Experiencing eye problems is worrisome enough without the added problem of not knowing what type of doctor to see. “Should I see an optometrist or ophthalmologist” – This can often be the very first question that comes to mind. In this article, I will explain when to see an optometrist and when to see an ophthalmologist.
Optometrist Vs Ophthalmologist
The difference between an optometrist and ophthalmologist is not trivial. Yes, they both center around treating disorders of the eye, but they are 2 entirely different professions.
Optometrists
- Optometrists provide comprehensive eye exams on a routine basis to the general public.
- Optometrists do not perform any type of eye surgery.
- You should see an optometrist regularly even if you don’t experience any problems with your eyes.
- Optometrists routinely prescribe glasses to patients.
Ophthalmologists
- Ophthalmologists provide consults for specific eye problems.
- Ophthalmologist perform all kinds of eye surgeries.
- You cannot see an ophthalmologist without a specific eye problem.
- Ophthalmologists can prescribe glasses but don’t do so often.
Both Optometrists and Ophthalmologists
- Treat and manage dry eye disease
- Treat and manage amblyopia (lazy eye) in children
- Treat bacterial and viral eye infections
- Treat anterior uveitis
- Offer visual field testing, retinal imaging, OCT imaging, corneal topography, etc.
Frequently Asked Questions:
Who do I see if I need glasses? Optometrist
What doctor do you see for a pink eye? Optometrist
Can optometrists do surgery? No
Can an optometrist prescribe medication? Yes
How do I know when to see an ophthalmologist? Your optometrist or family doctor will tell you
Should You See an Optometrist or Ophthalmologist?
The answer is almost always an optometrist first.
Optometrists are primary health care professionals, meaning they are the ones that you go to see for routine care or for specific problems. Most of the time, your optometrist will be able to solve your vision problem, however, if there is something that requires the attention of an ophthalmologist, he/she will refer you to one.
You should think of it the same way as the relationship between your family doctor and a specialist like an endocrinologist. If you suspect that you had a Thyroid disease, for example, you wouldn’t pick up the phone and book an appointment at the endocrinologist. You would first see your family doctor who would assess you and if need be refer you to one.
Should You See an Optometrist or Ophthalmologist?
Start by seeing an optometrist.
When To See An Ophthalmologist
Now that we know that to see an ophthalmologist you have to be referred by your optometrist (or other doctors), what situations will lead you to be referredl to one?
There are several:
Cataracts
Cataracts are a progressives opacification of the lenses inside the eyes. When severe enough, they reduce the vision to levels that are unacceptable for the patient.
Aside from surgery, there is no treatment for cataracts. Glasses cannot help, nor can eye drops or systemic medication. When cataracts require removal, there is nothing your optometrist can do for you aside from referring you to an ophthalmologist for a cataract surgery consult.
Glaucoma
Glaucoma is a disease of the eyes that is usually characterized by elevated internal eye pressure. This pressure causes damage to the optic nerves (the nerves that connect the eyes to the brain). Damage and visual loss from glaucoma are irreversible, hence the seriousness of the condition.
Glaucoma is not a single entity; it comes in many different forms. Depending on the type and severity, it can either be managed by an optometrist alone or co-managed between an optometrist and an ophthalmologist.
What’s extremely important to keep in mind is that the early stages of glaucoma are completely asymptomatic. The only way to know if you need to see an ophthalmologist for glaucoma is to have routine yearly eye exams with your optometrist.
Age-Related Macular Degeneration
Age-Related Macular degeneration (AMD) is a condition that affects the most specialized and sensitive part of the retina called the macula. It has 2 forms; dry age-related macular degeneration and wet age-related macular degeneration.
Much like glaucoma, in its early stages, AMD has no symptoms. If/when you begin to show signs of the early form – dry AMD – your optometrist will discuss measures aimed at slowing down the progression with you.
Should your optometrist suspect progression to the more aggressive form – wet AMD – you will be referred to an ophthalmologist. Treatment for wet AMD can only be administered by ophthalmologists.
Diabetic Retinopathy
If diabetes is not properly controlled, it can begin to damage the eyes. This is called diabetic retinopathy. It is highly recommended that people living with diabetes have a routine yearly eye exam with an optometrist.
Just like many other eye conditions, diabetic retinopathy can become quite severe without producing any warning signs. Once it reaches the tipping point, vision will rapidly and drastically become impaired.
Crossed Eyes Surgery
An eye that is constantly turned in or out is called a strabismus. Under certain circumstances glasses – and thus your optometrist – can help with an eye turn. However, some very big eye turns will require surgical realignment by an ophthalmologist.
Droopy Eye Lid Surgery
When an eyelid starts to droop due to weak eyelid muscles it can start to block out the top part of your vision. This is called a ptosis. When this is the case, your optometrist will talk with you about the possibility of eyelid surgery. Should you wish to proceed with the procedure you will be referred to an ophthalmologist.
Aside from ophthalmologists, plastic surgeons can also perform eyelid surgery.
Pterygium Surgery
A pterygium is a layer of skin and blood vessels that grows from the white of the eye onto the cornea. It is not painful but can obstruct vision. Additionally, it can make the eyes look constantly bloodshot.
If a pterygium grows too far onto the cornea, it has to be removed. Optometrists cannot perform this procedure and must, therefore, refer it to an ophthalmologist.
Persistent Stye Removal
Eyelid styes typically resolve on their own over time with treatment from your optometrist. However, a small proportion of them will never go away. This can leave a large and unsightly bump on the eyelid. When all other treatments have failed, the final option is to have it physically excised by an ophthalmologist.
Summary
So, should you see an optometrist or ophthalmologist? The answer is typically an optometrist first, followed by an ophthalmologist if needed. Keep in mind that this article only scratches the surfaces when it comes to reasons to be referred to an ophthalmologist. There are many more reasons why your optometrist would refer you to see an ophthalmologist but the process is always the same – bring your concerns to an optometrist and he/she will take care of the rest.
What has been your experience with being referred to an ophthalmologist? If you feel the system could/should be improved, let me know how in the comments below!