What is the difference between an Optometrist, Behavioural Optometrist, Ophthalmologist, and an Orthoptist?

1. An Optometrist is a university trained specialist in vision care who is trained to detect and treat eye diseases, to measure and correct vision problems. In New Zealand the Bachelor of Optometry (B.Optom.) degree takes 5 yrs to complete. Optometry is a psychophysical science- the interface between the human-ness of Perception and the physically measurable of Optics.
Optometrists use a variety of highly accurate equipment plus a series of detailed tests to assess each patient's vision. Optometrists will supply the spectacles and contact lenses that they prescribe and will help the patient choose a suitable spectacle frame. Optometrists must be able to exercise their judgement correctly to relate each set of test results to their patient's lifestyle, ensuring the best possible solution to each individual problem. Optometrists are well-trained in the treatment for Amblyopia, strabismus and binocular problems. Shattky's optometrists provide you and your family with Total Vision Care.

2. A Behavioural Optometrist is an Optometrist with extra training in binocular vision, Strabismus, Amblyopia and Visual/Spatial Perception. They are sometimes referred to as Neuro-developmental Optometrists. Their special training and therapies will open up new understanding about your Vision. For example strabismus is to be seen as a choice by the brain, and not a function of a muscle being too weak or too strong. They typically work to a Model of Vision that is far broader in its understanding of Light and the human-ness of the sensory experience called Vision. Ask them to tell you what their Model is.  Shattky's Behavioural Optometrists provide you and your family with better Visual Efficiency.

3. An Ophthalmologist is an eye surgeon, a medical doctor with specialised training in the diagnosis and treatment of medical problems of the eye.  Generally, much of what the ophthalmologist does overlaps with what the optometrist does. Both can prescribe glasses and contact lenses, both perform eye examinations and prescribe medicines. The difference really shows up when the patient is found to have a serious medical problem. If surgery or stronger drugs are indicated, only an ophthalmologist is trained and licensed to do this. On the other hand, when dealing with minor eye disease, the need for glasses and issues related to binocularity and functional vision, the optometrist generally has more training and experience.

4. An Orthoptist is university trained to work with eye surgeons. They cannot prescribe spectacles or medications. They have a mechanistic model for treatment of strabismus believing the muscles to be too strong or too weak.

Who should I go to for my eyecare, an Optometrist or an Eye Surgeon?

Under normal circumstances you would go to the optometrist first, they are primary eyecare providers capable of identifying your next best step. As ACC approved treatment providers, optometrists are competent, and equipped to identify the best management plan for you.As a result of the examination, on-referral to your GP or direct to an eye surgeon may occur.

At what age should I have my children's eyes examined?

As you may expect, opinions on this differ. At the very least, all experts agree that every child should have an eye examination before they turn five. This is a critical age as they are often assumed to be 'Ready for School' but many children are not "Visually Ready for School". Therefore, at the outside, each child should be examined no later than age 4 1/2.

It should also be noted that if a parent has any reason to suspect an eye problem at an earlier age he/she should not hesitate to seek an examination regardless of the child's age. Examining a child 1 year or older is not a problem. If you are unsure, call your optometrist and ask him/her if he will examine a child at your child's age. If not, he/she will certainly recommend somebody that will. The most common problems at a very young age are related to eye turning (in or out), and are generally treated before age 2 or 3.

Does it hurt to have my eyes tested?

This very reasonable and commonly asked question can be answered with a definite "No".

In the process of eye examination we use rather bright lights but there is no pain. If diagnostic eye drops are needed during the examination, we will warn you, some of them do sting a bit.

How long does it take to have my eyes tested?

We would typically allow 30 to 45 minutes for an eye examination.

This allows time to measure and examine your eyes and to discuss the options that you will have.

These may include spectacles (for which time is allocated to look at the frames), contact lenses (sometimes inserting some lenses for evaluation), eye exercises, more tests (extra fees may be necessary) or even referral to related practitioners.

How much does it cost to have a basic eye examination?

This is a hard question to answer because we do many different tests when results during the eye examination indicate that more should be done. We do our best to inform you as we go. The basic fee as at 2011 is $75 incl. GST. But total fees may be nearer $95 to $120.

Am I able to change Optometrists?

Yes, most definitely. All of us are different, both patients and practitioners, so we would always endorse your freedom to see the Optometrist of your choice. It is very important that the paying consumer feels confident and comfortable with their practitioner so don't just accept the status quo; make the change if you wish! We are always ready to greet new patients and because there are 4 of us at Shattky's you can even pick and choose between our different styles and personalities.

What is short-sightedness (Myopia)?

Short-sightedness, known medically as Myopia, is a condition where the eye's focus power is too strong for its length, causing the light to be focused in front of the retina. It can be that the curves on the front of the eye are too strong or perhaps the eye has become too long from front to back. In most cases of low myopia neither the power nor the length are abnormal, they just don't match up. Very few people are born short-sighted, but there is a strong genetic factor in determining whether you will become Myopic or not. The triggering cause for the emergence of myopic change to your eyes is thought to be that the eye has adapted to the amount & intensity of the near work that you have been doing i.e. the short-sightedness is the body's natural response to the stress of near work.

