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Optometry

Optometrist symbol; it is a caduceus with an eye at the top.
Occupation
Names	Optometrist Doctor of Optometry Ophthalmic Optician
Occupation type	Specialty
Activity sectors	Healthcare
Description
Competencies	Ocular disease, medical therapeutics, vision therapy, binocular vision, spectacles, contact lenses
Education required	BSc (Hons) Optometry/ Bachelor of Optometry/ Master of Optometry/ Doctor of Optometry
Fields of employment	Hospital, Clinic, Laboratory
Related jobs	Dispensing Optician, Ophthalmologist

Optometry is a health care profession which involves examining the eyes and applicable visual systems for defects or abnormalities as well as the medical diagnosis and management of eye disease. Traditionally, the field of optometry began with the primary focus of correcting refractive error through the use of spectacles. Modern day optometry, however, has evolved through time so that the educational curriculum additionally includes intensive medical training in the diagnosis and management of ocular disease in countries where the profession is established and regulated.

Optometrists (also known as Doctors of Optometry in the United States and Canada for those holding the O.D. degree^[1], or Ophthalmic Opticians in the United Kingdom^{[2][3][4][5][6][7]}) are health care professionals who provide primary eyecare through comprehensive eye examinations to detect and treat various visual abnormalities and eye diseases. Being a regulated profession, an optometrist's scope of practice may differ depending on the location. Thus, disorders or diseases detected outside the treatment scope of optometry are referred out to relevant medical professionals for proper care, more commonly to ophthalmologists who are physicians that specialize in tertiary medical and surgical care of the eye. Optometrists typically work closely together with other eye care professionals such as ophthalmologists and opticians to deliver quality and efficient eyecare to the general public.

The term "optometry" comes from the Greek words ὄψις (opsis; "view") and μέτρον (metron; "something used to measure", "measure", "rule"). The word entered the language when the instrument for measuring vision was called an optometer, (before the terms phoropter or refractor were used). The root word opto is a shortened form derived from the Greek word ophthalmos meaning, "eye." Like most healthcare professions, the education and certification of optometrists is regulated in most countries. Optometric professionals and optometry-related organizations interact with governmental agencies, other healthcare professionals, and the community to deliver eye- and vision-care.

Definition of optometry and optometrist

An optometrist examining the eyes of a patient with a slit lamp biomicroscope

The World Council of Optometry, World Health Organization and about 75 optometry organisations from over 40 countries all over the world adopted the following definition, to be used to describe optometry and optometrist.^[8]

Optometry is a healthcare profession that is autonomous, educated, and regulated (licensed/registered), and optometrists are the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes refraction and dispensing, detection/diagnosis and management of disease in the eye, and the rehabilitation of conditions of the visual system.^[9]

History

Page 423 from "A treatise on the eye, the manner and phaenomena of vision" by William Porterfield, Published 1759 in Edinburgh. In this book the word "optometer" appears for the first time.

Optometric history is tied to the development of

• 
  vision science (related areas of medicine, microbiology, neurology, physiology, psychology, etc.)


• optics, optical aids
  


• 
  optical instruments, imaging techniques


• other eye care professions
  

The history of optometry can be traced back to the early studies on optics and image formation by the eye. The origins of optometric science (optics, as taught in a basic physics class) date back a few thousand years BC as evidence of the existence of lenses for decoration has been found in Greece and the Netherlands.^{[citation needed]}

It is unknown when the first spectacles were made. The British scientist and historian Sir Joseph Needham, in his Science and Civilization in China, discusses the occasional claim that spectacles were invented in China. He states that the belief may have been based on a source that was modified during the Ming dynasty (14th - 17th century), that the original document made no references to eyeglasses, and that the references that were there^[which?] stated the eyeglasses were imported.^[10]

Alternatively, research by David A. Goss in the United States shows they may have originated independently in the late 13th century in Italy as stated in a manuscript from 1305 where a monk from Pisa named Rivalto stated "It is not yet 20 years since there was discovered the art of making eyeglasses".^[11] Spectacles were manufactured in Italy, Germany, and the Netherlands by 1300.

