ECPs – Eye Care Professionals

This page is written to introduce you to the different players in eye health and vision care. Frequently, people will lump all Eye Care Professionals (ECPs) together and can end up wasting time and money by consulting the wrong specialist. What follows is only a summary and the reader is encouraged to seek additional information from representative practitioners in each field for additional detail.

Optometrist: Optometrists are doctors with ‘OD’ degrees. They study various aspects of neurology, ophthalmology, detailed optics and principles of vision, orthoptics, and human behaviour. Optometry has a number of sub-specialties that help people improve visual performance for sport or high-performance tasks such as flying jet aircraft, and then there are developmental optometrists, which is the category that best describes what I do in my clinic. It takes a minimum of eight years and two university degrees to become a doctor of optometry, and they spend four years studying eye health and visual function alone. Currently in the United States, optometrists have a much wider scope of practice, meaning US optometrists provide many more services than they are permitted to provide here in Alberta. As an example, I myself was trained to do some simple procedures using a laser, and in certain States, I could apply these practices for patients for less money and a quicker turnaround time compared to an ophthalmology clinic. Here, my patients must wait months, usually, and the price is 5-10x higher and paid for by you, the taxpayer. The Province recognized these benefits some time ago, and this is why optometrists are primary eye care professionals in Alberta. This means any and all problems with eye health or vision should present first to a local eye clinic. These services were recently expanded and this means you never pay for visits to the eye clinic if you are having trouble with your eyes or vision.

Developmental (Behavioural) Optometrists:  Diagnose and treat problems with visual function. If you are a regular reader, you will know that there is much more to vision than eyes. Like a mechanic listens to and measures different aspects of a jet engine to diagnose and fix a problem, developmental optometrists break vision down into it’s various elements to fix whatever might be in disorder. This starts with looking for eye or nervous disease, then moves on to look at the finer points of how the eyes work and how the brain perceives. We help with many different problems ranging from reading/learning disabilities, to problems with balance and focus after brain injury, and a great many more. Currently, there is no more effective treatment for reading and learning problems than a reading program combined with visual neuro-rehabilitation.

Ophthalmologist: These are doctors with ‘MD’ degrees. They study principles of ophthalmology, some optics and aspects of vision, general medicine, and surgical techniques. It takes generally two degrees and 8 years to obtain an MD degree. Ophthalmologists continue for another 2 to 4 years to study eye health issues. Ophthalmologists provide therapeutic and rehabilitative help to people who are having complex trouble with eye disease. Whereas optometrists have specialized training in visual behaviour and eye health issues, ophthalmologists have specialty training in disease issues that can affect vision. Ophthalmologists will be either generalists or specialists, such as for retinal diseases, problems with the front parts of the eye (like for cataracts), or problems with the visual nervous system (neuro-ophthalmologists). Ophthalmology aims to ensure good eye health and maintain eyesight, but is not generally interested in the finer aspects of visual behaviour.

Orthoptist: Applies optical principles and devices in the correction of visual of the eyes; so, if you are in a car accident and see double afterwards, an orthoptist will measure the misalignment and refer you to surgery if needed. Optometrists are trained in orthoptics. Developmental optometrists can often realign vision without surgery.

Optician: Opticians study for one or two years in order to be knowledgeable and proficient with fitting and making prescription lenses. Lenses must be aligned to within a millimeter, and this is not something you can do over the Internet. Only someone with optician’s training can ensure your glasses fit well and are perfectly aligned.  When you buy glasses, you will likely be dealing with an optician to select, make, and then fit the glasses.

Ophthalmic Technician: Ophthalmic Technicians have up to to 24 months of training to operate equipment for pretesting, assist in surgery, and determine basic glasses prescriptions. You will work mostly with ophthalmic technicians when you go to see an ophthalmologist.

Optometric Assistant: Assists optometrists with gathering information about patient cases. Optometric Assistants generally perform a number of tests on patients before the doctor sees them. Optometric Assistants might also assist with glasses and with minor surgical procedures in the examination room. In Canada, the Optometric Assistant program is 9 months in duration.

Refractive Technician: Checks for refractive error, that is, determines the glasses prescription. Training is variable, and can be as short as a few hours. Refractive technicians typically work under the guidance of a doctor.

Vision Therapist: Vision Therapists work with developmental optometrists to deliver therapy to patients experiencing visual dysfunction. Vision Therapists can be either trained on site in Vision Therapy clinics, or undergo more formal training through approved organisations such as COVD (College of Optometry in Vision Development, www.covd.org). Currently, I personally provide all therapeutic guidance in my clinic and train parents to provide therapy to their children at home.

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