Why do optometrists do things an ophthalmologist should do, and vice versa?

Re: Why do optometrists do things an ophthalmologist should do, and vice versa?

On Jul 12, 4:24 pm, "Mike Tyner" <mty...@mindspring,com > wrote:

> So you're saying you should have to wait a week because optometrists aren't
> "supposed to" do what they're trained to do? Optometry schools aren't
> "supposed" to teach microbiology and pharmacology?
>
> Who does fillings better, a family dentist or an oral surgeon?
>

Opthalmology residency is highly competitive. It requires full 4 yrs
of medical school and an acceptance to an opthalmology residency,
which is an extra several years. Many US med grads do not get accepted
to a single one of these programs.

Optometry training is relatively easy to get admissions to ( < 3.0 gpa
in undergrad ), and is not comprehensive as medical school and
opthalmology residency.

I do not work in visual sciences and can't comment first-hand but this
is something to think about.

The fillings analogy is not a good example. Both general dentists and
oral surgeons undergo the exact same 4 yrs in dental school, where
fillings tend to be the bread/butter in the restorative curriculum.

Re: Why do optometrists do things an ophthalmologist should do, and vice versa?

On Jul 13, 6:10 pm, infinitec...@hotmail,com wrote:
>
> Optometry training is relatively easy to get admissions to ( < 3.0 gpa
> in undergrad ), and is not comprehensive as medical school and
> opthalmology residency.
>

I can speak to your statement since I have been to both medical and
optometry schools. My comments relate to the US health care system,
and there are significant differences in the training and scope of
practice of optometrists around the world.

Optometry school is indeed much more competitive to get into than you
think. The average GPA of the entering class in the school I attended
is ~3.4. The same university's medical school statistics are
similar. The prerequisites for admission to both schools is virtually
identical.

The optometry school curriculum is very similar to medical school
courses during the first two years-- basic science courses in human
anatomy, physiology, biochemistry, pharmacology, etc. The depth,
however, is not as great in some cases as it is in med school. But
optometry students spend considerable time also studying basic optics
and physiological optics to a level that ophthalmology programs or
medical schools simply do not even attempt to match.

IMHO, graduating from a US optometry school gives a person much
greater understanding of the eye than a general ophthalmologist has.
After all, in optometry school 4 years is spent concentrating on a
single organ system. The eye. How much does a med school graduate
really know about the eye-- the answer is, very little. A three year
residency in ophthalmology essentially provides a hands-on
apprenticeship in seeing how surgeons and subspecialists treat certain
ophthalmic conditions but does little to tie it all together, or to
provide for the lack of concentrated study in ocular anatomy and
physiology that is not provided in medical school. I believe that
optometrists get better training in understanding general eye
conditions in otherwise healthy patients who need little more than
eyeglasses or contact lens correction, or treatment of routine medical
problems like infections or abrasions. Such patients constitute the
vast majority of people seeking primary eye care. In short, see
Optometrist for primary health care, go to ophthalmologists for
surgical needs or when referred for complex conditions. Optometrists
can recognize pathologies and refer off to subspecialists as well as
any general ophthalmologist. Personally I think general
ophthalmologists are of negligible value in the US health care
system.

Not to mention that the demographics illustrate that there are
insufficient numbers of Ophthalmologists to meet the primary eye care
to the US population.

I think your understanding of this topic is rudimentary and simplistic.

Re: Why do optometrists do things an ophthalmologist should do, and vice versa?

