robert Sheets and Dr. Shah both in Midland. Both Excellent!

I agree there are good & bad in any group/profession. My question is why would you even consider going to a less trained person Ie: optometrist or podiatrist for care that is limited by the schooling & training when you could as easily go to an M.D. who by law is required, at the risk of being forced to give up his profession when it is risky to go to a less trained "professional"?

There are always good guys and bad guys but if I had a retinal detachment there are ophthalmologists in that field. There are very nice optometrists but they have no training in that area. I did share an office with an opthalmologist, trained in retinal detachment who trained St Baskin Robbins in Miami, top notch, at that time it was possible to have a perfect surgery and not have it work. that is, better to get the best available and be glad for it.

Ophthalmologists go to several years of medical school while optoms only take a 2-3 year course of study. Optoms do not carry malpractice liability insurance while MDs do. I would not see an optom for anything other fore an eye exam and glasses.

I'm not sure where you get your information. Optometrist go through a 4 year undergraduate program and the attend a 4 year doctoral program, that equals 8 years of college. Then we are also required to pass national board exams and complete CE ever year. We also have to have malpractice of $2 million/3million.

If in the Athens GA area trust your eyes to Five Points Eye Care and Dr Jon or Nadine Forche. Trust your eyes to the besr

Optometrists have been lobbying for years to gain privileges for which they are not adequately trained. They may take a 6 week course, and call themselves experts in surgery, shots, or other medical procedures. They are super for simple vision tests, glasses or contact lenses. Anything else should be left to the professionals who are MD's.

Never had an issue with optometrist, but in a couple of instances they would always recommend an MD if a medical opinion was advisable. I have the beginning of cataracts, and my optometrist is monitoring it but has a list of recommended MDs when the time comes for surgery. I would only be comfortable with that arrangement, regardless.

Your knowledge of optometry is limited and skewed. If you are going to pontificate, do so accurately

This debate has gone on for so long. We have optometrists working in our office and are good at prescribing glasses and taking care of minor ophthalmic problems including dry eye and astigmatism. The problem with most optoms is that they hold on to patients too long before realizing that their condition has deteriorated and then ophthalmologists are stuck taking care of a major problem which could have remained a minor problem. Is there a place for them in eye care? Absolutely! They are much better at fitting glasses and contacts than me -- I saw 4000+ patients yearly in residency which were mostly indigent and very sick. optometrists see about 200-300 patients yearly who are mostly well. they will spend more time fitting your glasses, I will recognize your medical issue and treat it correctly more rapidly and accurately. If you are well and need a prescription, see an optom. maybe see a true MD eye doctor every 2 years or so. If you have more problems, see an Ophthalmologist who is not just concerned with performing cataract surgery on you.

Tommy, including astigmatism with dry eye makes me question as to whether or not you are making up your experience, b/c astigmatism is a refractive error and is no way related to a medical issue. I do not know where you get your statistics (probably just make them up to try and make a point), but as an Optometrist I seeing 200 patients per week including a with at least half being scheduled for binocular vision problems(amblyopia, strabismus) glaucoma, anterior segment disease, and retinal patients including (Diabetics, AMD, etc..). A lot of my patients are in fact routine exams, but where do think all of these conditions are identified and treatment started. I have had many experiences with ophthalmology where they are doing surgery on patients that don't need it (cataracts on patients with 20/20 visual acuity, SLT over and over again). I am not saying that all ophthalmology is like that, in fact I have a very good relationship with the ophthalmologist affiliated with my practices. To claim that you will identify and treat more rapidly is a silly claim b/c 99% of patients present to eye care are first seen by optometrists.

We've been seeing an optometrist since 2000 and are very happy with her; we trust her to refer to an opthalmologist if necessary. (If you don't trust your doc... you need a new doc!)

Had a couple bad experiences at ophthalmologists-they could never get my glasses right. Have been going to my trusty local optometrist and receive the best, thorough eye exams!

I know a nurse practitioner who had a retinal detachment while allowing a optometrist to monitor her condition. I refer all my patients who have medical conditions that can affect vision.

DR. ANDY BAUSCH IN ALLENTOWN. FANTASTIC.

I only use an optomotrist when I only needed glasses. Now that I have cataracts I only see Dr Laurie Anglin of Brandon, FL. She only prescribes new glasses when there is change. I got my first change in 3 years, this year. I don,t need cataract surgery until at least next year. She won't let me get it too soon. The group is Brandon Cataract and Eyecare

I would only allow an ophthalmologist prescribe lenses and perform surgery on my eyes. I have a severe astigmatism, near sightedness and the start of a cataract. When I first got glasses as a child I saw an optometrist, but since I went to nursing school I switched to an ophthalmologist because they are MD's first and then specialize in the diagnosis and treatment of eye issues. I would never let an optometrist operate on my eyes.

I must agree re buying glasses or frames at office of Opthomologist, very poor treatment, frames not even fitted, and one time watched an elderly couple getting royally ripped off with paying huge full price for simple glass lenses, no refractions. I get a professional discount and still would not go back. Good point.

I have had bad experiences with medical doctors. One can't judge an entire profession by an experience. I, too, am an RN and I would trust my optometrist for the obvious, eye exam, glasses, contact lenses, but I would also see him for foreign body in the eye, corneal abrasion, glaucoma, and eye infections. If I needed surgery I would see an ophthalmologist. Optometrists are required to have ongoing education and are trained to do many things that state licensers won't allow them to do. I know my optometrist has found pituitary tumors and diabetes and referred those patients on to specialists.

