Dictionary Definition
optometrist n : a person skilled in testing for
defects of vision in order to prescribe corrective glasses [syn:
oculist]
User Contributed Dictionary
Translations
person trained in examining and testing the eyes
for defects
- German: Optometrist
Extensive Definition
Optometry is a doctoral-degree health care
profession concerned with eyes and related structures, as
well as vision, visual
systems, and vision
information processing in humans.
Like most health professions, optometry education, certification, and
practice is regulated
in most countries. Optometrists and optometry-related organizations
interact with governmental agencies, other health care
professionals, and the community to deliver eye and vision care.
Optometry is one of two doctoral-degree professional eye
care professions, the other being ophthalmology.
Scope of practice
Optometrists, also known as doctors of optometry, are primary health care providers for the eye and visual system. They examine, diagnose, and medically treat eye diseases, non-surgical injuries, and disorders of the eyes and visual system, including refractive problems such as near- or far-sightedness, and identify related systemic medical conditions affecting the eyes and ocular adnexa. In some locations, optometrists may perform laser surgery.Optometrists may serve the general public;
specialize in work with the elderly, children, or partially-sighted
persons who need specialized visual devices; develop and implement
ways to protect workers eyes from on-the-job strain or injury; or
specialize in contact lenses, sports vision, or vision
therapy.
Eye and vision examination
The typical optometric examination has three components: history-taking of both eye-related health and optical and visual functioning-related aspects of the patient, the evaluation of the health status for the detection of eye disease, and evaluating the optical and vision characteristics of the eye and observations during testings.Examination of ocular health may include:
- inspection of the external structures of the eye such as Cornea, Anterior Chamber, Physiological Lens as well as internal ocular structures such as Retina and Optic Nerve. This is done with various specialty equipment
- observation of various eye movements and alignment
- observation of pupillary reaction to light as a neurological test
- observation of overall health status of adnexal ocular structures such as eyelids and eyelashes, as well as the lacrimal system among others
- measurement of eye pressure also know as intraocular pressure
- evaluation of functional aspects of the eye such as visual fields
Examination of visual
skills:
- applying a battery of structured visual tasks for patient to complete to evaluate the functional characteristics of the visual system such as tracking and focusing aspects as well as muscle coordination.
Pre-optometric education
Prerequisites for admission to optometry schools are similar to those to most medical, osteopathic, and dental programs.Examples of equipment used for eye and vision health testing
Many types of equipment are used during an eye examination. Vision charts and machines are used to measure vision and visual fields. Trial (spectacle and 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. Test booklets, sheets, instructions, and pencils may be used for visual information processing examination.Penlights and transilluminators can be used when
assessing pupil light
response, a neurological screening test. Specialty magnifiers, such
as ophthalmoscopes and
slit-lamp
bio-microscopes, help with detailed inspection of external and
internal anatomical ocular structures. Diagnostic eye drops may
also be used to assess the various anatomical structures of the
eyes.
Many optometrists use 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 that are helpful in
diagnosing disease entity in early stages. Optometrists use digital
imaging equipment, such as digital cameras to document appearance
of the anterior and posterior parts of the eye. Corneal
topographers are used to gather information on anterior aspects of
the anatomy of the eye and cornea. Other sophisticated equipment
such as
Optical coherence tomography, GDX, or HRT II can
be used for various disease testing and treatment.
Diagnoses
Diagnoses made by optometry depends on integrating eye examination information.Some
ocular diseases can be associated with
systemic, neural, or other disease complications. Some
ocular disorders may be treated by an optometrist. In some cases,
referral to an ophthalmologist may be required for surgical
treatment.
Visual dysfunctions assessed by optometrists may
include:
- refractive error such as myopia, hyperopia, astigmatism and presbyopia
- accommodative-vergence disorders (related to dynamic focus and eye alignment)
Common examples of ocular pathologies diagnosed
and treated by optometrists include:
- glaucoma
- cataracts
- infection and inflammation of the ocular surface including conditions of the cornea, conjunctiva as well as internal pathologies of the retina, vitreous and optic nerve among others
- Strabismus (squint or turned eye) which might require surgical repair by an ophthalmologist
- Haemorrhage of vascular supply to the eye (internal or external)
Common examples of diseases of systemic origin
with eye complications that can be recognized and managed by
evaluation of the ocular structures include:
- diabetic eye disease and retinopathy caused by diabetes
- retinal changes caused by other systemic disorders such as hypertension and cholesterol problems
- evaluation of ocular changes caused by medications such as oral contraceptives and Plaquenil among others
Patient management
Optometric patient management may include:- Counsel on status regarding comprehensive or detailed evaluations of the human eye.
- Diagnosis and treatment or management of eye disease, ocular findings or visual disturbance.
- Prescribing medications such as antibiotics, antiinflammatory and other for the treatment of eye conditions and diseases.
- Prescribing optical aids such as glasses, contact lenses, magnifiers.
- Prescribing low vision rehabilitation.
- Prescribing vision therapy.
They give advice and follow-up care regarding use
of optical aids (especially contact lenses), provide referral to
other health professionals including internist and other primary
care physicians and particularly sub specialists like ophthalmologists for
surgical consultation, and interact with opticians and the optical
industry, which manufacture the optical aids such as glasses in
accordance to optical prescriptions.
History
Optometric history is tied to the development of- vision science (related areas of medicine, microbiology, neurology, physiology, psychology, etc)
- optics, optical aids
- optical instruments, imaging techniques
- other eye care professions
The term optometrist was coined by Landolt in
1886, referring to the "fitter of glasses". Prior to this, there
was a distinction between "dispensing" and "refracting" opticians in the 19th century.
