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30-AUGUST-2008 03:13:07 - Optometry Optometry is a health care profession concerned with eyes and related structures, as well as vision, visual systems, and vision information processing in humans. Like most health professions, optometry education, certification, and practice is regulated in most countries. Optometrists and optometry-related organizations interact with governmental agencies, other health care professionals, and the community to deliver eye and vision care. Optometry is one of two eye care professions, the other being ophthalmology which is a branch of Medicine. An optical refractor also called a phoropter in use. An optical refractor also called a phoropter in use. Contents 1 Etymology 2 Scope of practice 2.1 Eye and vision examination 2.1.1 Examples of equipment used for eye and vision health testing 2.2 Diagnoses 2.3 Patient management 3 History 4 Licensing 4.1 United Kingdom 4.2 United States 4.3 Argentina 4.4 Colombia 4.5 Europe 4.6 Ireland 5 Distinction from ophthalmology 6 Sub specialties 7 See also 8 External links 8.1 Organizations 8.2 Other 8.3 Some optometry-related publications 9 References Etymology The term optometry comes from the Greek word optos, meaning eye or vision, and metria, meaning measurement. Scope of practice Optometrists Optometric Physicians are the primary health care providers for the eye and visual system; however, are not medical doctors rather they are doctors of optometry O.D. As primary eye doctors, they examine, diagnose, and treat the majority of primary ocular diseases, non-surgical injuries, and disorders of the eyes and visual system, including refractive problems such as near- or far-sightedness, and identify related systemic medical conditions affecting the eyes and ocular adnexa. Optometrists may serve the general public; specialize in work with the elderly, children, or partially-sighted persons who need specialized visual devices; develop and implement ways to protect workers eyes from on-the-job strain or injury; or specialize in contact lenses, sports vision, or vision therapy. Eye and vision examination The typical optometric examination has four main components: Ocular and systemic history, assessement of neuro-muscular control, visual acuity and refraction, and ocular health examination. History taking: Information is obtainedExamination of ocular health may include: Observation of pupillary reaction to light as a neurological test Observation of ocular adnexa, such as eyelids and eyelashes, as well as the lacrimal system, among others. Inspection of the external structures of the eye such as the cornea, anterior chamber, iris, and physiological lens. This is performed with an instrument known as a slit lamp, which allows the doctor to pass a slit of light through the cornea to assess the transparency, depth, and/or dimensions of many ocular structures and abnormal lesions. Inspection of the Retina and Optic Nerve. This is performed with high-powered magnifying lenses, often in combination with the slit lamp mentioned aboveto achieve very detailed images. Measurement of eye pressure, also known as intraocular pressure Evaluation of functional aspects of the eye such as visual fields Examples of equipment used for eye and vision health testing Many types of equipment are used during an eye examination. Vision charts and machines are used to measure vision and visual fields. Trial spectacle and contact lenses or a phoropter and retinoscope may be used during refraction. Prism bars, small objects, and occluders may be used to assess eye movements and eye alignment. Test booklets, sheets, instructions, and pencils may be used for visual information processing examination. Penlights and transilluminators can be used when assessing pupil light response, a neurological screening test. Specialty magnifiers, such as ophthalmoscopes and slit-lamp bio-microscopes, help with detailed inspection of external and internal anatomical ocular structures. Diagnostic eye drops may also be used to assess the various anatomical structures of the eyes. Many optometrists use computerized equipment specifically designed to help diagnose and/or monitor certain ocular diseases. For example, many optometrists' offices have various visual field analyzers and tonometers that are helpful in diagnosing disease entity in early stages. Optometrists use digital imaging equipment, such as digital cameras to document appearance of the anterior and posterior parts of the eye. Corneal topographers are used to gather information on anterior aspects of the anatomy of the eye and cornea. Other sophisticated equipment such as Optical coherence tomography, GDX,1 or HRT II can be used for various disease testing and treatment. Diagnoses Diagnoses made by optometrists depend on integrating eye examination information. Some ocular diseases can be associated with systemic, neural, or other disease complications. Some ocular disorders may be treated by an optometrist. In some cases, referral to an ophthalmologist may be required for surgical treatment. Optical dysfunctions assessed by optometrists may include: refractive error such as myopia, hyperopia, astigmatism