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April 4, 2023

Careers in Vision Care: Optometry vs. Ophthalmology

Fascinated by the complex marvel of evolution that is the human eye? You may be considering a career in vision care. If so, you may know that there are two major pathways available to you–pathways with similar names and overall goals, but very different educational requirements and scopes of practice.

Those pathways are optometry and ophthalmology. This article explains how the two differ and describes the steps you need to take to pursue either one.

O.D. vs. M.D. - A Quick Comparison

The major distinction between optometrists and ophthalmologists is hinted at by the letters after their names. Optometrists have a Doctor of Optometry (O.D.), while ophthalmologists are medical doctors (M.D.) who have completed internships and residencies in a specialty area of vision care.

In most states, O.D.s act as primary care doctors for the eyes. Ophthalmologists are the specialists who treat specific diseases or perform eye surgeries for conditions optometrists spot.

Getting into Optometry School

The path to optometry school has several significant differences compared to the path to medical school. Perhaps the most distinctive is that not every school of optometry requires applicants to have completed their bachelor’s degree before enrolling! However, a look at the Association of Schools and Colleges of Optometry’s website (ASCO) reveals that all 23 of the O.D. programs in the U.S. require applicants to have completed upper-level undergraduate courses in biochemistry, microbiology, anatomy and physiology, and mathematics. 

These are courses most students will only take as part of a bachelor’s degree program, and ASCO states that “most students accepted have completed an undergraduate degree.” So, you can’t just walk in off the street and apply to an O.D. program. To be competitive, you’ll need a bachelor’s degree, and you’ll need to have completed roughly the same courses as a premedical student as part of that degree.

Applications and Entrance Exams

Optometry has its own centralized application system (OptometryCAS) and its own admissions test, the Optometry Admissions Test, or OAT. The OAT is a multiple-choice exam that covers four sections:

  • Natural sciences (100 questions)
  • Physics (40 questions)
  • Quantitative/mathematical reasoning (40 questions)
  • Reading comprehension (50 questions focused on analyzing scientific literature)

Like the MCAT, the OAT is offered year-round at Prometric test centers. 

GPA, Majors, and Demographics of O.D. Students

According to ASCO, students accepted to an O.D. program in 2022 had an overall average GPA of 3.52 (p. 14), and most students who applied majored in biology. Demographics by gender and ethnicity for the entering class of 2022 were:

  • 69.8% female
  • 30.2% male
  • 50% white
  • 29.9% Asian
  • 7.8% Hispanic or Latino
  • 4.0% Black or African-American
  • 0.6% Native American/Alaska Native
  • 0.2% Native Hawaiian/Pacific Islander

Students who applied to O.D. programs in 2021-2022 applied to four or five schools on average, compared to the 16 applications the average M.D. student makes.

What O.D.s Learn

Just like an M.D. program, O.D. programs take four years to complete. In the first year, O.D. students will cover many of the same foundational topics as M.D. students, such as anatomy and physiology, pathology, etc. Beginning from the second year, however, the curriculum deviates. 

Optometry students will focus solely on conditions that affect the eye and learn practical skills for performing eye examinations, devising vision rehabilitation programs, and providing other treatments. There is almost no study of surgical techniques in an O.D. program. At some optometry schools, the final year of study involves supervised clinical practice.

Ophthalmologists, on the other hand, take the broad curriculum required of M.D.s with very little focus on the health and treatment of the eye. It’s during the post-graduation internship and residency period that ophthalmologists specialize, learning to carry out eye surgery or focusing on a specific eye disease or patient population. M.D.s will then pursue board certification in ophthalmology.

By contrast, O.D.s do not need to complete a residency after graduation. Some O.D.s who want to work in vision rehabilitation may pursue an optional residency or internship, but overall, O.D.s can complete the steps for obtaining licensure in their state and begin practicing after graduation.

Scope of Practice

O.D.s are generalists in vision care, but what they do goes far beyond prescribing glasses. O.D.s can:

  • Treat glaucoma and eye ulcers
  • Diagnose and manage visual skill problems, like an inability to move or focus the eye
  • Provide visual rehabilitation after surgery or injury
  • Perform basic procedures such as removing foreign bodies
  • Screen for systemic diseases that manifest in eye or vision changes, including hypertension, diabetes, and brain tumors
  • Refer patients to ophthalmologists and other practitioners for further evaluation and care

O.D.s cannot perform surgery or injections on or around the eye area–that’s for ophthalmologists only. However, states and licensure boards are currently redefining the O.D. scope of practice, so this could change in the future.

Which Should You Choose?

If you want to provide primary vision care to patients of all ages, choose an O.D. program. If you’re interested in eye surgery or in treating a specialized eye disease, choose an M.D. program and pursue an ophthalmology residency after graduation. Both pathways lead toward fulfilling career paths performing vital medical care.

The Tiber MSMS Can Help You Prepare

No matter which pathway toward vision care you want to pursue, earning your Master of Science in Medical Sciences (MSMS) with a Tiber Health partner school can help. With a curriculum that mirrors the first year of medical school, dynamic classrooms and predictive analytics, a Tiber MSMS offers the academic rigor and support you need to pursue your professional goals. Learn more today!

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