The team
Ophthalmologists are the designated leaders of the eye care team. They are medical eye doctors who specialize in eye and vision care, diagnosis and the treatment of eye disease and provide comprehensive eye exams, prescribe corrective lenses, prescribe and administer medication and perform surgery.
Optometrists are non-medical practitioners trained to assess the eye and the visual system, sensory and ocular motor disorders and dysfunctions of the eye and the visual system, and diagnose refractive disorders. The optometrist prescribes and dispenses corrective and preventative devices and works hand in hand with other members of the eye care team in assuring that patients are referred appropriately for diagnostic and therapeutic needs.
Opticians are non-medical practitioners who supply, prepare and dispense optical appliances, interpret prescriptions prepared by ophthalmologists and optometrists, and fit, adjust and adapt optical appliances. Opticians are also known as ophthalmic dispensers or dispensing opticians.
Medical Practitioners
Ophthalmologist
Ophthalmologists are physicians who, upon graduation from medical school, undertake several years of post-graduate training in the diagnosis and treatment of diseases of the eye. This training begins with a broad exposure to general medical problem management, emergency services, pediatric care, and selected exposure to such disciplines as neurology and endocrinology. It also includes very intensive training in clinical settings with exposure to acute and chronic disease and the important experience of follow-up over long periods of time for such important ocular conditions as glaucoma, diabetic retinopathy, cataracts and degenerative disorders. Extensive surgical experience is also incorporated into the last 24 months of training. Many ophthalmologists continue their training for a further 12-24 months in a variety of subspecialties.
As the designated leader of the eye care team in his or her community or hospital, the ophthalmologist works closely with other members of the team including orthoptists, ophthalmic technicians and/or technologists, nurses and other physicians. The whole team also works closely with optometry in many communities.
Ophthalmologists offer a comprehensive approach to ocular symptoms and disease. As well as diagnosing and treating ocular disease either by medical or surgical means, ophthalmologists offer comprehensive ocular-visual assessment which may include the prescription of corrective lenses. Ophthalmologists are also involved in kerato-refractive surgery using both surgical and laser techniques to correct a variety of ailments.
Family Physicians
Family physicians play a pivotal role in the delivery of health care in Canada, This role includes both the prevention and the treatment of eye disease. Their comprehensive medical knowledge allows them to relate ocular symptoms and signs to systemic disease, and their knowledge of microbiology enables them to recognize and treat common eye infections. Family physicians also play an important role in referring patients, when necessary, to the appropriate health care professionals. This might be to an ophthalmologist for diagnosis and treatment of ocular disease or to an optometrist for an oculo-visual assessment.
Emergency Physicians
Many emergency physicians now staffing hospital emergency rooms are trained in emergency medicine. Others are family physicians who have developed a clinical expertise in emergency room care. These doctors have the clinical skills to deal with acute eye injuries and disease in an emergency situation. After initial treatment, patients are then referred to ophthalmologists for follow-up.
Pediatricians
Pediatricians are physicians with post graduate training which enables them to recognize and treat diseases in children and adolescents. As an active member of the eye care team, the pediatrician plays a vital role in recognizing ocular signs and symptoms of disease in their young patients.
Internist
Also an important member of the eye care team, internists are similar to pediatricians but look after an older age group. Internists also recognize the signs and symptoms of ocular disease and work closely with ophthalmologists in the management of patients who suffer from neurological disorders or diseases such as hypertension, diabetes, kidney disease and others.
Medically Trained Practitioners
Orthoptist
An orthoptist is specially trained to recognize and treat by non-medical and non-surgical means, anomalies of binocular vision which are usually associated with the misalignment of the patient's eyes.
Orthoptists play a vital role in working with the ophthalmologist in a standardized assessment of ocular motility which is important in the diagnosis of strabismus and amblyopia (lazy eye) an in the long term follow-up during treatment with glasses or a post-operative surgical correction.
Orthoptists have a strong professional association, The Canadian Orthoptic Society and are governed by the Canadian Orthoptic Council (COC) which sets standards for entry into the profession. The COC also carries out accreditation visits of orthoptic training programs and administers the written and clinical examinations given to graduates of training programs before they are accepted into the profession.
Ophthalmic Medical Assistant
The Ophthalmic Medical Assistant (OMA) is a qualified individual who carries out diagnostic and therapeutic procedures under the direction and supervision of a qualified ophthalmologist. The ophthalmologist is responsible for the performance of the assistant. Absolute responsibility for the patient lies with the ophthalmologist.
OMAs come from varied backgrounds and have different levels of proficiency. The Joint Commission on Allied Health Personnel in Ophthalmology recognizes the Ophthalmic Assistant, the Ophthalmic Technician and the Ophthalmic Technologist levels of training. Each has a well-defined curriculum and a rigid assessment program.
In Canada, training programs for ophthalmic technicians are given in Ottawa, Yellowknife and Halifax. The program in Halifax-a unique program in North America-is a combination of Ophthalmic Technologist and Orthoptics and is based at the IWK Children's Hospital.
A home study course for Ophthalmic Assistants is available through Centennial College of Applied Arts and Technology in Scarborough, ON.
There are also a whole variety of refresher or update courses for ophthalmic technologists offered on an on-going basis at sites across the country.
Non-medical Practitioners
Optometrists
The Optometrist is a health professional, trained to assess the eye and the visual system, sensory and ocular motor disorders and dysfunctions of the eye and the visual system, and diagnose refractive disorders. The optometrist identifies and assesses clinical findings and symptoms and offers the patient the appropriate response according to accepted optometric standards of practice.
The optometrist prescribes and dispenses corrective and preventative devices and works hand in hand with other members of the eye care team in assuring that patients are referred appropriately for diagnostic and therapeutic needs.
Optician
The Canadian guild of Dispensing Opticians defines the optician as one who supplies, prepares and dispenses optical appliances, interprets prescriptions prepared by ophthalmologists and optometrists, and fits, adjusts and adapts optical appliances. Opticians are also known as ophthalmic dispensers or dispensing opticians.
