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[IP] Re: exam exams

First, it should be clarified that ophthalmologists are not "the best."  
There are excellent ophthalmologists, and there are very poor ones.  Most 
fall in between.  And the same goes for optometrists:  some are excellent, 
some are poor and most are in between.  Second, most optometrists (all I have 
ever worked with) do dilate the eye and they do look at the back of the eye.  
Again, generally speaking, they are very capable of diagnosing retinal 
problems such as those associated with diabetes.  What they cannot do is 
treat it should it need treatment.  Most optometrists are capable of 
determining when treatment is needed and when it is not.  The biggest 
differences between optometrists and ophthalmologists is that 
ophthalmologists are trained to treat systemic disease and perform surgeries 
to treat pathology.  But even "surgery" lines are shifting.  ODs can remove 
foreign bodies.  In OK they can use laser for some procedures, but not 
retinal treatment.  They cannot take out a cataract or remove an appendix - 
but the ophthalmologist could.  I don't know of any who would do an 
appendectomy, but they could . . .  But an optometrist can take excellent 
care of your eyes.  If you concern is just new glasses - an optometrist 
(again generally) is the doc of choice.  The have much more training in 
binocular functions, refractions to get the glasses prescription and clinical 
optics than the MDs have.  If you see an MD, your glasses prescription will 
be largely determined by the technician who gets you ready for the MD.  
Again, this is not always the case, some MDs will refract you themselves.  
But not often.  The one big exception is in strabismus.  These 
ophthalmolgists who specialize in eye turns are pretty darn good with 
glasses.  But they are surgeons and will want to cut to reposition the 
muscles and straighten the eyes.
My background to provide this viewpoint:  I have worked with optometrists for 
about 10 years and for the last 3 have worked with ophthalmologists as a tech
nician.  Respect the doctor, regardless of the initials behind the name.  
They will take great care of you.

Andy Winters, ABOM, COA, COMT-OTS
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