It’s early Monday morning and Kim has a hectic week ahead. She wakes up and immediately realises she has a problem. Her eyes are burning, itchy and won’t stop tearing up, causing her vision to be extremely blurry. “I don’t have time for this,” she thinks to herself. Who should she see? Maybe a quick visit to the chemist? But that eye drops aisle is so overwhelming. Or perhaps she needs an eye specialist? But it can take weeks to get in and isn’t cheap. How about her GP? Maybe an optometrist can help? Or do they only sell glasses?
This scenario is all too common. What would you do? Taking a few minutes to understand what different health professionals can do for you can save you time, money, inconvenience and even your vision!
Optometrists
An optometrist is a health care professional who cares for their patients’ vision. They are university graduates and trained to take a detailed case history (i.e. find out from the patient the exact nature of their concern), then perform a number of examinations and tests to reach a diagnosis. The optometrist then explains the diagnosis to the patient, discusses treatment options and reach an agreement with the patient about how to proceed.
Treatment options include prescribing suitable spectacles (“prescription glasses”), sunglasses, contact lenses or eye exercises as well as lifestyle change. Some optometrists are “therapeutically endorsed” which means they have undertaken extra training and are qualified to prescribe medications to treat infections or other eye diseases. So the optometrist (who would usually see you on the same day, bulk billed by Medicare and without a long wait) would be a very reasonable first step for Kim.
General Practitioners
Kim could also see her GP for an opinion. It may surprise many readers to know that many GPs refer people with eye problems to optometrists! Although the doctors are very knowledgeable about eye problems, they usually do not have access to the expensive and bulky equipment that an optometrist would have.
This referral pathway is a two way street: sometimes optometrists would refer a patient back to their GP as well. Occasionally, an optometrist may detect a problem in the eyes that is suggestive of a general medical problem. For example, people with a certain pattern of bleeding at the back of their eyes may have diabetes and not know it! In these cases, the optometrist would refer the patient to their GP for blood tests.
If the optometrist is unsure about the diagnosis, or diagnoses an eye disease which requires medical or surgical treatment, the patient would then be referred to an ophthalmologist. Very occasionally, an optometrist may find evidence of a problem serious enough to warrant a visit to the Emergency Department (e.g. signs of a stroke).
Ophthalmologists
An ophthalmologist (commonly referred to as an eye doctor or eye specialist) is a doctor who specialises in the treatment of eye disease and surgery. They complete their medical degrees, work for at least two years in hospitals as junior medical officers and then complete ophthalmology training over at least four years. Many ophthalmologist then go on to develop a sub-speciality (e.g. focus on the retina; the back of the eye).
In addition to prescribing medications, ophthalmologist treat patients using lasers and also perform surgery (e.g. cataract surgery, repair of a retinal detachment). Ophthalmologists often refer their patients back to optometrists for ongoing monitoring and of course if glasses or contact lenses are required.
In order to see an ophthalmologist, a referral is required. This can come either from a doctor (GP or specialist) or from your optometrist. If you see your GP or optometrist and it is felt that an ophthalmologist visit is required, they can usually facilitate a same day appointment for you.
So what ended up happening to Kim? She made an appointment with her optometrist who diagnosed her with viral conjunctivitis. As her optometrist was therapeutically endorsed, she was prescribed eye drops and improved within 2 days. An ophthalmologist appointment was not required this time. She didn’t manage to do everything she has hoping that week but at least her eyes weren’t the reason!