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Dr Andrew Fink MD for
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Eye Clinic,
Medical Centre
88 Ahuza St
Ra'anana, Israel
Who's Best at Checking my Glasses?
How often have you wondered where to go to check your glasses? Does one visit the Optometrist or the Ophthalmologist? Who is more reliable? In the USA and Israel many visit the Ophthalmologist. In the UK nobody visits an Ophthalmologist for glasses, in fact if you did, the Ophthalmologist would probably be insulted!
Firstly what is the difference between the two professions-Optometry and Ophthalmology?
In Israel an Optometrist studies a 4 year degree course consisting of the optics and physiology of the eye, spectacle and contact lens fitting, and other allied fields such as orthoptics (the study of eye movements and squints). Although an Optometrist has some exposure to certain eye diseases during his training, his/her experience is limited. Moreover the Ministry of Health in Israel restricts Optometrists from performing certain tasks such measuring intraocular pressure (a screening test for glaucoma) with the more accurate contact technique, and instilling eye drops.
In contrast an Ophthalmologist is a doctor who has completed medical school (6 years), an eye specialist training programme (5 years in Israel) and sometimes an additional subspecialty training period of 1-2 years. He is an expert on eye disease, and many ophthalmologists are also eye surgeons. Somewhere along the way he spends a few days learning how to measure someone for a pair of glasses, often just before the final board exams.
The situation in Israel has also been complicated by the fact that for many years Optometry was a non regulated profession meaning that many non or poorly qualified individuals practised at a very low level giving the profession a bad name. More recently the confusion in the profession continued when training programmes opened, but some were not recognised by the Ministry of Health. As a result graduates, after 3-4 years of training, failed to get a licence to practise. Today two Optometry schools exist in Israel -at Bar Ilan and Haddassah, and graduates are of a very high standard but patients still often prefer to go to an eye doctor because it is cheaper through the Kupat Holim national health insurance, and old stigmas take a long time to die out..
So who should you go to for you glasses prescription? The answer will of course depend on who you speak to. Some Ophthalmologists have developed a particular interest in Optometry and even a medical contact lens fitters association exists in Israel. In contrast other Ophthalmologists will sit a patient in front of an automatic testing machine (not always accurate but suitably high tech for the easily impressed patient), take a reading and say good bye all within the space of 2 minutes.
I believe that to perform an accurate eye test, especially if the prescription is complicated with astigmatism (cylinder), takes not less than 20 minutes. In view of the fact that an Ophthalmologist’s time with each patient is limited, because of the nature of working practices in the public sector here in Israel, there is no way he can perform an accurate glasses check and examine the health of the eye in the time allowed. Moreover there is no need for him to do a full measurement as a licensed Optometrist is fully qualified to perform this task. In addition as the Optometrist sells the glasses, he/she should be taking responsibility for the product he is selling.
So, in conclusion, if you want your glasses checked, I recommend visiting firstly an Ophthalmologist to check the health of your eyes. He will also advise on whether you need glasses at all, or if your present glasses need updating. Then go to your Optometrist to have an accurate measurement and purchase your new glasses or contacts. That way both professions will be kept happy and you will get the best of both worlds.
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