The Difference Between an Optometrist and an Ophthalmologist

When you go to book an eye appointment, you will usually see two kinds of eye doctors listed: optometrists (OD) and ophthalmologists (MD or DO). The names sound alike, and both examine eyes, diagnose problems and prescribe treatment, so it is easy to wonder which one you need.

The short version is that they are two kinds of doctors with different training and different scopes, and they often work side by side. Here is how they compare, plus a simple guide to who to book for common eye concerns.

The Short Answer

An optometrist (Doctor of Optometry, OD) provides comprehensive eye exams, prescribes glasses and contact lenses, and diagnoses and manages many eye diseases. An ophthalmologist (MD or DO) is a medical doctor who also diagnoses and treats eye disease and is trained to perform eye surgery. For most eye care, including exams, prescriptions and many medical eye problems, either can be the right choice. Surgery, such as cataract surgery, is performed by an ophthalmologist.

What Is an Optometrist (OD)?

An optometrist is a Doctor of Optometry. After college, optometrists complete a four-year doctoral program in optometry, and some go on to complete an additional residency year in an area such as ocular disease, pediatrics or contact lenses. Optometrists are licensed by each state.

Day to day, optometrists:

• Perform comprehensive eye exams that check both vision and eye health
• Prescribe and fit glasses and contact lenses, including specialty lenses
• Diagnose and manage eye conditions such as dry eye, eye infections, allergies and inflammation
• Diagnose, treat and monitor chronic diseases such as glaucoma, and monitor conditions like cataracts and macular degeneration
• Perform diabetic eye exams and look for signs of other health conditions that show up in the eyes
• Prescribe medications, such as eye drops, for many eye conditions
• Care for patients before and after eye surgery

Learn more in our article on what an optometrist does.

What Is an Ophthalmologist (MD or DO)?

An ophthalmologist is a medical doctor (MD) or doctor of osteopathic medicine (DO) who specializes in the eyes. After college, ophthalmologists complete four years of medical school, a one-year internship and a residency in ophthalmology, typically about three years. Some complete an additional fellowship focused on one area, such as glaucoma, retina, cornea or pediatric eye care.

Day to day, ophthalmologists:

• Perform eye exams and diagnose eye diseases
• Prescribe medications and treat medical eye conditions
• Perform eye surgery, such as cataract surgery, glaucoma procedures and retinal procedures
• Perform laser treatments and in-office procedures such as eye injections
• Treat serious eye injuries and urgent eye conditions
• Can prescribe glasses and contact lenses

Learn more in our article on what an ophthalmologist does.

Optometrist vs. Ophthalmologist at a Glance

• Degree: Optometrists hold a Doctor of Optometry (OD). Ophthalmologists hold a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO).
• Training after college: Optometrists complete four years of optometry school, sometimes followed by a residency. Ophthalmologists complete four years of medical school, an internship and an ophthalmology residency, sometimes followed by a fellowship.
• Eye exams and prescriptions: Both perform eye exams. Glasses and contact lens care is a core part of optometry.
• Diagnosing and treating eye disease: Both diagnose and manage eye diseases and prescribe medications.
• Surgery: Ophthalmologists perform eye surgery. Optometrists do not perform major eye surgery, though state law may allow certain minor procedures.

Do Optometrists Do Surgery?

Not major eye surgery. Procedures such as cataract surgery, retinal surgery and incisional glaucoma surgery are performed by ophthalmologists. Depending on state law, optometrists may perform certain minor in-office procedures, such as removing a small foreign body from the surface of the eye.

Optometrists are often closely involved around surgery, though. They frequently diagnose the condition, help decide when surgery may make sense, and provide care before and after the procedure in coordination with the surgeon.

Can Optometrists and Ophthalmologists Prescribe Medication?

Yes, both can. Optometrists prescribe medications for many eye conditions, such as eye infections, inflammation, allergies and glaucoma. Ophthalmologists prescribe eye medications as well, including those used before and after surgery.

What About Opticians?

Opticians are a third member of the eye care team, and people often confuse them with eye doctors. Opticians do not examine eyes or diagnose conditions. They take the prescription from your optometrist or ophthalmologist and help you choose frames and lenses, take measurements, fit and adjust your glasses, and handle repairs. Each Tennessee Eye Care location has an optical center with opticians on hand.

You may also come across the word “oculist.” It is an older term that usually referred to an ophthalmologist and is rarely used today.

Which Eye Doctor Should I See?

Here is a practical guide for common situations. When in doubt, you can start with either one, and they will make sure you get to the right person on the team.

• Routine eye exam: An optometrist or an ophthalmologist. Optometrists perform a large share of routine comprehensive eye exams.
• New glasses or contact lenses: An optometrist is a common choice, especially for contact lens fittings, and an optician will help fit your glasses.
• Red, itchy or irritated eyes: Either. Many cases of pink eye, allergies and dry eye are diagnosed and treated by optometrists.
• Diabetes eye check: Either can perform a dilated diabetic eye exam. If treatment such as eye injections or laser is needed, an ophthalmologist provides it.
• Cataracts: Either can diagnose and monitor cataracts. When cataracts start to interfere with daily life, an ophthalmologist evaluates you for surgery and performs it, and follow-up care may be shared with an optometrist.
• Glaucoma: Both diagnose and manage glaucoma, including prescribing eye drops and monitoring over time. If laser treatment or surgery is needed, an ophthalmologist performs it. Our post on glaucoma treatment options explains the choices.
• Eye surgery of any kind: An ophthalmologist.

Get emergency care right away for sudden vision loss, a chemical splash in the eye, a serious eye injury, or a sudden shower of new floaters, flashes of light or a curtain over your vision. Don’t wait for a routine appointment.

How Optometrists and Ophthalmologists Work Together

The best way to think about optometrists and ophthalmologists is as one team with complementary skills, not a ladder. In many practices, patients see the doctor whose training fits what they need at the moment, and their care moves smoothly between doctors as their needs change.

For example, a patient might see an optometrist for a yearly exam, where cataracts or early glaucoma are found and monitored. If surgery becomes the right step, an ophthalmologist performs it, and the patient may return to the optometrist for ongoing care. When both doctors work in the same practice, that handoff is simpler for the patient.

Optometrists and Ophthalmologists at Tennessee Eye Care

Tennessee Eye Care has both optometrists and ophthalmologists, so routine exams, medical eye care and surgery can all happen within one practice. You can meet our optometrists and ophthalmologists and learn more about each doctor.

With clinics in Harriman, Knoxville, Lenoir City, Morristown and Powell, there is likely a location near you in East Tennessee. Find your nearest clinic and schedule an appointment.