Optometrist or Ophthamologist

For 17 years after being diagnosed, I have seen both of these doctors. Now I find myself at odds with my insurance company and these two docs. It is my understanding that an Optometrist prescribes glasses and Opthamologist can do surgery and also check deeper into any eye diseases. In my area we are at a very short supply with any specialists at all., so I feel fortunate to have found both where I live. However, they both do the same screening. Eye site check, diabetes checks, retina checks, med checks, bp checks, mapping my eyes for changes, exactly the same procedures. My insurance will not pay for the Ophthamologist visit simply because it is duplication of services. To be honest, I don’t know why I have to see them both, unless there would be major changes that have to be investigated further. AND I really can’t afford the extra charges on my bills. I have been a T2 on oral meds and Lantus once a day…my A1C’s are in the mid 6’s; I am 63 years old, have lost over 100 lbs in two years, exercise 4 times a week…and eat very carefully with 130 carbs alotted per day.
Any ideas on this one. It’s time to schedule those appts; and I’m stuck with what to do.

See an ophthalmologist.

Optometrists aren’t doctors. They pretend to be, and stretch their scope, way, way to far… I had an optometrist tell me I had diabetic retinopathy… It took an exam with a specialist to confirm that he had no idea what he was talking about. My endo has specifically told me never to go to an optometrist for an exam again…

If you need a pair of eye glasses, an optometrist is fine. If you need an eye doctor, an ophthalmologist is who you need— although an opthalmologist can also prescribe glasses / contacts / etc

If you are seeing an opthalmologist there is no reason to see an optometrist for anything. If you are seeing an optometrist you are missing out on a whole lot of expertise. I will never go to an optometrist again… If you’re already seeing an opthalmologist, all you are doing is wasting time and money with an optometrist… All they will do is refer you to an opthalmologist if you ever have any eye problems.

PS the optometrist (who’s not a doctor) also told me that my kidneys are probably failing after telling me that I have retinopathy–of course, they’re not, and I don’t. He told me all this before looking at the medical questionnaire I filled out before seeing him, which indicated that I’d only had diabetes for a few years and have an A1C of 5.0-5.3… once he saw that he backpedaled a bit. I have a very low opinion ever since of optometrists. I’m sure there are good ones, but they should stick to prescribing eyeglasses, which they are good at, not pretending to be doctors, which they are very bad at.


If your Ophthalmologist is one of those who thinks their ‘only’ job is to see after your eye health and not provide the screening and prescription to correct your vision then I would go with the Optometrist and yes, they DO the same job and if you need some further eye treatment or have complications then he/she can refer you to the necessary specialist. My long time ophthalmologist retired and I found an awesome optometrist who fits the bill just fine.

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My insurance is the opposite - will ONLY pay for the ophthalmologist (at specialist rate) because that’s considered ‘medical’ – otherwise, i pay out of pocket. Either way, i prefer to go to the medical professional and let the optometrist just make

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I see both, but if I had to pick one I would most definitely go with an ophthalmologist.

We have diabetes. A common secondary complication of diabetes is eye disease, such as retinopathy. My eyesight is precious to me as it is to everyone. I would not trust my annual exam to anyone but an opthamologist. The stakes are too high. This is not even a close call for me. I want a very experienced eye surgeon to examine my eyes and catch any untoward developments as soon as it happens. Someone who earns their living specifying corrective lenses is not someone I would trust with this vital responsibility.


An opthalmologist is an MD who has graduated from medical school and is licensed to practice medicine, which includes surgery. An optometrist is none of those things.

An optometrist is not qualified to diagnose or treat disease. Some do try and, the law of averages being what it is, I’m sure they sometimes get it right. But it is part of neither their job nor their training.

Unfortunately, it is also true that some opthalmologists aren’t interested in vision correction but only in dealing with genuine medical problems. So there is no simple absolute rule in the real world.

Whenever possible, I would have all my eye care needs seen to by an opthalmologist. If not, I would reluctantly go to both–but I would only use the optometrist for glasses and contact lenses and that’s all.

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[quote=“David_dns, post:7, topic:49017”]
An optometrist is not qualified to diagnose or treat disease. Some do try and, the law of averages being what it is, I’m sure they sometimes get it right. But it is part of neither their job nor their training.
But it is part of neither their job nor their training.[/quote]That is simply not true. At least in my state. My Optometrist does happen to be a doctor, not a surgeon however. And services include:
•Perform eye exams
•Treat conditions such as nearsightedness, farsightedness, and astigmatism
•Prescribe and fit eyeglasses and contact lenses
•Provide low vision aids and vision therapy
•Diagnose eye conditions such as glaucoma, cataracts, macular degeneration, diabetic retinopathy, and conjunctivitis
•Prescribe medications for certain eye conditions (in some states)
•Participate in pre- or post-operative care for people who need surgery

She refers to specialists when she can’t treat a condition. I trust my eye doc and in fact am going to get my eye check later on today.

Your comment bit quoted above is true about Opticians, maybe that is what you meant.

