So what does an Optometrist do?

[Placebo Power]

I know this may be a stupid/offensive question but what does an Optometrist do?
Today I went to an eye doctor, and I was seen by a "refractionist" which before this point I didn't know this job existed. They did the "number one, or number two". Then they said they would send the results off to someone to look over, then I got a prescriptions a few minutes later.

I thought this "number one or number two" is what optometrists do. Or should I consider "refractionists" as like a mid level practitioner?
I guess an answer that would help me would be. What would be the most complicated case an optometrist would solve? This would help me understand what they do and appreciate their level of expertise.

For example:
I am a pharmacist, and pharmacists do more than count pills
a complicated case for a pharmacist would be if an amputee patient with limited kidney function had an infection.

The pharmacist could make a recommendation to the doctor on the antibiotic based on what the bug would be susceptible to based on coverage, and recommend a dose based on the patient's amputation (less body surface area), and limited kidney function (less drug excretion). and be able to predict drug serum levels in 6 hours, to decide the frequency of drug administration, and screen for drug interactions, and side effects to look out for, maintaining drug serum levels where it is high enough to kill the bug but not too high as to cause loss of hearing or severe toxicity.

so what does an optometrist do?

---

Members don't see this ad.

 

[UnicornOpt]

Frequently Asked Questions – ASCO

optometriceducation.org

Link to the optometry school associated organization website for resources at a layman's term level about the career.


Learning to refract literally was a 10 hour course. Just 1 class in one quarter. I took 3 years of additional didactic education to become a doctor of optometry so I can understand your medical history & measure your vision and evaluate your ocular health, and then once I acquire that data see options I have to optimize your visual system and ocular health, and create an assessment and plan for things that aren't normal that need attention going forward.


Example of non-routine cases:

I started seeing double in the last week -- you have two heads, one to the left and one to the right? Dx 6th nerve palsy. I think because history of HTN and Diabetes, and you're 65 years old. Should I prescribe prism glasses to move the images back into one fused target? Nah, probably will resolve within 60 days as most textbooks suggest - this isn't an ocular emergency that necessitates imaging of the brain for neuro issues. Just occlude the eye for 2 months since seeing double is so disruptive to your daily life. Probably should see your adult medicine doctor to check you HTN and DM2.

Teenager I know is optically perfect but she is 20/40 acuity? What the, she was 20/30 last year, and 20/25 a few years ago? How come nobody is finding this trend odd. Dilate the eye, and she has all this drusenoid plaques going on in her retina. Sounds like Stargardt's. Damn girl, you're going to go blind by your thirties. Let's get genetic testing done to confirm and I'll have you see an ophthalmologist to see if there are any current treatment studies going on. I should probably look at your siblings. Oh god they have it too.

Your vision has large refractive error? This is exotic. And you said you had clear vision when 5 years ago when you were in highschool? What happened? Your prescription is huge, and you're overweight, and you snore you tell me, and your eyelids flop around when I try to manipulate them? Sounds like keratoconus to me! I can get you seeing better no problem, but we don't want your cornea to continue to weaken and potentially convert to advance keratoconus. Let's confirm the diagnosis with a tomography, and then I can send you to ophthalmology to get collagen cross-linking to strengthen the cornea so your condition doesn't progress.

 

[percyeye]

Sounds like you went to one of those "Tele-health" places where there really isn't an Optometrist on site. They have a glorified tech flip some dials and give you your prescription. It is legal because a MD signs off on it and no one actually looks at your eyes. You pretty much got scammed unfortunately.

It'd be like going to a dentist and just having a hygienist look at your teeth.

 

[Snakedoctor1]

Didn't know you could do that. How much can an MD expect to make from such an arrangement (asking for a friend of course)

Unless you're an OMD, you shouldn't be doing it at all. If you are an OMD, you'll make a lot more doing cataract surgery, but then again I suppose that's why they hired a tech to do the job instead of doing it themselves. This is not a knock on ophthalmologists, they're great at what they're great at, but when I was a mere optometry intern at a large ophthalmology practice, I spent half my time fixing prescriptions from ophthalmic techs who were frankly not good at refraction. While UnicornOpt is correct that refraction occupies a miniscule portion of overall optometric education, it is a skill, and one that benefits from a deeper understanding of visual function as well as experience.

To answer OP's question, Optometrists do quite a bit, ranging from the diagnosis and treatment of ocular disease, both acute and chronic, prescribing lenses and prisms not only for the correction of basic refractive error but also in the treatment and management of developmental binocular vision disorders as well as acquired binocular vision disorders from traumatic brain injury, stroke etc. to the use of specialty contact lenses, visual aids for the seeing impaired, as well as co-management of surgical cases.

 

[Placebo Power]

Frequently Asked Questions – ASCO

optometriceducation.org

Link to the optometry school associated organization website for resources at a layman's term level about the career.


Learning to refract literally was a 10 hour course. Just 1 class in one quarter. I took 3 years of additional didactic education to become a doctor of optometry so I can understand your medical history & measure your vision and evaluate your ocular health, and then once I acquire that data see options I have to optimize your visual system and ocular health, and create an assessment and plan for things that aren't normal that need attention going forward.


Example of non-routine cases:

I started seeing double in the last week -- you have two heads, one to the left and one to the right? Dx 6th nerve palsy. I think because history of HTN and Diabetes, and you're 65 years old. Should I prescribe prism glasses to move the images back into one fused target? Nah, probably will resolve within 60 days as most textbooks suggest - this isn't an ocular emergency that necessitates imaging of the brain for neuro issues. Just occlude the eye for 2 months since seeing double is so disruptive to your daily life. Probably should see your adult medicine doctor to check you HTN and DM2.

Teenager I know is optically perfect but she is 20/40 acuity? What the, she was 20/30 last year, and 20/25 a few years ago? How come nobody is finding this trend odd. Dilate the eye, and she has all this drusenoid plaques going on in her retina. Sounds like Stargardt's. Damn girl, you're going to go blind by your thirties. Let's get genetic testing done to confirm and I'll have you see an ophthalmologist to see if there are any current treatment studies going on. I should probably look at your siblings. Oh god they have it too.

Your vision has large refractive error? This is exotic. And you said you had clear vision when 5 years ago when you were in highschool? What happened? Your prescription is huge, and you're overweight, and you snore you tell me, and your eyelids flop around when I try to manipulate them? Sounds like keratoconus to me! I can get you seeing better no problem, but we don't want your cornea to continue to weaken and potentially convert to advance keratoconus. Let's confirm the diagnosis with a tomography, and then I can send you to ophthalmology to get collagen cross-linking to strengthen the cornea so your condition doesn't progress.

Thanks for the response
I just got an aha! moment
perhaps the refractionist doing the bulk of the work is the reason this place has 2.5 stars on yelp, and there are many complaints about people getting the wrong prescription.
How else can they offer eye exams for 25$ cash walk in?

Also thanks for explaining optometrist scope of practice. You guys brought up complexities I had never considered about eye conditions.

 

[Snakedoctor1]

lol what... NVM I'll just do EM and make $300/hr

I mean, where the hell did you even come from? Not only are we talking about a corporate outlet farming out cheap eye exams using "refractionists" rather than a private practice optometry office charging on average $150-250 per 15 minute eye exam, it's all a moot point for you because unless ophthalmology is your goal, or you switch career paths entirely, you'll never be qualified to perform an eye exam. What made you wander in here to begin with?

 

[Purkinja]

I mix in about 175 surgical procedures annually along with glaucoma management,medical eye and retina ,with my specialty contact lens and spectacle patients.

 

[allantois]

1 or 2?