and presbyopia accommodative-vergence disorders related to dynamic focus and eye alignment Examples of eye conditions diagnosed and treated by optometrists include: Amblyopia corneal abrasions Contact lens complications dry eyes or Keratoconjunctivitis sicca glaucoma Eye infections and inflammation of the ocular surface including conditions of the cornea, conjunctiva as well as internal pathologies of the retina, vitreous and optic nerve among others Strabismus squint or turned eye which might require surgical repair by an ophthalmologist Common examples of diseases of organ system and systemic origin with eye complications that can be recognized by evaluation of the ocular structures include: diabetic eye disease and retinopathy caused by diabetes Significant changes would then be referred to an ophthalmologist for the appropriate treament. retinal changes caused by other systemic disorders such as hypertension and cholesterol problems evaluation of ocular changes caused by medications such as hormonal contraception and Plaquenil among others Patient management Optometric patient management may include: Counsel on status regarding comprehensive or detailed evaluations of the human eye. Diagnosis and treatment or management of eye disease, ocular findings or visual disturbance. Prescribing both oral and topical medications such as antibiotics, antiinflammatory and other for the treatment of eye conditions and diseases. Prescribing optical aids such as glasses, contact lenses, magnifiers. Prescribing low vision rehabilitation. Prescribing vision therapy. They give advice and follow-up care regarding use of optical aids especially contact lenses, provide referral to other health professionals including internist and other primary care physicians and particularly sub specialists like ophthalmologists who would then be qualified to treat the more severe disease with laser treatments, intraocular injections, and surgical treatments. They also interact with opticians and the optical industry, which manufacture the optical aids such as glasses in accordance to optical prescriptions. History Optometric history is tied to the development of vision science related areas of medicine, microbiology, neurology, physiology, psychology, etc optics, optical aids optical instruments, imaging techniques other eye care professions The term optometrist was coined by Landolt in 1886, referring to the fitter of glasses. Prior to this, there was a distinction between dispensing and refracting opticians in the 19th century. The latter were later called optometrists. 2 The first schools of optometry were established in 1850-1900 in USA, and contact lenses were first used in 1940s 3 Licensing Most countries have regulations concerning optometry education and practice. Optometrists like many other health care professionals are required to participate in ongoing continuing education courses to stay current on the latest standards of care. Optometry is officially recognized: in North America Canada and US in Latin America and some Caribbean countries in most English speaking countries including UK, Republic of Ireland and Australia in Europe including Spain, Germany and France in Asia including Malaysia, China, Hong Kong, Thailand and Taiwan in the Middle East including Saudi Arabia, Iran and Israel See also: List of optometry schools United Kingdom In the United Kingdom, optometrists have to complete a 3 year undergraduate honours degree followed by a minimum of a one-year pre-registration period where they complete supervised practice under the supervision of an experienced qualified practitioner. During this year the pre-registration candidate is given a number of quarterly assessments and on successfully passing all of these assessments, a final one-day set of examinations. Following successful completion of these assessments and having completed one year's supervised practice, the candidate qualifies for membership of The College of Optometrists and is eligible to register as an optometrist with the General Optical Council GOC. There are 8 universities which offer Optometry in the UK, they are: Anglia Ruskin University, Aston University Birmingham, Bradford University, Cardiff University, Glasgow Caledonian University Glasgow City University London Manchester University, and University of Ulster Coleraine Registration with the GOC is mandatory to practice in the UK. Members of the College of Optometrists may use the suffix MCOptom. United States US optometrists after completing a 4 year bachelors degree complete a 4-year program that leads to a Doctorate in Optometry O.D. degree. Some American optometrists also may refer to themselves as optometric physicians; however, this is controversial, as they have not completed a medical school education. As primary eye care providers, optometrists are an integral part of the health care team. Prior to admittance into optometry school, optometrists typically complete four years of undergraduate study, culminating in a bachelor's degree. Required undergraduate coursework for pre-optometry students covers a variety of health, science and mathematics courses. Optometry school consists of four years of study focusing on the