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Optometrist, ophthalmologist, orthoptist: what’s the difference?

Feeling confused about the difference between eye care practitioners? Can’t […]

By Published On: 5 April 20195.9 min read

Feeling confused about the difference between eye care practitioners? Can’t tell an optometrist, from an ophthalmologist or orthoptist?  And where does an optician fit into the picture?

This post aims to clear up who’s who when it comes to optical professionals.

Every eye-care professional and eye-wear provider has their unique role to play in providing good vision, promoting eye health and meeting your visual needs.

What is an ophthalmologist?

If you’ve recently had an eye operation or are undergoing treatment for an eye disease or injury, you would usually see a medical specialist called an ophthalmologist.

Ophthalmologists are categorised as eye-surgeons, having studied for a medical degree and worked for a period in a teaching hospital as an intern in residence. They regularly undergo 12 years of training. 

Found in hospitals and private practice, ophthalmologists diagnose and treat eye disease and injury. They carry out the intricate surgery of removing cataracts and implanting lenses using traditional, as well as laser techniques.

Eye surgery has now become quite complicated in that most eye surgeons go on to further study and sub-specialise in certain parts of the eye.  For example, if you have macular degeneration you would be better to see a retinal ophthalmologist, as opposed to a general ophthalmologist.

There is considerable overlap in the services provided by optometrists and ophthalmologists, but ophthalmologists are the only professionals to perform major eye surgery and treat serious, sight-threatening eye disease.

You need a referral from an optometrist or GP to see an ophthalmologist.


When do I see an ophthalmologist?

  • If you’ve been referred by an optometrist or GP because you need surgery or medical treatment for an eye disease or eye injury.
  • If you have a chronic eye disease such as glaucoma, or wet macular degeneration, you will need to see your ophthalmologist on a regular basis.
  • An ophthalmologist is NOT the appropriate eye professional to see for routine comprehensive eye examination. (An optometrist is best qualified for this).


What is an orthoptist?

Orthoptists undergo at least four years of university training resulting in an orthoptics degree. They are health professionals who care for patients with a range of eye disorders. 

An orthoptist often (though not always) works closely with an ophthalmologist in hospitals, private practice, low vision clinics and rehabilitation centres. The orthoptist is usually the person to carry out the initial diagnostic tests on your eyes before you see your ophthalmologist.

They also provide vision training in many cases of eye movement disorders, especially in children.
An orthoptist is often the person who is primarily responsible for your eye care immediately before and after your cataract surgery or laser eye surgery. This may include assessing your potential vision, surgical requirements (including calculating the optical lens to be inserted in the eye during surgery) and the prescribing of glasses.

To perform these investigations, orthoptists are highly trained in using specialised technology to detect and measure the progression of eye disease – these include instruments such as ultrasound machines, retinal cameras and other imaging equipment.


When do I need to see an orthoptist?

  • If you’ve been referred to an ophthalmologist by your optometrist (or GP), the orthoptist will usually see you first to carry out a range of tests before you see the ophthalmologist.
  • Before and after cataract and laser eye surgery (at the ophthalmologist’s rooms).
  • If you’ve been referred to a low vision clinic or rehabilitation clinic to have vision training or for a range of eye disorders.


What is an optometrist?

Optometrists undergo at least 5 years of university training resulting in an optometry degree.  They are health professionals qualified to examine your eyes and detect, diagnose and manage vision problems and ocular diseases.

They prescribe glasses, contact lenses and other visual aids to optimise your vision. They may also recommend exercises to improve your focus, eye coordination and comfort.

Many optometrists are qualified to treat ocular disease through the prescription of medicated eye drops.  You don’t need a referral to see an optometrist. However, some eye diseases require collaboration with other health experts, in which case your optometrist will make the appropriate referral.

Optometrists can use the title of Doctor, as long as it’s clear that they are not a medical doctor. E.g. Dr Joe Bloggs, Optometrist. (This is the same for other health care professionals such as dentists).

In NSW, any optometrist who graduated since 2008 is therapeutically qualified. In addition, many other optometrists have undertaken additional courses of study to achieve therapeutic endorsement.

What does this mean for you? While optometrists do not perform surgery, they may use drugs, including antibiotic, anti-inflammatory and anti-glaucoma eye drops, provided they are therapeutically qualified.

This means that there is no other primary care provider who is better equipped and trained to manage a wide range of eye conditions including allergies, conjunctivitis, dry eyes etc. Optometrists can also manage glaucoma in consultation with their ophthalmology colleagues.

For serious and sight-threatening eye conditions such as corneal infections and complex glaucoma, as well as for any eye surgery procedure, your optometrist will refer you to an ophthalmologist who specialises in that particular area.


Optical Dispenser, optical mechanic or optician?

The same sort of confusion exists around the people who make up your glasses.


Optical dispenser

An optical dispenser is the one you are most likely to come across when you get a new pair of glasses. They work at the customer interface and provide advice on the ideal frame choice and lens design to best fulfil your visual needs.

Their training varies but usually involves a course of study and practical training in understanding lens design and measurements for accurately dispensing glasses as well as frame materials, repairs and adjustments.

Optical dispensers are responsible for dispensing spectacles or contact lenses received from an optometrist’s or an ophthalmologist’s prescription, in much the same way a pharmacist would dispense medication prescribed by a doctor. (This analogy isn’t strictly correct, as a pharmacist is required to undergo formal university training leading to qualification, whereas an optical dispenser is not necessarily obliged to).

An optical dispenser may also be called a frame stylist, especially in a retail fashion setting.


Optical mechanic

Optical mechanics work in the lens manufacturing factory, and are not usually in contact with customers. They actually make the lenses in the factory or lab that are then cut into the frame you select with the help of your optical dispenser.



In Australia this can be a confusing term.  It is a term that originates in the United Kingdom, where optometrists are often referrer to as ophthalmic opticians, whereas optical dispensers are called dispensing opticians. Because of the confusion, Australian legislation does not allow optical Dispensers to call themselves opticians, as it is too easily confused with an optometrist.

We hope you are now much clearer on the difference between the various eye care professionals and eye wear technicians.

Looking for the perfect frame for your face? Talk to the experts. Call The Eye Practice on (02) 9290 1899 or make an appointment online today.


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