Eye Doctors: Understanding the Difference Between Optometrists, Ophthalmologists, and Opticians

What do Optometrists do?

Optometrists perform eye examinations in order to diagnose eye diseases and vision problems, determine the suitable treatment and prescribe glasses. Some eye examinations can evaluate the quality of your vision and if you need to wear glasses, while other examinations can evaluate your eye health and detect eye diseases.

1. Paediatric Optometry

Paediatric optometrists are focused on the eye care and health of children, infants and toddlers. They can provide care for conditions that are common in these ages, such as astigmatism, amblyopia (lazy eye), strabismus (crossed or misaligned eyes), colour blindness and eye infections. Paediatric optometrists will assess visual acuity, which is the quality of vision from varying distances. Older children who are able to read are assessed with the eye chart that is used for an adult's eye examination. Small children will be tested on their identification of objects, shapes and colours. They will also assess your child's pupil function and eye movement. This specialised field of optometry typically requires additional residency in paediatric optometry.

2. Low Vision Optometry

Low vision optometry refers to optometry that concerns limited vision that can not be corrected with standard glasses or types of surgery like LASIK. Low-vision optometrists are optometrists who specialise in cases of low vision. Low vision differs from blindness as some sight still remains and may be helped through visual aids such as telescopic glasses, magnifying glasses, hand magnifiers and reading prisms. Other aids include non-optical options such as text reading software, check guides, high contrast clocks and watches and larger fonts. These optometrists will assess how much vision is still remaining and its quality. Depending on which of the various types of low vision, loss of central vision, peripheral vision, blurred vision, reduced contrast sensitivity, glare light sensitivity and night blindness, optometrists can advise what visual or non-optical aids may be helpful and how to take care of your remaining vision. This specialisation may requires a post-graduate residency.

3. Behavioural Optometry

Behavioural optometry looks into how children's vision problems may be related to the nature of their environment in terms of what their visual demands are. The eye examination for this would include the routine aspects of a regular eye exam. Optometrists will measure any problems with the functionality of your focus and eye coordination, which impact how you feel while you read, write and use computers and how well you do these activities. They will also measure distance focus, check if you are experiencing difficulties looking up from screens clearly and assess tracking abilities.

4. Sports Vision Optometry

Sports vision optometry can conduct various tests based on the specific needs of the individual. These tests will help optometrists assess the essential skills of dynamic visual acuity, eye tracking, eye focusing, peripheral vision, depth perception, visual reaction time, eye-hand coordination, visual memory, visualisation and visual concentration.

5. General Optometry

General optometry refers to optometrists who can take regular eye exams for any individual to ensure they are maintaining good eye health and can prevent late detection of vision problems or more serious conditions. While optometrists are qualified to treat minor problems, they may direct you to an ophthalmologist for further diagnosis and treatment of serious conditions.

6. Geriatric Optometry

Geriatric optometry refers to optometrists who specialise in age-related eye care, eye diseases and conditions. They perform eye examinations to detect common conditions for this age group, such as glaucoma, age-related macular degeneration (AMD), dry eye, diabetic retinopathy, presbyopia and cataracts. Optometrists will need to test for these conditions through eye pressure testing, visual field testing (side/peripheral vision), dilated retinal examination, slit lamp examination and refraction testing.

What Services and Treatments do Optometrists Typically Offer?

The services and treatments optometrists offer are eye examinations, diagnosis of vision problems and evaluation of eye health, and prescriptions for glasses and contact lenses. They can also prescribe different types of eye drops for eye problems. The possible services and treatments optometrists offer are listed below.

• Visual Acuity: This typically involves identifying letters, numbers or shapes on a chart, which will be able to let the optometrist know how well you can see detail from varying distances.
• Refraction: If the visual acuity test indicates you may require glasses or contacts, the optometrist will conduct a refraction test. This usually involves getting you to read from a chart around 20 feet away while also looking through a phoropter, which is an instrument that has cylinders, prisms and lenses.
• Visual Field: This is to test your peripheral vision and will have you looking in the centre of either the computer program or screen and either pressing a button or making a note whenever you can see an object in your peripheral vision.
• Tonometry: This is to test your intraocular eye pressure. This may involve either a non contact air puff or a small hand-held instrument that will touch the surface of your eye to assess the pressure.
• Slit-lamp: This test will enable the optometrist to examine the front of the eye more closely by using a microscope with a light.
• Funduscopy: This test uses the slit lamp in combination with a fundoscopy lens to assess the back of the eye.

