Optician, optometrist and ophthalmologist: what’s the difference?

Most people will be familiar with their local optometrist and optician, though fewer will have interacted with an ophthalmologist. Each of these professions are here to take care of your eyes but what they do, their qualifications and training differ.

What is an optician and what do they do?

Opticians, specifically known as dispensing opticians, help fit you for glasses and contact lenses. They aren’t qualified to perform eye tests and can’t write prescriptions for your vision. However, they can read your prescription to ensure you’re provided with appropriate vision correction.

Dispensing opticians need to complete a two-year diploma, approved by the General Optical Council (GOC), and a one-year work placement, as well as pass their Professional Qualifying Examinations.

What is an optometrist and what do they do?

An optometrist, also known as a prescribing optician or ophthalmic optician, can also help fit you for glasses and contact lenses but they can do much more. When you go to have your eyes tested at your local opticians, it will be an optometrist who carries out the test. They are also trained to check for eye diseases (eg glaucoma, diabetic retinopathy and age-related macular degeneration) and write the prescription for your vision. 

Optometrists need to complete a three-year university degree in optometry, approved by the GOC, complete a one-year work placement with a registered optometrist and pass the GOC final assessment.  

Some optometrists, who complete the Independent Prescribers qualification, can also prescribe a limited number of medications eg antibiotics and steroids to treat certain eye diseases . 

What is an ophthalmologist and what do they do?

If your optometrist finds that you have signs of eye disease, they will refer you to a doctor who specialises in treating the eyes ie an ophthalmologist. Ophthalmologists can help manage or treat any eye disease, as well as eye injuries, and most ophthalmologists also perform eye surgery. 

Ophthalmologists need to complete a four or five-year medical degree, two years of foundation training in hospital and then a further seven years of hospital training to specialise in ophthalmology. Many then go on to complete further fellowship training to become a subspecialist in ophthalmology.

If you have an eye condition, you will be referred by your optometrist or GP to see an ophthalmologist that specialises in treating that particular condition. Ophthalmologists subspecialise in different parts of the eye (eg medical retina, cornea) or different eye conditions (glaucoma, cataracts, diabetic retinopathy etc).

When to see an optician, optometrist or ophthalmologist

If you’re concerned that your vision isn’t as clear as it should be, it’s important to visit your local opticians to have an eye test performed by your optometrist. If you need vision correction, your optician can help fit your glasses or contact lenses. If your optometrist detects an eye disease, they will refer you to an ophthalmologist. 

You can also see your GP if you’re concerned that you have an eye condition. In certain cases, your GP may be able to treat your eye condition themselves eg they may prescribe antibiotics for severe, persistent eye infections. However, if they can’t treat your eye condition and/or think you need further investigations by a specialist to diagnose your eye condition, they will refer you to an ophthalmologist. 

If you want to see a private ophthalmologist and are self-paying, you can book a consultation with an ophthalmologist directly. However, if you’re using insurance to cover the cost of your care, you will usually need to see your GP or an optometrist first to get a referral letter. 

Depending on your eye condition, you may be monitored by an ophthalmologist via a hospital outpatient clinic (eg if you have glaucoma) or by your optometrist at your local opticians (eg if you have dry eye syndrome). In some cases, you may need ongoing monitoring and care by both your optometrist and your ophthalmologist.