Eye care professional

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An optometrist is an individual who provides a service related to the eyes or vision. It is any healthcare worker involved in eye care, from one with a small amount of post-secondary training to practitioners with a doctoral level of education.

Contents

Types

Ophthalmologist

Ophthalmology (/ˌɒfθælˈmɒlədʒi/ OFF-thal-MOL-ə-jee) is a surgical subspecialty within medicine that handles the diagnosis and treatment of eye disorders. [1] [2] Ophthalmologists are physicians (M.D./D.O/have a doctorate in medicine) that undergo subspecialty training in medical and surgical eye care. [3] To become an ophthalmologist the provider must first become a physician. To become a physician, after college they must go through 4 years of medical and surgical training where they are extensively educated in treating all parts of the human anatomy, including the eye. [4] [5] Their training includes, but is not limited to, coursework(classroom, clinical, and community experiences) that covers science, the latest innovations in treatment and diagnosis, problem-solving and communication skills, prevention and care, professionalism, and medical ethics. [4] After receiving the doctorate in medicine, the ophthalmologist completes 4 additional years of subspecialty training that includes an internship year, where they are exposed to broad clinical, hospital consultative and operative experiences in a variety of disciplines (subspecialties) covering every part of the eye including: cataract/anterior segment, cornea/external disease, glaucoma, neuro-ophthalmology/orbit, ocular pathology/oncology, oculoplastic/orbit, pediatric ophthalmology/strabismus, refractive management/intervention, retina/vitreous, and uveitis. [3] [5] [6] [7] Because of this training, ophthalmologists are the only physicians medically trained to manage the complete range of eye and vision care. [3] [6] After 8 years of post college education, about 40% of ophthalmologists choose to further subspecialize in a specific part of the eye, by completing 1-2 more years of fellowship training. [3] Because of their extensive medical and surgical training, ophthalmologists can and do handle general eyecare, including but not limited to general eye exams, prescribing glasses and contact lenses, and dispensing medications(eye drops and oral/I.V. medications including all scheduled substances). [3] [5] [6] [7] [8] Because of their first hand knowledge and access to all medical and surgical facilities and imaging modalities(ie CT/MRI), they diagnose and treat eye conditions and diseases, and perform in office procedures such as lasers, out-patient surgeries such as cataract surgery and in hospital surgeries, such as extensive eye tumor removal. [3] [5] [6] [7] [8] [9] They are the only eye care provider with this extensive amount of medical and surgical training, as well as clinical expertise and exposure to all aspects of the eye, orbit, optic tract and visual cortex. [3] [6] [7]

Ophthalmic medical practitioner

An ophthalmic medical practitioner is a physician who specializes in ophthalmic conditions but who has not completed a specialization in ophthalmology. This title only relates to providers in Europe.

Optometrist

Optometrists are healthcare professionals with a degree in eye care, specifically. In the United States and Canada, they are Doctors of Optometry (O.D.) - this includes optical, medical and some surgical eye care. Their training typically includes four years of college followed by four years of eye specific training (Optometry school). Some complete an additional 5th year in a specialty area. Optometry school is a specialized program - specific to the eyes and related structures. Optometrists receive their medical eye training while in Optometry school and during internships (hospitals, private practices, universities, VA's etc.). Education is provided by professors, optometrists and physicians. Often, Optometry students and Ophthalmology residents will work together to co-manage medical cases. O.D.'s are trained and licensed to manage any eye disease (infections, glaucoma, macular degeneration, etc.) and practice medicine for eye related conditions - including topical medications (eye drops) or those taken by mouth including some schedule controlled substances. They may also order imaging tests (CT/MRI), remove ocular foreign bodies and perform some laser procedures. They are also qualified to perform some surgical procedures. Optometrists have the most optical training of any eye care professional and are the only eye care providers with a degree specific to eye care.

In the United States, Optometrists in some cases are considered doctors within their scope of practice and bill medical insurances according to Medicare. [10]

Outside of the United States and Canada, Optometrists typically do not hold a doctorate degree and may be limited in providing surgical treatments. However, some countries such as the UK, include a combination of providers where some Optometrists hold postgraduate doctorate degrees and some do not.

Orthoptist

Orthoptists specialize in diagnosis and management of eye movement and coordination problems, misalignment of the visual axis, convergence and accommodation problems, and conditions such as amblyopia, strabismus, and binocular vision disorders, as outlined by the International Orthoptic Association. [11] They may assist ophthalmologists in surgery, teach orthoptic students, students of other allied health professions, medical students, and ophthalmology residents and fellows, act as vision researchers, perform vision screening, perform low vision assessments and act as clinical administrators. [12]

Ocularist

Ocularists specialize in the fabrication and fitting of ocular prostheses for people who have lost eyes due to trauma or illness.

Optician

Opticians specialize in the fitting and fabrication of ophthalmic lenses, spectacles, contact lenses, low vision aids and ocular prosthetics. They may also be referred to as an "optical dispenser", "dispensing optician", "ophthalmic dispenser". The prescription for the corrective lenses must be supplied by an ophthalmologist, optometrist or in some countries an orthoptist. This is a regulated profession in most jurisdictions.

