What is the Difference Between an Ophthalmologist and an Optometrist?

This is a question I get on a daily basis. It certainly seems that the general public has almost no idea, and even other medical professionals are unsure of the definitions.

An Ophthalmologist (abbreviated here as OMD going forward) typically completes a collegiate bachelor program, attends medical school for 4 years learning about the entire body, then continues on into a residency and/or fellowship program focused on the eyes and visual system. Many OMDs will end up concentrating further on one specific aspect of the eye and specialize in the cornea, cataract surgery, refractive surgery (like LASIK), retina, pediatrics (kids), neuro-ophthalmology, or glaucoma (to name a few). Most OMDs in the area where I practice concentrate in one or two of the subspecialty areas, although there are some that would be considered primary care that handle general eye care needs.

An Optometrist (abbreviated here as OD) typically completes a collegiate bachelor program, attends optometry school for 4 years, 2 of which concentrate on the entire body, and may continue on into a residency program focused on a number of different areas. The majority of practicing ODs today would be considered primary care, although many pursue specialty areas such as pediatrics, ocular disease, low vision, visual therapy, or specialty contact lens (to name a few).

In most states (like Illinois where I practice) an OMD and OD may hold the same Drug Enforcement Agency (DEA) license to prescribe the same ophthalmic, topical, and oral medications as one another and may therapeutically treat the same ocular diseases. The both also prescribe corrective ophthalmic lenses like glasses and contacts. The primary difference is that an OMD may be licensed to perform invasive surgeries whereas an OD cannot.

So who do I need to see, an ophthalmologist or an optometrist?

If you are not presently under the care of an eye doctor that is a specialist, then you should seek either an OMD or an OD that practices primary eye care. Most primary eye care doctors can easily identify a disease or condition that requires the attention or care of a specialist. Most established primary care providers have a trusted network of specialists and will get you into the proper hands should that be required.

I am extremely fortunate to practice in Chicago’s North Shore where I have a fantastic network of trusted, experienced, talented, and personable eye care specialists of which whom I have the privilege of working. I am able to get any of my patients into specialty emergency care very quickly when the need arises. Care transfer for all of our patients is always handled with ease - all referring doctors know each other on a first name basis and communicate frequently. I would trust both my own and my family’s eyes to all of the specialists to whom I refer.

I haven’t been to an eye doctor in a while, there’s a 2 month wait to see the specialist, but I think my vision is changing and I am concerned that it’s cataracts! (or glaucoma, diabetes, macular degeneration, etc) What do I do?

I predict that specialty eye care professionals are going to have a difficult time keeping up with demand in the coming decade. It is common knowledge among the health professions that the baby boomer population (all of whom require eye care and will be affected by ocular problems related to aging) will spike around the year 2020, thus both the number of people requiring more advanced eyecare and the frequency of visits to the eye doc will be increasing significantly. Unfortunately, the number of people requiring care from OMD specialists (many whom are already practicing at full patient capacity) will increase significantly as well. The number of OMDs entering practice and those retiring from it is essentially flat. OD programs, on the other hand, have been growing rapidly the past 20 years to help meet this demand.

It is very likely that we will start to see more and more ODs concentrating on medical primary eye care while the OMD specialists spend more time in the operating rooms performing surgeries versus one-on-one primary patient care.

Thus if you are having an eye related problem, or simply have not had your eyes examined for more than a year or two, seek out your local trusted primary eye doctor, whether they are an OD or OMD. Ask your family doctor for a recommendation for a trusted eye care provider. The public reviews of healthcare providers on trusted websites such as ratemds.com, healthgrades.com, and even yelp.com are also good resources in today’s digital age.

Dr. Andrew Neukirch is a primary care optometrist. He is therapeutically certified to practice medical optometry in the states of Illinois and Indiana. He is CEO of Carillon Vision Care and practices in Glenview, Illinois. Dr. Neukirch is a Member Director for the Independent Doctors of Optometric Care, a large network of providers working together to make their patients’ care and experience the best possible.