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Optometry (Greek: optos meaning seen or visible and metria meaning measurement) is a health care profession concerned with eyes and related structures, vision, visual system and vision information processing in humans.
Like most health professions, optometry education, certification and practice is regulated in most countries. Optometrists and related organizations interact with government, other health care professions and the community to deliver eyecare and visioncare. Optometry is a type of eyecare profession and optometrists often interact with other eye care professionals, such as ophthalmologists and opticians.
An optical refractor (also called a phoropter) in use.
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Optometrists are primary health care providers for the eye and visual system. Optometrists examine, diagnose and medically treat eye diseases, injuries, and disorders of the visual system as well as identify related systemic conditions affecting the eye[s]. Some optometrists specialize in work with the elderly, children, or partially sighted persons who need specailized visual devices. Others develop and implement ways to protect workers eyes from on-the-job strain or injury. Some specialize in contact lenses, sports vision,or vision therapy. A few teach optometry, perform research, and consult. SOURCE: Bureau of Labor Statistics/www.bls.gov
As with most health care, examination often includes history taking and both health related as well as optical related observations during tests. The typical examination has two components, the evaluation of the health status of the eye and evaluating the optical characteristics of the eye.
There are many types of equipment used during an eye examination. For example, various vision charts and machines are used to measure vision and visual fields. Trial (spectacle & contact) lenses or a phoropter and retinoscope may be used during refraction. Prism bars, small objects and occluders may be used to assess eye movements and eye alignment. Penlight/transilluminator can be used when assessing pupil light response. Specialty magnifiers such as ophthalmoscope, and slit-lamp bio-microsope help with detailed inspection of external and internal ocular structures. Diagnostic eye drops may also be used to assess the eyes. Various test booklets/sheets/instructions and pencils may be used for visual information processing examination.
For at least the past decade, many optometrists have used computerized equipment specifically designed to help diagnose and /or monitor certain ocular diseases. For example, many optometrists\' offices have various visual field analyzers and tonometers. Also some optometrists use digital imaging equipment, such as digital cameras to document appearance of the anterior and posterior eye, corneal topographer, Optical coherence tomography, GDX http://www.revoptom.com/HANDBOOK/oct02_sec4_9.htm, or HRT II.
Diagnoses made by optometry depends on integrating eye examination information.
Some ocular pathology can be associated with systemic, neural or other disease complications. Some ocular disorders may be treated by an Optometrist. In many cases, referral to an Ophthalmologist may be required for further evaluation and treatment.
Optometry management can include:
Optometric history is tied to the development of
The term optometrists was coined by Landolt in 1886, referring to the "fitting of glasses". Prior to this, there was a distinction between "dispensing" and "refracting" opticians in the 19th century. The latter were later called optometrists. History of Optometry, Lecture Handout at Indiana University School of Optometry by David A. Goss.
Apparently the first schools of optometry were established in 1850-1900 (presumably in USA) and contact lenses were first used in 1940\'s http://www.drjankowski.com/history.htm
Most countries have regulations concerning optometry education and practice. Often, optometrists are required to participate in ongoing continuing education courses to stay current on the latest standards of care.
Optometry is officially recognized:
In the United Kingdom, optometrists have to complete a 3 or 4 year undergraduate honours degree followed by a minimum of a one-year "pre-registration period" where they complete supervised practice under the supervision of an experienced qualified practitioner. During this year the pre-registration candidate is given a number of quarterly assessments and on successfully passing all of these assessments, a final one-day set of examinations. Following successful completion of these assessments and having completed one year\'s supervised practice, the candidate qualifies for membership of The College of Optometrists and is eligible to register as an optometrist with the General Optical Council (GOC).
Registration with the GOC is mandatory to practice in the UK. Members of the College of Optometrists may use the suffix MCOptom. Optometrists in the United Kingdom, as in most countries except the United States and Canada, receive a Bachelor of Optometry or Masters degree. They are not called "doctor" in the United Kingdom.
As primary eye care providers, doctors of optometry are an integral part of the health care team, earning their degree just as dentists or podiatrists do. Prior to admittance into optometry school, optometrists typically complete four years of undergraduate study, culminating in a bachelor’s degree. Required undergraduate coursework for pre-optometry students covers a variety of health, science and mathematics courses. Optometry school consists of four years of study focusing on the eye, vision, and some systemic diseases. In addition to profession-specific courses, optometrists are required to take health courses that focus on a patient’s overall medical condition as it relates to the eyes.
Upon completion of optometry school, candidates graduate from their accredited college of optometry and hold the optometry (OD) degree. Optometrists must pass a rigorous national examination administered by the National Board of Examiners in Optometry (NBEO)http://www.optometry.org/passfail.cfm. The three-part exam includes basic science, clinical science and patient care. (The structure and format of the NBEO exams are subject to change beginning in 2008.) Some optometrists go on to complete residencies with training in a specific sub-specialty. These specialties can include pediatric care, children’s vision, geriatric care, specialty contact lens (for keratoconus patients or other corneal dystrophies) and many others. All optometrists are required to participate in ongoing continuing education courses to stay current on the latest standards of care.
In Argentina optometrists are required to register with the local Ministry of Public Information, but licensing is not required. Anyone holding a Bachelor\'s degree may register as an optometrist after completing a written exam. Fees for the exam are set by the provincial government and vary from province to province.
