Optometrists

Optometrists, also known as doctors of optometry, or ODs, are the main providers of vision care. They examine people's eyes to diagnose vision problems, such as nearsightedness and farsightedness, and they test patients' depth and color perception and ability to focus and coordinate the eyes. Optometrists may prescribe eyeglasses or contact lenses, or they may provide other treatments, such as vision therapy or low-vision rehabilitation.

Optometrists also test for glaucoma and other eye diseases and diagnose conditions caused by systemic diseases such as diabetes and high blood pressure, referring patients to other health practitioners as needed. They prescribe medication to treat vision problems or eye diseases, and some provide preoperative and postoperative care to cataract patients, as well as to patients who have had corrective laser surgery. Like other physicians, optometrists encourage preventative measures by promoting nutrition and hygiene education to their patients to minimize the risk of eye disease.

Although most work in a general practice as a primary care optometrist, some optometrists prefer to specialize in a particular field, such as contact lenses, geriatrics, pediatrics, or vision therapy. As a result, an increasing number of optometrists are forming group practices in which each group member specializes in a specific area while still remaining a full scope practitioner.

 For example, an expert in low-vision rehabilitation may help legally blind patients by custom fitting them with a magnifying device that will enable them to read. Some may specialize in occupational vision, developing ways to protect workers' eyes from on-the-job strain or injury. Others may focus on sports vision, head trauma, or ocular disease and special testing. A few optometrists teach optometry, perform research, or consult.

Most optometrists are private practitioners who also handle the business aspects of running an office, such as developing a patient base, hiring employees, keeping paper and electronic records, and ordering equipment and supplies. Optometrists who operate franchise optical stores also may have some of these duties.

Optometrists should not be confused with ophthalmologists or dispensing opticians.

Ophthalmologists are physicians who perform eye surgery, as well as diagnose and treat eye diseases and injuries. Like optometrists, they also examine eyes and prescribe eyeglasses and contact lenses.

Dispensing opticians fit and adjust eyeglasses and, in some States, may fit contact lenses according to prescriptions written by ophthalmologists or optometrists.

Work Environment

Optometrists usually work in their own offices that are clean, well lighted, and comfortable. Although most full-time optometrists work standard business hours, some work weekends and evenings to suit the needs of patients. Emergency calls, once uncommon, have increased with the passage of therapeutic-drug laws expanding optometrists' ability to prescribe medications.

Training, Other Qualifications, and Advancement

The Doctor of Optometry degree requires the completion of a 4-year program at an accredited school of optometry, preceded by at least 3 years of preoptometric study at an accredited college or university. All States require optometrists to be licensed.

Education and training. Optometrists need a Doctor of Optometry degree, which requires the completion of a 4-year program at an accredited school of optometry. In 2009, there were 19 colleges of optometry in the U.S. and 1 in Puerto Rico that offered programs accredited by the Accreditation Council on Optometric Education of the American Optometric Association. Requirements for admission to optometry schools include college courses in English, mathematics, physics, chemistry, and biology. Because a strong background in science is important, many applicants to optometry school major in a science, such as biology or chemistry, as undergraduates. Other applicants major in another subject and take many science courses offering laboratory experience.

Optometry programs include classroom and laboratory study of health and visual sciences and clinical training in the diagnosis and treatment of eye disorders. Courses in pharmacology, optics, vision science, biochemistry, and systemic diseases are included.

One-year postgraduate clinical residency programs are available for optometrists who wish to obtain advanced clinical competence within a particular area of optometry. Specialty areas for residency programs include family practice optometry, pediatric optometry, geriatric optometry, vision therapy and rehabilitation, low-vision rehabilitation, cornea and contact lenses, refractive and ocular surgery, primary eye care optometry, and ocular disease.

Licensure

All States and the District of Columbia require that optometrists be licensed. Applicants for a license must have a Doctor of Optometry degree from an accredited optometry school and must pass both a written National Board examination and a National, regional, or State clinical examination. The written and clinical examinations of the National Board of Examiners in Optometry usually are taken during the student's academic career. Many States also require applicants to pass an examination on relevant State laws. Licenses must be renewed every 1 to 3 years and, in all States, continuing education credits are needed for renewal.

Other qualifications. Business acumen, self-discipline, and the ability to deal tactfully with patients are important for success. The work of optometrists also requires attention to detail and manual dexterity.

