Optometrists are trained and licensed to diagnose and treat more than one thousand ocular conditions and are qualified to screen for many eye diseases. What used to distinguish this "eye doctor" from an ophthalmologist is that he or she does not perform surgery and, in about half of the states, does not prescribe therapeutic medications. However, in forty-seven states and soon in Alberta, Saskatchewan, and New Brunswick, optometrists can treat some eye diseases with therapeutic medications. In a few states, optometrists have lobbied to be able to perform laser surgery. The optometrist's scope of practice includes:
- Checking for depth and color perception
- Evaluating the patient's ability to focus and coordinate eyes
- Prescribing corrective eyeglasses, contacts, vision therapy, and low-vision aids.
Although optometrists might be more limited than ophthalmologists in the type of treatment they provide, their practice structures are as varied and complex. Most of the thirty-seven thousand optometrists in the United States are in private practice, although an increasing number are being employed by the large superstores that offer quick turnaround and one-stop shopping for examinations and lenses. Other practice settings include:
- Group practice
- Multidisciplinary physician teams
- Private, group, or partnership practices in specialized hospitals and eye clinics
- Armed forces (There are now about five hundred commissioned officers.)
- Consultants to engineers specializing in improving work environments
- Multidisciplinary teams working with patients who are learning disabled
- Health advisory committees of federal, state, and local Governments
Optometrists, like ophthalmologists, may choose to limit their practice to a specialty that focuses on a particular patient population or type of care.
Low Vision
Low vision optometrists work in conjunction with ophthalmologists, social workers, and government and private agencies to provide vision aids to people who cannot see with conventional eyeglasses or contact lenses. The optometrist's role on this team is to design optical devices, such as laser canes and various types of magnifiers and illuminators.O.D.s design adaptive devices that improve the quality of life for low-vision clients by making it possible for them to work, go to school, and enjoy leisure activities like watching television.
Pediatric Optometry
Pediatric optometry is a popular specialty. It is estimated that 20 percent of the children between the ages of five tontine and over 30 percent of the children from fifteen to nineteen have vision problems. Myopia, amblyopic, and strabismus are common conditions that afflict children. Pediatric O.D.s is trained to work with a child and his or her parents to correct these conditions through training and therapy. The optometrist often utilizes advanced techniques in biofeedback and nutrition counseling to ensure that children receive optimal care and to overcome the problems that interfere with therapy compliance. Recently, pediatric optometrists have been working with the babies of addictive parents. Vision deficits are a common birth defect among this population.
Geriatric Optometry
On the other end of the age spectrum is geriatric optometry. Many of these specialists spend all or part of their time working in nursing and retirement homes. Almost all of the elderly have vision problems. An optometrist who has chosen to work with this population must be well acquainted with the ocular manifestations of age-related diseases, such as eye problems caused by diabetes. Since many elderly people take a variety of prescription drugs, the geriatric optometrist also must be an expert on how to detect the ocular side effects of a patient's medications. He or she must know how-to screen for eye diseases like glaucoma and cataracts that are more prevalent among the elderly and require timely intervention by an ophthalmologist. Optometrists frequently work with ophthalmologists to provide postoperative monitoring and care after procedures like cataract extractions. Many nursing and retirement homes have wellness centers that are specially equipped for the visiting optometrist. In some areas, the optometrist has equipped a van as a mobile unit. This enables the optometrist to offer complete care wherever he or she goes. Good optometric care is an important factor in pro- viding the best quality of life for older people, who now expect to be active well into their retirement years.
Contact Lenses
With more than fourteen million people wearing contact lenses, some optometrists have limited their practices to fitting contact lenses. The popularity of extended wear and tinted lenses has significantly increased the demand for optometrists who specialize in this field. In addition to regular contact lenses, optometrists are trained to design very specialized lenses. Orthokeratology is the practice of using series of progressively flatter contact lenses to gradually reshape the cornea and reduce myopia. Some optometrists choose the subspecialty of pediatric contact lenses. Teaching children to insert and care for their lenses is a special talent that these optometrists have mastered in addition to the complexity of fitting young patients. Contact lens specialists, because they have seen more patients with particular types of complications, are experts on the infections, irritations, and other problems related to wearing contact lenses. They are often hired as consultants to the lens manufacturing industry to assist in the design of more comfortable and problem-free products.
Developmental Vision
One of the less-well-known, yet fascinating, branches of optometry is developmental vision. This is the study of how eyesight is related to human behavior. Optometrists who specialize in this field frequently work with pediatricians, child psychologists, educators, and social workers to diagnose and treat learning disorders like dyslexia. Optometrists use their special training in eye-hand and other vision related sensory-motor coordination to guide young patients into a lifestyle that enables them to succeed at school and participate in sports and the other activities enjoyed by their peers. Developmental vision specialists frequently work with strabismus and amblyopic patients to help these patients overcome their vision problems. The relationship that evolves between the developmental optometrist, the patient, and other members of the interdisciplinary treatment team is very rewarding.
