Q: I know that Optometrists prescribe your glasses and contact lenses, but I am never sure who can take care of medical eye problems?
A: There is extensive overlap in what Optometrists and Ophthalmologists do, and many people are unsure who does what. In broad terms, Optometry is the primary care provider for general vision and eye health concerns. Ophthalmology is the primary provider for ophthalmic surgery. Each profession has sub-specialties as well, that generally use a referral system to access.
For example, if your child may have a developmental vision problem and maybe an eye alignment problem, you may want to see a pediatric or vision therapy specialist in Optometry. If you have a retinal detachment or need cataract surgery, you will need an Ophthalmologist. For routine vision care and prescribing for glasses or contacts, either provider can do that….although in Optometry the actual Doctor usually does the vision testing and prescribing, while in Ophthalmology, a technician generally does the vision testing.
When it comes to general medical eye care, also called primary eye care, either provider can treat most eye injuries, abrasions, infections, and the like. Both also typically diagnose and treat more chronic problems like glaucoma, dry eye disease, and diabetic eye care. When those problems require internal eye surgery, you may be referred to a retinal specialist, or a cataract specialist for treatment. Many eye and vison disorders are actually symptoms of a more generalized or “systemic” disease, like diabetes of high blood pressure. Both providers may order lab tests or imaging to help direct your appropriate care.
Most recently, West Virginia became the 13th state to authorize Optometry to utilize lasers in eye care treatments! These would be the most common problems where ophthalmic lasers are used: after cataract lens clouding, controlling eye pressures in glaucoma, and urgent eye pressure relief in acute emergency glaucoma. Ophthalmology has been providing those services, and soon patients will have access to more providers, and often closer to home with less waiting time.
So as you see, there is a lot of overlap in services. For most people beginning with your primary eye care provider makes sense, knowing that a referral may be needed. In a similar way, you would likely not go to a neurosurgeon initially for a headache, more commonly your primary care provider ( PCP ) or family practitioner is your logical starting point. Choosing your provider for eye care is similar in many ways.