Advancement. Optometrists who wish to teach or conduct research may study for a master's degree or Ph.D. in visual science, physiological optics, neurophysiology, public health, health administration, health information and communication, or health education.

Behavioral Optometry

Behavioral optometry also known as "Functional Optometry" is an expanded area of optometric practice that claims to use a "holistic" approach to the treatment of vision and vision information processing problems. The practice of behavioral optometry incorporates various vision therapy methods and has been characterized as a complementary alternative medicine practice. A review in 2000 concluded that there were insufficient controlled studies of the approach and a 2008 review concluded that "a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated."

History

Behavioral optometry is considered by some optometrists to have its origins in orthoptic vision therapy. However, Vision therapy is differentiated between strabismic/orthoptic vision therapy (which Orthoptists and Ophthalmologists practice) and non-strabismic vision therapy.A.M. Skeffington was an American optometrist known to some as "the father of behavioral optometry".Skeffington has been credited as co-founding the Optometric Extension Program with E.B. Alexander in 1928.

Part of behavioral vision care is concerned with impact of visual "skills" on performing visual tasks. Various behaviors and poor performance during visual tasks may suggest non-optimal visual skills. For example this could manifest as eyestrain symptoms experienced during visual tasks, or adopting poor posture (e.g. leaning in too close to visual material). Another example, could be difficulty understanding maps, difficulty recalling visual information, difficulty completing jigsaws and difficulty drawing/copying/interpreting visual information.

Claims have been made that behavioural optometry can aid with cognitive, behavioural or language disorders such as ADHD and dyslexia, although there is no evidence to support these claims. It is therefore popular among parents who may not want their children to be stigmatised by being labelled with a cognitive or language impairment, as it claims that poor vision is the "real" cause of their disorder.[3]

Research

In 1944-1945 the Wilmer Eye Institute of Johns Hopkins Hospital in Baltimore undertook a study of the use of behavioral optometry in the treatment of myopia. The training was undertaken by A. M. Skeffington and his associates, who traveled to Baltimore for the purpose, but who used a clinic outside the hospital, and were carefully kept apart from the staff in the Wilmer Institute who assessed their progress. The 103 candidates were school students and young adults with uncomplicated myopia. Independent examination before and after training was undertaken using Snellen charts, and use of a retinoscope after introduction of a cycloplegic agent. The examining physicians "were impressed by a psychologic improvement in a number of patients. Some patients while exhibiting no material change in their visual acuity, were nevertheless convinced that they saw better and that they used their eyes with greater satisfaction to themselves." 

The objective results were as follows.

Of the 103 subjects:

30 showed some improvement on all measures

31 showed overall improvement, but not on all measures

32 showed no overall change

10 showed deterioration of vision

The report's author concludes "With the possible exception of educating some patients to interpret blurred retinal images more carefully and of convincing some others that they could see better even though there was no actual improvement, this study indicates that the visual training used on these patients was of no value for the treatment of myopia."

A review of behavioural optometry in 2000 concluded that there were insufficient controlled studies of the approach and a 2008 review concluded that "a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated."

Case studies

In 2006, neurologist Oliver Sacks published a case study about "Stereo Sue" (Susan R. Barry), a woman who was strabismic and stereoblind since early infancy and who developed stereo vision after undergoing vision therapy. Barry, a professor of neurobiology, later published a memoir, Fixing My Gaze: a Scientist's Journey into Seeing in Three Dimensions,describing the therapy, the science underlying it, and her experience with it.

Optometry

What is Optometry?

According to Wikipedia, the free encyclopedia

Optometry is a health care profession concerned with eyes and related structures, as well as vision, visual systems, and vision information processing in humans. Optometrists are healthcare professionals who provide primary vision care ranging from sight testing and correction to the diagnosis, treatment, and management of vision changes. Optometrists qualify to diagnose and treat eye diseases such as Diabetic Retinopathy, Cataracts, Glaucoma, and Macular Degeneration.

Like most professions, optometry education, certification, and practice is regulated in most countries. Optometrists and optometry-related organizations interact with governmental agencies, other health care professionals, and the community to deliver eye and vision care.

