Original post by brawnybalboaHello Alisha,
Thank you for the well written response. So just wanted to respond to a few things really:
"Obviously this (Orthoptics being more varied than Optometry) is down to personal experience but has been mentioned many times by clinicians and lecturers when students are deciding between the two courses"
I find this to be curious, as I recall the exact same thing being mentioned by lecturers and clinicians when I attended open days! The only exception of course being that they said Optometry was more varied than Orthoptics. Both cannot be true, and I would accept that each would be biased (after all, if you want students to apply for your course, you would never say a similar course is better elsewhere!).
In my experience as an Optometrist (Private, Hospital and in Academia), I have generally observed that Optometry is more varied than Orthoptics, plainly due to the breadth of responsibilities. There is significant crossover between both professions.
"An Orthoptists role is more varied in the sense that patients who come to the clinic are being referred for a multitude of conditions all of which can have a multitude of aeitiologies"
These patients don't solely exist in secondary care, and more often than not are referred to secondary care from Optometrists.
In regards to your original quote (which itself was from the British and Irish Orthoptic Society's own website), I would point you towards another quote from the same page regarding Optometrists:
"Optometrists are trained to examine the eyes to detect defects in vision, signs of injury, ocular diseases or abnormality. They also identify the signs of problems with general health, such as diabetes of high blood pressure. All Optometrists are able to offer clinical advice, prescribe glasses or contact lenses and refer patients for further treatment. They typically work in high street opticians, carrying out eye examinations, but some also work in hospitals or community clinics.
Whereas an Orthoptist is concerned with how the eyes work together and interact with the brain to create vision, Optometrists are primarily focused on the examination of the eye itself."
We are legally obliged to perform an Ophthalmic examination. For example with myself, in a 30 minute appointment at least 20 minutes will be spent examining the eye. Not what I would call a 'brief assessment of visual health'.
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Orthoptists play a crucial role in secondary care, especially with complex BV issues and visual rehabilitation. I have no doubt that any reasonably competent Orthoptist has a greater knowledge of treating and managing BV issues than most Optometrists. But Orthoptics is inherently less varied as a profession than Optometry, through specialising in BV and working in secondary care. We have the same patient base after all, what we do with them is different.
As an Optometrist I can choose to manage BV issues in house without referring into secondary care. I can prescribe glasses, prisms, patching therapy and convergence exercises. I can assess fusional reserves, ocular motility, saccades, stereopsis, depth of suppression etc. In fact I quite regularly do. There will be times of course that I refer into Orthoptics for their expertise regarding a BV anomaly beyond my competence.
As an Optometrist, in addition to my legal requirements to prescribe and perform ocular examinations, I can undertake further accreditations (in low vision/paediatrics/medical retina/glaucoma), provide emergency eye care examinations, contact lens fitting, perform domiciliary work, administer intra-vitreal injections and become an independent prescriber. Most of these I currently do, or have done previously.
As an Optometrist, I can choose to work in a high street practice, a smaller independent practice, a hospital, and university. Currently I work in three.
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Which really brings me back to my original over simplification that an Optometrist can do what Orthoptists, Dispensing Opticians and Contact Lens Opticians can. For the most part we can, as it is within our remit and training. The breadth of our remit does not however allow us to have that depth which the other fields have, much like a GP compared to other specialities.
Which is why both careers are essential to form a competent and skilled multi-disciplinary team. If we did the same thing, there wouldn't be the need for both fields!