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Optometry is a doctoral-degree health care profession concerned with eyes and related structures, as well as vision, visual systems, and vision information processing in humans. The health care industry or health profession treats and tends to patients who are injured sick disabled or infirm Eyes are organs that detect Light, and send signals along the Optic nerve to the visual areas of the brain VisiCorp 's VisiOn was a short-lived but influential Graphical user interface -based Operating environment program for IBM PC compatible The visual system is the part of the Nervous system which allows organisms to see. In Psychology, visual perception is the ability to interpret information from Visible light reaching the Eyes The resulting Perception is also

Like most health professions, optometry education, certification, and practice is regulated in most countries. Education encompasses both the Teaching and Learning of Knowledge, proper conduct, and technical competency Optometrists and optometry-related organizations interact with governmental agencies, other health care professionals, and the community to deliver eye and vision care. Optometry is one of two doctoral-degree professional eye care professions, the other being ophthalmology. Ophthalmology is the branch of Medicine which deals with the diseases and surgery of the visual pathways including the Eye, Brain

An optical refractor (also called a phoropter) in use.
An optical refractor (also called a phoropter) in use. A phoropter (or phoroptor) is an instrument commonly used by Optometrists and Ophthalmologists during an Eye examination to measure an individual's

Contents

Scope of practice

Optometrists, also known as doctors of optometry, are primary health care providers for the eye and visual system. Primary health care, often abbreviated as PHC ( Primary Health Centre) and PC is "essential health care based on practical scientifically sound They examine, diagnose, and medically treat eye diseases, non-surgical injuries, and disorders of the eyes and visual system, including refractive problems such as near- or far-sightedness, and identify related systemic medical conditions affecting the eyes and ocular adnexa. In Anatomy, adnexa refers to the Appendages of an organ Examples of adnexa Adnexa of Eye Extraocular muscles In some locations, optometrists may perform laser surgery. Laser surgery is Surgery using a Laser to cut tissue instead of a Scalpel.

Optometrists may serve the general public; specialize in work with the elderly, children, or partially-sighted persons who need specialized visual devices; develop and implement ways to protect workers eyes from on-the-job strain or injury; or specialize in contact lenses, sports vision, or vision therapy.

Eye and vision examination

The typical optometric examination has three components: history-taking of both eye-related health and optical and visual functioning-related aspects of the patient, the evaluation of the health status for the detection of eye disease, and evaluating the optical and vision characteristics of the eye and observations during testings. An eye examination is a battery of tests performed by an Optometrist or Ophthalmologist assessing vision and ability to focus on and discern

Examination of ocular health may include:

Examination of visual skills:

Pre-optometric education

Prerequisites for admission to optometry schools are similar to those to most medical, osteopathic, and dental programs.

Examples of equipment used for eye and vision health testing

Many types of equipment are used during an eye examination. Vision charts and machines are used to measure vision and visual fields. An eye chart is a chart used to measure Visual acuity. Types of eye charts include the Snellen chart, Landolt C, and the Lea test. Eye examination Visual acuity (VA is acuteness or clearness of vision, especially form vision which is dependent on the sharpness of the retinal focus within the The term visual field is sometimes used as a Synonym to Field of view, though they do not designate the same thing Trial (spectacle and contact) lenses or a phoropter and retinoscope may be used during refraction. A phoropter (or phoroptor) is an instrument commonly used by Optometrists and Ophthalmologists during an Eye examination to measure an individual's Retinoscopy is a technique to obtain an objective measurement of the refractive condition of a patient's Eyes. Prism bars, small objects, and occluders may be used to assess eye movements and eye alignment. Test booklets, sheets, instructions, and pencils may be used for visual information processing examination. Visual skills can be divided to into two main categories visual perceptual motor skills and ocular motor skills

Penlights and transilluminators can be used when assessing pupil light response, a neurological screening test. The pupil is the hole that is located in the center of the iris of the eye and that controls the amount of light that enters the Eye. Specialty magnifiers, such as ophthalmoscopes and slit-lamp bio-microscopes, help with detailed inspection of external and internal anatomical ocular structures. The ophthalmoscope (or funduscope) is an instrument used to examine the Eye. The slit lamp is an instrument consisting of a high-intensity Light source that can be focused to shine as a slit Diagnostic eye drops may also be used to assess the various anatomical structures of the eyes.