Britannica Concise Encyclopedia: optometry

Profession concerned with examining the eyes for defects or faults of refraction. Optometrists prescribe optical aids (e.g., eyeglasses, contact lenses), supervise eye exercise programs to treat vision problems, and examine the eyes for disorders such as glaucoma and cataracts. They are generally not licensed to prescribe drugs or trained to perform surgery.

Oxford Companion to the Body: optometry

Optometry (meaning measurement of sight) is the science of measuring visual acuity to determine refractive errorsof the eyes, and prescribing and fitting appropriate corrective lenses (in spectacles or as contact lenses). The term ‘optometrist’, imported from the US, has virtually displaced the original word ‘optician’ in the UK.

Optometrists also have to deal with patients who have poor vision for whatever reason, prescribing special lenses or low-vision aids, which help them to lead independent lives. This is essential work in a world increasingly dominated by the visual image in television, films, advertising, and the Internet.

Oxford Dictionary of Sports Science & Medicine:

Branch of health care concerned with the examination, diagnosis, and treatment of the eyes and related structures, and with the determination and correction of vision problems using lenses and other optical aids. See also sports vision.

Columbia Encyclopedia:

optometry (ŏptŏm'ətrē), eye-care specialty concerned with eye examination, determination of visual abilities, diagnosis of eye diseases and conditions, and the prescription of lenses and other corrective measures. In most states optometrists may prescribe drugs for the treatment of eye diseases. The principal concern of early optometrists was the prescription of corrective lenses for defects of vision due to refractive error. Modern optometry also includes the fitting of contact lenses and of telescopic eyeglasses as an aid to the near-blind, as well as the field of orthoptics, i.e., the practice of strengthening the eye muscles and improving their coordination by eye exercises. Prescriptions for corrective lenses provided by an optometrist are often brought to an optician, who grinds and fits the lenses.The word optometry came into use in 1904 with the organization of the American Optometric Association. Until this time people bought eyeglasses from traveling vendors whose activities were not supervised. With the passage of optometry laws, this method of dispensing glasses was prohibited. Optometrists must now fulfill certain educational requirements and be examined and licensed by the state. Some of the schools of optometry in the United States are affiliated with colleges or universities. Optometry is a specialty requiring a four-year postgraduate professional degree. See also ophthalmology).

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Mosby's Dental Dictionary:

The professional discipline devoted to testing the eyes for visual acuity, prescribing corrective lenses, and recommending eye exercises and other health practices to preserve sight.

  optometry

An autonomous, healthcare profession involved in the services and care of the eye and visual system, and the enhancement of visual performance. Syn. ophthalmic optics (term used principally in the UK and the Republic of Ireland). See primary care optometry.

Behavioural optometry A branch of optometry concerned with the diagnosis and treatment of visual problems taking into account not only the ocular history, signs and symptoms but also the whole person and his or her environment.

Experimental optometry The branch of optometry concerned with the scientific investigation of optometric problems by experimentation upon humans or animals, or by clinical research. See psychophysics.

Geriatric optometry A branch of optometry concerned with the prevention, diagnosis and treatment of visual problems in old age.

Paediatric optometry A branch of optometry concerned with the prevention, development, diagnosis and treatment of visual problems in children.

Primary care optometry Term referring to the basic field of optometry to which patients usually come directly and are not usually referred by other professionals. Primary care optometric practitioners may refer some of their patients to other practitioners such as ophthalmologists, neurologists or to other optometric specialists for specialized services such as paediatric optometry, low vision aids or highly specialized aspects of contact lens fitting.

BACKGROUND



Optometrists are not M.D.'s. They are trained to prescribe and fit lenses to improve vision, not to diagnose or treat disease. Ophthalmologists are M.D.'s with additional training in diseases of the eye. Most are surgeons as well as diagnosticians.

The term "optometry" comes from the Greek words ὄψις (opsis; "view") and μέτρον (metron; "something used to measure", "measure", "rule"). The root word opto, is a shortened form derived from the Greek word, ophthalmos, meaning, "eye."

The eye, including its structure and mechanism, has fascinated scientists and the public in general since ancient times. Many of the expressions in the English language that mean to understand are equivalent vision terms. "I see," to mean I understand.

