Ophthalmology Scope

Scope of Practice: Ophthalmology and Optometry

Patients may not always understand the difference between an ophthalmologist and an optometrist. Both care for patients’ eyes, but their education, training, and scope of practice are different—and those differences matter when it comes to medical and surgical care.

Ophthalmologists are physicians. They complete medical school, followed by residency training in ophthalmology that prepares them to diagnose and treat a broad range of medical conditions and perform eye surgery. Their training encompasses the eye as well as the patient’s overall health and the medical conditions that can affect vision and eye health.

Optometrists are eye-care professionals who earn a Doctor of Optometry degree. Their training prepares them to provide primary eye and vision care, including eye examinations, vision correction, and the diagnosis and nonsurgical management of certain eye conditions. Optometry education does not include medical school or the same physician residency training required of ophthalmologists.

These differences become particularly important when legislation seeks to expand the procedures that optometrists may perform. A change in a scope-of-practice law does not change the education or clinical training required to safely perform a procedure.

What This Means for New Hampshire Patients

In New Hampshire, proposals to expand the scope of practice for optometrists to include laser or other eye surgery raise important questions about education, training, patient safety, and appropriate medical oversight.

Physicians support allowing health professionals to practice to the full extent of their education and training. At the same time, expanding a professional scope of practice should be based on evidence that the proposed practice is consistent with the clinician’s education, training, experience, and demonstrated competency.

Eye surgery is medical care. Procedures involving the eye can carry significant risks, including complications that require comprehensive medical knowledge and surgical training to recognize and manage.

For NHMS, the issue is not about limiting another profession. It is about making sure that New Hampshire patients receive the right care from the right professional, based on education, training, experience, and demonstrated competency.

Why Physician Training Matters

A medical degree is not simply another credential. Medical school and physician residency provide training in the diagnosis and treatment of disease across the entire body, including the ability to recognize how underlying medical conditions, medications, and other health issues can affect a patient and a proposed procedure.

As scope-of-practice proposals evolve, policymakers should consider the full education and training pathway of the professional who would be authorized to perform a procedure—not simply whether the procedure can technically be performed.

Patient safety should remain the standard for determining scope of practice.