Now, the difference between optometrists and ophthalmologists is often a confusing one to the average person and this is particularly true when we consider the differences in their roles that exist between countries, often between states to states within the same country.
In this blog post, I’m going to explain what the differences are, their qualifications and the roles they play, and also the places where they work. So keep reading and hopefully by the end of this blog post will be crystal clear about the difference between your optometrist from your ophthalmologist.
I’m going to be talking about the eye care professionals that are involved in helping you to see better.
So let’s get started…
So as an optometrist myself in the United Kingdom, most of the information in this blog post is going to be based on a UK perspective but it’s important to know that there are differences from country to country when it comes to eye care and optometry in particular, where possible I’m going to refer to some of those differences.
Training and Qualification
The training of an optometrist in the United Kingdom usually begins from about the age of 18 years after somebody has gone through their advanced level qualifications typically and they’re expected to achieve the high grades in three subjects, which are sciences or maths-based subjects. The kind of entry examination requirements would typically be A, B, or even straight A’s in those subjects at that point then the candidate would then go on to study optometry as a degree, at one of the universities that offer the program in the United Kingdom.
Typically the optometry degree in the United Kingdom is a three-year Bachelor of Science degree or it may also be a four years master’s degree. Now, this gives you the qualification of an optometrist but to practice in the UK, you have to then do a pre-registration year and this involves working full time for a year while preparing for professional examinations. Upon completing all of your professional examinations, then you are eligible to be registered and you can practice in the UK.
Essentially to practice as an optometrist in the UK, it’s a minimum of four or five years from starting your degree program, that’s important to know that in other countries the training program for optometrists are often four years or more and often lead to a doctorate of optometry and a degree, they then have the title of doctor. This is not the case in the United Kingdom, the training here leads to a Bachelor of Science degree or a master’s degree and we do not have the designated title of a doctor here. On the face of it, from what I can see, the training is essentially the same between UK optometrists and our fellow counterparts around the world, although they have a bit more extension in certain areas that allows them to have more. For example, rights to prescribe and treat certain conditions. So that is something that I suspect is likely to change with the expanding roles that are kind of happening in the United Kingdom more and more now that, likely, there will probably be a situation where a doctorate is then on the offer for optometrists here as well.
Now, ophthalmologists on the other hand are required to go to university and get a full medical degree and during their advanced level studies at higher education, you’ll be required to achieve a grade of A, B in your A-levels or most realistically, straight A’s, just because of the very competitive nature of the subject that upon completing your medical degree and working as a junior doctor, then you will have to specialize as an ophthalmologist.
So ophthalmology is essentially a specialty of medicine while some people go off and specialize to become a cardiologist, others may go and specialize in pediatric medicine, then to become an ophthalmologist requires you to apply for and successfully be accepted onto a program of training to become an ophthalmologist.
Having successfully applied and been accepted onto the program to train as an ophthalmologist, the successful candidates will then have to embark upon roughly seven-year training, at least to become a fully-fledged ophthalmologist. So you can think of it almost as having completed your medical degree. You now have to do an optometry degree as well as surgical training and perhaps some extra medical prescribing training for ocular conditions. At this point, then they are eligible to become registered with the governing bodies. They’ll already be registered with the General Medical Council as doctors, but then they’ll need to be registered with the Royal College of Ophthalmologists as well as the Royal College of Surgeons as well, ophthalmologists will have the qualification of a doctor and the title of doctor, but this will be an M.D. in recognition of the fact that they are medical doctors.
Now, just a little tip to think about, for those of you who are thinking about a career in ophthalmology or even optometry, then the reality is optometry school is a little bit easier to get into but that’s not necessarily because of the grades. The great requirements are very very similar between the two subjects, in fact, many of the people you’ll find on the optometry degree program already have the grades to do medicine but the reality is that medicine is just a very competitive program.
So if you’re somebody who finds yourself missing out on the medicine and you decide to do optometry, but you still have your heart set on becoming an ophthalmologist, then you may well find that actually completing the optometry program and then applying to medical school may be a faster route to become an ophthalmologist. You may well find you’re able to cut a few years off the number of steps that it takes to get there just because as a fully qualified optometrist, then you will usually be able to start medical school perhaps from the second year upon completing your degree program. You may well find actually that it’s easier for you to be able to get into the highly competitive specialty of ophthalmology because you’ve got this optometry background and also you may be able to give out some of the stages of the training as well because of your degree in optometry and the knowledge that you already have, so that’s something to think about if you’re somebody who has your heart set on that.
Role and scope of work
I know people who have been on the optometry training program and qualified and gone on to do ophthalmology and consult ophthalmologists now. I certainly recommend that you thoroughly do your research asking the right questions of the right people before you go and dive in. You know, I certainly wouldn’t want anybody calling me up in five years telling me that I ruined their life.
Optometry is a primary health care profession Now, what does this mean? Well, it means it carries a huge amount of responsibility and it can potentially be the difference between life
and death for some people. That might sound quite dramatic, but an example and a quick case in point is a story of a patient that I saw last year. This young girl was about 16 years old, she’s been getting quite dramatic headaches for the last two weeks and every day. Instantly it didn’t sound right to me in the first place when examining the back of her eyes, there were some very early signs of swelling that was going on at the optic nerve at the back of the eyes. So instantly, alarm bells rang for me and I knew I had to get her referred and seen by their department straightaway that day. So upon arranging that appointment and speaking with the consultant that their department, we agreed that she was going to come in and upon her going in within hours, they had admitted she had to have fluid drained from her spinal cord and it turned out that she had this buildup of pressure in her head, in a brain which needed to be reduced straight away. The scary thing for her was that the hospital advised her that if she had not come in even that day, it could have been a different outcome for her.
