Article Date: 6/1/2013

Street Smarts
Street Smarts

The Battle of the “O’s” Revisited

By Dan Beck, OD Leland, N.C.

RECENTLY, after completing an exam on a patient, he asked me THE question: “What’s the difference between an optometrist and an ophthalmologist?” Without hesitation, I looked him in the eye, and with a deadpan expression said “Ophthalmologists cut and puncture.” I allowed the statement to hang there, waiting for a reaction. After some time had passed with no reply, I explained that ophthalmologists are eye surgeons who operate with different instruments and technologies. I also told him I refer my patients to ophthalmologists when a specialist for a certain part of the eye is needed.

Knowing Your Place

This encounter demonstrates the confusion patients may have when it comes to ODs and MDs, and it shows how the eyecare system should work. We are primary eyecare providers. When secondary or tertiary eye care is needed, we refer to our ophthalmology friends — and we should be friends. When the system works, we send them patients and they return them to our care after their services completed. The system can break down when ophthalmologists badmouth and belittle optometrists. They claim we aren’t trained to do what they do and, in the truest sense, that statement is correct. The conflicts come when the ophthalmologists themselves do what WE are trained to do — provide primary eye care.

Although I doubt most would admit it, I believe ophthalmologists performing primary eye care do so out of financial necessity, not by choice. I’ve spoken with many doctors on both sides of this issue and I’ve come to the conclusion that ophthalmologists who provide primary eyecare services aren’t performing enough surgeries, period. The really good ophthalmologists love us because we keep them operating. We help them do what they were trained for. They’re too busy to perform primary eyecare and they’re happy their local optometrists are doing it. Show me an ophthalmologist who belittles optometry and I’ll show you a doctor who’s longing to get more time in the OR or surgical suite.

After another long silence my patient said, “So I can come to you and you’ll send me to an ophthalmologist if I need a specialist, same as when my regular doctor sent me to an orthopedic doc for my bad knees?” I smiled and told him I couldn’t have said it better myself. nOD

images Dr. Beck is a 1993 graduate of the Pennsylvania College of Optometry. You can reach him at

Optometric Management, Volume: , Issue: June 2013, page(s):