In Colombia optometry education has been accredited by the Ministry of Health. The last official revision to the laws regarding health care standards for the country was issued on the year 1992 through the Law 30.http://www.cna.gov.co/cont/publicaciones/estandares/salud/anexo_ant_for_pro_cie_sal.htm Currently there are eight official Universities that are entitled by ICFES to grant the Optometrist certification. The first optometrist arrived to the country from North America and Europe circa 1914. These professionals were specialized in optics and refraction. In 1933 under Decree 449 and 1291 the Colombian Government officially set the rules for the formation of professionals in the area of optometry. In 1966 La Salle University opens its first Faculty in Optometry after a recommendation of a group of professionals. At the present time optometrists are encouraged to keep up with new technologies through congresses and scholarships granted by the government or private companies (such as Bausch & Lomb).
Currently, optometry education and licencing varies through out Europe. For example, in Germany, the tasks of an optometrist are split between ophthalmologists and professionally trained and certified opticians. In France, there is no regulatory framework and optometrists are sometimes trained by completing an apprenticeship at an ophthalmologists\' private office. http://www.escrs.org/eurotimes/July2003/French_ophthalmology.asp
Since the formation of the European Union, "there exists a strong movement, headed by the Association of European Schools and Colleges of Optometry (AESCO), to unify the profession by creating a European-wide examination for optometry" and presumably also standardised practice and education guidelines within EU countries.The unification of European optometry: how the profession will change after 1992 by Hamakiotes DS, Thal LS in J Am Optom Assoc. 1992 Jun;63(6):388-9. ew
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The profession of Optometry has been represented for over a century by the Association of Optometrists, Ireland [AOI]. In Ireland an optometrist must first complete a four year degree in Optometry at D.I.T. Kevin Street. Following successful completion of the a degree, an optometrist must then complete Professional Qualifying Examinations in order to be entered into the register of the Opticians Board [Bord na Radharcmhaistoiri]. It is illegal to practice as an optometrist in the Republic of Ireland, unless registered with the Board.
The A.O.I. runs a comprehensive continuing education and professional development program on behalf of Irish optometrists. Unfortunately for the profession in Ireland, the legislation governing Optometry was drafted in 1956 and is hopelessly out of date. The unnecessary restrictions in this fifty year old piece of legislation restricts optometrists from using their full range of skills, training and equipment for the benefit of the Irish public. The amendment to the Act in 2003 addressed one of the most egregious restrictions - the use of cycloplegic drugs to examine children. Review of this legislation is urgent to allow the public to benefit from the skills of optometrists to reduce the enormous waiting lists in the public health service particularly for children.
Ophthalmologists after obtaining a 4 year bachelors degree, attend medical school for 4 years of medical training to obtain an MD degree. After medical school, ophthalmologists then complete an internship in surgery or internal medicine. Like physicians in other specialties, ophthalmologists train for an additional four to five years of residency training. Residency training in ophthalmology encompasses all aspects of diagnosis and management of diseases that affect the eye, orbit, and visual system of the brain. This includes both medical and surgical treatment. Many ophthalmologists pursue additional fellowship training in various subspecialties.
(Most of the following information pertains to Optometry in the United States): Optometrists also acquire a 4 year bachelor degree followed by 4 years of Optometry school to earn an OD degree. While in school, optometry students undergo a full year of internship training and have the option of a 1 year residency following graduation. Optometrists having completed a residency can further specialize in a particular area such as Pediatric Optometry, Geriatric Optometry, Behavioral Optometry or Neuro-optometry. Optometry school is more limited in scope, though courses include vision sciences, health sciences, pharmacology, and clinical education. Examples include courses in visual psychophysics, optics, as well as training in aspects of functional vision such as vision therapy, binocular vision, and low vision. Optometrists are also trained extensively in anatomy, histology, neuro, etc. and have a broad understanding of disease etiology, management, and treatment. In general, optometrists can do the same things ophthalmologists do with the exceptions of surgery and particular diseases (e.g. wet macular degeneration, proliferative diabetic retinopathy) that require extensive treatments. Depending on state law, however, many optometrists are trained in minor surgery and laser surgery. Some states prohibit or limit the prescribing of oral medications by optometrists. Although both ophthalmologists and optometrists are trained in refraction for glasses and contact lenses, optometrists go through extensive training in refraction while ophthalmologists understand merely the basics of the optics involved in refracting. Ophthalmologists also know only the basics regarding contact lenses -- optometrists are specialists in contact lens fitting techniques.
The two fields often have a mutually beneficial relationship:
Ophthalmologists may refer patients to optometrists for contact lenses or for optical aids or low vision rehabilitation whilst continuing to treat the underlying disease/condition that may have reduced vision. Similarly, complicated and emergency eye conditions are often referred from Optometry to Ophthalmology.
Both optometrists and ophthalmologists perform screening for common ocular problems affecting children (i.e., amblyopia and strabismus) and the adult population (cataract, glaucoma, and diabetic retinopathy).
Optometrists generally manage treatment of strabismus and amblyopia with vision therapy while Ophthalmologists manage these disorders with medical and surgical therapy.
See also Ophthalmology#Distinction from Optometry
There are currently nine sub-specialty residencies offered by various schools of optometry in the United States [1] [2]:
Many of these sub-specialties are also recognised in other countries.
Please note, refractive surgery and ocular surgery fellowships involve learning how to co-manage patients before and after eye surgery. Similarly, ocular disease residencies involve co-management practice with other health professionals. Also the College of Optometrists in Vision Development provides certification for eye doctors in vision therapy, behavioral and developmental vision care, and "visual rehabilitation". Training in binocular vision and orthoptics sub-specialties are often integrated into either pediatric or vision therapy programs.
This article is licensed under the GNU Free Documentation License. It uses material from Wikipedia