Many patients will be more concerned about diseases that affect vision than other, more lethal diseases when told that they may have an eye problem.^{[citation needed]} Being deprived of sight can have a devastating effect on the psyche, as well as economic and social effects.^{[citation needed]} Many blind individuals require significant assistance with activities of daily living and are often unable to continue gainful employment that might have previously been held while they could see. It is also well-known that serious diseases such as myasthenia gravis, diabetes, and atherosclerosis can show their first signs during an eye examination, well before a patient experiences any symptoms.

The maintenance of ocular health and correction of eye problems that decrease vision contribute greatly to the ability to appreciate the longer lifespan that all of medicine continues to allow. Given the importance of vision to quality of life, many optometrists consider their job to be rewarding, as they are often able to restore or improve a patient's sight.

Behavioral optometry 


is a related area of non-strabismus vision therapy that some optometrists practice. Generally ophthalmologists and orthoptists do not practice this. It generally involves intense therapy that requires at least a weekly visit with eye exercises at home. In some cases it can improve eye movement control beyond that which eyeglasses alone can do.

In the United States, optometry is currently governed by state boards that determine their scope of practice. The scope of practice can vary dramatically from state to state. Optometrists have been successful in getting the right to use certain types of medication, including oral medications (such as antivirals, antibiotics, and oral steroids), eye drops, and injections.^[1] In Oklahoma and Kentucky, optometrists are allowed by the state legislature to perform laser surgery.^[2]

History

Optometric history is tied to the development of

• Vision science (related areas of medicine, microbiology, neurology, physiology, psychology, etc.)
• optics, optical aids
• optical instruments, imaging techniques
• other eye care professions

The history of optometry can be traced back to the early studies on optics and image formation by the eye.

The origins of optometric science date back a few thousand years BC as evidence of the existence of lenses for decoration has been found. It is unknown when the first spectacles were made, but the British scientist and historian Sir Joseph Needham stated in his research that the ancient Chinese invented the earliest eyeglasses 1000 years ago and were also mentioned by the Venetian Marco Polo in his account of his travels in ancient China. Alternatively, research by David A. Goss, O.D., Ph.D., shows they may have originated independently in the late 13th century in Italy as stated in a manuscript from 1305 AD where a monk from Pisa named Rivalto stated “It is not yet 20 years since there was discovered the art of making eyeglasses”.Spectacles were manufactured in Italy, Germany, and the Netherlands by 1300 AD.

Benito Daza de Valdes published the third book on optometry in 1623, where he mentioned the use and fitting of eyeglasses. The term optometrist was coined by Edmund Landolt in 1886, referring to the "fitter of glasses". Prior to this, there was a distinction between "dispensing" and "refracting" opticians in the 19th century. The latter were later called optometrists.

In 1692, William Molyneux wrote a book on optics and lenses where he stated his ideas on myopia and problems related to close-up vision.

The scientists Claudius Ptolemy and Johannes Kepler also contributed to the creation of optometry. Kepler discovered how the retina in the eye creates vision.

From 1773 until around 1829, Thomas Young discovered the disability of astigmatism and it was George Biddell Airy who designed glasses to correct that problem that included spherocylindrical lens.^[5]

A pilgrim named Peter Brown is believed to be the first person to wear a pair of glasses in the US, however, eyeglasses were only made in Europe for a long period of time which made them both expensive and difficult to find. The first man to buy a pair of eyeglasses in the US was John McAllister Sr.from Philadelphia Pennsylvania, 

In 1783 McAllister, together with his son, John McAllister Jr. started making the first eyeglasses in the US in 1811. Their business continued until the 20th century. 

The family also taught refraction, and one of their students, James W. Queen also began his own business in 1853.

Benjamin Pike and James Prentice were two other early optometrists who studied in England and came to the US in 1847. They trained their sons, and James's son, Charles Prentice, had an important role in the development of optometry in the US.

The American Optometric Association was then formed on January 11, 1922 after Morris Steinfeld held a meeting with seven optometrists to discuss whether optometry should be a business or a profession. At the end of this meeting, they formed the American Academy of Optometry with the vision to transform the entire body optometric to a profession with a scientific base.^[6] The American 

Optometric Society was formed in August 2009. Doctors were concerned that policy decisions by the AOA leadership did not represent the desires of the majority of the profession and were considered to not be in the best interest of the profession.

