Over half the people in the United States wear glasses or contact lenses. Optometrists (doctors of optometry, also known as O.D.'s) provide most of the primary vision care people need.
Optometrists examine people's eyes to diagnose vision problems and eye disease. They treat vision problems, and in most States, they treat certain eye diseases such as conjunctivitis or corneal infections, as well. Optometrists use instruments and observation to examine eye health and to test patients' visual acuity, depth and color perception, and their ability to focus and coordinate the eyes. They analyze test results and develop a treatment plan. Optometrists prescribe eyeglasses, contact lenses, vision therapy, and low vision aids. They use drugs for diagnosis in all States and, as of 1993, they may use topical and oral drugs to treat some eye diseases in 37 States. Optometrists often provide postoperative care to cataract patients. When optometrists diagnose conditions that require care beyond the optometric scope of practice such as diabetes or high blood pressure, they refer patients to other health practitioners.
Optometrists should not be confused with ophthalmologists or dispensing opticians. Ophthalmologists are physicians who diagnose and treat eye diseases and injuries. They perform surgery and prescribe drugs. Like optometrists, they also examine eyes and prescribe eyeglasses and contact lenses. Dispensing opticians fit and adjust eyeglasses and in some States may fit contact lenses according to prescriptions written by ophthalmologists or optometrists. (See statements on physicians and dispensing opticians elsewhere in the Handbook.)
Most optometrists are in general practice. Some specialize in work with the elderly, with children, or with partially sighted persons who use specialized visual aids. Others develop and implement ways to protect workers' eyes from on-the-job strain or injury. Some specialize in contact lenses, sports vision, or vision therapy. A few teach optometry or do research.
Most optometrists are private practitioners who also handle the business aspects of running an office, such as developing a patient base, hiring employees, keeping records, and ordering equipment and supplies. Optometrists who operate franchise optical stores may also have some of these duties.
Optometrists provide most of the primary vision care people need.
Optometrists work in places usually their own offices that are clean, well lighted, and comfortable. The work requires attention to detail and manual dexterity. Most full-time optometrists work about 40 hours a week, but a substantial number work more than 50 hours a week. Many work Saturdays and evenings to suit the needs of patients, but emergency calls are few.
Optometrists held about 31,000 jobs in 1992. The number of jobs is greater than the number of practicing optometrists because some optometrists hold two or more jobs. For example, an optometrist may have a private practice, but also work in another practice, clinic, or vision care center.
Although many optometrists are in solo practice, a growing number are in partnership or group practice. Some optometrists work as salaried employees of other optometrists or of ophthalmologists. Others work in hospitals, health maintenance organizations (HMO's), or retail optical stores.
Some optometrists are consultants for industrial safety programs, insurance companies, manufacturers of ophthalmic products, HMO's, and others.
All States and the District of Columbia require that optometrists be licensed. Applicants for a license must have a Doctor of Optometry degree from an accredited optometry school and pass both a written and a clinical State board examination. In many States, applicants can substitute the examinations of the National Board of Examiners in Optometry, usually taken during the student's academic career, for part or all of the written examination. Licenses are renewed every 1 to 2 years and in most States, continuing education credits are needed for renewal.
The Doctor of Optometry degree requires completion of a 4-year program at an accredited optometry school preceded by at least 3 years of preoptometric study at an accredited college or university (most optometry students hold a bachelor's degree). In 1993, 17 U.S. schools and colleges of optometry were accredited by the Council on Optometric Education of the American Optometric Association.
Requirements for admission to schools of optometry include courses in English, mathematics, physics, chemistry, and biology. A few schools require or recommend courses in psychology, history, sociology, speech, or business. Applicants must take the Optometry Admissions Test (OAT), which measures academic ability and scientific comprehension. Most applicants take the test after their sophomore or junior year. Competition for admission is keen.
Optometry programs include classroom and laboratory study of health and visual sciences, as well as clinical training in the diagnosis and treatment of eye disorders. Included are courses in pharmacology, optics, biochemistry, and systemic disease.
Business ability, self-discipline, and the ability to deal tactfully with patients are important for success.
Optometrists wishing to teach or do research may study for a master's or Ph.D. degree in visual science, physiological optics, neurophysiology, public health, health administration, health information and communication, or health education. One-year postgraduate clinical residency programs are available for optometrists who wish to specialize in family practice optometry, pediatric optometry, geriatric optometry, low vision rehabilitation, vision therapy, contact lenses, hospital based optometry, and primary care optometry.
Employment of optometrists is expected to grow about as fast as the average for all occupations through the year 2005 in response to the vision care needs of a growing and aging population. The maturing of the baby-boom generation, together with rapid growth in the elderly population will drive this growth. Persons over the age of 45 visit optometrists and ophthalmologists more frequently because of the onset of vision problems in middle age and the increased likelihood of cataracts, glaucoma, diabetes, and hypertension in old age. Employment of optometrists will also grow due to greater recognition of the importance of vision care, rising personal incomes, and growth in employee vision care plans.
Employment of optometrists would grow more rapidly were it not for anticipated productivity gains which will allow each optometrist to see more patients. These gains will result from greater use of optometric assistants and other support personnel, and the introduction of new equipment.
Replacement needs are low. In this occupation, replacement needs arise almost entirely from retirements and deaths. Optometrists generally remain in practice until they retire; few transfer to other occupations.
According to the American Optometric Association, new optometry graduates in their first year of practice earned median net income of about $45,000 in 1992. Overall, optometrists earned median net income of about $75,000. Optometrists in private practice generally earned more than salaried optometrists.
Incomes vary depending upon location, specialization, and other factors. Salaried optometrists tend to earn more initially than optometrists who set up their own independent practice. However, in the long run, those in private practice generally earn more.
Workers in other occupations who apply scientific knowledge to prevent, diagnose, and treat disorders and injuries are chiropractors, dentists, physicians, podiatrists, veterinarians, speech-language pathologists, and audiologists.
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Reprinted with Permission of U. S. Department of Labor