There’s a lot of confusion about the functions these three members of the eye care team provide.
Ophthalmologists and optometrists both perform eye exams, but they are very different types of providers.
Ophthalmologists are medical doctors who have completed a residency in ophthalmology after medical school and an internship in internal medicine.
They can perform surgery as well as perform more routine eye exams. Because they have far more extensive training in general medicine prior to a residency in ophthalmology they are better able to recognize, diagnose and treat systemic disease which is apparent from an eye exam. Some ophthalmologists become specialists in specific areas such as retina, cornea, oculoplastics and neuro-ophthalmology among others by completing fellowships after their general ophthalmology residencies.
You might be surprised that a thorough eye exam can indicate uncontrolled diabetes and high blood pressure as well as more even more serious disorders. such as internal bleeding.
Optometrists generally follow a different business model than ophthalmologists. Most optometrists offer eyeglasses and contacts as well as exams. A far smaller proportion of ophthalmologists dispense eyewear.
In addition, optometrists are more likely to participate in vision insurance plans..
Note that I am working on a separate post about vision insurance because I’ve found some vision providers charge far more than ophthalmologists for routine care, even when you have coverage.
Should you choose an ophthalmologist or optometrist for your exam?
I managed my former husband’s ophthalmology practice for 15 years and my inclination is to recommend ophthalmologists for eye exams especially if you are over the age of 60 and/or have underlying medical conditions because of their more extensive training and focus on science. Ophthalmologists are less likely to participate in vision plans, but you might not realize medical insurance pays for eye exams when your appointment is for a medical condition, even one as seemingly minor as dry eye or seasonal eye allergies. The refraction (measurement for glasses prescription) is generally not covered by medical insurance.
Finally, opticians help fit your glasses and order lenses using valid prescriptions from ophthalmologists. I'm a licensed dispensing optician in the State of Tennessee.
There is a wide range in who is an optician and what their qualifications are. Some states, such as Tennessee, offer licensure. But fewer than half of the states in the US even offer licensure. And, although there are some complicated rules about who can dispense glasses here in Tennessee, there is no guarantee that the person waiting on you is licensed.
So, what’s a consumer to do?
If you go to an optical shop, whether independent, one affiliated with an eye care provider or a chain, ask the person helping you what their position is. Just because someone is a licensed optician doesn’t guarantee their level of expertise, but it does generally indicate some training.
And explore some of my other posts here about specific questions to ask. You’re spending your money on a product that affects your ability to see and thus to perform important tasks such as driving and work. While you might rely on a less qualified person to help you pick a frame, ask for the highest level of expertise in choosing lenses.