Defined: Ophthalmology

Ophthalmology is the branch of medicine which deals with the diseases and surgery of the visual pathways, including the eye, brain, and areas surrounding the eye, such as the lacrimal system and eyelids. The word ophthalmology comes from the Greek roots ophthalmos meaning eye and logos meaning word, thought or discourse; ophthalmology literally means "The science of eyes." As a discipline it applies to animal eyes also, since the differences from human practice are surprisingly minor and are related mainly to differences in anatomy or prevalence, not differences in disease processes. However, veterinary medicine is regulated separately in many countries and states/provinces resulting in few ophthalmologists treating both humans and animals. By convention the term ophthalmologist is more restricted and implies a medically trained specialist. Since ophthalmologists perform operations on eyes, they are generally categorized as surgeons.

Ophthalmologists are medical doctors or osteopaths who have completed medical school and embark on a training schedule that generally lasts four years after medical school in most countries. Many ophthalmologists also undergo additional specialized training in one of the many subspecialities. Ophthalmology was the first branch of medicine to offer board certification, now a standard practice among all specialties.

In the United States, four years of training after medical school are required, with the first year being an internship in surgery, internal medicine, pediatrics, or a general transition year. The scope of a physician's licensure is such that he or she need not be board certified in ophthalmology to practice as an ophthalmologist. The American Academy of Ophthalmology (AAO) promotes the use of the phrase "Eye MD" to distinguish ophthalmologists from optometrists who hold the degree OD (Doctorate in Optometry). (This, however, sometimes leads to confusion among patients, since a few ophthalmologists' primary medical degree is a D.O., or Doctor of Osteopathic Medicine, rather than an M.D. In both cases, the same residency and certification requirements must be fulfilled.) Completing the requirements of continuing medical education is mandatory for continuing licensure and re-certification. Professional bodies like AAO, ASCRS organise conferences and help members through CME programs to maintain certification, in addition to congress advocacy and peer support. There is often some confusion in the differences between ophthalmologists and optometrists.

An ophthalmologist has earned a general medical degree at medical school, and has undertaken the postgraduate medical training required of an ophthalmologist by his or her jurisdiction (see above). Ophthalmologists are thus trained to perform surgery. Optometrists are not medical doctors. Ophthalmologists treat all aspects of medical and surgical diseases of the eye, but may refer low vision patients (i.e. advanced macular degeneration) to optometrists for testing and dispensing of low vision aids (such as telescopes and magnifiers). Optometry training encompasses knowledge of optics and the visual system. While both ophthalmologists and optometrists are trained in refraction, optometrists may receive advanced training in correction of particularly challenging refractive issues (such as irregular astigmatism and hard contact lens fitting for keratoconus). In addition, optometrists are trained to diagnose and treat common nonrefractive ocular diseases, while making appropriate referrals to ophthalmologists when surgery or more advanced treatment is warranted.

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 can prescribe for the treatment of infections and glaucoma, but do not (in most states) perform laser or other forms of surgery. Organized optometry continues to lobby for legislative change in order to further broaden their field of treatment to encompass the skills that they learn during their training.