There was a time when optometrists and ophthalmologists did not work together. If you talk to older optometrists and ophthalmologists, you will learn that they considered each other rivals. Now many optometrists and ophthalmologists work together, either in a co-management capacity or within the same practice. One reason for this is the growth of refractive surgery, in particular LASIK. Another reason has to do with healthcare reforms. With some insurance companies not accepting consultation codes, many eye care practices may choose to be integrated in order to be more efficient. Still, how did they go from rivals to colleagues? Here’s how a few practices utilize both optometrists and ophthalmologists.
Empire Eye is an ophthalmologic practice in Spokane Valley, Washington and the practice has been utilizing optometrists since the late 1980s. It started with the co-management of cataract patients and when LASIK came along, the optometrists on staff were involved from referrals to post-operative care. Currently, the optometrists on staff organize continuing education programs, develop marketing programs, as well as do all routine and post-operative care. In addition, this practice has an ocular surface disease clinic that is run entirely by optometrists. This allows the ophthalmologists in the practice to concentrate on patients who either have serious vision conditions or need surgery.
Another practice, Elmquist Eye Group in Fort Myers, FL also has both optometrists and ophthalmologists on staff. Owner, ophthalmologist Trevor Elmquist, DO is an advocate of what he calls “success through cooperation”. His practice is an integrated practice, in which ophthalmologists, optometrists, opticians, etc. work together in the same practice to provide vision care to patients. He feels that when both optometrists and ophthalmologists work together, the patient benefits since they can care for the vast needs and spectrum of eye patients more efficiently.
Another way the optometry and ophthalmology partnership works is in the area of refining both patient care and treatment. Two eye doctors from Italy, Edoardo Ligabue, MD, and Cristina Giordano, OD started working together in the 1990’s when corneal topography was introduced. At this time, they wrote their first article on the corneal map of the Orbscan II, a device that provides a 3D slit scan of the anterior and posterior surface of the cornea.
As studies of aberrometry (measurement of refractive aberrations) appeared, the doctors implemented aberrometric evaluations. In 2007, they wrote an article about interpreting aberrometric measures in cataract surgery by measuring the errors in refraction through skiascopy to evaluate visual quality after intraocular lens implantation. Next, they started speaking at international meetings where they presented papers on the optical properties of premium intraocular lenses, patient selection and how to best examine patients pre and postoperatively. Drs. Ligabue and Giordano found that their partnership helps in finding solutions for patients who complain of problems, such as low visual quality or photic phenomena.
What makes the collaboration unique is that in Italy, partnerships between optometrists and ophthalmologists are rare. In fact, regulations in Italy assign the assistant role in ophthalmology to the orthoptic graduate. So, their partnership, like others mentioned, benefits the patient and the practice.
As ophthalmologist Trevor Elmquist, DO stated about optometric and ophthalmologic partnerships “It matters very little what the two letters are on the end of your name. As long as you are practicing and caring for your patient at a high level of skill and quality, and within the bounds of your license, then have at it.”