There are two main types of eye doctors: ophthalmologists (MD or DO) and optometrists (OD). Confused about who does what? Here's a look at how they differ.
What Is an Ophthalmologist?
An ophthalmologist is an MD or DO who diagnoses and treats complicated eye problems.
After graduating medical school, ophthalmologists complete a one-year internship and a residency of three years. Subspecialists, such as retina specialists, train for an additional two years in a fellowship focused on, for example, retinal diseases and surgery.
They offer complete eye care services:
- Vision services, including eye exams
- Medical eye care, for conditions such as glaucoma, iritis, and chemical burns
- Surgical eye care for trauma, crossed eyes, cataracts, glaucoma, and other problems
- Diagnosis and treatment of eye conditions related to other diseases, such as diabetes or arthritis
- Plastic surgery, to raise droopy eyelids or smooth out wrinkles
In ophthalmology, there are many specialties. Each of these specialties has special skills, training, and equipment. They include:
Cornea and refractive ophthalmology. These doctors deal with issues directly affecting the cornea and vision. They operate on the cornea (transplant and repair) and on the lens (cataract and vision).
Glaucoma ophthalmology. This specialist deals specifically with the management of disorders of eye pressure and changes in the optic nerve and visual field. They typically use drops to lower eye pressure, but they also employ laser and cutting surgeries to control eye pressure. These doctors take care of both adults and children.
Retina ophthalmology. Retina specialists deal with diseases of the central retina (macula), such as macular degeneration and inherited retinal diseases. Retina specialists operate to repair retinal detachments, epiretinal membranes, and macular holes. Diseases that damage the retina and require injection therapy, such as diabetes, stroke, and macular degeneration, are treated by retina specialists.
Pediatric ophthalmology. These doctors treat eye problems in children. They can perform ophthalmic surgery on children who have crossed eyes or cataracts. They can treat retina issues that happen when babies are born early and inflammation that can cause vision loss, among other issues.
Neuro-ophthalmology. This type of doctor deals with eye issues that are caused by problems in your brain or optic nerve. Those can include drooping eyes, uncontrolled blinking, migraine, and eyelid spasms.
Ocular oncology. These are doctors who diagnose and treat cancers of the eye, the eyelid, and the eye socket.
What Is an Optometrist?
They focus on regular vision care and primary health care for your eye. After college, they spend four years in a professional program and get a Doctor of Optometry (OD) degree. But they don't go to medical school. No further training is required, though some optometrists get additional clinical training or complete specialty training after optometry school. They:
- Perform eye exams and vision tests
- Prescribe and fit eyeglasses and contact lenses
- Monitor eye conditions related to diseases such as diabetes
- Manage and treat conditions such as dry eye and glaucoma
- Provide low-vision aids and vision therapy
There are specialties among optometrists. They include:
Pediatric optometry. These providers work with babies, toddlers, and children, using special techniques to test their vision.
Neuro-optometry. If you have vision problems that result from a brain injury, this is the type of optometrist you might visit.
Low-vision optometry. Low-vision optometrists can help you if you have low vision, which means you can't see well enough to do your daily activities and your sight can't be corrected by glasses or contact lenses, medicine, or surgery. They offer devices and strategies that can improve your quality of life.
Ophthalmologist vs. Optometrist
You may see both an optometrist and an ophthalmologist for eye care. But their roles aren't the same. This chart helps explain when to see each one.
| See an optometrist (OD) for: | See an ophthalmologist (MD or DO) for: |
|---|---|
| Annual vision checkups and eye exams | Sudden vision loss or flashes of light |
| Glasses or contact lenses prescriptions | Eye injury or chemical exposure |
| Blurry vision or trouble reading | Glaucoma, cataracts, or macular degeneration |
| Routine screening | LASIK, cataract, or retinal surgery |
| Minor eye irritation or dryness | Diabetic eye disease |
| Referral to ophthalmologist if needed | Persistent eye pain, redness, or infection |
What Is an Optician?
Opticians aren't eye doctors, and they can't give eye exams. They have an optician license or certificate, and most states have no education requirements. They fill the prescription your optometrist gives you for glasses or contact lenses. They also:
- Check lens prescriptions
- Provide, adjust, and repair glasses, frames, and contact lenses
- Take facial measurements
- Help decide which type of lenses and frames will work best
- Order and check products, including contacts and eyeglass lenses
How to Choose an Eye Doctor
The right choice depends on your needs. The best eye doctor for you should be:
- Recommended by your doctor, friends, or family
- Someone you like and trust
A good rule of thumb would be:
- For primary eye care, you may wish to start with a general ophthalmologist or an optometrist. They'll refer you to a specialty ophthalmologist if needed.
- If you think you need eye surgery for cataracts, glaucoma, or another eye disease, an ophthalmologist with the appropriate specialty would be a good place to start.
- One thing to note is that complete eye exams should include drops to dilate the pupil to allow full examination of the eye and retina.
Takeaways
Ophthalmologists (MD or DO) are medical doctors who can diagnose and treat eye conditions with medicine or surgery. Optometrists (OD) focus on routine vision care, eye exams, and prescribing glasses or contacts, without attending medical school. Opticians aren't doctors; they fill prescriptions and fit glasses or contacts, but they can't perform exams. You might see an optometrist for regular care and an ophthalmologist when surgery or specialized treatment is needed.
FAQs: Optometrists and Ophthalmologists
Why does my vision insurance cover an optometrist visit and my health insurance an ophthalmologist?
Vision insurance pays for routine, non-medical eye care such as exams, glasses, contacts — the bulk of what optometrists do. Your health insurance covers diagnosing and treating actual eye diseases or conditions, which is an ophthalmologist's territory. What matters is the reason for the visit, not just which doctor you see.
Do I need an optometrist or primary care physician to see an ophthalmologist?
Generally, no. You can usually see an ophthalmologist directly without a referral, especially for something specific such as an eye injury, sudden vision changes, or a known condition such as cataracts. But your insurance plan may need a referral.
Can optometrists perform laser eye surgery or minor surgical procedures?
Yes, to a degree, but only for certain procedures and in some states.
What's the difference between an MD and a DO ophthalmologist?
They complete the same ophthalmology residency and board certification, and both are fully licensed to diagnose eye disease, prescribe medication, and perform eye surgery. The difference is their medical school training. DOs go to osteopathic medical school, and MDs go to allopathic medical school.
