Ophthalmologists are physicians who specialize in the care of eyes and in the prevention and treatment of eye disease and injury. They test patients’ vision and prescribe glasses or contact lenses. Most ophthalmologists also perform eye surgery, treating problems such as cataracts (which cloud vision) and other visual impairments. Because problems with vision may signal larger health problems, ophthalmologists may work with other physicians to help patients deal with diseases such as diabetes or multiple sclerosis.
Ophthalmologist Career History
Ophthalmology is a medical specialty that dates back to around 1600 b.c., when many vision problems were already recognized. The treatments that were available at the time were primitive, such as using crocodile dung and lizard blood to treat eye problems. Since then, treatments have (thankfully!) advanced.
Although the surgeon Susruta performed cataract surgery in India more than 2,000 years ago, Western Europe did not develop the specialty until the mid-1800s. During this era, a solid base of scientific research and medical advances in ophthalmology evolved. The ophthalmoscope, which is an instrument used to view the inside of the eye, was developed during this time.
Ophthalmology has undergone numerous significant scientific and technological breakthroughs in the past decade or so. Using retinal laser surgery (such as LASIK) to correct vision impairments is one recent groundbreaking procedure that has become a common practice among ophthalmologists.
Ophthalmologist Job Description
Most ophthalmologists spend four days a week in the office seeing patients and one day a week performing surgery, usually at a hospital. Office visits typically involve performing eye examinations and screening for diseases and infections such as glaucoma and conjunctivitis, or pink eye. Part of the job of ophthalmologists is to prevent vision problems before they start, so many of their patients may have near perfect vision but come in for prevention purposes.
Ophthalmologists treat patients of all ages, from infants to elderly adults. During an examination, they check a patient’s vision and prescribe glasses and contact lenses to correct any problems. They also screen for diseases using tools such as an ophthalmoscope, which is an instrument used to look at the inside of the eye. When examining a patient’s eyes, the ophthalmologist looks for signs of diseases that affect other parts of the body, such as diabetes and hypertension. When such a health problem is discovered, the ophthalmologist may work with another physician in diagnosing and managing treatment.
In a typical workweek, an ophthalmologist may see more than 100 patients and perform two major surgeries. The most common surgery performed is removing cataracts, which cloud the lens of the eye and cause partial or total blindness. Cataract surgery generally lasts just 30 minutes to an hour and usually helps patients regain all or most of their vision. Ophthalmologists also perform surgery to correct crossed eyes and glaucoma.
Ophthalmologists may treat patients who have diseases that could cause them to lose some or all of their vision. That possibility can make patients feel fearful and anxious and can create stress for both the patients and the doctor. For this reason, ophthalmologists need to be able to show patients compassion and understanding in offering their medical expertise.
“It’s not a profession for the faint-hearted,” cautions Dr. Anne Sumers, an ophthalmologist in Ridgewood, New Jersey. If patients go blind or their vision doesn’t improve after surgery, they may be (justifiably) disappointed and angry at the ophthalmologist. “It can be a terrible feeling,” she says.
Despite those downsides, Dr. Sumers feels that being an ophthalmologist is a rewarding medical specialty. “Most surgery is cheerful because people see better afterward, so they’re happy with the results,” she says.
Ophthalmologist Career Requirements
High School
To prepare for a career as an ophthalmologist, high school students should enroll in a college preparatory course, and take courses in English, languages (especially Latin), the humanities, social studies, and mathematics, in addition to courses in biology, chemistry, and physics.
Postsecondary Training
There is often confusion over the difference between an ophthalmologist and an optometrist. Ophthalmologists have medical degrees, while optometrists do not. After earning an M.D. degree and becoming licensed to practice medicine, ophthalmologists complete at least one year of general clinical training and at least three years in an eye residency program at a hospital. Often ophthalmologists work at least one more year in a subspecialty fellowship.
Certification or Licensing
Licensing is mandatory in the United States. It is required in all states before any doctor can practice medicine. In order to be licensed, doctors must graduate from medical school, pass the licensing test of the state in which they will practice, and complete a residency. Physicians licensed in one state can usually get licensed to practice in another state without further testing, however, some states may limit reciprocity.
