What Is an Optometrist?
An optometrist is a health care professional who provides primary vision care. That means they do wellness checks of your eyes. Known as a comprehensive eye exam, this is an important part of your yearly health checkup.
If you have eye or vision problems, your optometrist is often your first stop. In most cases, your optometrist can treat the problem themselves. But if your problem is outside the scope of their practice or requires certain surgical interventions, they can refer you to a medical doctor called an ophthalmologist.
Optometrists don't go to medical school, but they do attend a 4-year optometry program where they study the eyes in depth. Many also do a 1-year residency after optometry school to get hands-on experience with patients. In the U.S., they must also pass the National Board of Examiners in Optometry (NBEO) exam before applying for their license to practice.
Read on to learn more about what optometrists do, their training, and what to expect when you go for an eye exam.
What Does an Optometrist Do?
As part of their practice, your optometrist may:
- Perform eye exams to check your visual acuity and look for or monitor eye diseases, such as glaucoma, diabetic retinopathy, and age-related macular degeneration
- Write prescriptions for contact lenses and glasses
- Write prescriptions for both ophthalmic and systemic medicines you may need for your eyes
- Do low-vision rehabilitation and vision therapy
- Perform some eye surgeries (depending on what your state allows)
- Counsel patients on their treatment options
Optometrist vs. ophthalmologist
Ophthalmologists are medical doctors who have done extra training in diagnosing and treating eye conditions during a 4-year residency program. They may also do a 1- or 2-year fellowship if they want to specialize in a specific patient population (such as pediatrics) or condition (such as glaucoma). Ophthalmologists treat all kinds of eye problems and do all kinds of eye surgery. Ophthalmologists may also do research on the function of eyes, eye conditions, and new treatments.
In contrast, an optometrist is not a medical doctor but has done a 4-year, specialized program dedicated to the eyes. They can prescribe medicines and do some types of eye surgery if the state they practice in allows it. For eye and vision problems, your first appointment is likely to be with an optometrist who may refer you to an ophthalmologist, depending on what kind of condition you have and what kind of treatment you need.
Optometrist vs. optician
Opticians are specialists who help you pick out eyeglasses, contact lenses, or other corrective devices. Unlike an optometrist or ophthalmologist, they don't give eye exams or write prescriptions. Instead, they fill the glasses and contacts prescriptions your optometrist or ophthalmologist wrote for you — sort of like a pharmacist for your eyes. They also help you pick out frames and lenses for your glasses and ensure your glasses fit you well. If your glasses need an adjustment, you'll bring them to your optician.
Optometrist Education and Training
In the U.S., many optometry schools are postgraduate programs. This means you must have a bachelor's degree to attend. Some optometry schools don't require a degree for admission, but you still must have passed prerequisite college classes in science and math before applying. This is because to get into optometry school, you generally need good scores on the Optometry Admission Test (OAT), Medical College Admission Test (MCAT), Graduate Record Examinations (GRE), Dental Admission Test (DAT), or any other standardized test the school you're interested in will accept.
Optometry school is a 4-year program where you will learn all about human eyes and how to run a practice, with courses including:
- Anatomy and physiology of the eye, brain, and nervous system
- Eye diseases and how to maintain eye health
- How to examine patients and diagnose conditions
- Pharmacology and how to prescribe both ophthalmic and relevant systemic medicines
- Optics so you understand the physics of how vision works and how to correct it
- Contact lens and glasses materials
- Clinical management
After graduating from optometry school, you earn a Doctor of Optometry (OD) degree. Then, you need to pass the National Board of Examiners in Optometry (NBEO) exam before applying for a license to practice in your state.
Once you have your license, you can also do a fellowship for more clinical training or to specialize in a specific patient population or eye condition.
What Conditions Does an Optometrist Treat?
In addition to checking on your general eye health, your optometrist can diagnose and treat common vision problems and some eye diseases, such as:
- Astigmatism, which is a condition that causes blurry vision due to your cornea or lens being more curved that normal
- Cataracts, which cloud the lens of your eye and lead to vision loss
- Color blindness
- Double vision
- Eye infections and inflammation
- Farsightedness (hyperopia), where you have blurry vision when looking at things close-up
- Glaucoma, a disease that damages your optic nerve
- Macular degeneration, which is a common age-related condition that makes it hard for you to see things directly in front of you
- Nearsightedness (myopia), where you have blurry vision when looking at things far away
- Presbyopia, which is a natural part of aging that makes it harder to see things close-up
- Problems with your retina, such as diabetic retinopathy, or damage to the blood vessels in the back of the eye related to diabetes
Reasons to See an Optometrist
An important part of your overall health is the wellness of your eyes. Ask your optometrist how often they recommend you get your eyes checked. But they generally suggest the following schedule:
- Children should have their first eye exam during their first year, and then every 1-2 years after that.
