What’s the Difference Between the Three O’s?


Angels in Snow Stick FigureAngels 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.

washpost12_20That 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.

2 thoughts on “What’s the Difference Between the Three O’s?

  1. The problem between Optometry and Ophthalmology is a fundamental neurodevelopment disorder with a social component compounded by teaching in medical schools regarding other professions. The O’s need to understand each other and how we think about each other. We can accomplish this by establishing the bias one profession has against the other. To do this Len, we need to sit down with Ophthalmology and find their bias and our bias. MY OPINION.

    On a larger scale, if society continues to be wrong about what people are thinking in their minds, societies will continue the political-social problems up to and including what I call the Newtown Syndrome. Dr. Rebecca Saxe, a neuroscientist established a single location in the brain, the right temporoparietal junction, where the brain intuits what someone else is thinking. This section, just behind the right ear drives much of our thoughts about others {Scientific American, December 2012}. Adam Lanza was never treated correctly for his mental condition, and government knows this so they shift the blame to guns.

    I take this one step further; mental disorders cause social disorders; we will not be able to do well socially if we are systematically wrong about what others are thinking. Government upticks this by passing laws in favor of one group which then disfavors another group. An example of this is not allowing a young white male to have a profession or a job based on filling that position with what the government calls a minority. I do not know what part this has in violence in America, but I do not think the violence we see is related to guns, bullets, knives,TV, or even video games.
    August
    P.S. You might get an extra copy of this as my computer in Cancun has problems with their wi fi.

  2. In regards to optician training… Manual dexterity and superior communication skills are extremely important but are not easily taught. Even though knowledge of optics and even anatomy is a must, these skills can be taught using advanced training and can be the difference between a good optician and a great one.

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