| 21 September 2016

Whose Who

Health Care Professionals: A Whose Who

There are a number of different healthcare professionals that you may interact with when it comes to looking after your eyes, including opticians, optometrists, ophthalmologists and orthoptists. Each of these professionals has a different role in caring for eye health, explained below.

What is an optician?

Opticians are technicians trained to design, verify and fit lenses and frames, contact lenses, and other devices to correct eyesight.

What is an optometrist?

Optometrists are healthcare professionals who provide primary vision care ranging from sight testing and correction to the diagnosis, treatment, and management of vision changes. An optometrist is not a medical doctor.

What is an ophthalmologist?

An ophthalmologist, also called an eye doctor, is a medically trained doctor who has undertaken further specialist training and study in the human eye. In the Republic of Ireland there are two types of Eye Specialists; Medical Eye doctors who undergo 11 years of clinical medical training, and Eye Surgeons who undergo on average 14 years of clinical medical training.

What is an orthoptist?

An orthoptist is an allied health professional involved in the assessment, diagnosis, and management of disorders of the eyes, extra-ocular muscles and vision. Orthoptists are an important part of the eye care team and work in close association with ophthalmologists, usually in a hospital based setting. They are involved in many areas of care, including paediatrics, neurology, community services, rehabilitation, geriatrics, neonatology and ophthalmic technology.

What Happens at Your Ophthalmology Appointment?

When you visit your ophthalmologist, you will be asked to perform a number of tests that measure different parts of your vision and look at different parts of your eyes. Some of the tests are very quick and straightforward while others will take more time as they require drops in your eyes to take effect before they can be performed. Some of the tests require you to look at something and respond about what you see. Your ability to perform these tests will depend on your level of vision, and some people may find them difficult or frustrating. Other tests involve the measurement of involuntary responses of the eye or taking photographs of the eye. Some of the tests that are used are explained below. If you have any questions about any of the tests or are unsure of anything taking place during your appointment, don’t be afraid to ask your ophthalmologist or test technician to explain it you.

  • Visual Acuity Testing

Most people are familiar with visual acuity testing, which involves reading letters from a chart while sitting or standing a certain distance away. The purpose of this test is to measure your central vision which is the ability to see fine detail.

  • Colour Testing

This test measures your colour perception. You will be asked to look at a series of images composed of many small circles. Someone with normal colour vision can recognise numbers within the images.

  • Visual Field Testing

This test measures the scope or range of vision, including peripheral (side) vision and central vision. A light is brought in from the side on a screen, and slowly moved to the centre of vision. You are asked to press a button as soon as you see the light.

  • Electroretinogram (ERG)

This measures the electrical response of the light-sensitive cells in the eye, the rods and cones. It also measures retinal function. Prior to this test, you will be given drops in your eyes to dilate the pupils. You will also be given an anaesthetic eye drop to numb your eyes. A special type of recording contact lens will then be placed over your eye and electrodes will be placed on the skin near the eye. You will be asked to watch some flashing lights; these are used to stimulate the retina. The electrodes measure the electrical response of the retina to the flashing lights. The test will be performed first in a dark room and then again when the lights are turned on. The test is not painful, but some people may find it uncomfortable. Because of the drops used, you may notice that your vision is blurred for quite some time afterwards.

  • Fundus Photographs

This test takes a photograph of the retina fundus at the back of the eye using a special camera. The images will show any changes or abnormalities in the back of the eye. You will be given drops to dilate your eyes before this test.

  • Fluorescein Angiogram

During this test a special dye, called fluorescein, is injected into the bloodstream. The dye is injected through the arm. Its purpose is to highlight the blood vessels in the back of the eye so they can be photographed. This makes it easier for a doctor to see abnormalities in the back of the eye.

Questions to Ask your Doctor

You may feel overwhelmed by the information you receive at your appointment so it can be useful to make a list of questions beforehand to take with you. Here are some suggestions that might be helpful;

  • What is my diagnosis?
  • How will my vision be affected?

A doctor will not be able to give you an exact answer to this question as everyone is different and conditions can progress at different rates in different people. They will be able to tell you which parts of your vision are most likely to be affected, for example, your central vision or peripheral vision.

  • How will it affect my home and work life?

The doctor may be able to give you an example of how the condition will affect an everyday task such as reading or driving.

  • What is the short-term and long-term prognosis for my disease or condition?

Many conditions will cause your vision to change over time. A doctor will not be able to give you an exact prognosis or time line but may able to give you an idea of what can happen in the short and long term in most cases of your condition.

  • What caused the disease or condition?

Is your condition genetic or can it be affected by lifestyle or environmental factors.

  • Are there local agencies or organisations that can help me learn more about my condition and vision loss?

There may be an organisation or support group that deals specifically with your condition, and may be able to give you more information.

  • Has my vision changed since my last visit?
  • Could medication or health supplements I take have any effect on my vision?

If this is something you are unsure about, bring a list of any medications or supplements to your appointment and ask your doctor about them.













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