Optometry

From Wikipedia, the free encyclopedia

(Redirected from Optometrists)
Jump to: navigation, search

Optometry (Greek: optos meaning seen or visible and metria meaning measurement) is a health care profession concerned with eyes and related structures, vision, visual system and vision information processing in humans.

Like most health professions, optometry education, certification and practice is regulated in most countries. Optometrists and related organizations interact with government, other health care professions and the community to deliver eyecare and visioncare. Optometry is a type of eyecare profession and optometrists often interact with other eye care professionals, such as ophthalmologists and opticians.

An optical refractor (also called a phoropter) in use.
An optical refractor (also called a phoropter) in use.

Contents

Optometrists are the primary health care providers for the eye and visual system. They are not surgeons but may refer patients for surgical care when needed. Optometrists examine, diagnose and medically treat eye diseases, injuries, and disorders of the visual system as well as identify related systemic conditions affecting the eye[s]. Some optometrists specialize in work with the elderly, children, or partially sighted persons who need specailized visual devices. Others develop and implement ways to protect workers eyes from on-the-job strain or injury. Some specialize in contact lenses, sports vision,or vision therapy. A few teach optometry, perform research, and consult. SOURCE: Bureau of Labor Statistics/www.bls.gov

As with most health care, examination often includes history taking and observations during tests.

  • Examination of ocular health may include:
    • inspection of the external and internal ocular structures with various specialty equipment
    • observation of various eye movements and alignment
    • observation of pupillary reaction to light
  • Examination of visual skills:
    • applying a battery of structured visual tasks for patient to complete

There are many types of equipment used during an eye examination. For example, various vision charts and machines are used to measure vision and visual fields. Trial (spectacle & 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. Penlight/transilluminator can be used when assessing pupil light response. Specialty magnifiers such as ophthalmoscope, and slit-lamp bio-microsope help with detailed inspection of external and internal ocular structures. Diagnostic eye drops may also be used to assess the eyes. Various test booklets/sheets/instructions and pencils may be used for visual information processing examination.

Another less common example of equipment used in optometry is Fresnel goggles which disables the patient from focusing, and thus is a tool to evaluate patients with Balance disorders [1]

For at least the past decade, many optometrists have begun using computerized equipment specifically designed to help monitor or detect certain ocular diseases. For example, many optometrists' offices have various visual field analyzers and tonometers. Also some optometrists use digital imaging equipment, such as digital cameras to document appearance of the anterior and posterior eye, corneal topographer, Optical coherence tomography, GDX [2], or HRT II.

Diagnoses made by optometry depends on integrating eye examination information.

Some ocular pathology can be associated with systemic, neural or other disease complications. Some ocular pathology and visual dysfunctions or disorders may require further specialty testing. Hence, referral may be required to refine diagnoses and/or to implement appropriate treatment.

Optometry management can include:

  • advice and follow-up care regarding use of optical aids (especially contact lenses)
  • referral to other health professionals, often including medical doctors, and other eyecare professionals such as ophthalmologists and optometrists practicing sub-specialties
  • interacting with opticians and the optical industry which manufacture the optical aids according to the prescription

Optometric history is tied to the development of

The term optometrists was coined by Landolt in 1886, referring to the "fitting of glasses". Prior to this, there was a distinction between "dispensing" and "refracting" opticians in the 19th century. The latter were later called optometrists. [3]

Apparently the first schools of optometry were established in 1850-1900 (presumably in USA) and contact lenses were first used in 1940's [4]

Most countries have regulations concerning optometry education and practice. Often, optometrists are required to participate in ongoing continuing education courses to stay current on the latest standards of care.

Optometry is officially recognized:

See also: List of optometry schools

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).

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.

As primary eye care providers, doctors of optometry are an integral part of the health care team, earning their doctoral degree just as dentists, podiatrists and other doctors do. 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 is extensive and covers a wide variety of advanced health, science and mathematics courses. Optometry school consists of four years of post-graduate, doctoral level study focusing on the eye, vision and associated systemic diseases. In addition to profession-specific courses, optometrists are required to take systemic 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 their accredited college of optometry and hold the doctor of optometry (OD) degree. Optometrists must pass a rigorous national examination administered by the National Board of Examiners in Optometry (NBEO). 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 advanced training in a specific sub-specialty. These specialties can include pediatric care, children’s vision, geriatric care, pre- and post-surgery care, specialty contact lens (for keratoconus patients or other corneal dystrophies) and many others. All optometrists are required to participate in ongoing continuing education courses to stay current on the latest standards of care. Optometrists in the United States are among the few who are granted the degree of "Doctor of Optometry" instead of a bachelor's or master's degree in optometry.

Currently, optometry education and licencing varies through out Europe. For example, in Germany, the tasks of an optometrist are split between 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. [5]

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.[6]

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]. It is illegal to practice as an optometrist in the Republic of Ireland, unless registered with the Board.