Possible eyedrop options that may be prescribed are listed below according to MyHealth Alberta.

• Anti-glaucoma
• Antibiotics
• Antiviral eye
• Anti-inflammatory
• Tear supplements

What Training and Qualifications are Required to Become an Optometrist?

The training and qualifications required to become an optometrist in Canada require them to complete a minimum of three years in an undergraduate science program. This is then followed by a four-year degree in optometry at a university that is recognised by the Accreditation Council in Optometric Education. University students will complete courses covering visual neurophysiology, visual optics, clinical techniques, as well as the health and diseases of the human visual system, according to the University of Waterloo. The first two years will consist of developing a foundation of knowledge in pharmacology, disease, optics, basic sciences of health and visual sciences. Patient interaction will take place in the third year fourth years with more concentration on clinical training and internships. Upon graduation, optometrist students will be ready for registration exams according to the University of Waterloo.

How Much Do Optometrists Make?

How much an optometrist in Canada makes can depend on their level of education, experience and workplace.

How to Choose an Optometrist?

Choosing the right optometrist is important for the assurance of quality eye care and services. Depending on your specific vision needs, you can make a more educated decision by referring to a number of steps beforehand. The steps to assist you in how to choose an optometrist are listed below.

1. First, determine what your main concerns are. If you're experiencing any changes to your vision. Familiarise yourself with the different services our optometrists at Oscar Wylee have to offer; they'll be able to help you with your specific needs.
2. Second, research what available Oscar Wylee branches are available near you; you can find them on our locations page. We have over 10 stores in Canada.
3. Third, confirm the cost will suit your ideal price range and budget. If your private health insurance provider covers eye exams, we can directly bill them on your behalf.
4. Fourth, you can visit in-store to book an appointment and browse through our range of glasses while you're there.

How Often Should People Get Their Eyes Examined by an Optometrist?

People should get their eyes examined once every one to two years. Regular eye exams ensure the maintenance of good eye health and vision and may help with identifying any problems, conditions or diseases early. It is especially important to get your eyes checked if you have sustained any eye injuries.

What do Ophthalmologists do?

Ophthalmologists are medical doctors who specialise in eye health. They mainly deal with the treatment and management of eye diseases such as cataracts, glaucoma, partial or complete loss of vision or vision irregularities, retinal abnormalities, eye injury or inflammation. The procedures and services they carry out include cataract surgery, refractive or laser surgery, glaucoma surgery, reconstructive eye surgery and cancer removal.

1. Paediatric Ophthalmologists

A paediatric ophthalmologist specialises in dealing with children's eye health, vision problems and conditions. They are medical and surgical doctors who pursued specialised training, education and experience in assessing children's eyes and hold extensive knowledge on the conditions that can affect this age group. Neurologic development of vision takes place through to the age of twelve, but with strabismus, refractive error that is left untreated, myopia and astigmatism can hinder this development. Paediatric ophthalmologists may conduct a vision assessment, determination of refractive error or motility testing during the appointment.

2. Glaucoma Ophthalmologists

Glaucoma ophthalmologists are specialised in examining glaucoma and identifying the underlying cause. They have been thoroughly trained in how to treat and manage it. There are many different treatments for glaucoma, which include eye drops, laser treatment and surgery. Ophthalmologists will decide on the best treatment suitable according to the nature of your condition, according to the University of Waterloo.

3. Neuro-Ophthalmologists

Neuro-ophthalmologists are experts in dealing with visual problems that relate to the central nervous system. For ophthalmologists to diagnose your condition, they will need to ask you about your medical history and carry out tests, including eye alignment testing, eye movement testing, pupil, anterior and posterior segment testing, full optic nerve functional assessment, tests of higher visual processing and structural measures of nerve and retina according to the Canadian Journal of Ophthalmology.