In 1907, Professor Berthold Laufer, who was a German American anthropologist, stated in his history of spectacles 'the opinion that spectacles originated in India is of the greatest probability and that spectacles must have been known in India earlier than in Europe'.^[12][13]

In Sri Lanka It is well documented that during the reign of King Bhuvanekabahu the IV (AD 1346 – 1353) of the Gampola period the ancient tradition of optical lens making with natural stone called Diyatarippu was given royal patronage. A few of the craftsman still live and practice in the original hamlet given to the exponents of the craft by royal decree even today.

But Joseph Needham stated in his "Science and Civilization" that the paper by Laufer had many inconsistencies, and that the references in the document used by Laufer were not in the original copies but added during the Ming dynasty.^[14]

However, the German word brille (eyeglasses) is derived from Sanskrit vaidurya.^[15] Etymologically, brille is derived from beryl, Latin beryllus, from Greek beryllos, from Prakrit verulia, veluriya, from Sanskrit vaidurya, of Dravidian origin from the city of Velur (modern Belur). Medieval Latin berillus was also applied to eyeglasses, hence German brille, from Middle High German berille, and French besicles (plural) spectacles, altered from old French bericle.^[16]

Benito Daza de Valdes published the first full book on optometry in 1623, where he mentioned the use and fitting of eyeglasses.^[17] In 1692, William Molyneux wrote a book on optics and lenses where he stated his ideas on myopia and problems related to close-up vision. The scientists Claudius Ptolemy and Johannes Kepler also contributed to the creation of optometry. Kepler discovered how the retina in the eye creates vision. From 1773 until around 1829, Thomas Young discovered the disability of astigmatism and it was George Biddell Airy who designed glasses to correct that problem that included spherocylindrical lens.^[18]

Although the term optometry appeared in the 1759 book A Treatise on the Eye: The Manner and Phenomena of Vision by Scottish physician William Porterfield, it was not until the early twentieth century in the United States and Australia that it began to be used to describe the profession. By the early twenty-first century however, marking the distinction with dispensing opticians, it had become the internationally accepted term.

Training, licensing, representation and scope of practice

Optometry is officially recognized in many jurisdictions.^[19] Most have regulations concerning education and practice. Optometrists, like many other healthcare professionals, are required to participate in ongoing continuing education courses to stay current on the latest standards of care. The World Council of Optometry has a web resource that provides basic information on eye care providers for more than 46 countries.

Africa

In 1993 there were five countries in Africa with optometric teaching institutes: Sudan, Ghana, Nigeria, South Africa and Tanzania.^[20]

Sudan

Faculty of optometry and visual sciences

Established in 1954 as institute of optometry in Khartoum eye hospital.
Joined ministry of Higher Education in 1986 as the High Institute of Optometry, and lastly was annexed to Alneelain University in 1997 when it was re- named to become Faculty of Optometry and Visual Sciences (FOVS).

Currently FOVS has the following programs:

1- BSc optometry in 5 years with sub- specialization in either orthoptics, contact lenses, ocular photography or ocular neurology.
2- BCs in ophthalmic technology in 4 years.
3- BCs in optical dispensary in 4 years.

FOVS also offers MSc and PhD degrees in Optometry.

FOVS is the only of its kind in Sudan and is the first in Middle East and Africa. There is similar colleges in only 30 out of 193 countries in the world.

In 2010, Alneelain University Eye Hospital was established as part of FOVS to expand training capacity and to serve community.

Ghana

The Ghana Optometric Association (GOA) regulates the practise of Optometry in Ghana. After the six-year training at any of the two universities offering the course, the O.D degree is awarded. The new optometrist must write a qualifying exam, after which the optometrist is admitted as a member of the GOA, leading to the award of the title MGOA.

Mozambique

The first optometry course in Mozambique was started in 2009 at Universidade Lurio, Nampula. The course is part of the Mozambique Eyecare Project. University of Ulster, Dublin Institute of Technology and Brien Holden Vision Institute are supporting partners.

Nigeria

In Nigeria, optometry is regulated by the Optometry and Dispensing Opticians Registration Board of Nigeria established under the Optometry and Dispensing Opticians ( Registration ETC ) Act of 1989 (Cap O9 Laws of Federation of Nigeria 2004). The Boards publishes from time to time lists of approved qualifications and training institutions in the federal government gazette.^[21] The Doctor of Optometry degree is awarded after a six-year training at one of the accredited universities in Imo, Edo and Abia states.

