What’s the difference between an ophthalmologist and an optometrist?  

  

An ophthalmologist is a medical (MD) or osteopathic doctor (DO) who specializes in eye and vision care. Ophthalmologists differ from optometrists in their levels of training and in what they can diagnose and treat. Ophthalmologists are licensed to practice medicine and surgery. They are qualified to deliver total eye care, including vision services, eye examinations, medical and surgical eye care, and diagnosis and treatment of disease and visual complications that are caused by other conditions, such as diabetes. 

 

An optometrist is not a medical doctor. An optometrist receives a doctor of optometry (OD) degree. They are licensed to practice optometry, which involves providing primary vision care, including routine eye exams and vision tests, prescribing and fitting eyeglasses and contact lenses, monitoring eye conditions related to diseases such as diabetes, and providing low-vision aids. In the United States, what optometrists are licensed to do for patients varies from state to state. 

  

What level of training does it take to perform eye surgery?  

  

Ophthalmologists complete 8 to 10 years of training and education, including medical school. This advanced medical education, hospital internship, and years of clinical and surgical residency training prepares ophthalmologists to perform eye surgery. Most importantly, ophthalmologists’ advanced training provides them with the surgical judgement required to be an eye surgeon. Throughout their training, all ophthalmology residents are required to regularly practice and develop their surgical skills by treating and operating on live patients under the direct one-on-one supervision of an attending ophthalmologist.  

 

In contrast, optometry’s education model does not provide an optometrist with the opportunity to receive this level of extensive surgical training. Every optometry school, in all but two states, is located in states where it is illegal for optometrists to perform laser surgery on live human patients. Collectively, this represents 95% of optometry students nationwide. Optometrists are not required to attend any type of surgical residency or fellowship training following graduation from optometry school. While there are some optional short courses on laser procedures available to optometrists, the training is minimal and does not require optometrists to practice their skills on live patients prior to passing the course.   

   

There are no short cuts to becoming a surgeon. Brief optometry school courses cannot replace an ophthalmologist’s substantial amount of surgical training which teaches surgeons It takes years to learn how to identify who qualifies for eye surgery, how to perform the surgery safely, and what to do if there are surgical complications. Eye surgery is delicate and requires precision. One quick slip of a laser or scalpel, and a patient can suffer permanent damage or blindness. In some cases, surgical complications from laser surgeries can quickly become an emergency which can only be treated by an ophthalmologist. 

  

What about laser eye surgery? Isn’t that different than typical surgery with a blade?  

  

Surgery is surgery, whether you use a blade or laser. Mastering the use of a laser requires the same, if not more, practice and experience as using a surgical scalpel. Lasers are surgical instruments that cut as deeply and as sharply as any scalpel.  

  

Optometrists have little experience in the modalities and complications of laser surgery. Veterans should insist that any surgery be performed by medically licensed surgeons only.   

  

Would you want anyone other than a trained medical doctor, an ophthalmologist, to perform surgery or delicate eye procedures on your eyes or your loved one’s eyes? 

 

Won’t allowing optometrists to provide surgical eye care increase veterans access to care? 

  

Veterans typically have ready access to ophthalmologists in VA facilities, and there is no documented concern over access for laser eye surgery. Moreover, the Community Care Program also provides veterans with timely access to medical services when the VA cannot provide the care needed. Combined, these programs support the VA’s core strategy of providing high quality of veteran-centered care, and the VA has no basis for taking actions that would lower the standard of care for veterans. There is no evidence that ophthalmologists are unavailable under the Community Care Program to perform eye surgeries.  

 

Optometrists are valued members of the eye care team who play an important role in delivery of care. But their education and training model does not provide them with the necessary education, surgical training, and clinical experience necessary to qualify them to perform eye surgery.  

 

Access to care is not the same as access to quality care. You cannot sacrifice quality for the sake of access. Our nation’s veterans deserve and have earned the right to have access to the highest quality of care – no matter where they live in the country.   

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