Many optometrists use computerized equipment specifically designed to help diagnose and/or monitor certain ocular diseases. For example, many optometrists' offices have various visual field analyzers and tonometers that are helpful in diagnosing disease entity in early stages. The term visual field is sometimes used as a Synonym to Field of view, though they do not designate the same thing In music a tonometer is an instrument used to determine the pitch or vibration rate of tones such as a Tuning fork. Optometrists use digital imaging equipment, such as digital cameras to document appearance of the anterior and posterior parts of the eye. Corneal topographers are used to gather information on anterior aspects of the anatomy of the eye and cornea. Other sophisticated equipment such as Optical coherence tomography, GDX,[1] or HRT II can be used for various disease testing and treatment. Optical coherence tomography (OCT is an optical signal acquisition and processing method allowing extremely high-quality micrometre-resolution three-dimensional images from within optical Scanning laser polarimetry is the use of Polarised light to measure the thickness of the Retinal nerve fiber layer as part of a Glaucoma workup

Diagnoses

Diagnoses made by optometry depends on integrating eye examination information.

Some ocular diseases can be associated with systemic, neural, or other disease complications. This is a partial list of human Eye diseases and disorders. The World Health Organization publishes a classification of known diseases and injuries called the This is a list of systemic diseases with ocular manifestations. A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly Some ocular disorders may be treated by an optometrist. In some cases, referral to an ophthalmologist may be required for surgical treatment.

Visual dysfunctions assessed by optometrists may include:

Common examples of ocular pathologies diagnosed and treated by optometrists include:

Common examples of diseases of systemic origin with eye complications that can be recognized and managed by evaluation of the ocular structures include:

Patient management

Optometric patient management may include:

They give advice and follow-up care regarding use of optical aids (especially contact lenses), provide referral to other health professionals including internist and other primary care physicians and particularly sub specialists like ophthalmologists for surgical consultation, and interact with opticians and the optical industry, which manufacture the optical aids such as glasses in accordance to optical prescriptions. Ophthalmology is the branch of Medicine which deals with the diseases and surgery of the visual pathways including the Eye, Brain Scientific Equipment OpticianAn optician is an Eye care professional who provides corrective lenses based on a prescription for the correction of a Refractive

History

Optometric history is tied to the development of

The term optometrist was coined by Landolt in 1886, referring to the "fitter of glasses". Vision science is the Science dedicated to the Interdisciplinary study of Visual perception and the Visual system. Optics began with the development of lenses by the Ancient Egyptians and Mesopotamians followed by theories on Light and vision developed by ancient An optical instrument either processes Light waves to enhance an image for viewing or analyzes light waves (or Photons to determine one of a number of characteristic An eye care professional is an individual who provides a service related to the Eyes or vision. Prior to this, there was a distinction between "dispensing" and "refracting" opticians in the 19th century. Scientific Equipment OpticianAn optician is an Eye care professional who provides corrective lenses based on a prescription for the correction of a Refractive The latter were later called optometrists. [2]

The first schools of optometry were established in 1850-1900 (in USA), and contact lenses were first used in 1940s [3]

Licensing

Most countries have regulations concerning optometry education and practice. Optometrists like many other health care professionals are required to participate in ongoing continuing education courses to stay current on the latest standards of care.

Optometry is officially recognized:

See also: List of optometry schools

United Kingdom

In the United Kingdom, optometrists have to complete a 3 or 4 year undergraduate honours degree followed by a minimum of a one-year "pre-registration period" where they complete supervised practice under the supervision of an experienced qualified practitioner. The Caribbean (ˌkærəˡbiən kæ'rəbiən Cariben|Caraïben or Caraïben; Caraïbe or more commonly Antilles; Caribe is a Region consisting For a topic outline on this subject see List of basic Australia topics. For the biogeographical region see Malesia Malaysia (məˈleɪʒə or /məˈleɪziə/ is a country that consists of thirteen states and China ( Wade-Giles ( Mandarin) Chung¹kuo² is a cultural region, an ancient Civilization, and depending on perspective a National Hong Kong ( officially the Hong Kong Special Administrative Region, is a territory located on China 's south coast on the Pearl River Delta, and borders The Kingdom of Thailand (ˈtaɪlænd ราชอาณาจักรไทย, râːtɕʰa-ʔaːnaːtɕɑ̀k-tʰɑj Taiwan ( Taiwanese: Tâi-oân/Tāi-oân (historically 大灣/台員/大員/台圓/大圓/台窩灣 is an Island in East Asia. The Kingdom of Saudi Arabia, KSA ( المملكة العربية السعودية, al-Mamlaka al-ʻArabiyya as-Suʻūdiyya) or Suudi For a topic outline on this subject see List of basic Iran topics. This is a list of Optometry Schools sorted alphabetically by country The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located During this year the pre-registration candidate is given a number of quarterly assessments and on successfully passing all of these assessments, a final one-day set of examinations. Following successful completion of these assessments and having completed one year's supervised practice, the candidate qualifies for membership of The College of Optometrists and is eligible to register as an optometrist with the General Optical Council (GOC). The College of Optometrists is the professional scientific and examining body for Optometry in the United Kingdom, working for the public benefit