Asia

Bangladesh

From 2010 Optometry was first introduced in Bangladesh in Institute of Community Ophthalmology Under Medicine Faculty of University of Chittagong http://icoedu.org. This institute offers a four years Bachelor of science in Optometry (B.Optom) course. Currently there are 60 Graduated Optometrists in Bangladesh. The association which controls the quality of Optometry practice all over the country is named as 'Optometrists Association of Bangladesh' which is also a country member of World Council of Optometry(WCO).

In the year 2018 Chittagong Medical University formed and the Bsc. in Optometry course shifted to this University.

In Bangladesh Optometrists perform primary eye care like Diagnosis and primary management of some ocular diseases, Prescribe Eye Glasses, Low vision rehabilitation, contact lens practice and all type of Orthoptic evaluations and management.

Hong Kong

The Optometrists Board of the Supplementary Medical Professions Council regulates the profession in Hong Kong.^[22] Optometrists are listed in separate parts of the register based on their training and ability. Registrants are subject to restrictions depending on the part they are listed in.^[23] Those who pass the examination on refraction conducted by the Board may be registered to Part III, thereby restricted to practice only work related to refraction. Those who have a Higher Certificate in Optometry or have passed the Board's optometry examination may be registered to Part II, thereby restricted in their use of diagnostic agents, but may otherwise practice freely. Part I optometrists may practice without restrictions and generally hold a Bachelor degree or a Professional Diploma.^[24]

There are around 2000 optometrists registered in Hong Kong, 1000 of which are Part I.^[25] There is one Part I optometrist to about 8000 members of the public. The Polytechnic University runs the only optometry school. It produces around 35 Part I optometrists a year.^[26]

India

In 2010, it was estimated that India needs 115,000 optometrists; whereas India has approximately 9,000 optometrists (4-year trained) and 40,000 optometrists (2-year trained).^[27] In order to prevent blindness or visual impairment more well trained optometrists are required in India.^[28] It should be noted that definition of optometry differs considerably in different countries of the world.^[29] India needs more optometry schools offering four-year degree courses with a syllabus similar to that in force in those countries where practice of optometry is statutorily regulated and well established with an internationally accepted definition.

In 2013, it was reported in the Indian Journal of Ophthalmology that poor spectacle compliance amongst school children in rural Pune resulted in significant vision loss.^[30]

In 2015, it was reported in the Optometry and Vision Science that, optometrists need to be more involved in providing core optometry services like binocular vision and low vision.^[31]

Training in India

At present there are more than fifty schools of optometry in India. In the year 1958, two schools of optometry were established, one at Gandhi Eye Hospital, Aligarh in Uttar Pradesh and other one at Sarojini Devi Eye Hospital, Hyderabad in Telangana, under second five-year plan by Director General of Health Services of Government of India. These schools offered diplomas in optometry courses of two years duration validated by State Medical Faculties.

Subsequently, four more schools were opened across India situated at Sitapur Eye Hospital, Sitapur in Uttar Pradesh, Chennai (formerly Madras) in Tamil Nadu, Bengalooru (formerly Bangalore) in Karnataka and Regional Institute of Ophthalmology, Thiruvananthapuram (formerly Trivandrum) in Kerala.^[32]

The Elite School of Optometry (ESO) was established in 1985 at Chennai and was the first to offer a four-year degree course.

Academic degrees such as Bachelor of Optometry, Master of Optometry and Doctor of Philosophy in Optometry are awarded in India by the universities recognised by University Grants Commission (India),^[33] a statutory body responsible for the maintenance of standards of higher education in India.

Optometrists across India are encouraged to register with the Optometry Council of India, a self-regulatory body registered under the Indian Company Act.^[34]

Malaysia

It takes four years to complete a Degree in Optometry. Today, optometry courses are well received by citizens. More universities and higher education studies are about to implement the courses, e.g., National Institute of Ophthalmic Sciences in Petaling Jaya whereby it is the academic arm of The Tun Hussein Onn National Eye Hospital.