On Jul 13, 5:10 pm, infinitec...@hotmail,com wrote:
> On Jul 12, 4:24 pm, "Mike Tyner" <mty...@mindspring,com > wrote:
>
> > So you're saying you should have to wait a week because optometrists aren't
> > "supposed to" do what they're trained to do? Optometry schools aren't
> > "supposed" to teach microbiology and pharmacology?
>
> > Who does fillings better, a family dentist or an oral surgeon?
>
> Opthalmology residency is highly competitive. It requires full 4 yrs
> of medical school and an acceptance to an opthalmology residency,
> which is an extra several years. Many US med grads do not get accepted
> to a single one of these programs.
>
> Optometry training is relatively easy to get admissions to ( < 3.0 gpa
> in undergrad ), and is not comprehensive as medical school and
> opthalmology residency.
>
> I do not work in visual sciences and can't comment first-hand but this
> is something to think about.
>
> The fillings analogy is not a good example. Both general dentists and
> oral surgeons undergo the exact same 4 yrs in dental school, where
> fillings tend to be the bread/butter in the restorative curriculum.

Anybody who really cares can look up the class profiles of any of the
optometry schools and see that your statements are total nonsense.

Re: Why do optometrists do things an ophthalmologist should do, and vice versa?


<infinitecore@hotmail,com > wrote

>The fillings analogy is not a good example. Both general dentists and
>oral surgeons undergo the exact same 4 yrs in dental school

And after 4 years, both of them are allowed to provide medical care within
the scope of their training.

So if optometry students endure the same four years, share the same basic
sciences curriculum and get comparable specialty training, they should
likewise be allowed to provide medical care within the scope of their
training.

-MT

Re: Why do optometrists do things an ophthalmologist should do, and vice versa?

Hello all:

very interesting topic.

we do not have practicing optometrists (own praxis) here in Germany
(not allowed), they work in opticians shops, or hospitals, or
ophthalmology private praxis.

I did not have the time to read every comment thoroughly, but I think
I did not read the following argument, which in my opinion is VERY
important:

Optometrists do not have a general medical education with more than
good lay insight into all other medical subspecialities.
Ophthalmologists have. Bot only education, but individual working
experience.

Finishing medical school / optometric school: of course (!!)
optomentrists are far more experienced in all parts of ophthalmology.

But the final medical student choosing ophthalmology runs through
another 5+++ years of highly specialized training. 5 yrs is the
minimum in Germany, and then you are a General Ophthalmologist, NOT a
corneal, retinal, paediatric, whatever..... specialist, this requires
further training. AND you have the background of a full medical
course, including working (!!) as junior house officer in all the main
and big fields: internal medicine, surgery, paeds, etc.

I agree however that the General Ophthalmologist is probably in spite
of the 5 years less trained in refraction, and low vision device
fitting.

Concerning the eye infection:


> I have an eye infection, and went to my optometrist about it, a few days
> ago. Why? I've been to him for contact lenses, and I haven't been to an
> ophthalmologist, don't know any. Also, he's close, and when I called, they
> said I could come in right away, for him to see me.
>
> The optometrist seemed knowledgeable about it, but perhaps an
> ophthalmologist would have been better. I don't know. He put me on
> antibiotic eye drops (zymar), and of course I'm not wearing my contacts now.
> I don't know what an ophthalmologist might have done differently.

1. did the optometrist do a slit lamp examination? Contact lens
wearing problems, corneal ulceration?
2. did he do microbiology (cave: keratoconjunctivitis epidemica is
highly transmissable, and would have meant a sick leave to protect
others!
3. did he do an antibiogramm to check whether these drops are
effective?
4. did he inquire about any other of your health issues?
immunologically relevant diseases?

> Although I have vision insurance, which paid part of the cost for my contact
> lens fitting and lenses, I was told at the optometrist's office that my
> vision insurance doesn't pay at all for an eye infection, and I had to pay
> $65 on the spot, for a few minute office visit.

I don´t quite believe that..... really?

I work in the field of paediatric and neuro-ophthalmology plus low
vision. I do need my general medical knowledge and practical
experience *every day* (including the low vision part! one does have
to know about the general medical, surgical and neurological diseases
affecting the elderly to fit low vision devices correctly!), and I
have studied paediatrics, medicine of the aged patient and much
genetics on my way as well.

You never know what you do not know if you do not know.......

greetings,
Barbara

(Consultant of Paed., Neuroophth, Low Vis., university-based)