eye, vision, and some systemic diseases. Upon completion of optometry school, candidates graduate from accred college of optometry and hold the optometry OD degree. Optometrists must pass a national examination administered by the National Board of Examiners in Optometry NBEOhttp://www.optometry.org/passfail.cfm. The three-part exam includes basic science, clinical science and patient care. The structure and format of the NBEO exams are subject to change beginning in 2008. Some optometrists go on to complete 1-2 year residencies with training in a specific sub-specialty such as pediatric care, children's vision, geriatric care, specialty contact lens for keratoconus patients or other corneal dystrophy and many others. All optometrists are required to fulfill continuing education requirements to stay current on the latest standards of care. Argentina In Argentina optometrists are required to register with the local Ministry of Public Information, but licensing is not required. Anyone holding a Bachelor's degree may register as an optometrist after completing a written exam. Fees for the exam are set by the provincial government and vary from province to province. Colombia In Colombia optometry education has been accred by the Ministry of Health. The last official revision to the laws regarding health care standards for the country was issued in 1992 through the Law 30.4 Currently there are eight official Universities that are entitled by ICFES to grant the Optometrist certification. The first optometrist arrived to the country from North America and Europe circa 1914. These professionals were specialized in optics and refraction. In 1933 under Decree 449 and 1291 the Colombian Government officially set the rules for the formation of professionals in the area of optometry. In 1966 La Salle University opens its first Faculty in Optometry after a recommendation of a group of professionals. At the present time optometrists are encouraged to keep up with new technologies through congresses and scholarships granted by the government or private companies such as Bausch Lomb. Europe Currently, optometry education and licencing varies throughout Europe. For example, in Germany, optometric tasks are performed by ophthalmologists and professionally trained and certified opticians. In France, there is no regulatory framework and optometrists are sometimes trained by completing an apprenticeship at an ophthalmologists' private office. 5 Since the formation of the European Union, there exists a strong movement, headed by the Association of European Schools and Colleges of Optometry AESCO, to unify the profession by creating a European-wide examination for optometry and presumably also standardised practice and education guidelines within EU countries.6 Ireland The profession of Optometry has been represented for over a century by the Association of Optometrists, Ireland AOI. In Ireland an optometrist must first complete a four year degree in Optometry at D.I.T. Kevin Street. Following successful completion of the a degree, an optometrist must then complete Professional Qualifying Examinations in order to be entered into the register of the Opticians Board Bord na Radharcmhaistoiri. Optometrists must be registered with the Board in order to practice in the Republic of Ireland. The A.O.I. runs a comprehensive continuing education and professional development program on behalf of Irish optometrists. The legislation governing Optometry was drafted in 1956. The legislation restricts optometrists from using their full range of skills, training and equipment for the benefit of the Irish public. The amendment to the Act in 2003 addressed one of the most significant restrictions - the use of cycloplegic drugs to examine children. Distinction from ophthalmology In the United States, Ophthalmologists, after obtaining a 4-year bachelor degree, attend medical school for 4 years of medical training to obtain an MD or DO. Ophthalmologists train for an additional 4-5 years of residency training. Residency training in ophthalmology encompasses all aspects of diagnosis and management of diseases that affect the eye, orbit, and neurological system of the brain. This includes surgical treatment. This combination of medical school and long term residency allows them to understand not just the eye as a single unit but as a part of the whole body. Some ophthalmologists pursue additional fellowship training in various subspecialties, including oculoplastics / orbit, pathology, pediatric ophthalmology, neuro-ophthalmology, retina, cornea, and uveitis. In the USA, optometrists acquire a 4-year bachelor degree, followed by 4 years of Optometry school training to earn an OD or Doctor of Optometry degree. This program provides broad-based medical background while focusing on ocular diseases, and management of refractive errors. After graduation, optometry students may complete an optional 1-2 year residency program in a particular area such as Pediatric Optometry, Geriatric Optometry, Glaucoma, Behavioral Optometry or Neuro-optometry. However, they are not trained in surgical techniques or procedures. Optometry school curriculums in the United States include such courses as