When you go to "get your eyes checked," there are a variety of eye care providers you might see. Ophthalmologists, optometrists and opticians all play an important role in providing eye care services to consumers. However, each group has different levels of training and expertise; you should be sure you are seeing the right provider for your condition or treatment.
What is an ophthalmologist?
An ophthalmologist – Eye M.D. – is a medical or osteopathic doctor who specializes in eye and vision care. Ophthalmologists are specially trained to provide the full spectrum of eye care, from prescribing glasses and contact lenses to complex and delicate eye surgery. Many ophthalmologists are also involved in scientific research into the causes and cures for eye diseases and vision problems.
How is an ophthalmologist different from an optometrist and an optician?
Ophthalmologists are different from optometrists and opticians in their training and in what they can diagnose and treat. As a medical doctor, an ophthalmologist is licensed to practice medicine and surgery. An ophthalmologist diagnoses and treats all eye diseases, performs eye surgery and prescribes and fits eyeglasses and contact lenses. Ophthalmologists complete:
• four years of college;
• four years of medical school;
• one year of internship;
• three years, at least, of residency (hospital-based training) in the diagnosis and medical and surgical treatment of eye disorders.
An optometrist receives a Doctor of Optometry (OD) degree and is licensed to practice optometry, not medicine. The practice of optometry traditionally involves examining the eye for the purpose of prescribing and dispensing corrective lenses, screening vision to detect certain eye abnormalities, and prescribing medications for certain eye diseases.
An optician is trained to design, verify and fit eyeglass lenses and frames, contact lenses, and other devices to correct eyesight. They use prescriptions supplied by ophthalmologists or optometrists, but do not test vision or write prescriptions for visual corrections. Opticians are not permitted to diagnose or treat eye diseases.
How does an ophthalmologist become certified?
After four years of college and eight additional years of medical education and training, a certified ophthalmologist must pass a rigorous two-part examination given by the American Board of Ophthalmology.
What is a subspecialist?
While all ophthalmologists specialize in eye problems and can treat all conditions, some decide to specialize in a specific area of medical or surgical eye care. This person is called a subspecialist. He or she usually completes a fellowship, which is one or two more years of additional training in the chosen area. Common areas of subspecialty include glaucoma, retina, cornea, pediatrics and plastic surgery.
When should I see an ophthalmologist?
You should have your eyes examined by an ophthalmologist if you have any of these signs or risk factors for eye disease:
• decreased vision, even if temporary;
• distorted vision;
• new floaters (black “strings” or specks in
the vision) and/or flashes of light;
• a curtain or veil blocking vision;
• haloes (colored circles around lights);
• an eye injury or eye pain;
• red eye;
• bulging of one or both eyes;
• misaligned eyes;
• double vision;
• loss of peripheral (side) vision;
• high blood pressure
• diabetes mellitus;
• thyroid disease-related eye problems
• a family history of eye disease;
• excess tearing;
• eyelid abnormalities;
Based on the examination, your ophthalmologist will let you know how often to return for follow-up exams.
Because of an increased risk for glaucoma, people of African or Hispanic descent should see an ophthalmologist even if they have no other signs of or risk factors for eye disease. Your ophthalmologist will let you know how often to return for follow-up exams.
You should also see an ophthalmologist if your primary care provider or optometrist refers you to one.
When you have no particular problems or risk factors, recommended intervals for eye exams are:
Newborn, pre-school and pre-teen: Eye exams should be given by a pediatrician, family doctor or ophthalmologist at the following intervals:
• newborn to 3 months
• 6 months to 1 year
• 3 years old
• 5 years old
• later as needed
Adults 20 to 64 years of age: Adults with no signs or risk factors for eye disease should get an eye disease screening at age 40—the time when early signs of disease and changes in vision may start to happen. Based on the results of the initial screening, your ophthalmologist will let you know how often to return for follow-up exams.
Adults 65 years or older: Every one to two years, as recommended by your ophthalmologist.
What happens during an eye examination?
Your ophthalmologist and his or her assistants ask about your current symptoms and review your medical history. Eye drops to dilate your eyes may or may not be used during the exam. The examination typically evaluates:
• visual acuity;
• need for eyeglasses or contact lenses (refraction);
• eyelid health and function;
• coordination of eye muscles;
• pupil response to light;
• side (peripheral) vision;
• intraocular pressure (pressure inside
• the anterior segment in the eye (the area
in front of the lens, including the cornea
• the interior and back of the eye.
What treatments are available for my eyes?
Your ophthalmologist will discuss the results of your eye examination with you. If your eyes are healthy, you may need only eyeglasses or contact lenses to correct your vision. Or you may not need any vision correction at all.
Some eye diseases are treated with medication, such as eye drops or pills. Other diseases may require laser surgery or other surgical procedures.
Your ophthalmologist can provide you with the treatment you need or, in some cases, may refer you to a subspecialist.
Some eye conditions cannot be cured. Nevertheless, your ophthalmologist can offer counseling and support while monitoring your condition.
Good medical care is based on a cooperative relationship between you and your doctor.
You should trust your ophthalmologist to give you accurate information about your eye problem and tell you about the risks and benefits of treatment options. You should also trust your ophthalmologist to keep your personal information confidential and to provide care with courtesy and respect. Your role in this cooperative relationship is to ask your ophthalmologist questions about your problem and treatment options and tell him or her about any other health factors that may affect your condition.
Loss of sight can be prevented!
Many eye diseases do not cause symptoms for months or years. Therefore, regular visits to your ophthalmologist are as important as regular visits to your family physician. In many cases, early treatment of glaucoma, diabetic eye disease, crossed eyes and some forms of macular degeneration can prevent loss of sight and even blindness.
Together, you and your ophthalmologist can work toward the goal of protecting your sight through early diagnosis and treatment of eye conditions.