What is the difference between an optometrist and an ophthalmologist?

I think this is a question which comes up a lot, and can be confusing to many people accesing our health care system.

An Ophthalmologist is a medically trained Eye Specialist. In other words they have trained as a doctor, become registered as a medical practitioner and worked as a doctor, and then specialised in the medical and surgical treatment of eye disease.

Currently in Australia to become an Ophthalmologist we are required to do a medical degree, obtain full medical registration by working as a doctor in the public hospital system, and then gain entry into specialist training in Ophthalmology - This is currently a further 5 years of specialised training on top of the training required to be a doctor in the first place. During this period as an Ophthalmology trainee there is intense study, the need to pass theoretical and practical exams of a very high standard, all the while working (under supervision) as a ‘registrar’ in public hospitals where the trainee gains first hand experience in the medical and surgical management of the complete range of eye diseases.

Many of us then do further training in various areas of Ophthalmology (sub-specialty training) either locally, interstate or overseas. Current medicare arrangements require patients to obtain a referral from their GP or Optometrist to see an Ophthalmologist as they are a medical specialist.

There is a fair deal of overlap in the work that Ophthalmologists and Optometrists do, but the fact that Ophthalmologists are trained as doctors and the focus of their training is on the management of eye disease (both with medical treatments, and surgery where necessary) is a key difference.

Although the name sounds the same and both groups of professionals are involved in eye health, there are significant and fundamental differences between Ophthalmologists and Optometrists.

Optometrists as a bare minimum do a 3 year bachelors degree in Optometry (some may do further study). When qualified, they are experts in the assessment and dispensing of glasses and contact lenses. As part of their assessment, optometrist are also able to screen for common eye conditions such as cataract, macular degeneration and glaucoma. It is important to appreciate that they have no medical training even though some use the title “Dr.”

In contrast, Ophthalmologists are doctors. As a minimum, they have completed a bachelors degree in medicine and surgery followed by work in general medicine for usually 2-3 years prior to completion of specialized Ophthalmology training that is currently 5 years. Some do further study, often internationally, to become an expert in a subspecialty of ophthalmology such as retina, glaucoma or oculoplastics. They are able to diagnose and manage all medical conditions that effect the eye with a full range of medicinal, laser and surgical treatments. They also fully understand how the eye interacts with health problems that effect other parts of the body and the complex interaction between treatments for the eye and treatments for other conditions.

When an Optometrist is concerned about a potential health problem with the eye, they should refer this on to an ophthalmologist for further assessment and management. When problems with vision are due to a refractive error, correctable with glasses or contact lenses, then an Optometrist should manage this and Ophthalmologists will often ask an Optometrist to help in this regard when other causes of reduced vision have been excluded.

An optometrist is a primary health care provider, often being the first point of professional contact for people experiencing problems with their eyes or who have difficulty seeing.  Optometrists have a unique role in providing accessible and vital eye care to the community.  Apart from general practice, optometry is the only profession to have its consultations covered by Medicare without the need for a referral.

Optometrists are experts in: the optics of lenses, eye health and visual performance.  They assess, diagnose and manage ocular diseases, injuries and disorders across a wide range of patients.  Where clinically necessary, optometrists prescribe spectacles, contact lenses and devices for the visually impaired.

Practicing optometrists are registered health professionals who have undertaken a university degree in optometry and who are registered by the Optometry Board of Australia.
 
An ophthalmologist is a medical specialist who has undertaken postgraduate medical training to specialise in eye health and vision.  They “provide diagnostic, treatment and preventative medical services related to diseases, injuries and deficiencies of the human eye and associated structures” (ABS Australian Standard Classification of Occupations 2nd edition).

Ophthalmologists are trained and registered to provide total care of eyes, from performing comprehensive eye examinations to prescribing corrective lenses, diagnosing diseases and disorders of the eye, and carrying out the medical and surgical procedures necessary for their treatment.  Their work includes prevention of blindness, promotion of eye health, and the rehabilitation of people with visual disability.

Ophthalmologists practice both medicine and surgery, providing both primary care as well as highly specialised treatment.  They are the only providers of laser and surgical correction of eye disorders.

I do agree with Glaucoma Australia in this response. An Optometrist is the primary health provider, in this field.

Optometrist degrees are offered at University of Melbourne, NSW, QLD, Flinders and now Deakin which has established the GOLD standard for Optometrist education. Most Optometrists now are therapeutic, (listed on Optometrist Australia website). This allows Optometrists to full prescribing rights ,which is controlled by  AHPRA ,these are exactly what Ophthalmologists prescribe.

The Optometrist Board of Australia,OBA guidelines enable endorsed Optometrists to initiate and implement management of patients with Glaucoma. Opthalmologists specialise in  final diagnosis and surgery such as cataracts.

This suits both professions, as Medical Specialists don't need their consulting rooms full of  patients who simply need pressure tests ,or visual fields analysis. The cost benefit to the Australian health system is significant.

Ophthalmologists require a referral  from a GP or similar health care provider. Ophthalmologists must first be a medical doctor and then undertake more training in management of eye diagnosis. This takes approximately 10 years. Both fields now work in conjunction with each other in these areas of training. Optometry  is now a  5 year degree course.