An Ophthalmologist’s Perspective
What is the difference between an ophthalmologist and an optometrist? Both are often referred to as “eye doctors,” but their roles are very different.
A key difference between the two is that an ophthalmologist is a physician. In this video, Adam Sise, MD - an ophthalmologist who practices in southern Maine - shares more detail about an ophthalmologist's education and training, which minimally includes four years of medical school, a one-year internship, and a two-year residency. Subspecialty ophthalmologists like Dr. Sise pursue additional training as well.
“After residency training, you can decide to stop there and enter practice as a comprehensive ophthalmologist, or you can decide to proceed with a subspecialty fellowship. They are one to two years, depending on what you want to study, “ Dr. Sise explains. “I did a one-year fellowship for my cornea training to learn how to manage that specific part of the eye. It's very small, but you can do a whole year of training just in that one small part of the eye.”
Optometrists and ophthalmologists collaborate closely to provide eye care to patients. Optometrists provide routine eye care to patients and refer to ophthalmologists for cases that might require surgery, special medications, or other complex treatments or procedures. Dr. Sise emphasizes the importance of the optometrist’s role in making sure that patients with eye problems receive the appropriate ophthalmology care.
“Working with optometrists is very important for what we do. A lot of the patients who are sent to me, the vast majority of them, are going to be sent to me from an optometrist. The optometrist provides their routine primary eye care. They're going to see the patient typically once a year, they're going to tweak their glasses, maybe prescribe them contact lenses and do their routine annual eye exams to make sure their eyes are healthy. . . And as long as the patient is healthy and happy, and their eyes are stable, generally the optometrists will take care of that patient,” says Dr. Sise.
“But if a problem develops, the other great role of the optometrist is that they're going to triage these problems. They're going to be able to identify what the issue is, and they're going to know who to send it to. So if there's a condition with the front part of the eye, they're going to know to send that to me. And they can also tell me how urgent the issue is. It might be a cornea ulcer that needs to be addressed this week and we have to find a spot in our schedule to fit them in, or it may be an issue that's been going on for several months and I can give them some ideas for additional treatments while the patient's waiting for their appointment to come and see me.”
Another difference between an optometrist and ophthalmologist is that ophthalmologists will often work with other physician specialists to manage patients with complex health conditions.
“We'll often work with other doctors. Most importantly, for my specialty as a cornea specialist, rheumatology comes into play. Rheumatologists will manage a lot of systemic conditions that can show up on the eye. And while it may be affecting their eye, the treatment they need is not from an eye doctor, it's actually from a rheumatologist. We'll coordinate care with the rheumatologist so that they can get the appropriate treatment for their systemic condition, which will also help their eye.”
Adam Sise, MD, is a Portland, Maine-based ophthalmologist who subspecializes in cornea and cataract surgery. He received his medical degree from the Temple University School of Medicine in Philadelphia, PA. He completed two residencies at Washington Hospital Center and Georgetown University Hospital, both based in Washington, DC, followed by a fellowship at the University of Miami - Bascom Palmer Eye Institute in Miami, FL. He is also a diplomate of the American Board of Ophthalmology and a Fellow of the American Academy of Ophthalmology.