I'd like to start off my first post with a topic that is near and dear to my heart: What’s the difference between an ophthalmologist and an optometrist?
Both can be referred to as “eye doctors.” However, the route that each takes to earn this designation is different. Optometrists complete 4 years of undergraduate studies, then go to a 4-year optometry school, of which there are several in the country.
Optometry school focuses on glasses and contact lens prescriptions, as well as eye and body anatomy, medical diseases, and the management of these diseases. Students take a three-part certification exam over the course of the 3rd and 4th years of optometry school. In order to obtain a state license to practice after graduation, you must pass all three sections.
After optometry school, some optometrists choose to do a 1-year residency program, typically with a busy practice, where they can see a full range of eye diseases and pathology so they’ll feel more comfortable in independent practice. There’s also a board certification program for optometrists that some will take to further demonstrate their knowledge. However, an optometrist doesn’t need any further training after optometry school to go into practice. Thus, becoming an optometrist usually requires 8 years of school total, with the option of a 9th.
Ophthalmologists complete 4 years of undergraduate studies before going to a 4-year medical school program -- just like my physician counterparts such as psychiatrists, internists, and orthopedic surgeons. Both medical doctor (MD) and doctor of osteopathic medicine (DO) medical school graduates are eligible to become ophthalmologists.
Next is a 4-year residency program -- sort of like an apprenticeship -- that offers on-the-job training in a full range of eye diseases, as well as medical and surgical management of disease. (If you’ve ever watched medical shows like Grey’s Anatomy or the first several seasons of Scrubs, many of the characters were still in their residency training programs.) Between medical school and residency, you must also pass the three parts of the United States Medical Licensing Examination (USMLE) in order to obtain a state license to practice medicine in any specialty.
Once someone finishes residency training, they must complete a two-step board certification process to call themselves a “board-certified ophthalmologist.” Some ophthalmologists, such as myself, will choose to do 1 or 2 years of fellowship training in order to gain the additional exam and surgical skills necessary to be a subspecialist. Examples of subspecialties are cornea, glaucoma, pediatrics, and medical or surgical vitreoretinal diseases -- conditions that affect the retina or the gel-like fluid part of the eye. Altogether, an ophthalmologist will have a minimum of 12 years of school/training, with the option of 13 or 14.
Once an ophthalmologist and an optometrist are out of training and (finally!) into practice (whether by themselves, as part of a small or larger eye-only group, or as part of a large multispecialty medical group), their practices can look similar or may be very different, depending on their area of interest and specialty training. Both will have to obtain licensure in the state where they practice, which can take several months while the state licensing board gathers and reviews the relevant paperwork.
Most optometrists focus on medical exams of the eyes as well as measuring patients’ eyes for glasses and contact lens prescriptions, including specialty glasses or contact lenses such as hard contact lenses, scleral lenses, prism glasses for double vision, etc. Depending on state laws, some optometrists can prescribe medicines such as drops or pills for the management of diseases, but do not do surgery.
Most ophthalmologists will focus on medical exams and surgical evaluations, then typically spend between 20% and 50% of their time performing surgery as well, depending on their practice. Ophthalmologists have the full range of medical and surgical treatments available, depending on their expertise and interests.
And there you have it! Everything you ever wanted to know about “what is an eye doctor,” but were afraid to ask!
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