The latter were later called optometrists.
The first schools of optometry were established
in 1850-1900 (in USA), and contact lenses were first used in
1940s
Licensing
Most countries have regulations concerning optometry education and practice. Optometrists like many other health care professionals are required to participate in ongoing continuing education courses to stay current on the latest standards of care.Optometry is officially recognized:
- in North America (Canada and US)
- in Latin America and some Caribbean countries
- in most English speaking countries including UK, Republic of Ireland and Australia
- in Europe including Spain, Germany and France
- in Asia including Malaysia, China, Hong Kong, Thailand and Taiwan
- in the Middle East including Saudi Arabia, Iran and Israel
see also
List of optometry schools
United Kingdom
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).There are 6 universities which offer Optometry in
England, they are: Anglia Ruskin University, Aston University,
Bradford University, Cardiff University, London City, and
Manchester University
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.
United States
US optometrists complete a 4-year program that leads to a Doctorate in Optometry (O.D.) degree. Many optometrists complete a one- or two-year residency to specialize. A sample curriculum is available from the Inter American University School of Optometry. As primary eye care providers, doctors of optometry are an integral part of the health care team. 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 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 include pediatric care, children’s vision,
geriatric care, specialty contact lens (for keratoconus patients or
other corneal
dystrophy) and many others. All optometrists are required to
fulfill continuing education requirements to stay current on the
latest standards of care.
Argentina
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.Colombia
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 in 1992 through the Law 30. 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).Europe
Currently, optometry education and licencing varies throughout Europe. For example, in Germany, optometric tasks are performed by 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.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. ew
Ireland
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].
Optometrists must be registered with the Board in order to practice
in the Republic of Ireland.
The A.O.I. runs a comprehensive continuing
education and professional development program on behalf of Irish
optometrists. The legislation governing Optometry was drafted in
1956. The 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 significant restrictions - the use of cycloplegic drugs to
examine children.
Distinction from ophthalmology
Ophthalmologists after obtaining a 4-year bachelor degree, attend medical school for 4 years of medical training to obtain an Doctor of Medicine (MD) or an Osteopathic (DO) degree. Ophthalmologists train for an additional three to four years of residency training. Residency training in ophthalmology encompasses all aspects of diagnosis and management of diseases that affect the eye, orbit, and neurological system of the brain. This includes surgical treatment. Many ophthalmologists pursue additional fellowship training in various subspecialties.In the USA, optometrists also acquire a 4-year
bachelor degree followed by 4 years of Optometry school to earn an
OD or Doctor of Optometry degree. While in school, optometry
students undergo internship training and after completion of the
degree, have options of 1- to 2-year residency programs for further
specialization.
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 curriculum in the United States
include such courses as vision sciences, health sciences,
pharmacology, encompassing diagnosis and management of diseases
that affect the eye, orbit, and neurological system of the brain.
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, neurology, vision perception.
They have a broad understanding of disease etiology, management,
and treatment. In general, optometrists can do the same things
ophthalmologists do with the exception of managing diseases (e.g.
ptosis, strabismus, wet macular degeneration, proliferative
diabetic retinopathy, glaucoma, cataracts) that require surgical
expertise. Depending on state law, however, many optometrists are
licensed to perform minor surgery as well as laser surgery. Some
states limit the prescribing of oral medications by optometrists
depending on licensure and regulatory requirements.
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 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 refractive, orthoptic, medical and
surgical therapy.
Sub-specialties
There are currently nine sub-specialty residencies offered by various schools of optometry in the United States http://www.optometryresident.org/List_header.htm http://www.opted.org/residencies_faq.cfm:- Cornea and contact lenses
- Family practice optometry
- Geriatric optometry
- Glaucoma
- Low vision rehabilitation
- orthoptic practice
- Ocular disease
- Pediatric optometry
- Primary care optometry
- Vision therapy and rehabilitation
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.
Etymology
The term "optometry" comes from the Greek word optos, meaning eye or vision, and metria, meaning measurement.See also
External links
Organizations
- World Council of Optometry
- Optometry Giving Sight
- American Academy of Optometry
- American Optometric Association
- Association of Optometrists Ireland
- Association of Schools and Colleges of Optometry (ASCO)
- Canadian Association of Optometrists
- College of Optometrists (UK)
- Comprehensive Optometry Site (AU)
- Optometrists Association Australia
- Victorian College of Optometry, Australia
- The General Optical Council
- The Association of Optometrists, Ireland
- Association of Regulatory Boards of Optometry
Other
- Optometrists Network
- U.S. Bureau of Labor Statistics Optometry Page
- Optometry Giving Sight Organization
- International Centre for Eyecare Education
- The development of western optometry--a case for history, by Tannebaum S. in J Am Optom Assoc. 1990 Sep;61(9):666-8
- Optometry.com
Some optometry-related publications
References
optometrist in Catalan: Optometria
optometrist in Danish: optometrist
optometrist in German: Optometrie
optometrist in Spanish: Optometría
optometrist in French: Optométrie
optometrist in Italian: Optometrista
optometrist in Dutch: Optometrie
optometrist in Polish: Optometria
optometrist in Portuguese: Optometria
optometrist in Slovenian: Optometrija
optometrist in Thai: ทัศนมาตรศาสตร์
optometrist in Chinese:
视光学
OPTOMETRY