There are 6 universities which offer Optometry in England, they are: Anglia Ruskin University, Aston University, Bradford University, Cardiff University, London City, and Manchester University

Registration with the GOC is mandatory to practice in the UK. Members of the College of Optometrists may use the suffix MCOptom. Optometrists in the United Kingdom, as in most countries except the United States and Canada, receive a Bachelor of Optometry or Masters degree. They are not called "doctor" in the United Kingdom.

United States

US optometrists complete a 4-year program that leads to a Doctorate in Optometry (O. D. ) degree. Many optometrists complete a one- or two-year residency to specialize. A sample curriculum is available from the Inter American University School of Optometry. As primary eye care providers, doctors of optometry are an integral part of the health care team. Prior to admittance into optometry school, optometrists typically complete four years of undergraduate study, culminating in a bachelor’s degree. Required undergraduate coursework for pre-optometry students covers a variety of health, science and mathematics courses. Optometry school consists of four years of study focusing on the eye, vision, and some systemic diseases. In addition to profession-specific courses, optometrists are required to take health courses that focus on a patient’s overall medical condition as it relates to the eyes.

Upon completion of optometry school, candidates graduate from accredited college of optometry and hold the optometry (OD) degree. Optometrists must pass a rigorous national examination administered by the National Board of Examiners in Optometry (NBEO)http://www.optometry.org/passfail.cfm. The three-part exam includes basic science, clinical science and patient care. (The structure and format of the NBEO exams are subject to change beginning in 2008. ) Some optometrists go on to complete residencies with training in a specific sub-specialty. These specialties include pediatric care, children’s vision, geriatric care, specialty contact lens (for keratoconus patients or other corneal dystrophy) and many others. Keratoconus (from Greek: kerato- horn cornea and konos cone is a degenerative disorder of the Corneal dystrophy is a group of disorders characterised by a noninflammatory inherited bilateral opacity of the transparent front part of the Eye called the Cornea All optometrists are required to fulfill continuing education requirements to stay current on the latest standards of care.

Argentina

In Argentina optometrists are required to register with the local Ministry of Public Information, but licensing is not required. For a topic outline on this subject see List of basic Argentina topics. Anyone holding a Bachelor's degree may register as an optometrist after completing a written exam. Fees for the exam are set by the provincial government and vary from province to province.

Colombia

In Colombia optometry education has been accredited by the Ministry of Health. Colombia (kəˈlʌmbɪə officially the Republic of Colombia () is a country in northwestern South America. The last official revision to the laws regarding health care standards for the country was issued in 1992 through the Law 30. [4] Currently there are eight official Universities that are entitled by ICFES to grant the Optometrist certification. ICFES is an Acronym for Instituto Colombiano de Fomento de la Educacion Superior ("Colombian Institute for the fomenting of Higher Education" The first optometrist arrived to the country from North America and Europe circa 1914. These professionals were specialized in optics and refraction. Refraction is the change in direction of a Wave due to a change in its Speed. In 1933 under Decree 449 and 1291 the Colombian Government officially set the rules for the formation of professionals in the area of optometry. A decree is an order made by a Head of state or government and having the force of Law. In 1966 La Salle University opens its first Faculty in Optometry after a recommendation of a group of professionals. At the present time optometrists are encouraged to keep up with new technologies through congresses and scholarships granted by the government or private companies (such as Bausch & Lomb). Bausch & Lomb is an American company based in Rochester New York, is one of the world's leading suppliers of Eye health products such as Contact