4. Cornea and External Disease Ophthalmologists

These ophthalmologists are qualified in the diagnosis and treatment of diseases that relate to the cornea, sclera and eyelids. Their role may involve conducting corneal transplant surgery and other kinds of corneal surgery.

5. Retina and Vitreous Ophthalmologists

Retina and vitreous ophthalmologists are qualified to diagnose and treat the back of the eye. This region of the eye includes the retina, which is the light-sensitive tissue at the back of the eye, the macula, which is part of the retina that helps with central vision and the vitreous, which is the clear fluid that fills the bulk of the eye and has a jelly-like consistency. These ophthalmologists may carry out tests such as ultrasound and dye techniques. Their role may also include treatments such as laser therapy, removal of the vitreous, a freezing treatment known as cryotherapy and surgery to fix torn or detached retinas, according to Vision Eye Institute.

6. Oculoplastic and Orbital Ophthalmologists

Oculoplastic and orbital ophthalmologists are experts in carrying out comprehensive examinations, and medical and surgical treatment of disorders that affect the eyelids, the tear gland and issues with tears being able to drain out. Orbital issues and diseases include thyroid eye disease and traumatic orbital fractures as a result of a physical strike to the area, according to Alberto G. Distefano in a paper published in the Chobanian & Avedisian School of Medicine.

7. General Ophthalmologists

A general ophthalmologist, also known as a comprehensive ophthalmologist, is thoroughly educated and trained in treating eye diseases and conducting eye surgery. For conditions such as glaucoma or cataracts, there are general ophthalmologists who have undergone more training to treat those specific eye conditions. However, in the case of detecting a condition that needs more specialised care for a specific region of the eye, you'll be referred to a subspecialist.

What Services and Treatments do Ophthalmologists Typically Offer?

The services and treatments ophthalmologists typically offer are examining and treating more serious conditions and problems. If your optometrist has identified an eye disease or vision disorder, you may be directed to see an ophthalmologist. This includes partial or complete vision loss, eye injuries, pain or swelling, glaucoma and health conditions that can impact their eyes like diabetes and high blood pressure, according to the Visionary Eye Centre. The services and treatments that ophthalmologists offer are listed below.

• Cataract surgery: This procedure involves making a small cut in your eye to replace the cloudy lens with a new artificial lens.
• Refractive or laser surgery: This procedure is intended to reshape the cornea to correct short-sightedness, long-sightedness or astigmatism.
• Strabismus surgery: This is surgery that corrects eye misalignment.
• Ocular melanoma: Ophthalmologists may also treat cancers in the eye, such as melanoma.
• Eye injury treatment: Ophthalmologists may also provide treatment for any potential damage as a result of eye injuries.
• Fluorescein Angiography: Ophthalmologists are able to perform a fluorescein angiography for patients who are exhibiting signs of eye conditions such as diabetes-related retinopathy or macular degeneration. A fluorescein angiography is a test that involves capturing images of the retina, which is located in the back of the eye. During a fluorescein angiography, the ophthalmologist will need to dilate your pupils to widen them and inject a dye known as fluorescein into your arm.

What Training and Qualifications are Required to Become an Ophthalmologist?

The training and qualifications that are required to become an ophthalmologist include certain education pathways and programs, and the successful completion of the required examinations. The training and qualifications required to become an ophthalmologist include a 3-4 year university undergraduate degree in science or a pre-med universities that require students to complete a science or health-related undergraduate program. When students have completed their undergraduate degree, they may be required to sit for the Medical College Admission Test, depending on their chosen medical institution. Graduates can then apply to medical school to begin practical training. During medical school, you will take the first part of the Medical Council of Canada Qualifying Exam (MCCQE). You will then need to apply for a residency programme, where you will choose which area of ophthalmology you would like to specialise in. The residency programme typically takes around 2-7 years to complete

How Much Do Ophthalmologists Make?

How much ophthalmologists make in Canada is dependent upon their level of experience, education and workplace.

How Often Should People Get Their Eyes Tested by an Ophthalmologist?

People should get their eyes tested by an ophthalmologist only if their doctor or optometrist has specifically referred them. Ophthalmologists specifically focus on complex conditions and problems; therefore require a referral before making an appointment to see one.

