Scope Of Practice

Optometrists are primary health care providers for the eye and visual system. Optometrists are also known as doctors of optometry. They examine, diagnose, and medically treat eye diseases, 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. In some locations, optometrists may perform laser surgery.

The practice is defined by the World Council of Optometry (a member of the World Health Organisation) as follows:

Optometry is a healthcare profession that is autonomous, educated, and regulated
(licensed/registered), and optometrists are the primary healthcare practitioners
of the eye and visual system who provide comprehensive eye and vision care,
which includes refraction and dispensing, detection/diagnosis and management of disease in the eye, and the rehabilitation of conditions of the visual system.

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.

1) Eye and vision examination

As with most health care, examination often includes history-taking of both eye-related health and optical and visual functioning-related aspects of the patient. The typical examination has two components: the evaluation of the health status for the detection of eye disease, and evaluating the optical and vision characteristics of the eye and observations during testings.

Examination of ocular health may include:

inspection of the external structures of the eye such as Cornea, Anterior Chamber, Physiological Lens as well as internal ocular structures such as Retina and Optic Nerve. This is done with

• various specialty equipment
• observation of various eye movements and alignment
• observation of pupillary reaction to light as a neurological test
• observation of overall health status of adnexal ocular structures such as eyelids and eyelashes, as well as the lacrimal system among others
• measurement of eye pressure also know as intraocular pressure
• evaluation of functional aspects of the eye such as visual fields
  

Examination of vision and visual function may include:

• measurement of vision at distance and near
• detailed refraction for distance and near with specialty equipment
• measurement of optical aids such as glasses, contact lenses and magnifiers
• measurement of stereopsis, color vision screening tests

Examination of visual skills:

• applying a battery of structured visual tasks for patient to complete to evaluate the functional characteristics of the visual system such as tracking and focusing aspects as well as muscle coordination.
  

2) Pre-optometric education

Prerequisites for admission to optometry schools are the same as admission to medical, osteopathic, and dental programs.

3) Optometric education

Optometrists complete a 4-year program that leads to a Doctorate in Optometry (O.D.) degree. Many optometrists complete a one- or two-year residency to specialize.
A sample curriculum is available from the Inter American University School of Optometry.

4) 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, or HRT II can be used for various disease testing and treatment.

5)Diagnoses

Diagnoses made by optometry depends 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 many cases, referral to an ophthalmologist may be required for surgical treatment.

Visual 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)
  

Common examples of ocular pathologies diagnosed and treated by optometrists include:

• glaucoma
• cataracts
• infection 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
• Haemorrhage of vascular supply to the eye (internal or external)
  

Common examples of diseases of systemic origin with eye complications that can be recognized and managed by evaluation of the ocular structures include:

• diabetic eye disease and retinopathy caused by diabetes
• retinal changes caused by other systemic disorders such as hypertension and cholesterol problems
• evaluation of ocular changes caused by medications such as oral contraceptives and Plaquenil among others
  

6) Patient management

Optometry clinical patients management can 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 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 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 for surgical consultation, and interact with opticians and the optical industry, which manufacture the optical aids such as glasses in accordance to optical prescriptions.

(Taken from Wikipedia.com)