Graphic by Joseph Chen

Optometry: A Diamond in the Rough

by Nate Briggs

If you are considering a career in the health professions (and I am assuming there is a good chance of this as you are reading The Pitt Pulse), you may find it difficult to decide which specific field to undertake: physician, midwife, dentist, pharmacist, nurse, paramedic, speech-language pathologist and physical therapist are just a few of the many paths before you. Any one of them would undoubtedly make a noble career. But how do you decide which one is the best?

This is not an easy task by any means. For me, I have decided to pursue a career in optometry, and I would like to tell you a little bit about the profession. My intention is not to try to sway you towards this wonderful occupation, but rather to give you an objective look into what it entails and what is required in order to best prepare for entering this field. Before we get into the good stuff, let’s start with some basic information.

Optometrist/Ophthalmologist/Optician

Optometrists, ophthalmologists, and opticians are three different types of eye-care professionals who are quite commonly confused with one another. However, they all carry out different functions that are important in ensuring that you have the clearest vision possible. Depending on whether your issue is mundane or sight threatening, it becomes crucial to know which one of these professionals should be your go-to.

So, let’s say the lenses on your glasses crack or perhaps the frames were bent. To whom would you take the broken glasses? If you guessed “optician,” give yourself a pat on the back! In addition to repairing glasses, opticians are also trained in designing and fitting lenses for contacts and glasses. While they do not test for vision or write lens prescriptions, opticians use an ophthalmologist or optometrist’s written orders to design the lenses.

On the other hand, ophthalmologists are health professionals who diagnose and manage ocular diseases and disorders, as well as perform surgeries. Like any medical doctor, ophthalmologists must successfully complete medical school after earning a bachelor’s degree. They then have to complete a three-year ophthalmology residency followed by a one-year internship.

Last but not the least, where does an optometrist fit into all this? Like ophthalmologists, optometrists are also trained in diagnosing and treating disorders of the eye. They primarily test near and far vision, determine your lens prescription, and prescribe medications for treating common infections. Unlike an ophthalmologist, however, they do not perform surgeries and are only required to go through an additional four years of schooling (after earning a bachelor’s degree) at an accredited college of optometry in order to obtain the title of Doctor of Optometry (OD). David Jancaro, OD, of 3 Guys Optical Oakland branch sums it up pretty nicely: “It’s basically like primary care for your eyes.” 

For most people, a routine trip to the optometrist involves getting a new prescription for contacts. However, optometrists are also trained and equipped to deal with a wide variety of ocular issues. In addition, just by looking at your eyes, they can determine a host of things about your health and refer you to a specific health care professional if necessary.

Andrew Iwach, MD, spokesperson for the American Academy of Ophthalmology, lends a great point of credence to the uniqueness of the eye: "It's the only place in the body where, without surgery, we can look in and see veins, arteries, and a nerve (the optic nerve)." Through this unique property, an optometrist can check for many problems seemingly unrelated to your eyes, such as risk of stroke, diabetes and high blood pressure. For younger individuals, however, these health issues are not as common. So, it is easy to see how optometrists’ breadth of capabilities can seem generally under-appreciated to undergraduate clients like us.

However, what if you recognized the vast scope of their field and decided that it is something you would like to be a part of? What type of preparation would that require on your part?

Preparing for the Profession

As I noted earlier, optometrists undergo four years of training at an accredited optometry school. Here in the United States, there are 21 such institutions. But how exactly would you end up attending one of these fine establishments if you so desire?

Gaining acceptance is similar to applying to medical or dental school. Like pre-medical and pre-dental undergraduates, aspiring optometrists are required to complete the same biology, organic and inorganic chemistry, physics and calculus pre-requisite classes, to name a few. Analogous to the MCAT or DAT, the Optometry Admission Test (OAT) is a standardized examination consisting of four sections designed to test your comprehension of scientific information.

Most applicants also shadow doctors of optometry in various settings in order to get a feel for the profession. While most schools do not require a set minimum number of hours, most of them highly recommend some shadowing. Supplemental information, such as letters of recommendation, is also required. To further strengthen your application, Pitt has various activities in which you can participate, such as the Pre-Optometry Club, Global Brigades’ weekly glasses readings, and the UPMC Guerrilla Eye Service.

Once you have completed all of the aforementioned steps and received admission into a college of optometry, congratulations! Now it is finally time to get into the meat and potatoes. While the sequence of the coursework varies between optometry schools, there are commonalities between them. The first two years are usually spent concentrating on basic health science courses like anatomy, physiology and biochemistry, while the last two years are spent engaging in clinical experience.

During this time, students must also take the National Board of Examiners in Optometry test (NBEO), which consists of three parts. The first part is taken during the spring of your third year and consists of 500 questions over four sessions, testing what you learned in the first two years. The second part—a computer-based test (CBT)—presents students with simulated patient histories, clinical data and multiple-choice questions pertaining to them. The third and final part assesses students’ clinical skills while performing tests on real patients.

After successfully completing your optometry school’s four-year curriculum and passing all three parts of the NBEO test, you are certified to practice optometry! So, now that you have laboriously gone through eight years of rigorous schooling, what kind of payoff can you anticipate? 

What to expect from a career in Optometry

Once you are in the thick of the profession, you will find yourself to be a part of a prosperous and dynamic field. The statistics for the career are not too shabby, with median pay at $101,410 per year and job outlook from 2014-2024 projected to increase 27 percent in employment (which the United States Department of Labor Statistics considers “much faster than average”).

You can also choose to specialize further by undergoing a one-year residency program dealing with geriatrics, low vision, pediatrics or sports-related injuries. At some point in your career, you may even choose to open up your own private practice!

At the end of the day, you will come to find the job to be personally rewarding. Humans are highly dependent on sight for everyday functioning. As a matter of fact, Bausch and Lomb’s 2012 survey of more than 11,000 people across 11 countries revealed that 68 percent of people would rather lose a limb and 67 percent would rather lose 10 years of their life, than lose their eyesight. Three quarters of those surveyed said they would rather have their salary cut in half than experience their visual acuity cut in half.   

Final Words

Well friends, it seems like we have reached the end. I hope that I’ve been able to shed some light on what an optometrist is and, at the very least, helped you gain an appreciation for what they do. As I previously stated, my goal is not to turn you over to a career in optometry, but to simply present you with what it has to offer. All things being said, I will let you be the judge.