Ophthalmic medical personnel

A collective term for allied health personnel in ophthalmology. It is often used to refer to specialized personnel (unlike ocularists or opticians). In many countries these allied personnel may just be known as an "ophthalmic assistant". Their training is usually combined with a two or three year applied science degree and they assist an ophthalmologist or optometrist in the hospital or clinic with vision testing.

In the USA the Joint Commission on Allied Health Personnel in Ophthalmology administers OMP certifications:

Oculist

Oculist is an older term that was primarily used to describe eye care professionals that are trained and specialized in the eye care field, specifically ophthalmologists and optometrists. The term is no longer used in the United States.

Vision therapist

A vision therapist, usually either an orthoptist or optometrist, works with patients that require vision therapy, such as low vision patients. Commonly, vision therapy is performed in children who develop problems with their vision mostly because they are using their eyes up close. This type of therapy is however generally used in patients who need visual correction but for whom the corrective lenses are not enough to reverse the condition. Visual therapy in children is performed by optometrists who specialize in children's eye care. To specialize in vision therapy, doctors must complete extensive post-graduate training beyond their optometric degree, at which time they are eligible to sit for their national boards to become fully certified as specialists in children's vision. A doctor's title after passing the national board in vision therapy is Fellow in the College of Optometrists in Vision Development, or F.C.O.V.D. Optometrists who provide vision therapy but who have not yet sat for their certification exams are board-eligible Associates in the College of Optometrists in Vision Development. Vision therapists typically use prisms, eye patches, filtered lenses, and computerized systems to conduct therapy sessions.

Most eye care professionals do not practice iridology, citing a significant lack of scientific evidence for the practice.

Distinction between ophthalmologists, optometrists and orthoptists

Ophthalmologists generally provide specialty eye care and manage late stage eye disease (often only mitigated with surgery).

Optometrists typically provide comprehensive eye care - including medical, up to a moderate stage (managed with prescription medications). There is considerable overlap in scope of practice between professions. Optometrists are licensed to provide exactly the same medical care as ophthalmologists, but not invasive surgery.

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 are trained to treat patients using optical aids and eye exercises. [13] [ failed verification ] Orthoptists are primarily found working alongside ophthalmologists and optometrists to co-manage binocular vision treatment, visual field loss management and accommodative therapy. They often do standard eye and vision testing along with computerised axillary 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). [14] All are required to participate in ongoing continuing education courses to maintain licensure and stay current on the latest standards of care.

See also

Related Research Articles

<span class="mw-page-title-main">Ophthalmology</span> Field of medicine treating eye disorders

Ophthalmology is a clinical and surgical specialty within medicine that deals with the diagnosis and treatment of eye disorders. A former term is oculism.

<span class="mw-page-title-main">Optometry</span> Field of medicine treating eye disorders

Optometry is a specialized health care profession that involves examining the eyes and related structures for defects or abnormalities. Optometrists are health care professionals who typically provide comprehensive eye care.

Orthoptics is a profession allied to the eye care profession. Orthoptists are the experts in diagnosing and treating defects in eye movements and problems with how the eyes work together, called binocular vision. These can be caused by issues with the muscles around the eyes or defects in the nerves enabling the brain to communicate with the eyes. Orthoptists are responsible for the diagnosis and non-surgical management of strabismus (cross-eyed), amblyopia and eye movement disorders. The word orthoptics comes from the Greek words ὀρθός orthos, "straight" and ὀπτικός optikοs, "relating to sight" and much of the practice of orthoptists concerns disorders of binocular vision and defects of eye movement. Orthoptists are trained professionals who specialize in orthoptic treatment, such as eye patches, eye exercises, prisms or glasses. They commonly work with paediatric patients and also adult patients with neurological conditions such as stroke, brain tumours or multiple sclerosis. With specific training, in some countries orthoptists may be involved in monitoring of some forms of eye disease, such as glaucoma, cataract screening and diabetic retinopathy.

<span class="mw-page-title-main">Eye surgery</span> Surgery performed on the eye or its adnexa

Eye surgery, also known as ophthalmic surgery or ocular surgery, is surgery performed on the eye or its adnexa. Eye surgery is part of ophthalmology and is performed by an ophthalmologist or eye surgeon. The eye is a fragile organ, and requires due care before, during, and after a surgical procedure to minimize or prevent further damage. An eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. It continues to be a widely practiced class of surgery, with various techniques having been developed for treating eye problems.

<span class="mw-page-title-main">Southern College of Optometry</span>

The Southern College of Optometry is a privately owned educational institution located in Memphis, Tennessee. It specializes in optometry and offers a comprehensive program in this field.

<span class="mw-page-title-main">Eye examination</span> Series of tests assessing vision and pertaining to the eyes

An eye examination, commonly known as an eye test, is a series of tests performed to assess vision and ability to focus on and discern objects. It also includes other tests and examinations pertaining to the eyes. Eye examinations are primarily performed by an optometrist, ophthalmologist, or an orthoptist. Health care professionals often recommend that all people should have periodic and thorough eye examinations as part of routine primary care, especially since many eye diseases are asymptomatic.

