Choosing The Best Eye Doctor: Part 2
In Choosing The Best Eye Doctor: Part 1, we discussed the two types of doctors who provide eye care – optometrists and ophthalmologists. Within both optometry and ophthalmology there are primary care providers and those who specialize within a certain aspect of eye care. Beyond that, certain doctor enjoy seeing certain types of patients. Different people have different visual needs and those visual needs should influence who you see for your eye care.
If you have a child with special needs, you would want to take them to a residency-trained pediatric optometrist who provides comprehensive eye exams and functional vision assessments – not a doctor who performs cataract operations on geriatric patients all day. If you see double or have prism in your glasses you would want to see an optometrist who is residency-trained in neuro-optometry. If you are considering LASIK you would want to work with a LASIK surgeon and an office who routinely performs LASIK and PRK procedures.
There are many factors that influence who you should see for your eye care. So let's discuss some of the factors you should consider when finding a good match for you.
What factors into the type of eye doctor you should see?
Whether you are nearsighted (myopia), farsighted (hyperopia), or have astigmatism, the overwhelming majority of prescriptions are well managed by optometrists. One misconception is that having a prescription means you need to see an ophthalmologist when in fact the opposite is likely true. Many people who go to an ophthalmologist have their refraction done by a technician who has no schooling in vision or eye care – that's right they have never had formal training in determining refractive error. It is far better to see an optometrist and have the prescription determined by a doctor with four years of training in vision and eye care. Determining your prescription is part of your primary eye care, which is why this is done as part of your annual eye exam with your primary eyecare provider – your optometrist.
Contact lens wear
Contact lens wearers are best managed by optometrists. Ophthalmologists are trained in medical eye care and surgery, which is why technicians with no formal schooling or training often fit contact lenses in the practice. Contact lens fitting is part of an optometrist's schooling – spherical, toric (for astigmatism), multifocal, corneal rigid gas permeable (RGP) and scleral contact lenses are all fit by optometrists. If you require a specialty contact lens, it is important that you see an optometrist who fits specialty contact lenses. Your contact lens affects not only how well (and how comfortably) you see, but also your eye health. This is why your doctor, not the technician, should fit and prescribe your contact lenses (technicians are not licensed to prescribe glasses or contacts).
Every pediatric patient should be seen by an eye doctor who has advanced training in pediatric eye care. A residency-trained pediatric optometrist should serve the role of primary eyecare provider. A residency-trained pediatric optometrist has the training and knowledge to manage vision conditions specific to the pediatric population – amblyopia, strabismus not requiring surgery, accommodative dysfunction (eye focusing), binocular vision dysfunction (eye teaming), objectively determine the prescription to prescribe glasses or contacts, manage ocular health, treat conjunctivitis (pink eye) and serve the role of primary eyecare provider. A residency-trained pediatric optometrist also serves a unique role for patients with special needs, cortical visual impairment, or who receive additional academic services (IEP/504, physical therapy, occupational therapy, or speech therapy). Residency-trained pediatric optometrists perform functional vision assessments, or specialized vision assessments, to evaluate a person's visual abilities and limitations. This allows visual modifications to be made to both the academic and home environment and provides the care team with a better understanding of the patient's visual skills. A pediatric ophthalmologist has the training and knowledge to perform surgery (such as strabismus surgery) and manage eye emergencies & complex eye diseases. Pediatric ophthalmologists can also perform annual eye exams, manage ocular health and treat conjunctivitis (pink eye).
Specific Eye Condition
If you have a specific vision or eye condition (and no astigmatism does not count), you may need to see a sub-specialist within optometry or ophthalmology. Individuals with binocular vision dysfunction (eye teaming deficits, such as convergence insufficiency) should see an optometrist who is residency-trained in binocular vision. Patients with glaucoma or macular degeneration can see either an optometrist or ophthalmologist, depending on the severity of the disease. Glaucoma suspects, for example, will often continue care with their primary care optometrist, while patients with end stage glaucoma, or those requiring glaucoma surgery, should be seen by an ophthalmologist specializing in glaucoma. Many retinal conditions (such as retinal detachments) are seen by retinal surgeons (ophthalmologists) and their optometrists in a coordinated effort. For many patients with eye conditions, they will find that they have a team of eye doctors who perform the duties of primary eye care and tertiary care.
History of acquired brain injury (stroke, traumatic brain injury, concussion)
Several changes to the visual system occur as the result of an acquired brain injury. Patients who have suffered an acquired brain injury should see an optometrist with residency-training in neuro-optometry. These optometrists have a unique skill set as they understand both the diagnosis of vision conditions specific to acquired brain injury as well as the management of these conditions – often using prism or neuro-optometric vision rehabilitation. The residency trained neuro-optometrist is a crucial part of the rehabilitation team, as early intervention for vision provides the opportunity for success with all rehabilitation activities.
The visual demands of athletes are far greater than simply reading 20/20. Competitive athletes, or those who aspire to be competitive athletes, should see a sports vision optometrist. A sports vision optometrist understands the specific visual demands of your sport and can prescribe the best glasses or contacts lenses for competition or develop a sports vision training program to improve visual and athletic performance.
Low Vision Patients
Many low vision patients require a complex care team. Often they will work with an ophthalmologist who manages their ocular disease and work with an optometrist who is residency-trained in low vision. This care team works to prevent progression of vision loss as well as provide training and adaptation for the vision loss that has already occurred. The residency-trained low vision optometrist is a crucial part of the overall care team, as they provide insight to the visual needs of the patient and prescribe the devices used during training with an occupational therapist.
Check out Part 1 for more information on optometrists and ophthalmologists.
Join us for Part 3, where we discuss a few tips on how to better-search for an eye doctor online and a few questions to ask when you are scheduling your appointment.
Posted by Artisan Optics at 4/29/2016 4:31:00 PM