Pakistan

Optometry is taught as a five/four-year Doctor/ Bachelors/ Bachelors with Honors course at many institutions notable among which are Department of Optometry & Vision Sciences (DOVS) FAHS, ICBS, Lahore, Pakistan Institute of Community Ophthalmology (PICO) Peshawar, College of Ophthalmology & Allied Vision Sciences (COAVS) Lahore and Al-Shifa Institute of Ophthalmology Islamabad. After graduation the optometrists can join a four-tiered service delivery level (Centre of Excellence, Tertiary/Teaching, District headquarter and sub-district /Tehsil headquarters). M.Phil in Optometry is also available at select institutions such as King Edward Medical University, Lahore
Department of Optometry & Vision Sciences (DOVS) FAHS, ICBS, Lahore started bridging programmes for Bachelors/ Bachelors with Honors to become Doctor of Optometry OD, Post Professional Doctor of Optometry(PP-OD), Transitional Doctor of Optometry(t-OD).
Optometry is not yet a regulated field in Pakistan as there is no professional licensing board or authority responsible for issuing practice licenses to qualified optometrists. This creates difficulty for Pakistani optometrists who wish to register abroad.
University of Lahore has recently launched Doctor of optometry (OD).
Imam Hussain Medical University also has launched Doctor of Optometry Program, Chairman Imam Hussain medical university Dr Sabir Hussain has vowed to regulate OD curriculum according to international standard.

Philippines

Optometry is regulated by the Professional Regulation Commission of the Philippines. To be eligible for licensing, each candidate must have satisfactorily completed a doctor of optometry course at an accredited institution and demonstrate good moral character with no previous record of professional misconduct. Professional organizations of optometry in the Philippines include Optometric Association of the Philippines^[35] and Integrated Philippine Association of Optometrists, Inc. (IPAO).

Saudi Arabia

In Saudi Arabia optometrists must complete a five-year doctor of optometry degree from Qassim University and King Saud University also they must complete a two residency .

Singapore

Tertiary education for optometrists takes 3 years at the following institutions.

Singapore Polytechnic - Diploma in Optometry Singapore Polytechnic

Ngee Ann Polytechnic - Diploma in Optometry Ngee Ann Polytechnic

Thailand

Since late 1990, Thailand has set goal to provide more than 600 optometrists to meet the minimal public demands and international standards in vision cares. There are more than three university degree programs in Thailand. Each program accept students that have completed grade 12th or the third year in high school (following US education model). These programs offer "Doctor of Optometry" degree to graduates from the program that will take six years to complete the courses. Practicing optometrists will also required to pass licensing examination (three parts examinations) that is administrated through a committee under the Ministry of Public Health.

Nowadays, the number of practicing optometrists in Thailand is still less than one hundred (2015). However, it has projected that the number of practicing optometrists in Thailand will greatly increase within the next ten years. In theoretical scenario, the number of optometrists should be able to meet minimal public demands around 2030 or earlier.

Europe

Since the formation of the European Union, "there exists a strong movement, headed by the Association of European Schools and Colleges of Optometry (AESCO), to unify the profession by creating a European-wide examination for optometry" and presumably also standardized practice and education guidelines within EU countries.^[36] The first examinations of the new European Diploma in Optometry were held in 1998 and this was a landmark event for optometry in continental Europe.^[37]

France

There is no regulatory framework and optometrists are sometimes trained by completing an apprenticeship at an ophthalmologists' private office.^[38]

Germany

Optometric tasks are performed by ophthalmologists and professionally trained and certified opticians.

Greece

Hellenic Ministry of Education founded the first department of Optometry at Technological Educational Institute of Patras in 2007. After protests from the department of Optics at Technological Educational Institute of Athens (the only department of Optics in Greece, until 2006), the Government changed the names of the departments to "Optics and Optometry" and included lessons in both optics and optometry. Optometrists-Opticians have to complete a 4-year undergraduate honours degree. Then the graduates can be admitted to postgraduate courses in Optometry at universities around the world.

Since 2015, a Master of Science (MSc) course in Optometry is offered by the Technological Educational Institute of Athens.

