NONMEDICAL SPECIALISTS: OPTOMETRISTS, OPTICIANS, AND EYE CARE
Vision is crucial to our well-being, but there is a great deal of confusion about who is qualified to examine eyes. In most Western countries physicians are trained to evaluate major diseases that may show signs of affecting the eye. If you have diabetes mellitus or high blood pressure, for example, your physician will periodically examine your eyes with an ophthalmoscope, which illuminates the retina. The progress of these diseases can sometimes be judged by the condition of the blood vessels in the retina.
For a serious eye condition your physician will usually send you to an ophthalmologist (eye specialist). In order to receive his diploma, he must have a further three to five years of training after medical school. An ophthalmologist is a medical doctor who can evaluate and treat abnormal conditions of the eye and perform eye surgery.
Many people confuse nonmedical eye specialists who are trained to perform specific services related to vision with ophthalmologists, who are physicians. Depending on the country, state, or province, the training of these nonmedical professionals varies, and what they are permitted to do may differ. An optician is primarily responsible for grinding lenses according to a prescription, but he may also be allowed to fit and sell lenses. However, he does not examine eyes.
Optometrists have special training in the visual sciences. Although often titled “doctor,” they are nonmedical specialists. They can examine eye movements and test for errors in refraction (sharpness of vision), and in many regions they test eye pressure. Although trained to recognize major abnormalities of the eye, they have limited knowledge of the many complex eye problems that especially affect the elderly. They may work closely with an optician and thus both examine eyes and sell glasses.
To get optimal eye care, you should know which of these professionals to consult. An optometrist may be the first person to suspect that you have an eye disorder if you return frequently to have your glasses changed. A careful eye examination by an optometrist may reveal early signs of glaucoma, cataracts, infections of the eye, or retinal diseases. Because of the many disorders that can affect the eyes of older people—and the interactions with medical illnesses and their treatments—an ophthalmologist should be consulted periodically. If your general health is good and your vision relatively stable, you probably should see an ophthalmologist once a year. You can expect a measurement of the pressure in your eye, an evaluation that you can see fully in all directions, an assessment of whether you may be developing cataracts, and an examination of your retina. The muscles and other tissues of the eyes will also be examined. If you need a change in glasses, the ophthalmologist can give you a prescription, which can be filled by an optician.
Full cooperation among these professionals is the rule, and you should take advantage of each in their areas of expertise. Although it is a common practice, do not rely exclusively on the services of a nonphysician specialist to care for your eyes. Many senior-citizen centers, outpatient clinics, and nursing and retirement homes make arrangements with all these specialists to have regular eye examinations for their members.
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