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Preparing for a Career in Optometry

The profession of optometry involves much more than just prescribing and fitting eyeglasses and contact lenses. ODs are trained to evaluate any patient’s visual condition and to determine the best treatment for that condition. Optometrists are not medical doctors. The American Optometric Association’s definition of optometrists reads: “Doctors of optometry are independent primary health care providers who are trained and state licensed to examine, diagnose, treat and manage diseases and disorders of the visual system, the eye and associated structures as well as diagnose related systemic conditions.” The Association of Schools and Colleges of Optometry has assembled a Career Guide that might be helpful to students who are interested in pursuing optometry or specializations within optometry as a profession.

Most optometrists are self-employed, receive relatively few emergency calls and can establish a flexible working schedule. The average net income from the primary practice of optometry was $129,385 in 2011, according to a recent AOA survey of member optometrists.  Optometrists who own their practice reported an average net income of $156,550 while optometrists employed by others reported average earnings of $105,757. According to the U.S. Department of Labor, Bureau of Labor Statistics’ Occupational Outlook Handbook 2012-2013, employment of optometrists is expected to grow 33% between 2010 and 2020, in response to the vision care needs of a growing and aging population.

The number of new practicing optometrists is limited by the fact that there are 21 schools and colleges of optometry in the United States and Puerto Rico, with two additional schools in Canada. An optometrist completes a pre-professional undergraduate education at a college or university and then completes four years of professional education at a college of optometry. Students should examine the prerequisite courses for each school they plan to apply. All optometry schools require applicants to take a standardized entrance exam called the Optometry Admissions Test (OAT). This test is taken before the application cycle begins, and covers the Survey of the Natural Sciences (Biology, General Chemistry, and Organic Chemistry), Reading Comprehension, Physics and Quantitative Reasoning.

Optometry residencies and specialties

While one four-year doctoral degree allows a student to begin a primary care practice, it is possible to enter residency programs and specialties. Completing a residency in optometry is a unique and invaluable experience. The rich rewards gained from the year of advanced clinical training under an experienced mentor serve to enhance career opportunities and add to the level of confidence the resident has when beginning his/her post-residency career. There are numerous types of optometric residencies from which to choose. These areas of emphasis include Family Practice Optometry, Primary Eye Care, Cornea and Contact Lenses, Geriatric Optometry, Pediatric Optometry, Vision Therapy and Rehabilitation, Low Vision Rehabilitation, Ocular Disease, Refractive and Ocular Surgery, Community Health Optometry, and Brain Injury Rehabilitation.

Optometry vs Ophthalmology

Optometrists and ophthalmologists are both eye doctors, and each play an important role in providing eye care to patients. However, these specialists follow different educational paths and have different scopes of practice. The range of services and procedures that can be performed by each provider also range by state, therefore, it is important to be aware of the rules and regulations of your state licensing board.

Optometrists: Optometrists perform comprehensive examinations of the internal and external structures of the eye, perform subjective and objective tests of visual function, and diagnose and treat medical and visual disorders of the eye. Optometrists are often referred to as a "primary eye-care provider".  Although optometrists are not M.D.s, most current optometrists can prescribe certain medications, as well as diagnose and treat a broad-range of medical conditions that impact the eye, including glaucoma, macular degeneration, cataracts, retinal disease and ocular disorders associated with diabetes and high blood pressure. In fact, it’s not unusual for a skilled optometrist to be the first health care professional to spot developing systemic conditions like diabetes during routine eye exams. Since Optometrists are not physicians; they may refer a patient to surgeons for treatments beyond the scope of their legal practice whenever needed.

Ophthalmologist: The American Academy of Ophthalmology definition of ophthalmologists reads: “Ophthalmologists are medical and osteopathic physicians who provide comprehensive eye care, including medical, surgical and optical care.” An ophthalmologist is a medical doctor that completes college, has at least eight years of additional medical training, and is able to perform surgical eye care for trauma, crossed eyes, cataracts, glaucoma, and other problems. An ophthalmologist may also perform plastic surgery related to wrinkles and sagging eyelids. In order to become an ophthalmologist, acquisition of an M.D. or a D.O. (doctor of osteopathy) degree is necessary following the completion of college. After 4 years of medical school and a year of internship in general medicine, every ophthalmologist spends a minimum of 3 years in a university and hospital-based residency specializing in ophthalmology.

Listed below are some general similarities and differences between the two fields.

Optometrist – Doctor of Optometry

  • General vision services like eye exams, and treatment of conditions like strabismus and amblyopia
  • Diagnosis and basic treatment of eye conditions like glaucoma, cataracts, macular degeneration, diabetic retinopathy and conjunctivitis (pink eye.)
  • Prescribing medications for certain eye conditions (for example, antibiotics for eye infections)
  • Eye disease and injury-prevention
  • Prescribing and fitting eyeglasses and contact lenses
  • Vision therapy services, such as eye exercises and low-vision aids
  • Pre- and postoperative care for people who have had eye surgery or Lasik surgery.

Ophthalmologist – Doctor of Medicine (M.D. or D.O.)

  • Provides vision services including eye exams
  • Medical eye care for conditions such as glaucoma, iritis, and chemical burns
  • Performs 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
  • May also perform plastic surgery related to wrinkles or sagging eyelids.

Careers in academia

The optometry profession is growing, as is the expansion of scope of practice that requires greater expertise. With the growth of optometrists, there is a greater need for ODs to teach future generations of optometrists, as well as conduct ground-breaking research. If you are interested in teaching or conducting research in academia after receiving your OD, the ASCO publication on Career Opportunities for ODs in Academia may be of interest. There is also a PowerPoint about careers for ODs in academia available for viewing and download on the site. There are also specific specialty academic positions that can be found on the ASCO site.

Getting Started

Have you decided to pursue a career in optometry? These resources will answer many of the questions you may have about pursuing a career in optometry and the process of applying to optometry school: