The National Market Exchange - NMEX

The Real Difference between Optometry & Ophthalmology

An age old question that many patients, and others have, is what is the difference between an Optometrist and an Ophthalmologist?

The true answer is somewhat complicated. Interestingly, based on my experience as an Optometric Physician, Lawyer and Educator, most Optometrists and Ophthalmologists do not know the complete answer.

The functional and legal roles and differences between these two types of Eye Doctors as is with all licensed professions, controlled by State Law and Statutes within the United States. Also, in other countries the legal differences and nomenclature used to describe these two professions may be significantly different than the United States. For example in recent decades within the United States many Optometrists and State Laws refer to Optometrists as ‘Optometric Physicians’

As an Optometrist (Optometric Physician), former professor, lawyer, and State Legislative Lobbyist I have had an intimate look at the true answer.

Because both Professions practice under different types of Statutory Licenses outlined by State Law, the only Doctor actually practicing as an Eye Doctor under Statute or Law is The Optometrist. Optometrists are specifically licensed and controlled by Statute to practice as an Eye Doctor or Eye Physician. By Statute Ophthalmologists are Licensed only as General Medical Doctors, obtained at the time they finish their general medical training, and are not specifically licensed to practice as an Eye Doctor by the State Government. They become Eye Doctors through Specialty Training in a residency program after they receive their general medical degree which may be an M.D., D.O., or MBBS or other designation based on their country of Training.

In fact, no Specialty in Medicine is licensed by Statute and Law to actually practice their Specialty. It is expected that they should pass a Board Certification Exam after a qualified residency in order to practice the specialty. This in fact has been the age old problem with specialties in Medicine, the quality of residency training, certification and lack of State and Government licensing of Medical Specialists has over history presented problems for securing the safety of patients seeking medical care because the public generally has no idea as the actual training, qualifications and certifications of medical specialists, particularly due to the wide variance of these factors and the lack of government and State licensure. The general government license that Medical Specialists obtain before they even enter into specialty training cannot therefore adequately govern Specialty practice.

This is just the opposite with Doctors of Optometry (Optometrists) whose training and practice is specifically dictated and outlined by State Statutes and Law. For example all Optometry School in the United states follow a strict, detailed and uniform course dictated by Statutory Law in every State ensuring that patients seeking care by Optometric Physicians (Optometrists) receive a uniform and specific standard of care. For example, if a patient is treated for the disease/disorder of Glaucoma by an Optometrist, the State Law and Statute details the equipment, process and procedures that must be used. This is not so for treatment by an Ophthalmologist who is governed only by a General Medical License received even before any Ophthalmology Training.

Medical Specialists become specialist only after their specialty training and many do not even sit or pass the specific privately required Board Certification Examinations which are generally used to allow them to obtain privileges to practice in Institutions and Hospitals.

Generally in modern times Ophthalmologists within the United States are mostly Eye Surgeons who specialize in Cataract, Retina, Cornea and other surgical disciplines. Optometrists generally practice as Primary Care Eye Doctors specializing in diagnosing & Treating Vision Anomalies, Eye Disease, and other Non Surgical Eye Treatments. However, Optometrists by law in many States may also engage in various Eye Surgery Treatments.

Interestingly, the public generally may not understand that in the case of Eye Doctors, the reference to Ophthalmologists as the Eye Specialist really references the fact that they specialize in Eye Care rather and practice as a General Medical Doctor as their license allows them to. Optometrists are also Eye and Vision Specialists in Special Areas of Training and Practice which they obtain in residencies and other Post-Graduate Training after obtaining their Doctor of Optometry Degree (O.D.).

Also, due to the legislative requirements for Optometric Education most Schools and Colleges of Optometry require the same or more training in General Medicine and Pharmacology to obtain the Doctor of Optometry Degree (O.D.) as required for the Doctor of Medicine (M.D.) Degree, and  usually in Courses taught by the same professors.

Another interesting fact about these two professions is that despite their differences in Training and licensure, their scope of practice is essentially the same as relates to the standards of care and treatment, and represents a unique situation in Health Care delivery and practice. Optometry is essentially the only none Allopathic (M.D.), or Osteopathic (D.O.) type of proprietary Health Practitioner that practices what is essentially a Medical Specialty outside of Allopathic or Osteopathic Medicine.

The functional Difference between an Optometrist and a properly trained and certified Ophthalmologist is therefore very similar to the difference between a Cardiologist and Cardiac Surgeon, or a Neurologist and Neuro Surgeon.

Having considered the facts relating to these two professions, patients can ask the appropriate questions about their particular Eye Doctor’s training and other qualifications, and then make an informed decision as to which type of Eye Doctor they choose for their Eye and Vision Care.