Role of Ophthalmology and the Ophthalmologist

Policy:

The ophthalmologist's principal responsibility and obligation is to deliver quality eye care in an ethical and humanistic fashion. As a medically trained physician, the ophthalmologist is the only health care provider specifically trained and educated to utilize fully the science and art of medicine to provide comprehensive medical and surgical eye care to patients.

Background:

Ophthalmology is the branch of medical science concerned with the etiology, diagnosis, and treatment of disorders related to the eye, orbit, and visual system. Ophthalmologists have been on the leading edge of progress in diagnostic medicine, and they have developed some of the most effective medical and surgical treatments. With the formation of the American Board of Ophthalmology in 1916, ophthalmologists pioneered the certification process for postgraduate specialty training throughout the world. More recently, ophthalmologists developed the first and only code of ethics in American medicine approved by the Federal Trade Commission. In many ways, ophthalmology has demonstrated itself to be one of the more progressive specialties in medicine.

The practice of ophthalmology has historically encompassed all aspects of visual function in health and disease, including refraction, orthoptics, binocular vision, and strabismus, as well as medical and surgical treatment of diseases involving the eye, structures around the eye, and the visual pathways. The practice of ophthalmology provides patients with total eye care. This includes disease prevention; refractive and optical services; diagnosis and management of eye disease; plus medical, surgical, and rehabilitative services.

Although nonmedical optometric practitioners (optometrists) may provide vision care services, only ophthalmologists are trained, certified and regulated within the field of medicine to diagnose and manage all eye disease. Actions taken by the optometry lobby to support expansion of the optometric scope of practice has increased public confusion about the difference between ophthalmology and optometry. Optometrists are nonmedical practitioners, variably "certified" by optometric boards, who train and practice independent of traditional medical supervision and regulation. Moreover, they are often privileged by their respective boards to be called "optometric physicians," which further confuses the public about the difference between a medical doctor and an optometrist. A survey undertaken by the National Consumers League and released in November 2005, confirmed that many consumers, including those seeking eye care, are uncertain about the differences among various eye care providers, the services they perform, and the training and education they must complete.

Evaluation:

For the protection of the American public, a clearer distinction should be made between ophthalmologists and optometrists. The ophthalmologist is the eye care provider entrusted with the entire spectrum of comprehensive, refractive, medical, and surgical eye care. The delivery of ophthalmic services by a nonphysician practitioner is limited and does not provide the patient with the benefits of the ophthalmologist's specialized medical expertise. On the other hand, an ophthalmologist-led eye care team that incorporates optometrists and other nonmedical personnel in a cohesive unit is appropriate as a means of enhancing the quality and timeliness of comprehensive medical services.

Recommendation:

Incomplete, limited, and nonmedical eye care may be hazardous to the health and vision of individuals with eye disease or other eye conditions that require medical or surgical care. Professionals who provide health care, administrators of health services, and those who regulate medical care have an obligation to inform the public of the qualifications and limitations of those who deliver their eye care.

©2011 American Academy of Ophthalmology®
P.O. Box 7424 / San Francisco, CA 94102 / 415.561.8500