Health Essentials from Cleveland Clinic

Whether you’re scheduling your first routine eye exam, getting new glasses or having a problem with your vision, a quick search online for eye doctors may leave you scratching your head. Is an optometrist or ophthalmologist best? And where do opticians fit in?

Ophthalmologist Scott Wagenberg, MD, helps answer your questions about what each type of eye doctor can do. He also offers examples of what services each may offer.

What does an optician do?

Opticians can help you select and fit your prescription eyeglasses properly. They can advise you on frames and certain types of lenses and lens coatings.

They work from orders written by optometrists or ophthalmologists. But they don’t give eye exams or write prescriptions themselves. “They do not diagnose or treat eye problems at all,” Dr. Wagenberg says.

How do ophthalmologists and optometrists differ?

1. Postgraduate education

Much of the difference comes down to education.

“Optometrists go to optometry school for four years and often do an extra year of residency,” Dr. Wagenberg says. “Ophthalmologists go to medical school for four years, followed by four years of residency.”

He adds that ophthalmologists often do a one- or two-year fellowship to specialize. They may focus on such things as glaucoma or pediatrics.

An ophthalmologist will have an MD (doctor of medicine) or a DO (doctor of osteopathic medicine) after his or her name. Optometrists will have an OD after their names. They earn a doctor of optometry degree.

2. Medical vs. surgical

Another key difference is whether doctors perform surgery.

“Optometrists can handle nearly all the medical aspects of ophthalmology. But they do not perform surgery,” Dr. Wagenberg explains. Ophthalmologists are surgeons and can treat your medical needs as well.

Both can prescribe medications and treat eye diseases. States may limit which conditions optometrists can treat. Ophthalmologists can treat all eye diseases, he says.

Which doctor is best for your eye care?

The answer depends on your needs and preferences.

Exams and prescriptions. Either optometrists or ophthalmologists may perform eye exams. And either can prescribe glasses or contact lenses.

Special contact lens fittings. An optometrist is often the better option for contact lens wearers. “Optometrists often specialize in difficult contact lens fittings, and are often best for that type of examination,” Dr. Wagenberg says.

Laser and other surgeries. If you’re considering laser surgery or need other surgeries, an ophthalmologist is the right choice. “Otherwise, a good optometrist can handle what a general ophthalmologist can,” he says.

Serious eye conditions. If you have a serious condition — severe macular degeneration or diabetic retinopathy, for instance — you’ll typically see a specialist (ophthalmologist). If you don’t have any serious eye problems, the choice is really up to you.

Which doctor is best when you’re having problems?

When you have blurry vision, eye pain or “floaters,” it’s fine to see either an optometrist or an ophthalmologist, Dr. Wagenberg says.

A good eye doctor will help point you in the right direction if you need to see a different doctor or a specialist.

“An optometrist will refer you to an ophthalmologist for any difficult medical conditions such as uncontrolled eye infections, medically unmanageable glaucoma, cataract surgery, corneal transplants or retinal problems,” he says.

Ultimately, what’s best for your eye health is that you have regular exams and take steps to protect your vision.