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Your optometrist is not a ‘real’ doctor, and did not go to medical school. They all call themselves doctors but aren’t really, by any reasonable definition other than their own.

Doctors have an MD or a DO after their name. Optometrist have an OD-- or Doctor of optometry which is a graduate level degree but not a medical doctorate. They are not recognized as physicians by any medical board in the world and have no provider privileges at any hospital.

You are right that in some states they have very very limited authority to prescribe meds— but nowhere near even what a nurse practitioner does.

But by all means if you’re happy with your optometrist keep going to see them-- just be advised that they certainly aren’t ophthalmologists…

More info available here http://www.aapos.org/terms/conditions/132

Well, it evidently varies. My statement was accurate for where I live. Perhaps the nomenclature is not standardized from place to place.

Here are two links that detail the differences between the two types of eye-care professionals:




An optometrist is qualified to diagnose and treat some basic eye conditions, at least in Canada. I’ve had mine diagnose allergic conjunctivitis, competently treat a severe corneal abrasion, as well as alert my ophthalmologist about a potential problem which he agreed with and resulted in referral to a second ophthalmologist specialist for treatment.

But, I see both mostly because I have numerous eye conditions which makes my situation complex, and the optometrist I see specializes in low vision (an ophthalmologist basically stops trying to measure vision accurately once you’re no longer able to read any letters on the eye chart). If I was only worried about screening and treatment for diabetes-related problems and could only pick one, I’d still choose an ophthalmologist.


[quote=“Sam19, post:9, topic:49017, full:true”]
Your optometrist is not a ‘real’ doctor, and did not go to medical school. They all call themselves doctors but aren’t really, by any reasonable definition other than their own.[/quote]Well I don’t know where you got your information on my eye doc. My optometrist is most certainly a ‘real’ doctor, and she did indeed go to medical school, in fact a very fine one and practiced at two hospitals in the largest medical center in the world. I wish I had taken a pic of her degree while I was there today.

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I have gone to both…my insurance pays for one eye exam per year. This year I asked for an ophthalmologist. I think for your overall eye health you should stick with a specialist. You have a great A1C!

I suppose someone could have obtained both an optometry degree and gone to medical school, but this is probably pretty unusual, and the vast majority of optometrists do not have medical degrees. If your optometrist has the same qualifications as an ophthalmologist (medical degree plus further specialzed training in eye medicine), I don’t understand why she would call herself an optometrist rather than an ophthalmologist.

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I think to keep her practice small and local and to be able to stay in the office rather than an institution. I am glad, she is awesome and does the exact same exam my old “real” doctor did. I HAD to find a new eye care provider because my “real” one retired. But then I go for the unusual whenever possible LOL!!

If your optometrist is an MD or a DO, they are not practicing as one in the field of optometry, because those two medical degrees do not certify optometrists… Only the OD does (a non-medical degree.)

This would make next to no sense for someone to go to the lengths of going to medical school and then practice optometry… Because they would have to again go to a 4 year optometry school, and accept a salary of about 30% what a ‘real doctor’ makes, but hey who knows…

If they went to a real medical school, and are a real doctor… I think you’re actually seeing an ophthalmologist… Which are some of the most highly trained doctors out there… Whereas optometrists often work at places like LensCrafters or the prestigious Walmart Vision Centers.

I researched this subject pretty thoroughly after my run in with the optometrist I disliked so much.

But hey like I said if you’re satisfied that’s all that matters… For me, based on my experience and the advice of my endocrinologist, I will never go to an optometrist again for anything other than an eyeglasses prescription .

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OMG - As long as Kate the OP and moi are getting the eyes checked by one or the other and the doc or wannabe doc does the looking inside the eyes for retina damage, optical nerve damage, glaucoma, and checks the vision ability then what difference can it make what they have after their name. Some folks can’t afford anything more than Wamart or Lenscrafters - I remember those days and I needed GLASSES to drive to work. Sheesh.

It can make a huge difference in the quality and knowledge. I’m sure there are optometrists who are good at spotting medical problems and then referring to doctors— but I personally would not choose to count on it.

I acknowledge I get a little touchy about titles… I have a professional title that took me almost 20 years to achieve, which others banty around after getting an entry level certificate and like to pretend it’s the same thing-- which is fairly irritating to me, I probably project that frustration onto other fields as well.

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The OP was asking which would be better to see if there was a choice between only an optometrist or only an ophthalmologist. As far as I read, money wasn’t an issue—if it was, then sure, any eye exam is probably better than none.

I would guess that the majority of people have little idea what constitutes a comprehensive eye exam. For example, I don’t know about other optometrists, but my optometrist looks in my eyes but never dilates them, and doesn’t use very powerful equipment to see the back of my eyes. A lot of people may assume that’s a comprehensive eye exam, and for people without diabetes it’s fine, but someone with diabetes needs their eyes dilated and the right equipment used to look into their eyes to properly check for any problems.

An ophthalmoloigst gives the highest chance of actually getting a comprehensive exam, spotting damage early, and knowing what needs to be done in regards to treatment.

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