Though this is actually a good thing for reading vision, it results in a blur for distant tasks. Optometrists compensate for this focus error by using minus powered spectacle or contact lenses placed in front of the eye to reduce the over-strong total power of the eye's optical system. This restores clarity for distance vision. Eye surgeons create the minus lens effect by surgical removal of tissue or implanting plastic lenses inside the eye.

If the sources of near point stress on the eye continue, the length of the eye increases, which increases the prescription power needed to restore good vision for distance. This process continues until the effects of age slow up the ability of the eye to keep changing- this typically occurs by the age of 30. Short-sighted people tend to prefer the "detailed view" on life, they are often more interested in intense, detailed, near tasks (especially reading) and can be more specific in their thinking.

In terms of how a person's vision functions when they have Short-sightedness, it is actually a clever adaption to the intensity of the near task, allowing the person to see clearly at the range they like to work at without having to use their accommodation, pretty clever Stress management! The symptom of short-sightedness is typically just the blur at distance, seldom headaches nor strain.

What is long-sightedness (Hyperopia)?

Long-sightedness, known medically as Hyperopia or Hypermetropia, is a condition where the eye does not have enough focusing power for its length. This may occur because of flatter (weaker) degree of curvature on the front of the eye or too short an eyeball from front to back. In most cases of low Hyperopia neither the power of the eye nor the length are abnormal, they just don't match up. Longsighted people tend to prefer the "long view" on life, they are often more interested in outdoors and 'big picture' thinking.

The result of Hyperopia is that light entering the eye focuses too late, behind the retina (the back of the eye). To compensate for this, a positive (plus) powered lens is placed in front of the eye to assist the power of the eye.

Hyperopia is confusing to many people, especially those under 40, because most hyperopic eyes can see well despite the Hyperopia. That is because they can "borrow" focusing power from the ability to focus up close for reading that we all have. As a result, many hyperopic patients have no problem with their distance vision, but complain about their near vision, such as when using computers or reading. In these cases, uncorrected Hyperopia causes symptoms of fatigue, headaches, or blurred vision up close but seldom blur at a distance.

In terms of how a person's vision functions when they have Long-sightedness, it is actually a clever adaption to the need for a relaxed wide view of the dangers in the outside world. It is a form of letting go on the detailed stuff of life and allowing one's mind to see the forest rather than the trees. Because the person can usually accommodate their focus for sharpness when they need it anyway, you can see why Long-sighted people are often relaxed about life and only engage when they need to! Pretty clever Stress management! Chilled out though it is, this is not the teacher's preferred mode for their pupil to operate in, so that's why long-sighted children need glasses to keep them "in-the-moment" during class!

The symptoms of long-sightedness are numerous. Typically headaches and/or eyestrain, but quite often blur at near, and less often blur at distance.

What is Astigmatism?

Astigmatism is the trickier focus problem to explain, and its name is less familiar so patients are often concerned that it is somehow more serious than the other focus problems, it is not. It is very common indeed; most people have some amount of astigmatism on both eyes.

In most cases, astigmatism results from an oddity about the corneal curves. The cornea is the front surface of the eye made of clear gristle. It could be said that a normal eye's curves are very similar at different angles of measurement, akin to a soccer ball which has the same radius of curvature all over its surface. However astigmatism is more akin to the curves on a rugby ball, along some parts it has a longer radius of curvature (flatter curve) than it does around the other parts which are more tightly curved. The more unequal the curves are at different angles, the more astigmatism there is.

In terms of how a person's vision functions when they have Astigmatism, it is actually a clever adaption to the intensity of the near task, allowing the person to see clearly at more than one focal length without having to change their accommodation, pretty clever Stress management! The symptoms of astigmatism are also numerous. Typically headaches and/or eyestrain but quite often blur at near and distance as well.

Why can't I see better with my "Lazy Eye?"

"Lazy Eye", properly called Amblyopia, is an eye that is not seeing as well as its appearance would suggest it is capable of. By this we mean that it appears to have no pathology, (e.g. no apparent disease or injury), yet cannot get to the lower letters on the letter chart.

In these cases the problem lies with the brain suppressing the valuable detailed information that the eyeball is actually seeing well.

Why would the brain suppress this information?

The brain will generally choose to suppress the images from an eye for one reason - Stress. If the eyes don't point in the same place (e.g. crossed eyes) you will see double unless one eye is suppressed. Seeing double is not a desirable state for the brain, so it quickly learns to suppress one eye. The more years you have been doing this the better you are at it. It can become a deeply embedded skill. Children can learn to suppress the information very quickly. In some ways it is clever to suppress the vision, because at least it does reduce double vision, but unfortunately it is not in the best long term interest of the child. After all, we all know that "Two eyes are better than one"! That is why we attempt to reduce the suppression.

Because the brain suppression develops early, often by age 2, and because it is easier to treat in its earliest stages, it is important to have your child checked at least once when they are four.

How do we see?

Vision actually occurs in a part of the brain called the visual cortex. The job of the eye is to collect the visual information and transmit it, by way of the optic nerve, to the visual cortex. There the brain interprets it and, rather magically, creates the image we see. Therefore, along with the eye, the health and development of the visual cortex is essential to good vision. From birth the brain "learns" how to create visual pictures from the impulses it receives from the eye, and develops the cellular structure to do so.