To qualify for certification by the American Board of Ophthalmology (ABO) a candidate must successfully complete an ophthalmology course of education and pass written and oral examinations given by the ABO. The ophthalmologist must then complete continuing education requirements and web-based self-review tests to maintain his or her certification. While certification is voluntary, it is highly recommended. Most hospitals will not grant privileges to an ophthalmologist without board certification. Health maintenance organizations and other insurance groups will not make referrals or payments without certification.
Other Requirements
Certain visual and motor skills are necessary to be an ophthalmologist. Without good motor skills, depth perception, and color vision, an ophthalmologist may have trouble using instruments that are part of the practice. In addition, ophthalmologists need to be patient and good at communicating with people in order to work with patients and other doctors.
Exploring Ophthalmologist Career
To learn more about this career, ask your biology teacher or guidance counselor to set up an information interview with an ophthalmologist. You might also volunteer at a local hospital or clinic to get a feel for what it’s like to work around other health care professionals and patients and possibly determine exactly where your interests lie.
Employers
Ophthalmologists are able to choose from a variety of exciting and challenging work environments. Many ophthalmologists go into private practice, sometimes by themselves, but more commonly in a small group. These small group practices are either multispecialty practices, or single-specialty practices. Other ophthalmologists choose to work at universities and medical schools, teaching and conducting research. An academic career offers the clinical exposure of a private practice combined with the opportunity to perform more unusual surgeries. Usually, academic careers provide the opportunity to teach, as well as handle administrative duties. The additional responsibilities of teaching and running a department are time-consuming, but rewarding.
Starting Out
There are no shortcuts to entering the medical profession. Requirements are an M.D. degree, a licensing examination, a one- or two-year internship, and a period of residency that may extend as long as five years.
Upon completing this program, which may take up to 15 years, ophthalmologists are then ready to enter practice. They may choose to open a solo private practice, enter a partnership practice, enter a group practice, or take a salaried job with a managed-care facility or hospital. Salaried positions are also available with federal and state agencies, the military, including the Department of Veterans Affairs, and private companies. Teaching and research jobs are usually obtained after other experience is acquired.
Advancement
Ophthalmologists advance in their careers by keeping current with new technologies, medications, and techniques. Publishing articles in respected medical journals, such as the Journal of the American Medical Association, is another avenue for professional enhancement. Many ophthalmologists combine research and teaching with a private practice. Others work as professors at universities or teaching hospitals and may advance to an administrative position as the head of a university or hospital ophthalmology department.
Earnings
Ophthalmologists’ salaries vary by the size of the hospital or health care facility where they work and the city or town where they practice. Other factors affecting salary include the ophthalmologist’s practice, hours worked per week, and professional reputation. According to Physicians Search, a physician recruitment agency, average starting salaries for ophthalmologists ranged from $120,000 to $190,000 in 2004. Ophthalmologists in practice for three years or more earned salaries that ranged from $161,763 to $417,000, with an average of $256,872.
Work Environment
The offices and examining rooms of most ophthalmologists are well equipped, attractive, well lighted, and well ventilated. There is usually at least one nurse-receptionist on the ophthalmologists’ staff, and there may be several nurses, a laboratory technician, one or more secretaries, a bookkeeper, or receptionist.
Ophthalmologists usually see patients by appointments that are scheduled according to individual requirements. They may reserve all mornings for hospital visits and surgery. They may see patients in the office only on certain days of the week.
Ophthalmologists in academic medicine or in research have regular hours, work under good physical conditions, and often determine their own workload. Teaching and research ophthalmologists alike are usually provided with the best and most modern equipment.
Ophthalmologist Career Outlook
Employment growth for all physicians is projected to be faster than the average through 2014, according to the Occupational Outlook Handbook. However, the demand for specialty care may provide more job opportunities for ophthalmologists and other specialists. The increasing number of elderly people will drive demand for vision care. Also, new technology (such as a wider use of lasers to correct vision problems) will allow doctors to treat and detect vision disease and impairments that were previously treatable by invasive surgery or eyewear.