Ophthalmologists, Optometrists and Orthoptists
In a gross oversimplification, it can be said that ophthalmologists are eye surgeons while optometrists are primary eye care providers. There is considerable overlap in scope of practice between professions. Laws regarding licensure vary by location, but typically ophthalmologists are licensed to provide the same care as an optometrist, with the addition of surgical options. In most locations surgery is the biggest difference between the two professions. Optometrists frequently refer patients to ophthalmologists when the condition requires surgery or intra-ocular injection.
Historically, ophthalmology has developed as a specialization of medical doctors while optometry originated as a profession that fitted people with glasses. As of 2012, this difference has decreased as the majority of optometrists screen for and treat eye disease and many ophthalmologists fit people with corrective lenses. This difference in background previously caused some conflict between the two professions. Ophthalmologists have voiced concern that an optometrist’s educational background is different from their own. Optometrists have criticized ophthalmologists of caring for the health structure of the eye while letting other vision disorders go untreated. For example, consider a patient with glaucoma and spasm of accommodation. Ophthalmologists would be concerned that an optometrist would fail to identify or otherwise mistreat the glaucoma. Optometrist would worry that the ophthalmologist would fail to identify or mistreat the spasm of accommodation. As of 2012, both these concerns are invalid because the education of both types of professionals prepares them to handle both conditions. (This may not be true outside of the United States.) Because of cooperation between optometrists and ophthalmologists, the quality of care depends more on the abilities of the individual doctors than it does what type of professional they are.
Orthoptists specialize in the diagnosis and management of problems with eye movement and coordination, such as misalignment of the visual axis, binocular vision problems, and pre/post surgical care of strabismus patients. They do not directly treat ocular disease with medications or surgery. Orthoptists treat patients using optical aids and eye exercises and primarily work alongside doctors to co-manage binocular vision treatment, but also often do eye and vision testing.
All three types of professional perform screenings for common ocular problems affecting children (such as amblyopia and strabismus) and adults (such as cataracts, glaucoma, and diabetic retinopathy). All are required to participate in ongoing continuing education courses to maintain licensure and stay current on the latest standards of care.