How Do Canadian Optometrists and Ophthalmologists Collaborate?

Canadian optometrists and ophthalmologists collaborate formally and informally in order to lessen the wait times and increase and improve accessibility for patients by utilising optometrists to examine and manage patients as opposed to having those patients be seen by an ophthalmologist. The number of optometrists that are working in public hospitals has increased in order to reduce the workload of ophthalmologists and enhance overall eye care, according to the Canadian Journal of Ophthalmology.

What is the Future of Optometrists and Ophthalmologists in Canadian Healthcare?

The future of optometrists and ophthalmologists in Canadian healthcare is reported to decrease in terms of the ratio between the number of optometrists and ophthalmologists to the population. According to Buys, M. Y and Bellan, L. (2023) in the Canadian Journal of Ophthalmology, based on the annual change in ophthalmologists' numbers staying the same as the previous 10 years, the total of ophthalmologists per 100,000 population is estimated to be slightly reduce for people aged over 65. This is expected to be the same for the number of optometrists in Canada per 100,000 population over 65, according to the Canadian Council of the Blind in their 2023 report on Vision Health in Canada.

Why Go to an Optometrist Instead of an Ophthalmologist?

It is advised to go to an optometrist before being referred to an ophthalmologist when seeking regular eye care services. Optometrists can provide eye exams and tests to assess your eye and vision health, for the prescription of glasses and contact lenses, and to ensure there are no symptoms of more serious conditions. Optometrists are also trained to prescribe eye medication, such as eye drops, for minor eye problems. Your optometrist would only refer you to an ophthalmologist if they have detected symptoms of a condition or disease. Ophthalmologists specialise in diagnosing and treating complex conditions such as partial or complete vision loss, eye injuries, pain and swelling, glaucoma and eye problems related to diabetes.

What Kinds of Eye Problems Does an Opticians Treat?

Opticians are do not treat eye problems or examine patients. They received training specifically for providing advice on frames, selecting lenses, contact lenses, sunglasses and safety eyewear. They deliver great customer service, selling products and services according to the Canadian Association of Optometrists.

What Are the Different Types of Opticians?

There is only one type of optician in Canada; they are trained to design and fit frames and lenses and interpret prescriptions. Although in the UK and the US, they have different types of opticians, typically known as optical managers and contact lens opticians.

How Can Opticians Help Visually Impaired Customers?

Opticians can help visually impaired customers after the patient has been referred to an ophthalmologist by an optometrist. Opticians can then design glasses based on the supplied prescription. This may involve different prescriptions for each eye; however, ophthalmologists are the professionals who mainly help patients who are experiencing this condition.

How do Opticians Help Clients Choose Eyeglass Frames and Lenses?

Opticians help clients choose eyeglass frames and lenses by taking measurements of the client's face to ensure they can produce the appropriate frame and lenses that are suitable for the client. Due to the unique nature of every individual's facial features, it is important to get these details right. Nose sizes and shapes and cheekbone positions, and shapes all differ from person to person. These professionals must take accurate measurements of the distance between the lenses and the bridge and the length of the nose, and the length of the client's face. Additional factors that need to be taken into account are the extent of curving of the frames that best fit the client's face shape, the distance between the client's eyes and the back surface of the lens, what most comfortably fits around the client's ears and the lens height and width that help the client's eyes to be centered.

How do Opticians Conduct Eye Exams?

Optical dispensers do not conduct comprehensive eye exams or tests, as they are not trained in carrying these out. This responsibility lies in the role of an optometrist and ophthalmologist, as they have received specific training and education.

How Has Technology Changed the Optometry Profession in Recent Years?

Technology has significantly changed the optometry profession in recent years by improving access to care, diagnostic accuracy, and the overall experience for patients. The increased use of telehealth resources has made it possible for patients in rural and remote areas to receive comprehensive eye exams through virtual platforms, according to the University of Waterloo. Advanced imaging technologies like Optical Coherence Tomography (OCT) and AI-assisted retinal scans are now widely used to detect conditions such as glaucoma and diabetic retinopathy earlier and more accurately.