Europe

Currently, optometry education and licencing varies throughout Europe. For example, in Germany, optometric tasks are performed by ophthalmologists and professionally trained and certified opticians. Ophthalmology is the branch of Medicine which deals with the diseases and surgery of the visual pathways including the Eye, Brain Scientific Equipment OpticianAn optician is an Eye care professional who provides corrective lenses based on a prescription for the correction of a Refractive In France, there is no regulatory framework and optometrists are sometimes trained by completing an apprenticeship at an ophthalmologists' private office. [5]

Since the formation of the European Union, "there exists a strong movement, headed by the Association of European Schools and Colleges of Optometry (AESCO), to unify the profession by creating a European-wide examination for optometry" and presumably also standardised practice and education guidelines within EU countries. The European Union ( EU) is a political and economic union of twenty-seven member states, located primarily in [6] ew

Ireland

The profession of Optometry has been represented for over a century by the Association of Optometrists, Ireland [AOI]. In Ireland an optometrist must first complete a four year degree in Optometry at D. I. T. Kevin Street. Following successful completion of the a degree, an optometrist must then complete Professional Qualifying Examinations in order to be entered into the register of the Opticians Board [Bord na Radharcmhaistoiri]. Optometrists must be registered with the Board in order to practice in the Republic of Ireland.

The A. O. I. runs a comprehensive continuing education and professional development program on behalf of Irish optometrists. The legislation governing Optometry was drafted in 1956. The legislation restricts optometrists from using their full range of skills, training and equipment for the benefit of the Irish public. The amendment to the Act in 2003 addressed one of the most significant restrictions - the use of cycloplegic drugs to examine children.

Distinction from ophthalmology

Ophthalmologists after obtaining a 4-year bachelor degree, attend medical school for 4 years of medical training to obtain an Doctor of Medicine (MD) or an Osteopathic (DO) degree. Ophthalmology is the branch of Medicine which deals with the diseases and surgery of the visual pathways including the Eye, Brain Ophthalmologists train for an additional three to four years of residency training. Residency training in ophthalmology encompasses all aspects of diagnosis and management of diseases that affect the eye, orbit, and neurological system of the brain. This includes surgical treatment. Many ophthalmologists pursue additional fellowship training in various subspecialties.

In the USA, optometrists also acquire a 4-year bachelor degree followed by 4 years of Optometry school to earn an OD or Doctor of Optometry degree. While in school, optometry students undergo internship training and after completion of the degree, have options of 1- to 2-year residency programs for further specialization.

Optometrists having completed a residency can further specialize in a particular area such as Pediatric Optometry, Geriatric Optometry, Behavioral Optometry or Neuro-optometry.

Optometry school curriculum in the United States include such courses as vision sciences, health sciences, pharmacology, encompassing diagnosis and management of diseases that affect the eye, orbit, and neurological system of the brain. Examples include courses in visual psychophysics, optics, as well as training in aspects of functional vision such as vision therapy, binocular vision, and low vision. Optometrists are also trained extensively in anatomy, histology, neurology, vision perception. They have a broad understanding of disease etiology, management, and treatment. In general, optometrists can do the same things ophthalmologists do with the exception of managing diseases (e. g. ptosis, strabismus, wet macular degeneration, proliferative diabetic retinopathy, glaucoma, cataracts) that require surgical expertise. Depending on state law, however, many optometrists are licensed to perform minor surgery as well as laser surgery. Some states limit the prescribing of oral medications by optometrists depending on licensure and regulatory requirements.

The two fields often have a mutually beneficial relationship:

Ophthalmologists may refer patients to optometrists for contact lenses or for optical aids or low vision rehabilitation whilst continuing to treat the underlying disease/condition that may have reduced vision. Similarly, complicated and emergency eye conditions are referred from Optometry to Ophthalmology.

Both optometrists and ophthalmologists perform screening for common ocular problems affecting children (i. e. , amblyopia and strabismus) and the adult population (cataract, glaucoma, and diabetic retinopathy). Amblyopia, otherwise known as lazy eye, is a disorder of the Visual system that is characterized by poor or indistinct vision in an eye that Strabismus (from Greek: στραβισμός strabismos, from στραβίζειν strabizein "to squint" from στραβός strabos A cataract is a clouding that develops in the crystalline lens of the Eye or in its envelope varying in degree from slight to complete opacity Glaucoma is a group of diseases of the Optic nerve involving loss of retinal ganglion cells in a characteristic pattern of optic neuropathy. Diabetic retinopathy is Retinopathy (damage to the Retina) caused by complications of Diabetes mellitus, which can eventually lead to Blindness

Optometrists generally manage treatment of strabismus and amblyopia with vision therapy while Ophthalmologists manage these disorders with refractive, orthoptic, medical and surgical therapy.

