Angels in the Snow. What kind of graphic is that for understanding the difference between the three O’s? When I conduct my seminars on vision I always ask attendees three open ended questions:
1) What is normal vision?
2) Where does vision occur in the body?
3) What’s the difference between an optometrist, an ophthalmologist, and an optician?
The answers to the first two questions help set the framework for the third, and it’s always interesting to hear the answers given. Most attendees figure out that opticians are the ones who don’t examine eyes and mainly fill prescriptions, but they struggle to differentiate an optometrist from an ophthalmologist. Many attendees will identify an optometrist by what she or he doesn’t do. In other words, the ophthalmologist is the one who does surgery. It is presumed that that the ophthalmologist (“Eye MD”) does everything the optometrist does, plus. Essentially it’s a definition of exclusion rather than inclusion. By the time we get to the end of the seminar, it is very clear to OTs, PTs, and SLPs that that the optometrist is skilled in visual function to an extent far greater than the ophthalmologist for the populations that are the subject of the lecture/workshop. Not only do attendees learn that ODs and MDs speak different languages relative to vision, but they understand which cases require the expertise of behavioral, developmental, and rehabilitative ODs.
That is why it was such a joy to receive the email that I did from Pam Happ this morning. Pam is the superb Executive Director of the College of Optometrists in Vision Development, and she shared a wonderful column from the Washington Post written by Marguerite Kelly. Ms. Kelly’s Family Almanac column of December 18 was written in response to a parent’s inquiry about a bright child who is completely unmotivated to learn at school or to read at home, and she writes: “Although an ophthalmologist will tell you how well your son can see, it usually takes a developmental or behavioral optometrist to tell you how well his eyes are working when he reads or when he looks back and forth from the blackboard to the printed page. Some children get headaches because they can’t focus well or their vision is blurry, but they don’t complain because they think that heads are supposed to hurt or that the world is a blur for everyone.If your son has these or other vision problems, don’t despair. Vision therapy is to the eyes what physical therapy is to the body, and it’s effective 90 percent of the time.”
I’ve always felt that we would come to a tipping point for the populations we deal with where Optometrists would be defined in the marketplace by the services and guidance we provide, and Ophthalmologists would be identified by the limitations of their scope of practice and services. Ms. Kelly’s column heralds that we have arrived at that tipping point.