Unlike an optometrist, an ophthalmologist is qualified to perform surgery on the eye. Optometrists are primarily responsible for treating refractive disorders such as near-sightedness and prescribing corrective lenses. Although optometrists can sometimes detect and manage other eye disorders, and they can prescribe drugs if they are certified by their state board of optometry, they cannot perform surgery.
An ophthalmologist diagnoses and treats diseases of the eye, including different kinds of infections, cataracts (clouding of the lenses), glaucoma (increased pressure inside the eye, leading to damage to the optic nerve), macular degeneration (age-related degeneration of the central part of the vision), and diabetes-related retinopathy (damage to the blood vessels supplying the retina of the eye). Often, ophthalmologists can detect systemic diseases such as high blood pressure, stroke, and cancer through examination of the eyes. In fact, it is sometimes the ophthalmologist who first discovers that a person has diabetes through changes in the retina.
The Ophthalmologists role is also key to mitigating the burden of diabetes-related eye disease. Preserving vision in patients with diabetes requires ophthalmologists to be aware of the importance of reinforcing preventive strategies, maintaining communication with primary care doctors, and keeping up to date with current treatment approaches.
Annual screening for diabetes-related eye disease, along with glycemic and blood pressure stability, help to prevent diabetes-related retinopathy-related vision loss. However, available data show poor patient engagement to those strategies. In speaking to patients, ophthalmologists need to reinforce these goals and their importance.
Though tighter glycemic stability is better for overall health, and in terms of diabetes-related retinopathy risk, ophthalmologists need to be sensitive to the fact that glycemic targets are individualized for patients based on a variety of features.