There are several different types of eye doctors, a fact that is sometimes confusing to both patients and other health care professionals alike. This diversity is, in my view, advantageous for patients because each kind of eye care provider has unique strengths which, when use in a spirit of professional cooperation, combine to give all patients better care than the separate parts could on their own.
Here is brief description of the various kinds of eye doctors:
Optometrist - Optometrists are, most often, the eye care equivalent of the "family doctor." They are trained and licensed to diagnose and treat disorders and diseases of the eyes and visual system through non-surgical means, including the use of prescription eye drops (and oral medications in most states), as well as to detect the ocular manifestations of systemic disease (for example, diabetes) and refer patients to other health care specialists for eye surgery and/or further medical evaluation. Optometrists perform the majority of routine eye examinations in the United States.
Optometrists are not medical doctors (M.D. degree), but doctors of optometry (O.D. degree). Becoming an optometrist requires four years of pre-medical undergraduate education (identical to medical doctors) and then an additional four years of optometry school. Optometry school education consists of courses in geometric, physical and physiological optics, ocular anatomy and physiology, general anatomy and physiology, general and ocular pathology, general and ocular pharmacology, ocular manifestations of systemic disease, binocular vision, vision therapy, pediatric vision, geriatric vision, refraction, cosmetic and medical contact lens applications, and specialized electrodiagnostic testing.
The final two of four years is spent seeing patients in eye clinics and hospitals, including externships with eye surgeons and sub-specialists, and conducting original ophthalmic research. Three sets of national board examinations and individual state board examinations are required for licensure, with mandatory continuing education requirements every one to two years (depending upon the particular state). Some doctors of optometry complete an additional one-year residency in sub-specialties such as ocular disease and low vision (treatment and rehabilitation of visually impaired patients), and a few complete multi-year specialty fellowships in areas like retinal disease and glaucoma (see below).
Ophthalmologist - Ophthalmologists are medical doctors (M.D. degree) who specialize in the medical and surgical treatment of eye disease, as well as the ocular manifestations of systemic diseases (like diabetes). Like optometrists, ophthalmologists also see patients for routine eye care, including prescription of eyeglasses and contact lenses. The majority of ophthalmologists have completed a surgical residency and practice in affiliation with a hospital or 'ambulatory surgery center.'
Becoming an ophthalmologist requires four years of pre-medical undergraduate educations, four years of medical school, and an additional three to six years of residency/post residency training, depending upon the degree of sub-specialization. The medical school curriculum covers all aspects of human disease and principles of medical treatment and management, with only basic training in eye disease and the human visual system.
As the surgical skills required for eye surgery are so demanding, a great deal of time is spent honing those skills. Ophthalmologists must pass rigorous national licensure examinations and a series of board examinations in order to practice. Continuing medical education requirements must be met for re-licensure. After ophthalmology residency, some doctors receive additional fellowship training in sub-specialties such as glaucoma, oculoplastics (eyelid and eye socket surgery), corneal disease and retinal disease.
Retina Specialist - Retina specialists are eye doctors, typically (but not exclusively) ophthalmologists, who have completed additional sub-speciality fellowship training in the diagnosis and medical, surgical, and laser treatment of retinal disease. Other eye doctors, both optometrists and ophthalmologists, refer many of their patients to retina specialists, who frequently see the most complicated and challenging retinal diseases. A large percentage of retina specialty practices consist of patients with diabetic retinopathy.
As with any profession, some doctors, both optometrists and ophthalmologists, will have more knowledge, experience, and compassion than others will. No matter which type of eye doctor a diabetic patient sees, the most important consideration is finding someone knowledgeable about and experienced with diabetic eye disease. My recommendation is to ask your prospective eye doctor about his or her knowledge and experience, using this book as a guide.