The A.O.I. runs a comprehensive continuing education and professional development program on behalf of Irish optometrists. Unfortunately for the profession in Ireland, the legislation governing Optometry was drafted in 1956 and is hopelessly out of date. The unnecessary restrictions in this fifty year old piece of 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 egregious restrictions - the use of cycloplegic drugs to examine children. Review of this legislation is urgent to allow the public to benefit from the skills of optometrists to reduce the enormous waiting lists in the public health service particularly for children.

Ophthalmologists complete a general medical degree (M.D.) at an accredited medical school, and an additional four years of postgraduate specialty medical and surgical training in ophthalmology.

In addition to training with respect to medical conditions of the eyes and visual system, Optometry courses usually include many vision science subjects. Examples include courses in visual psychophysics, as well as training in aspects of functional vision such as vision therapy, binocular vision, and low vision. Ophthalmology training focuses more on medical and surgical management of ocular and systemic disease with less emphasis on functional vision. While both ophthalmologists and optometrists are trained in refraction, optometrists often receive more detailed training in prescribing optical aids such as spectacles and contact lenses, however, in all 50 states in the USA, optometrists may prescribe medications to treat most eye diseases, including glaucoma.

The two fields often have a mutually beneficial relationship.

Ophthalmologists may refer patients to optometrists for optical aids or low vision rehabilitation whilst continuing to treat the ocular disease/condition that may have reduced vision. 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 and ophthalmologists sometimes co-manage treatment of strabismus and amblyopia with a combination of vision therapy, medical or surgical treatment.

See also Ophthalmology#Distinction from Optometry

There are currently nine sub-specialty residencies offered by various schools of optometry in the United States [1] [2]:

  1. Cornea and contact lenses
  2. Family practice optometry
  3. Geriatric optometry
  4. Glaucoma
  5. Low vision rehabilitation
  6. Ocular disease
  7. Pediatric optometry
  8. Primary care
  9. 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.

Optometry in USA, is largely regulated by state legislations and ongoing battles are currently and constantly at work. Scope of practice is the main topic where optometrists are fighting to practice at the peak of their license, where various groups (including the American Medical Association) are attempting to legislatively prohibit them from doing so.

Oral Medications are a hot topic in New York, Florida, and Massachusetts as they remain the last 3 states where optometrists are not allowed to prescribe orals. Systemic treatment and pharmacology is strictly taught at all US Optometry schools and the basis of the restriction is largely doubted.

Surgery and most surgical procedures are also prohibited by Optometrists in all states except Oklahoma. Although full-blown surgery is not taught to Optometrists, many minor and important surgeries that Optometrists are trained to perform cannot be done due to these restrictions.

Glaucoma treatment and management are strictly regulated in many states, more notably California where many hours of supervision under ophthalmologists must be completed before one can manage on their own, despite a comprehensive eye care curriculum that includes diagnosis, treatment, and management of the various glaucomas.

  1. ^ http://www.tchain.com/otoneurology/practice/frenzels.htm
  2. ^ http://www.revoptom.com/HANDBOOK/oct02_sec4_9.htm
  3. ^ History of Optometry, Lecture Handout at Indiana University School of Optometry by David A. Goss.
  4. ^ http://www.drjankowski.com/history.htm
  5. ^ http://www.escrs.org/eurotimes/July2003/French_ophthalmology.asp
  6. ^ The unification of European optometry: how the profession will change after 1992 by Hamakiotes DS, Thal LS in J Am Optom Assoc. 1992 Jun;63(6):388-9.
v • d • e
Academic degrees
v • d • e
Health science > Allied health professions
Retrieved from "http://en.wikipedia.org/wiki/Optometry"
Advanced Search
Included Web Search Engines


Safe Search

close

Top Matching Results

Occasionally Search.com will highlight specialized results that are based on the context of your query. Examples of specialized results include specific links to news, images, or video.

Top Matching Results may highlight information from other Search.com pages, content from the CNET Network of sites, or third party content. The listings are based purely on relevance. Search.com does not receive payment for listings in this section but our partners that provide this data may get paid for listing these products.

Sponsored Links

This section contains paid listings which have been purchased by companies that want to have their sites appear for specific search terms and related content. These listings are administered, sorted and maintained by a third party and are not endorsed by Search.com.

Search Results

Search.com sends your search query to several search engines at one time and integrates the results into one list which has been sorted by relevance using Search.com's proprietary algorithm. You can customize the list of search engines included in your metasearch from the preferences.

The search engines that are used in your metasearch may allow companies to pay to have their Web sites included within the results. To view the Paid Inclusion policy for a specific search engine, please visit their Web site. Search.com does not accept payment or share revenue with any search engine partner for listings in this section.