The first schools of optometry were established in 1850–1900 and contact lenses were first used in 1940s

The first schools of optometry in the US began in the late 19th century, with the Illinois College of Optometry in 1872, and the New England College of Optometry in 1894. In 1914, a program in optometry began at The Ohio State University after Professor Charles Sheard gave a presentation to the Ohio State Optical Association who assisted him financially to open the program. It started as a two-year course that later became a four-year degree-granting program. Until 1937 the program was known as Applied Optics, when it then became known as Optometry.^[8]

Nowadays, there are many community and local resources to help those with financial difficulties to secure free or reduced cost eye care. Contact can be made to charities or non-profit organizations in the area to receive such help.^[9]

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:

• in North America (Canada and US)
• in Latin America and some Caribbean countries
• in most English speaking countries including UK, Republic of Ireland, Australia, New Zealand and South Africa
• in Europe including Spain, Germany and the English speaking European countries
• in Asia including China,Pakistan Hong Kong, Malaysia, Philippines,^[10] Singapore, Taiwan and Thailand
• in the Middle East including Saudi Arabia, Iran and Israel

Argentina

In Argentina optometrists are required to register with the local Ministry of Public Information, but licensing is not required. 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.

Australia

Australia currently has three recognised courses in Optometry. These are offered through the University of New South Wales: Bachelor of Optometry Bachelor of Science (BOptom BSc), a 5 year course; Queensland University of Technology: Bachelor of Vision Science and Masters of Optometry, a 5 year course; and Melbourne University which is transitioning to a Doctor of Optometry course a 4 year postgraduate course. These courses are developments of prior course offerings at these institutions that have been expanded along with the increased scope of practice for Optometrists in Australia, specifically the ability to prescribe certain therapeautic agents.

New courses are being developed at Flinders University in South Australia, which accepted students in a science degree in 2010 and will begin the post graduate component of the course in 2013. A second new course is expected to be offered at Deakin University in Geelong, Vic at the beginning of 2012.

Canada

In Canada optometrists hold a Doctorate of Optometry degree and are licensed by the boards in the provinces they wish to practice. There are two schools of optometry, one at the University of Waterloo and the other at Université de Montreal.

Colombia

In Colombia optometry education has been accredited by the Ministry of Health. The last official revision to the laws regarding health care standards in the country was issued in 1992 through the Law 30.Currently there are eight official universities that are entitled by ICFES to grant the Optometrist certification. The first optometrists arrived in the country from North America and Europe circa 1914. These professionals specialized in optics and refraction. In 1933, under Decrees 449 and 1291, the Colombian Government officially set the rules for the formation of professionals in the field of optometry. In 1966 La Salle University opened its first Faculty of Optometry after recommendation from 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 the private sector (such as Bausch & Lomb).

Ghana

In Ghana the Ghana Optometric Association (GOA) regulates the practise of Optometry. After the six year training at any of the two Universities offering the course, the O.D degree is awarded. The new Optometrist has to write a qualifying exam after which the optometrist would be admitted to be a member of the GOA leading to the award of the certificate MGOA.

Europe

Currently, optometry education and licensing varies throughout Europe. For example, in Germany, optometric tasks are performed by ophthalmologists and professionally trained and certified opticians. In France, there is no regulatory framework and optometrists are sometimes trained by completing an apprenticeship at an ophthalmologists' private office.^[12]

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 standardized practice and education guidelines within EU countries.^[13] The first examinations of the new European Diploma in Optometry were held in 1998 and this was a landmark event for optometry in continental Europe.^[14]

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. Some feel that 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.

United Kingdom

In the United Kingdom, optometrists have to complete a 3 or 4 (Scotland) year undergraduate honours degree followed by a minimum of a one-year "pre-registration period", (internship), where they complete supervised practice under the supervision of an experienced qualified practitioner. During this year the pre-registration candidate is given a number of quarterly assessments, often including temporary posting at a hospital, and on successfully passing all of these assessments, a final one-day set of examinations (Examination details correct for candidates from 2006 onwards). Following successful completion of these assessments and having completed one year's supervised practice, the candidate is eligible to register as an optometrist with the General Optical Council (GOC) and, should they so wish, are entitled to membership of the College of Optometrists. Registration with the GOC is mandatory to practice in the UK. Members of the College of Optometrists (incorporated by a Royal Charter) may use the suffix MCOptom. There are 8 universities which offer optometry in the UK, these are Anglia Ruskin, Aston, Bradford, Cardiff, City, Glasgow Caledonian, Manchester and Ulster Universities.