See also Ophthalmology#Distinction from Optometry

Sub-specialties

There are currently nine sub-specialty residencies offered by various schools of optometry in the United States [1] [2]:

  1. Cornea and contact lenses
  2. Family practice optometry
  3. Geriatric optometry
  4. Glaucoma
  5. Low vision rehabilitation
  6. orthoptic practice
  7. Ocular disease
  8. Pediatric optometry
  9. Primary care optometry
  10. Vision therapy and rehabilitation

Many of these sub-specialties are also recognised in other countries. Ophthalmology is the branch of Medicine which deals with the diseases and surgery of the visual pathways including the Eye, Brain The cornea is the transparent front part of the Eye that covers the iris, Pupil, and Anterior chamber. A contact lens (also known simply as a contact) is a corrective, cosmetic, or therapeutic lens usually placed on the Cornea Geriatrics is the branch of Medicine that focuses on health care of the elderly Glaucoma is a group of diseases of the Optic nerve involving loss of retinal ganglion cells in a characteristic pattern of optic neuropathy. Low vision is a subspecialty within the professions of Optometry and Ophthalmology and Opticianry dealing with individuals who have less than normal vision This is a partial list of human Eye diseases and disorders. The World Health Organization publishes a classification of known diseases and injuries called the Pediatrics (also spelled paediatrics) is the branch of Medicine that deals with the medical care of Infants Children and Adolescents Vision therapy, also known as visual training, vision training, or visual therapy, is a group of techniques attempting variously to correct or improve presumed

Please note, refractive surgery and ocular surgery fellowships involve learning how to co-manage patients before and after eye surgery. Similarly, ocular disease residencies involve co-management practice with other health professionals. Also the College of Optometrists in Vision Development provides certification for eye doctors in vision therapy, behavioral and developmental vision care, and "visual rehabilitation". The College of Optometrists in Vision Development (COVD is an international non-profit optometric membership organization that provides education evaluation and board certification programs in Behavioral optometry (also known as "functional optometry" is an expanded area of optometric practice that uses a holistic approach in the treatment of vision and Training in binocular vision and orthoptics sub-specialties are often integrated into either pediatric or vision therapy programs. Binocular vision is vision in which both Eyes are used together

Etymology

The term "optometry" comes from the Greek word optos, meaning eye or vision, and metria, meaning measurement.

See also

External links

Organizations

Other

Some optometry-related publications

References

  1. ^ Handbook of Ocular Disease Management - Understanding Nerve Fiber Layer Analysis
  2. ^ History of Optometry, Lecture Handout at Indiana University School of Optometry by David A. Goss. Behavioral optometry (also known as "functional optometry" is an expanded area of optometric practice that uses a holistic approach in the treatment of vision and An eye care professional is an individual who provides a service related to the Eyes or vision. An eye examination is a battery of tests performed by an Optometrist or Ophthalmologist assessing vision and ability to focus on and discern An eyeglass prescription is a written order by an Optometrist or Ophthalmologist to an Optician for Eyeglasses. Ophthalmology is the branch of Medicine which deals with the diseases and surgery of the visual pathways including the Eye, Brain Optometry is a health care profession that provides comprehensive eye and vision care which includes the diagnosis and management of eye diseases Vision therapy, also known as visual training, vision training, or visual therapy, is a group of techniques attempting variously to correct or improve presumed In Psychology, visual perception is the ability to interpret information from Visible light reaching the Eyes The resulting Perception is also Visual skills can be divided to into two main categories visual perceptual motor skills and ocular motor skills
  3. ^ History
  4. ^ Consejo Nacional de Acreditación
  5. ^ Welcome to Eurotimes
  6. ^ The unification of European optometry: how the profession will change after 1992 by Hamakiotes DS, Thal LS in J Am Optom Assoc. 1992 Jun;63(6):388-9.

Dictionary

optometry

-noun

  1. The art and science of vision and eye care.
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