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An eye care professional is an individual who provides a service related to the eyes or vision. It is a general term that can refer to 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 of eye care professionals

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Current terminology

  • Ophthalmologist – A medical doctor (MD) who specializes in surgical eye care. In the US, this requires four years of college, four years of medical school, and four to six more years of internship, residency, and/or fellowship and sub specialty training.
  • Ophthalmic medical practitioner – A medical doctor (MD) who specialises in ophthalmic conditions but who has not completed a specialisation in ophthalmology. (term used in the UK).
  • Optometrist – Diagnoses common eye diseases and disorders as well as refractive vision correction. In some countries they can treat with a limited number of pharmaceuticals. In a small number of countries they do minor surgery within the limits of what General Practitioners do, although sometimes the scope of this is disapproved by ophthalmologists.
    • In most countries, optometry is either a 4 year or 5 year college degree and they are not classified as Doctors (except in the Philippines).
    • In the USA, the standard education is four years of college and four years of optometry school at an accredited Doctor of Optometry (OD) program. An additional one to two years of residency, internship, fellowship and/or specialty training is required for qualification in certain positions. Many US states forbid optometrists from advertising specialties, but each state allows optometrists to treat common eye problems and prescribe certain pharmaceuticals.
  • Orthoptist – Specializes in diagnosis and management of ocular motility, amblyopia and binocular vision disorders, as outlined by the International Orthoptic Association. They also assist ophthalmologists in surgery and in most countries are accredited ocular sonographers.[1]
    • In many countries including the USA, the standard education is three years of college, plus two years in post graduate college.
    • In other countries (such as Australia), it is a 4 year Master's degree.
  • Ocularist – Specialize in the fabrication and fitting of ocular prostheses for people who have lost eyes due to trauma or illness.
  • Optician – Specializes 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 orthoptist in the hospital or clinic with vision testing.
    • In the USA the Joint Commission on Allied Health Personnel in Ophthalmology administers OMP certifications:
      1. Certified Ophthalmic Assistant (COA) – entry level
      2. Certified Ophthalmic Technician (COT) – intermediate level
      3. Certified Ophthalmic Medical Technologist (COMT) – advanced level

Older terminology

  • Oculist – Either an ophthalmologist or optometrist.
  • Vision therapist – Usually either an orthoptist or optometrist. Works with patients that require vision therapy, such as low vision patients.

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

The distinction between ophthalmologist, optometrist and orthoptist

The American Academy of Ophthalmology describes an ophthalmologist as follows:

A medical doctor who specializes in all aspects of eye care including diagnosis, management, and surgery of ocular diseases and disorders.

An optometrist is defined by the World Council of Optometry (a member of the World Health Organisation) as follows:

Optometry is a healthcare profession that is autonomous, educated, and regulated (licensed/registered), and optometrists are the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes refraction and dispensing, detection of disease in the eye, and the rehabilitation of conditions of the visual system.

The World Health Organization defines the eyecare work of an orthoptist as:

The study and treatment of defects in binocular vision resulting from defects in the optic musculature or of faulty visual habits. It involves a technique of eye exercises designed to correct the visual axes of eyes not properly coordinated for binocular vision.[2]

Two important distinctions are evident in these definitions:

  • Ophthalmologists are medical doctors and have attended medical school and specialize in surgical as well as medical care of the eye, optometrists are eyecare professionals who have attended optometry school that specialize in the refractive and primary medical care of the eye and vision, while orthoptists are eyecare professionals who have attended orthoptic school and specialize in the binocular vision and pre/post surgical care of strabismus patients.
  • Second, ophthalmologists are responsible for surgical treatment or ocular disease. Optometrists "provide comprehensive eye and vision care, which includes refraction and detection/diagnosis and limited management of disease in the eye." Optometrists refer to ophthalmologists patients requiring treatments such as ocular surgery, intraocular injections, and lasers. Orthoptists primarily work alongside ophthalmologists to co-manage binocular vision treatment, but also often do comprehensive eye and vision testing.

There are also important similarities. Both optometrists and ophthalmologists treat patients with medications, optical aids and eye exercises; orthoptists treat using optical aids and eye exercises.[3] All perform screenings for common ocular problems affecting children (such as amblyopia and strabismus) and the adult population (such as cataracts, glaucoma, and diabetic retinopathy).[4] All are required to participate in ongoing continuing education courses to maintain licensure and stay current on the latest standards of care.

International organizations

Organisations by country

References

  1. ^ http://www.internationalorthoptics.org/download/1160331924_3.1._pr_01_rev_06.doc
  2. ^ http://ghl.wpro.who.int/php/decsws.php?tree_id=G02.573&lang=en
  3. ^ http://www.ranzco.edu/orthoptists-and-prescribing-in-nsw/view?searchterm=None
  4. ^ Georgievski Z, Koklanis K, Fenton A, Koukouras I. Victorian orthoptists' performance in the photo evaluation of diabetic retinopathy. Clinical & Experimental Ophthalmology, 2007, 35(8): 733-738. [Pubmed Link]

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