What’s The Difference Between An Ophthalmologist & Optometrist?

Photographed by Rockie Nolan.
Getting contact lenses or prescription glasses online is as easy as ordering takeout these days. But, unlike the burrito you can summon to your door with minimal human interaction, you have to see an eye doctor IRL to get the prescription for your glasses or contacts before you can order them.
To make the process even more complicated, there are two types of eye doctors: optometrists and ophthalmologists. They sound the same, and can do some of the same things, but there are some distinct differences that are important to keep in mind before you make an appointment.
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Basically, an ophthalmologist is a medical doctor who specializes in eye care after medical school, says Mitra Nejad, MD, an ophthalmologist at the Stein Eye Institute at the University of California, Los Angeles. Ophthalmologists can practice medicine, perform surgery, diagnose and treat eye diseases, and prescribe glasses or contacts, she says.
Optometrists, on the other hand, are not medical doctors, but go to optometry school to get a degree. "Their practice primarily involves performing vision exams and prescribing glasses or contact lenses, detecting some eye pathologies, and occasionally treating certain eye conditions with medications," Dr. Nejad says. If you just need to get your vision checked or prescription updated, an optometrist will do the trick. But "they are not medical doctors, so they may not be familiar with all health conditions that can affect the eye," Dr. Nejad says, and there are restrictions on the drugs they can prescribe, which may vary by state.
If you see an optometrist for glasses, you might also work with an optician, a technician who has special training in designing and fitting eyeglasses and contacts, Dr. Nejad says. "They do not test or examine patients themselves, but use the prescriptions written by optometrists or ophthalmologists." Usually, an optometrist will connect you with an optician to fit your glasses, but you're not necessarily going to make an appointment with them.
So which one should you see? An optometrist is often the best starting point for most people. Although optometrists aren't medical doctors, they can pick up on eye abnormalities during your routine glasses check, and they might refer you to an ophthalmologist for further evaluation, she says. Some optometrists can also treat common eye conditions, such as dry eye or borderline glaucoma, Dr. Nejad says. So if you're concerned about those issues, you might want to mention it to your optometrist, and they'll let you know if you need to get a second opinion from an ophthalmologist.
Around age 40, some doctors recommend a routine screening exam for everyone from an ophthalmologist, because "unfortunately, many sight-threatening conditions are unnoticeable at first," she says. If you have a family history of eye conditions, such as glaucoma or macular degeneration, that would also warrant regular eye exams from an ophthalmologist, starting in your 40s.
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But "there are a number of health conditions that can affect eyesight, such as high blood pressure or diabetes," Dr. Nejad says. And if you have one of those conditions, your primary physician will often recommend starting your regular exams earlier.
There's one other huge factor to consider when choosing an eye doctor: health insurance. Since an ophthalmologist is a medical doctor, a visit would fall under your medical plan — even though it seems like it would fall under your vision insurance. If you have vision insurance, that will usually cover basic eye exams, but won't necessarily cover a visit to an ophthalmologist, according to Healthcare.gov. Either way, if you have health or vision insurance, do your research to make sure the optometrist or ophthalmologist.
So, yes, getting your eyes checked out can be a challenge — and it's definitely confusing. But it's worth figuring out for your eye health and comfort. Plus, once you do go to the doc, then you can focus on the really important stuff, like, you know, picking out glasses that make you look cool.
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