Pediatric ophthalmology is a sub-speciality of ophthalmology concerned with eye diseases, visual development, and vision care in children.

Vision therapy (VT), or behavioral optometry, is an umbrella term for alternative medicine treatments using eye exercises, based around the pseudoscientific claim that vision problems are the true underlying cause of learning difficulties, particularly in children. Vision therapy has not been shown to be effective using scientific studies, except for helping with convergence insufficiency. Most claims—for example that the therapy can address neurological, educational, and spatial difficulties—lack supporting evidence. Neither the American Academy of Pediatrics nor the American Academy of Ophthalmology support the use of vision therapy.

Convergence insufficiency is a sensory and neuromuscular anomaly of the binocular vision system, characterized by a reduced ability of the eyes to turn towards each other, or sustain convergence.

The Optometric Extension Program Foundation (OEPF) is an international, non-profit organization dedicated to the advancement of the discipline of optometry, with recent emphasis on behavioral optometry and vision therapy.

<span class="mw-page-title-main">Illinois College of Optometry</span>

The Illinois College of Optometry (ICO) is a private optometry college in Chicago, Illinois. Graduating approximately 160 optometrists a year, it is the largest optometry college in the United States and the oldest continually operating educational facility dedicated solely to the teaching of optometrists. The college complex incorporates more than 366,000 square feet (34,000 m2) including an on-site eye care clinic, electronically enhanced lecture center, library, computerized clinical learning equipment, cafeteria, fitness center, and living facilities.

The International Joint Commission on Allied Health Personnel in Ophthalmology (IJCAHPO) is an American nonprofit professional association for Allied Ophthalmic Personnel (AOP).

Marshall B. Ketchum University is a private university focused on graduate programs in healthcare and located in Fullerton, California. MBKU expanded from the Southern California College of Optometry which was founded in 1904. The university was officially established as a multidisciplinary university with the addition of School of PA Studies in 2011 and College of Pharmacy in 2013. Along with Hope International University, the campus bookends the north and south sides of the Cal State Fullerton campus respectively.

The International Orthoptic Association represents over 20,000 orthoptists, in over 20 countries.

<span class="mw-page-title-main">Eye care in Ghana</span>

The eye care system in Ghana can be said to be one in its infant or growing stages. Today there are less than 300 eye care professionals taking care of the eye needs of over 23 million Ghanaians.

Jeffery J. Machat MD, FRCSC, DABO is an ophthalmologist in the United States and Canada specializing in surgical vision correction better known as refractive eye surgery. He is most known for being the Co-Founder of TLC Laser Eye Centers with Elias Vamvakas in 1993. The first TLC clinic was located in Windsor, Canada and treated thousands of patients from across all of North America. The clinic also hosted thousands of eye care specialists trying to learn about LASIK and PRK prior to US FDA approval which came three years later. Together Vamvakas and Machat built an incredible company of 83 LASIK clinics through both organic growth and strategic acquisition by May 2002 to become the largest provider of LASIK in North America. Dr. Machat pioneered not only LASIK but the concept of Optometric Comanagement throughout the 1990s, helping build a TLC network of over 14,000 referring optometrists by 2000. In 2005-2006, Machat spent time in Europe working to build Optical Express, helping David Moulsdale, owner and Founder, to transform the company from 300 optical stores into the leading provider of LASIK vision correction in Europe with 55 clinics in the span of 2 years.

<span class="mw-page-title-main">Stereopsis recovery</span> Medical phenomenon

Stereopsis recovery, also recovery from stereoblindness, is the phenomenon of a stereoblind person gaining partial or full ability of stereo vision (stereopsis).

<span class="mw-page-title-main">College of Ophthalmology and Allied Vision Sciences</span>

College of Ophthalmology and Allied Vision Sciences (COAVS) (Urdu: کالج آف آفتھلمالوجی اینڈ ایلائیڈ ویژن سائنسز) formerly known as Punjab institute of Preventive Ophthalmology (PIPO) is one of the finest Ophthalmic Institute in Pakistan. it is attached with Mayo Hospital which was built in 1872 and was named after Lord Mack Mayo and King Edward Medical University which was built in 1860 and was named after King Edward.

<span class="mw-page-title-main">Dean Evan Hart</span> American optometrist (born 1957)

Dean Evan Hart, O.D., M.A., M.S., B.S., A.A.S., F.A.A.O. is an American scientist, clinical optometrist, professor, and the founder of Woodbury Ophthalmic Group and Woodbury Optical Studio. Dean ran for Nassau County Legislature in 2015. He was a candidate for the New York State Assembly in the 15th Assembly District of the 2016 election. Hart also ran for town office in 2017.

Bachelor of Optometry is a four-year degree programme in the field of Optometry, awarded upon graduation from an optometry school under a recognised university. Its curriculum is designed to impart knowledge related to eye and it's connected organs, the correction of refractive errors, and the treatment and management of eye diseases. This degree comprises four years of education including one year of clinical internship at a tertiary eye care center. This degree is the minimum required qualification to be called as an optometrist, and to practice optometry in several countries of the world.

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