The Institute of Vision and Optics (IVO) of the University of Crete focuses on the sciences of vision and is active in the fields of research, training, technology development and provision of medical services. Professor Ioannis Pallikaris has received numerous awards and recognitions for the Institute’s contribution to ophthalmology. In 1989 he performed the first LASIK procedure on a human eye.

Hungary

Optometrist education takes 4 years in the medical universities in Hungary, and they will get a Bachelor of Science degree. They work in networks and retail stores and private optics, very few are located in the Health Care care system as ophthalmologists as an assistant.^[39]

Ireland

The profession of Optometry has been represented for over a century by the Association of Optometrists, Ireland [AOI]. In Ireland an optometrist must first complete a four-year degree in optometry at Dublin Institute of Technology. Following successful completion of the degree, an optometrist must then complete professional qualifying examinations to enter the register of the Opticians Board [Bord na Radharcmhaistoiri]. Optometrists must be registered with the Board to practice in the Republic of Ireland.

The A.O.I. runs a comprehensive continuing education and professional development program on behalf of Irish optometrists. The legislation governing optometry was drafted in 1956. Some feel that the legislation restricts optometrists from using their full range of skills, training and equipment for the benefit of the Irish public. The amendment to the Act in 2003 addressed one of the most significant restrictions: the use of cycloplegic drugs to examine children.

Italy

In Italy Optometry is unregulated profession. It is taught at seven universities: Padua, Turin, Milan, Salento,^[40] Florence, Naples and Rome, as three years course (like a BSc) of "Scienze e tecnologie fisiche" as sector of the Physics Department. Additionally, courses are available at some private institutions (as at Vinci Institute near Firenze) that offer advanced professional education for already qualified opticians (most of the Italian optometrists are also qualified opticians, i.e. "ottico abilitato"). In the last thirty years several verdicts from High Court (Cassazione) proof that optometry is a freely practice and has truly education path.^[41]

Norway

In Norway, the optometric profession has been regulated as a healthcare profession since 1988. After a three-year bachelor program one can practice basic optometry. At least one year in clinical practice qualify for a post-degree half-year sandwich course in contact lens fitting, which is regulated as a healthcare specialty. A separate regulation for the use of diagnostic drugs in optometric practice was introduced in 2004.

Russia

In Russia, optometry education has been accredited by the Federal Agency of Health and Social Development.^{[citation needed]}
There are only two educational institutions that teach optometry in Russia: Saint Petersburg Medical Technical College, formerly known as St. Petersburg College of Medical Electronics and Optics, and The Helmholtz Research Institute for Eye Diseases. They both belong and are regulated by the Ministry of Health. The optometry program is a four-year program. It includes one to two science foundation years, one year focused on clinical and proficiency skills, and one year of clinical rotations in hospitals. Graduates take college/state examinations and then receive a specialist diploma. This diploma is valid for only five years and must be renewed every five years after receiving additional training at state accredited programs.

The scope of practice for optometrists in Russia includes: refraction, contact lens fitting, spectacles construction and lens fitting (dispensing), low vision aids, foreign body removal, referrals to other specialists after clinical condition diagnoses (management of diseases in the eye).

United Kingdom

Licensing

Optometrists in the United Kingdom (also known as Ophthalmic Opticians) are regulated by the General Optical Council under the Opticians Act 1989 and distinguished from medical practitioners.^[3] Registration with the GOC is mandatory to practice optometry in the UK. Members of the College of Optometrists (incorporated by a Royal Charter granted by Her Majesty Queen Elizabeth II)^[42] may use the suffix MCOptom.

Licensing

Optometrists in the United Kingdom (also known as Ophthalmic Opticians) are regulated by the General Optical Council under the Opticians Act 1989 and distinguished from medical practitioners.^[3] Registration with the GOC is mandatory to practice optometry in the UK. Members of the College of Optometrists (incorporated by a Royal Charter granted by Her Majesty Queen Elizabeth II)^[43] may use the suffix MCOptom.

The National Health Service provides free sight tests and spectacle vouchers for children and those on very low incomes. The elderly and those with some chronic conditions like diabetes get free periodic tests.^[44] Treatment for eye conditions such as glaucoma and cataracts is free and checked for during normal eye examinations.