This decription is not complete in any way. Your website is giving a very biased view of these two professions. Optometrists are experts in vision care and are usually the ones who people buy their glasses from. That's the nature of the business. However, most ophthalmologists are now selling glasses as well; having worked in both types of offices I can tell you the exam for glasses or contacts is generally much better from an optometrist. Optometrists are also trained in medical eye care however. They are well trained and licensed to treat many eye conditions from infections to glaucoma. I believe ophthalmologists should be the surgeons. They are trained in that and in reality that is their main role in eye care. Optometrists are primary eye care doctors. Just as your primary care doctor is for your general health. You don't immediately go to a cardiologist just because you have high blood pressure. It's the same thing. Optometrists are also trained to know when a patient needs surgery and to refer appropriately. There are good and bad doctors in every profession. Unfortunately a portion of optometry has turned to "one hour" places where those doctors are not in the best position to provide comprehensive eye care as they should or would like to. I believe this has cast a negative light on the profession. Yet the public continues to demand these types of places and doesn't value eyecare as I believe they should. But working in these type of offices does not make these people bad doctors or any less knowledgeable. It would be nice if a site like this would take an opportunity like this to properly and fairly educate the public on this topic. Instead we get a very biased description of these two professions. I hesitate to trust any other "unbiased" information on this site.

I use both. We have an Eye Group where I live that includes both Ophthalmology and Optometry. I love both my "eye doctors". I see my Optometrist for my checkups and my Ophthalmologist did my surgery.I have total confidence in them both!!

Being a health care professional, I am well aware of the differences between an optometrist and an ophthalmologist. I would be very comfortable seeing an optometrist for attention to normal vision problems that are correctable with glasses or contacts. However, for those with "medical" eye problems, the extensive training of an ophthalmologist, who is a medical doctor, is the way to go. Four years of training versus twelve years of training is a no-brainer.

Your comment is misleading. Ophthalmologist have 4 years of college, 4 years of general medical school, 4 years of eye training. Optometrists have 4 years of college, 4 years of eye training. Both doctors have 4 years of eye training. If you need an ophthalmologist, an optometrist will refer you to one. Unless you need surgery, you will find an Optometrist more interested in your case.

I spent nearly two years going to a large ophthalmology practice for treatment of what seemed to be chronic corneal ulcers. I found the doctors to be pleasant but not especially interested in getting to the root of the problem. They were happy to let insurance pay for appointment after appointment with no resolution. I also used this practice for basic exams and contact lens fittings, and found the optometrists on staff to be quick, careless, and unconcerned with ensuring a good, comfortable fit. I was even given the wrong prescription and had to get it corrected myself. With my corneal condition now under control, thanks to the resolution of other underlying medical issues, I have tried an optometrist-only practice and have been much happier with the level of service and attention, including a much more thorough eye exam and much more common-sense advice about what was really causing my corneal problems and how to address it. Perhaps it depends on the practice, but I have to say that the optometrists win out when it comes to excellent basic eye care.

Believe it or not? This is the second time this issue was addressed. http://magazine.angieslist.com/eye-doctors/articles/optometrists-ophthalmologists-fight-over-eye-care.aspx Unfortunately, I am, as a consumer, do not see the point of this article. 80% of Americans will continue to see an optometrist when they first experience an eye- related problem, then you go from there. So, let's say in the majority of the cases for the majority of the public (which I hope this article meant to address), knowing the difference, does it mean that I should seek an Ophthalmologist when I first experience an eye related problem? "Who you should see for certain procedures" will remain the job of the first eye care provider, which in this case I give an optometrist a two-thumbs-up. I think that this article did not really address its tittle "Who do you trust for your eye care?" but rather belittling a profession over another. I rather just watch them fight over their scopes of practices (as Ophthalmologists fight for their facial plastic surgecal procedures and optometrists fight for their non-invasive surgeries). I think the scope expasion is a natural growth of any profession. Shame on you, AL

To those of you who state that opthamologists aren't specialists in vision. Are you kidding? Yes, they are surgeons but they are also vision specialists. An optometrist can check basic near/farsightedness and pressure but if you want someone who has all the skills, it should be an opthamologist because not only do they provide the full range of services but their education far exceeds that of an optometrist.

You comment that their education far exceeds optometrists and though you are correct in that the time they are in school does exceed an optometrists their training in ophthalmic specific care does not it is just different. Ophthalmologists attend 4 years of medical school during which time there is very little dedicated to specialty training, most if their ocular training comes after medical school during their residency. Ophthalmologists do in fact spend significantly less time than Optometrists learning about the specifics of refractive (glasses/optical care) because they are supposed to be masters of surgery. Like my father always said do you want to me a jack of all trades...master of none? The answer is no especially with an eye surgeon (ophthalmologist) if you need surgery on your eyes go to a Ophthalmologist that is a SPECIALIST (retinal surgeon, cataract surgeon etc.) If you want a comprehensive eye exam and you have no known issues go to an Optometrist. You can think of Optometrists as your "primary care" eye doctors and Ophthalmologists as your "specialists" . By the way most Optometrists do treat and manage common eye disease (like glaucoma) until they need surgical intervention, at which time they will be sent to a Glaucoma "SPECIALIST".

find it interesting that you can't spell ophthalmologist....

everybody wants to be a doctor, but nobody wants to go to medical school, internship, residency, etc...Optometrists are good @ what they are trained to do, but they are basically technicians...an optometrist doing surgery is like the water boy playing quarterback....MD, FACS

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