Philippines

Optometry is regulated by the Professional Regulation Commission of the Philippines. To be eligible for licensing, each candidate must have satisfactorily completed a Doctor of Optometry course at an accredited institution and demonstrate good moral character with no previous record of professional misconduct. Professional organizations of optometry in the Philippines include Optometric Association of the Philippines^[15] and Integrated Philippine Association of Optometrists, Inc. (IPAO)^[16]

Russia

In Russia optometry education has been accredited by the Federal Agency of Health and Social Development.^{[citation needed]} There are only two educational institutions that teach optometry in Russia: Saint Petersburg Medical Technical College, formerly known as St. Petersburg College of Medical Electronics and Optics, and The Helmholz Research Institute for Eye Diseases. They both belong and are regulated by the Ministry of Health. The Optometry program is a 4 year program. It includes 1–2 science foundation years, 1 year focused on clinical and proficiency skills, and 1 year of clinical rotations in hospitals. Graduates take college/state examinations and then receive a specialist diploma. This diploma is valid for only 5 years and must be renewed every 5 years after receiving additional training at state accredited programs.

United States

The American Optometric Association (AOA) and the American Optometric Society (AOS) represent optometrists nationally in the USA. 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. These courses include: 4 semesters of chemistry to include organic and biochemistry, 2 semesters of physics and biology, as well as 1 semester of calculus, statistics, physiology, anatomy, microbiology, and psychology. Additional requirements are imposed by specific institutions. Once completing these courses in order to be admitted to an optometry doctorate program one must score well on the O.A.T., Optometry Admission Tests. There are currently 20 optometry schools in the United States, and admission into these schools are considered to be extremely competitive.

Optometrists are required to complete a four-year postgraduate degree program to earn their Doctor of Optometry (O.D. - Oculus Doctor) titles. The four-year program includes classroom and clinical training in geometric, physical, physiological and ophthalmic optics, ocular anatomy, ocular disease, ocular pharmacology, neuroanatomy and neurophysiology of the vision system, binocular vision, color, form, space, movement and vision perception, design and modification of the visual environment, and vision performance and vision screening. In addition, an optometric education also includes a thorough study of human anatomy, general pharmacology, general pathology, sensory and perceptual psychology, biochemistry, statistics and epidemiology. There are three new colleges of optometry (Midwestern University Arizona College of Optometry, University of the Incarnate World School of Optometry, Western University of Health Sciences College of Optometry) that have received the pre-accreditation status of preliminary approval from the Accreditation Council on Optometric Education (ACOE). Programs with “Preliminary Approval" have shown that they are developing within the ACOE's standards. The programs have approval to begin recruiting and admitting students, and to begin offering the program.

Upon completion of an accredited program in optometry, graduates hold the Doctor of Optometry degree. Optometrists must then pass a national examination administered by the National Board of Examiners in Optometry (NBEO).

 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 1–2 year residencies with training in a specific sub-specialty such as pediatric eyecare, geriatric eyecare, specialty contact lens, ocular disease or neuro-optometry. All optometrists are required to fulfill continuing education requirements to stay current regarding the latest standards of care.

Within the healthcare system, optometrists function as primary eye care providers who are especially experienced in fitting contact lenses and glasses prescriptions. Optometrists are labeled as physicians under Medicare. Optometrists also have the ability to treat a wide variety of eye diseases though the administration of topical, oral and injectable medicines (depending on the state) although their scope is limited to the eye. Optometrists may be trained in some surgical techniques, including those for foreign body removal, corneal injury, eyelid & lacrimal disease, and others. In Oklahoma, the state optometry board also allows state-certified optometrists to perform surgeries limited to the anterior segment of the eye. In Kentucky, recent legislation permits Optometrists to perform a multitude of laser procedures.

Difference b/w Opthomologists and Optometrists

Ophthalmologists differ from optometrists in that ophthalmologists are licensed to perform all eye surgeries, can treat systemic diseases, and who have completed 4 years of medical school and a residency in ophthalmology.

In many cases optometrists and ophthalmologists work together in the treatment and management of patients with various eye conditions. Opticians generally dispense corrective eye wear, and in some cases will also construct the corrective eye wear. The scope of practice in optometry varies as it is regulated by each state.