Training

In the United Kingdom, optometrists have to complete a 3 or 4 (Scotland) year undergraduate honours degree followed by a minimum of a one-year "pre-registration period", (internship), where they complete clinical practice under the supervision of a qualified and experienced practitioner. During this year the pre-registration candidate is given a number of quarterly assessments, often including temporary posting at a hospital, and on successfully passing all of these assessments, a final one-day set of examinations (details correct for candidates from 2006 onwards). Following successful completion of these assessments and having completed one year's supervised practice, the candidate is eligible to register as an optometrist with the General Optical Council (GOC) and, should they so wish, are entitled to membership of the College of Optometrists. Twelve universities offer Optometry in the UK: Anglia Ruskin, Aston, Bradford, Cardiff, City, Glasgow Caledonian, Hertfordshire, Manchester, University of Plymouth, Ulster University at Coleraine, University of Portsmouth and University of the West of England, Bristol.

Additionally, in 2008 the Institute of Optometry in London established a post-graduate professional doctorate in optometry in partnership with London South Bank University.^[45][46] Also from 2008 Aston University has offered courses leading to a post-graduate professional doctorate in optometry.

Scope of Practice

In 1990, a survey of the opinions of British medical practitioners regarding the services provided by British optometrists was carried out by Agarwal^[47] at City, University of London. A majority of respondents were in favour of optometrists extending their professional role by treating external eye conditions and prescribing broad spectrum topical antibiotics through additional training and certification.

Since 2009, optometrists in the UK have been able to undertake additional postgraduate training and qualifications that allow them to prescribe medications to treat and manage eye conditions.^[48] There are currently three registerable specialties:

• 
  Additional supply specialty - to write orders for, and supply in an emergency, a range of drugs in addition to those ordered or supplied by a normal optometrist.


• 
  Supplementary prescribing specialty - to manage a patient’s clinical condition and prescribe medicines according to a clinical management plan set up in conjunction with an independent prescriber, such as a GP or ophthalmologist or qualified optometrist.


• 
  Independent prescribing specialty - to take responsibility for the clinical assessment of a patient, establish a diagnosis and determine the clinical management required, including prescribing where necessary.^[49]
  

North America

Canada

Training

In Canada, Doctors of Optometry (O.D.) typically complete four years of undergraduate studies followed by four to five years of optometry studies, accredited by the Accreditation Council on Optometric Education. There are two such schools of optometry located in Canada — the University of Waterloo and the Université de Montreal. Canada also recognizes degrees from the twenty US schools.

Licensing

In Canada, Doctors of Optometry must write national written and practical board exams. Additionally, optometrists are required to become licensed in the province in which they wish to practice. Regulatory of professions is within provincial jurisdiction. Therefore, regulation of optometry is unique to individual provinces and territories. In Ontario, optometrists are licensed by the College of Optometrists of Ontario.

Representation

In Canada, the profession is represented by the Canadian Association of Optometrists. In the province of Ontario, the Ontario Association of Optometrists is the designated representative of optometrists to the provincial government.

Scope of Practice

Optometrists in Canada are trained and licensed to be primary eye care providers. They provide optical and medical eye care. They are able to diagnose and treat most eye diseases and can prescribe both topical and oral medications^[50]

United States

Doctors of Optometry (O.D.) (optometric physicians / optometrists) function as primary eye care providers. The scope of optometry has expanded in modern times and significantly overlaps with general ophthalmology, the branch of medicine involving the health of the eyes and visual system. Optometrists in the US are trained and licensed to diagnose and manage all common eye diseases. They can prescribe all topical medications (prescription eye drops) and most oral medications (tablets/capsules by mouth), as well as administer diagnostic agents.^[51][52][53] In some states, Optometrists may also be licensed to perform certain types of eye surgery ^[54].