This is essentially what I mean by being a primary health care professional, It means that you have to have a burden of training to be able to know what is normal and what is not normal and a range of conditions and urgencies that they need to be referred and dealt with so that you can be an effective person at screening and making sure that people are protected that come to you as patients.
Optometrists examine for eye conditions and also are vigilant for other non-eye-related conditions that may be visible through looking at the back of the eyes and also along with the symptoms that people present that may be non-eye-related things that you may be able to refer them to their family doctor about.
Optometrists make the diagnosis on the conditions that they manage and they also make a provisional diagnosis on the conditions that they refer to ophthalmologists or family doctors and other health care professionals.
Optometrists can manage a range of eye care conditions and more specifically, those that do not require medical treatment or surgical intervention.
Optometrists have limited prescribing rights, and this varies from country to country, perhaps from state to state and wherever you are in the world, optometrists in the United Kingdom have extended prescribing rates, which means that they can prescribe a wider range of medications for the treatment of conditions with a prescription-only medication.
Optometrists can use certain drugs to make a clinical diagnosis, so this includes the drops that dilated pupils drops that relax your focus, and also anesthetic drops as well that help us to further investigate certain conditions.
Optometrists can fit and supply contact lenses, as well as optical glasses and lenses with a prescription.
An optometrist can manage a range of binocular vision problems, these are a range of conditions that affect how your eyes align and line up straight. Usually, though, most optometrists will probably refer patients to the eye department to professionals that we call Orthoptist.
Optometrists may choose to specialize in some specialties such as sports vision therapy. I have qualifications in low vision and aging coal management of cataract and ocular therapeutics and moving over to ophthalmologists.
I certainly in the UK, ophthalmologists mainly operate as secondary healthcare professionals and this means that most of their patients come to them via referrals from optometrists, family doctors, and other health care professionals.
Ophthalmologists can of course operate as primary health care professionals as well and this often happens when they’re not in the hospital setting because most referrals from optometrists and family doctors are sent to a hospital. So if an ophthalmologist has a private clinic, then you usually find that patients that come to them directly may be in a primary health care situation.
Now, the work of an ophthalmologist is all about making diagnoses and making calls on surgical and medical treatments for the eyes. Certainly in the United Kingdom, ophthalmologists are the only ones that can certify a person legally blind or partially sighted.
Ophthalmologists treat eye and whole-body systemic and medical conditions with the use of prescription-only medications and ophthalmologists carry eye surgery because it’s a major part of their work. The exact type of surgery that they will do will depend on their chosen sub-specialty.
Ophthalmologists often specialize in two or three sub-specialties, such as vitro-retinal surgery, corneal surgery, or even glaucoma. A lot of people don’t know this but the training of an ophthalmologist does include the ability to do refractions, which means that they’re able to determine what glasses you need and to be able to issue a prescription for you to obtain glasses in terms of where they work.
There is overlap in this optometrist generally has a bit more freedom and options in terms of the different environments and the different scenarios in which they can work. So optometrists can work in the community setting in community practice. They can also work in the hospital environment, you get some optometrists who work as domiciliary optometrists. That means they go out to your home to do the examination or they may go out to care homes and do examinations on the population of the care.
Optometrists also work in multidisciplinary practices where you have a mixture of health care professionals such as dentists, ophthalmologists, family doctors, etc.
Finally, optometrists often can work as well in vision, science, research, and laboratory-type environments. For the most part, ophthalmologists can be found work in the hospital-based settings, but they can also work and do often work in private practices where they may run
private glaucoma, probably cataract clinics, and you may also find them in multidisciplinary medical practices, although this is generally less common.
And then finally, there are a lot of ophthalmologists, of course, involved in medical research and vision, science research, some people might argue that we don’t need both of these eye care professionals. In fact, in the past, there has been a little bit of friction between the two because of some of these overlaps, however with time a better understanding between the two eye care professionals which only really makes sense when we think about the fact that we’ve got a hugely aging population around the world with really significant eye care conditions on their eyes and only a small number of ophthalmologists and a relatively small amounts of optometrists tasked with trying to serve this population.
So the two have learned to work hand in hand cooperatively with optometrists being able to screen out and filter out only the essential medical or surgical cases that need to be referred to the ophthalmologist and then the ophthalmologist, in turn, being able to focus on really these essential medical needs and surgical needs that only they are capable of doing. That’s also worth mentioning that there are the eye care professionals that are part of the wider eye care team and this includes the dispensing optician, also known as an optician in other parts of the world, in the UK we call them dispensing opticians and they have their qualifications and are registered as well.
We have an Orthoptist as well. Orthoptists mainly work in hospital settings dealing with binocular vision problems and dealing with child care binocular vision and coordination problems. These two eye care professionals often don’t receive the recognition that their work demands, but they are certainly valuable members of the wider eye care team and that’s perhaps a subject for another blog post.
Leave me a comment in the comments section below. Let me know what your thoughts are on the difference between an optometrist versus an ophthalmologist and if that has caused you confusion in the past as well.
So thank you for reading and until the next time, take care.
