Not All Eye Doctors Are the Same!

There are three different kinds of eye doctors. The roles that they play may overlap to some extent, but their training is vastly different. In the United States and the developed world, these three types of doctors are referred to as ophthalmologists, optometrists and opticians. The type of care that a patient gets may be very different for a given condition, based on what type of eye doctor they go to for diagnosis and treatment.

An ophthalmologist is a medical doctor (M.D.) with a license to practice medicine in the state in which he/she practices. This doctor will have graduated from an accredited university undergraduate program with a bachelor's degree (or higher) and an accredited medical school in the United States or foreign country. Further training in medicine and surgery is obtained after medical school by completing an internship. This is a one-year supervised apprenticeship in a hospital in which the new doctor practices the diagnostic and therapeutic skills he learned in medical school. The training varies with the size of the hospital/hospital system and by whether the program is associated with an academic institution. After completing this program, an ophthalmologist must compete for and be accepted into an ophthalmology residency training program. This is a three-year apprenticeship in the medical and surgical treatment of eye disease. This is a total of eight years post-graduate training. The ophthalmology resident learns how to determine if an eye is functioning properly and if glasses or contact lenses are needed to optimize vision. Once this has been mastered, training begins in the fundamentals of the diagnosis and treatment of eye disease. This builds upon the education and practical skills that were received in medical school and internship. Even though the eye is a small structure, it is complex and the medical and surgical procedures that are used in this specialty take years of supervised training to do correctly. Once through with the residency, the ophthalmologist attempts specialty certification in his field by taking the Ophthalmology Boards, a grueling year-long process. Not all candidates pass and become Board Certified.

An optometrist is an eye care practitioner who is licensed in their state as a doctor of optometry (O.D.), not a medical doctor (M.D.). An OD attends an undergraduate university to get their bachelor's degree (or higher) and then graduates from an accredited four-year optometry school. An OD has four years of post-graduate training. The curriculum in this school teaches the student the basics about the evaluation of the normal and abnormal eye. The courses they take may include pharmacology and ocular disease and management. An optometrist is trained to evaluate the refractive state of the eye in order to optimize vision by prescribing glasses and contact lenses. ODs are taught to recognize eye pathology and to refer patients with these conditions to ophthalmologists. Some optometrists take externships with ophthalmologists to further familiarize themselves with eye disease. They are certified by a state board of optometry. In the State of California among others, they can earn a therapeutic license (TPA) by completing extra training under an ophthalmologist or other TPA-certified optometrist. This license allows a TPA certified optometrist to treat basic glaucoma and infections. States that allow optometrists TPA privileges usually have large rural areas that are underserved by ophthalmologists (MDs). Most optometrists that practice under this expanded scope of privileges co-manage patients that have eye disease with an ophthalmologist.

An optician is an eye care practitioner who is trained in dispensing glasses and contact lenses. They are frequently talented fashion designers with a flair for helping people look their best by choosing flattering frame styles. Opticians are skilled in ordering eyeglass prescriptions from optical labs and making sure that the correction you receive is the one the ophthalmologist or optometrist wanted you to have. They are typically good communicators.