Scope of Practice

Doctors of Optometry (O.D.) (optometric physicians / optometrists) function as primary eye care providers, providing both comprehensive optical and medical eye care. They can prescribe corrective lenses (glasses and contacts) to aid optical abnormalities (e.g., myopia, hyperopia, presbyopia, astigmatism). They also manage vision development in children including amblyopia diagnosis and treatment. Moreover, Optometrists are trained and licensed to diagnose all forms of eye disease and provide medical treatment (e.g., infections, inflammation, glaucoma, macular degeneration, diabetic retinopathy, corneal/retinal abnormalities, uveitis, etc.). They can write prescriptions for all topical medications (eye drops) and most medications taken by mouth (e.g., antibiotics, anti-inflammatory, anti-viral, allergy, pain). Optometrists may also order lab tests including: bacterial cultures, blood work, MRI, CT, ultrasound etc. When patients exhibit an advanced form of disease or require surgery, optometrists may refer to specialists (ophthalmologists with fellowship in particular area). Optometrists many also provide pre/post operative surgical care, however, optometrists are not trained to perform invasive surgery.

Ophthalmologists are Medical/Osteopathic Doctors (MD/DO) who specialize in the eye. They provide comprehensive medical and surgical eye care. While ophthalmologists can prescribe corrective lenses, they are primarily trained to manage complicated eye diseases, many involving surgery. Often, ophthalmologists choose to specialize in a particular area of the eye, such as the retina or cornea.

In Oklahoma and Louisiana, the state optometry board also allows state-certified optometrists to perform surgeries limited to the anterior segment of the eye. In Kentucky, recent legislation permits optometrists to perform a multitude of laser procedures.

Regulation

Doctors of optometry in the United States are regulated by state boards, which vary from state to state.
The Association of Regulatory Boards of Optometry (ARBO) assists these state board licensing agencies in regulating the practice of optometry.

Licensing

Optometrists must complete all course work and graduate from an accredited College of Optometry. This includes passage of all parts of the national board examinations as well as local jurisprudence examinations, which vary by state.

Education and Training

Doctors of Optometry (O.D.) (Optometric physician / Optometrist) typically complete four years of undergraduate studies followed by four years of Optometry school plus an optional year of study in a specialty area (residency). The program includes intense classroom and clinical training in geometric, physical, physiological and ophthalmic optics, specialty contact lens evaluation and fitting, general anatomy, ocular anatomy, ocular disease, pharmacology, ocular pharmacology, neuroanatomy and neurophysiology of the visual system, pediatric visual development, gerontology, binocular vision, color vision, form, space, movement and vision perception, systemic disease, histology, microbiology, sensory and perceptual psychology, biochemistry, statistics and epidemiology.

Moreover, modern day optometry exhibits significant overlap with general ophthalmology. In Optometry school, students receive extensive ophthalmology training (branch of medicine involving the eye and related structures). Students are trained to diagnose and manage all common eye diseases and ocular emergencies. Students are also educated on all systemic diseases that may cause eye disease, or eye disease indicative of systemic disease. Classes are taught by O.D's, M.D's and various Ph.D's. Optometry students often take five to six classes per quarter as well as complete clinical shifts in their first three years. The fourth year of Optometry school is 100% clinical where students must complete internships in various settings such as hospitals, universities and private clinics. In many internships, optometry students work with ophthalmology residents to co-manage medical cases and also observe surgery, however, optometrists are not trained to perform invasive surgery like ophthalmologists are.

Admission to Optometry school is very competitive. Applicants must take the Optometry Admission Test (OAT) and have excellent undergraduate grades to apply. To graduate, candidates must pass all three parts of the National Board of Examiners of Optometry (NBEO). Part 1 NBEO is a two day written exam. Part 2 is a computer based exam, takes all day and based on clinical studies including the treatment and management of ocular disease. Part three is a practical exam that must be taken in person in North Carolina. Once a candidate has successfully completed all applicable coursework, clinical rotations, passed all parts of NBEO exams, and satisfied all financial obligations ($225,000 USD), a Doctor of Optometry degree will be conferred.

Ophthalmologists are Medical/Osteopathic Doctors (MD/DO) who specialize in the eye. They provide comprehensive medical and surgical eye care. Ophthalmologists complete four years of undergraduate studies, four years of medical school, three years of ophthalmology training (residency), and optional year (or two) of specialty training (fellowship). While ophthalmologists can prescribe corrective lenses, they are primarily trained to manage complicated eye diseases, many of which involving surgery. Many ophthalmologists choose to become specialists and specialize in a particular area of the eye (e.g., retina, cornea, etc.).