vision sciences, health sciences, pharmacology, encompassing diagnosis and management of diseases that affect the eye, orbit, and neurological system of the brain. Examples include courses in visual psychophysics, optics, as well as training in aspects of functional vision such as vision therapy, binocular vision, and low vision. Optometrists are also trained extensively in anatomy, histology, neurology, biochemistry, neuro-anatomy, ocular development and vision perception. They have an understanding of ocular disease etiology, management, and treatment. In general, an ophthalmologists is responsible for providing surgical care of eye conditions. The scope of prescribing oral medications by optometrists is dependent on licensure and regulatory requirements which vary by state. The two fields often have a mutually beneficial relationship: Ophthalmologists may refer patients to optometrists for contact lenses or for optical aids or low vision rehabilitation. Often the professions will co-manage ocular conditions. Both optometrists and ophthalmologists perform screening for common ocular problems affecting children i.e., amblyopia and strabismus and the adult population cataract, glaucoma, and diabetic retinopathy. Furthermore, optometrists and ophthalmologists both manage strabismus and amblyopia with refractive and/or vision therapy. However, if the strabismus is too large for successful vision therapy, surgical intervention by an ophthalmologist may be required. See also Ophthalmology#Distinction from Optometry Sub specialties There are currently nine sub-specialty residencies offered by various schools of optometry in the United States 1 2: Cornea and contact lenses Family practice optometry Geriatric optometry Glaucoma Low vision rehabilitation orthoptic practice Ocular disease Pediatric optometry Primary care optometry Vision therapy and rehabilitation Many of these sub-specialties are also recognised in other countries. Ocular disease residencies involve co-management practice with other health professionals such as ophthalmology. Also the College of Optometrists in Vision Development provides certification for eye doctors in vision therapy, behavioral and developmental vision care, and visual rehabilitation. Training in binocular vision and orthoptics sub-specialties are often integrated into either pediatric or vision therapy programs. See also Behavioral optometry Eye care professional Eye examination Eyeglass prescription Ophthalmology Optometry in Singapore Orthoptics Vision therapy Visual perception Visual skills External links Organizations World Council of Optometry Optometry Giving Sight American Academy of Optometry American Optometric Association Association of Optometrists Ireland Association of Schools and Colleges of Optometry ASCO Canadian Association of Optometrists College of Optometrists UK Comprehensive Optometry Site AU Optometrists Association Australia Victorian College of Optometry, Australia The General Optical Council The Association of Optometrists, Ireland Association of Regulatory Boards of Optometry Other Optometrists Network U.S. Bureau of Labor Statistics Optometry Page Optometry Giving Sight Organization International Centre for Eyecare Education The development of western optometry--a case for history, by Tannebaum S. in J Am Optom Assoc. 1990 Sep;619:666-8 Optometry.com Optometry Practice Loans Some optometry-related publications Optometry and Vision Science Clinical and Experimental Optometry Ophthalmic and Physiological Optics Optometry: Journal of the American Optometric Association Review of Optometry The Optician Web Sight MD The Optometry Blog References ^ Handbook of Ocular Disease Management - Understanding Nerve Fiber Layer Analysis ^ History of Optometry, Lecture Handout at Indiana University School of Optometry by David A. Goss. ^ History ^ Consejo Nacional de Acración ^ Welcome to Eurotimes ^ The unification of European optometry: how the profession will change after 1992 by Hamakiotes DS, Thal LS in J Am Optom Assoc. 1992 Jun;636:388-9. v d e Academic degrees Associate's degree U.S. · Foundation degree U.K. except Scotland · Bachelor's degree · Master's degree · Diplom · Magister · DEA · MAS · Licentiate · Specialist degree · Engineer's degree · Professional degree · Doctoral degree v d e Health science Allied health professions Athletic training Audiology Chiropractic Dentistry Dental hygiene Dietetics Electrocardiographic technicians Emergency medical services Hemodialysis technicians Massage therapy Medical assistants Medical physics Medical technologist Medical transcription Music therapy Nuclear medicine technology Nutrition Occupational therapy Optometry Pharmacy Phlebotomy Orthotics/Prosthetics Physical therapy Podiatry Psychology Radiation therapy Radiography Radiologic technologist Respiratory therapy Speech and language pathology Social work Ultrasonography Retrieved from http://en..org/wiki/Optometry Categories: Optometry Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Català Dansk Deutsch Español Français Italiano Nederlands Polski Português SlovenÅ¡Ä?ina ไทย ä¸æ–‡ This page was last modified on 28 August 2008, at 20:35
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