- Adults aged 18-55 should have an eye exam every 1-2 years.
- Adults aged over 55 should have an eye exam every year.
You may need to get your eyes checked more often if you wear glasses, contacts, or other visual aids. You should also get your eyes checked if you:
- Have a chronic disease such as diabetes, which has a greater risk of eye disease
- Have a family history of vision loss or eye disease
- Take prescription medications that affect your eyes
Go see your optometrist if you have any of the following symptoms:
- You notice your vision is getting worse
- Blurry vision
- Double vision
- Circles that look like halos around lights
- New eye pain, especially if it doesn't go away after a day or two
- Eye redness and irritation
- Floaters — specks that float before your eyes
- Flashes of light
- Light sensitivity
What to Expect at the Optometrist
If you already have glasses or contact lenses, make sure you wear them to your appointment. And bring a pair of sunglasses if you think you'll have your eyes dilated. Bright sun or indoor lights may be uncomfortable or painful for a few hours until the drops wear off.
When you have a comprehensive eye exam, your optometrist will usually start by asking about:
- Any eye or vision problems you're having
- When your eye or vision symptoms started
- Any environmental or work conditions that may affect your vision
- Your personal and family medical history, especially any known eye conditions in your family and medicines you're taking
After this, your optometrist will examine your eyes using several different tools and assessment methods, including:
Preliminary and visual acuity/refraction tests
During the preliminary exam, your optometrist will assess your:
- Depth perception, peripheral, and side vision (visual fields)
- Color vision
- Eye muscle movements
- Pupils as they respond to light
- Eye health evaluation, often using dilating eye drops to open your pupils enough so they can get a good look inside your eyes
During the visual acuity test, your optometrist will assess how clearly you can see with each eye. They usually do this by covering each eye and asking you to read lines from an eye chart both close-up and further away.
Eye focusing, teaming, and movement testing
During this test, your optometrist will assess if your eyes align well and move well in all directions without the need to move your head. For instance, they may perform a:
- Cover test to determine how well your eyes work together. You'll focus on a small target kept at a specific distance while your optometrist covers and uncovers each eye to see how they move separately and together.
- Eye muscle movement test to see how well your eyes align. Your optometrist will ask you to keep your eyes on a target, such as a pen or a fingertip, as they move it in different directions.
Keratometry/topography
This is particularly important if you're getting contact lenses. During this test, your optometrist will measure the curve of the clear outer surface of your eye (cornea). They usually do this with a slit lamp, which is a tool with a light and magnifying lens to look at the outside and inside of your eyes. They will use the slit lamp to focus a circle of light on your cornea and measure the angle of reflection.
Refraction
If you have farsightedness, nearsightedness, or astigmatism, you will likely need glasses or contacts. During this part of your exam, your optometrist may use an instrument that automatically assesses how well your eyes can focus. Then, they will use an instrument called a phoropter to fine-tune the corrective power needed for your glasses or contacts to help you see the best. They may also use an instrument called a retinoscope to see how the lenses you chose are focusing light at the back of your retina.
Retinal exam
Your optometrist will use a tool called an ophthalmoscope to look at the back of your eyes, including your retina, blood vessels, optic nerve, and the fluid in your eyes. Your optometrist will also check the fluid pressure in your eyes for any signs of glaucoma.
Takeaways
An optometrist is a health care professional who will likely be your first point of contact for almost any condition that affects your eyes or vision. They also do wellness checks of your eyes, which is an important part of your yearly health checkup. Optometrists aren't medical doctors, but they do go to optometry school for 4 years where they study the eyes in depth. They can write prescriptions for contact lenses and glasses and treat most eye conditions with medicine, therapy, and sometimes, surgery. If your problem is outside the scope of their practice, they can refer you to an ophthalmologist, who is a medical doctor specializing in eye conditions.