All O.D.'s and M.D.'s are required to complete continuing education to maintain licensure.

Oceania

Australia

Australia currently has five recognized courses in optometry, and one course seeking to obtain accreditation with the Optometry council of Australia and New Zealand :

• Bachelor of Vision Science and Master of Optometry (BVisSci MOptom), Deakin University
  


• Bachelor of Medical Science (Vision Science) and Master of Optometry, Flinders University
  


• Bachelor of Vision Science and Master of Clinical Optometry (BVisSc MClinOptom), University of New South Wales
  


• Bachelor of Vision Science and Master of Optometry, Queensland University of Technology
  


• Doctor of Optometry, Melbourne University (post-graduate)


• Bachelor of Vision Science and Master of Optometry, University of Canberra (Seeking accreditation)^[55]
  

To support these courses the Australian College of Optometry provides clinical placements to undergraduate students from Australian Universities and abroad.

in 2016, almost 5000 optometrists in general practice were licensed with their regulatory body, the Optometry Board of Australia. Of these, approximately 2300 were registered with the scheduled medicines endorsement, which enables them to prescribe some medicines for the treatment of conditions of the eye.^[56]

New Zealand

New Zealand currently has one recognised course in optometry:

• Bachelor of Optometry (BOptom), The University of Auckland
  

In July 2014, the Medicines Amendment Act 2013 and Misuse of Drugs Amendment Regulations 2014 came into effect. Among other things, the changes to the Act name optometrists as authorised prescribers. This change enables optometrists with a therapeutic pharmaceutical agent (TPA) endorsement to prescribe all medicines appropriate to their scope of practice, rather than limiting them to a list of medicines specified in regulation; this recognises the safe and appropriate prescribing practice of optometrists over the previous nine years.^[57]

South America

Brazil

The Brazilian Government does not state rules about optometry, and the Brazilian Council of Ophthalmology recommends against its official legal recognition.^{[citation needed]}

The CBOO (Brazilian Council of Optics and Optometry), which is affiliated to the WCO (World Council of Optometry), represents Brazilian optometrists. In conjunction with organizations representative weight of Brazilian companies, including the National Commerce Confederation for goods, services and tourism (CNC), through the CBÓptica/CNC, its defense arm of optometric and optical industry, are defending the right of free and independent practice of optometrists, even if it is against the interests of ophthalmologists.

The Federal Supreme Court (STF), the Brazilian Court of Justice and the Superior Court of Justice (STJ), another important National Court, ruled several processes granting inquestionable victories to ophthalmologists.

In Brazilian law, however, there is an explicit recommendation that the one prescribing corrective lenses are prohibited to sell them. This restricting rule to the ophthalmologists has keeping the optic shops away from Hospitals and Eye Care Clinics since 1930, and it has to be reviewed before any further regulation for the optometrists.

Colombia

In Colombia, optometry education has been accredited by the Ministry of Health. The last official revision to the laws regarding healthcare standards in the country was issued in 1992 through the Law 30.^[58] Currently there are eight official universities that are entitled by ICFES to grant the optometrist certification. The first optometrists arrived in the country from North America and Europe circa 1914. These professionals specialized in optics and refraction. In 1933, under Decrees 449 and 1291, the Colombian Government officially set the rules for the formation of professionals in the field of optometry. In 1966 La Salle University opened its first Faculty of Optometry after recommendation from a group of professionals. At the present time optometrists are encouraged to keep up with new technologies through congresses and scholarships granted by the government or the private sector (such as Bausch & Lomb).

See also

• World Council of Optometry


• American Academy of Optometry


• Behavioral optometry


• Eyeglass prescription


• Least distance of distinct vision


• Ophthalmology


• Visual neuroscience

References

Sources

• http://www.oregonoptometry.org


• http://oaop.org/oaop


• http://idaho.aoa.org


• https://web.archive.org/web/20131021065719/http://washington.aoa.org/


• http://www.njsop.org/aws/NJSOP/pt/sp/home_page


• http://www.ijo.in/article.asp?issn=0301-4738;year=2012;volume=60;issue=5;spage=401;epage=405;aulast=De

External links

Wikimedia Commons has media related to Optometry.

• DMOZ optometry page