OPHTHALMOLOGIST (M.D.)

This is a medical doctor who specializes in the diagnosis, treatment, and surgery of the eye. He or she prescribes whatever eye treatment you may need, including prescriptions for glasses and the fitting of contact lenses. All ophthalmologists can provide a prescription for glasses and contact lenses; half of them also specialize in fitting contact lenses. Ophthalmologists spend a minimum of eight years training after college: After four years of general medical study at an approved medical school, they then spend an additional one to two years in general internship, and at least three more years in special ophthalmologic residency training at an approved hospital.

OPTOMETRIST (D.O.)

A doctor of optometry spends four years in specialized optometric study after college. He or she is trained to examine the eyes, to prescribe, and to fit glasses and contact lenses. There are about twice as many optometrists as there are ophthalmologists, and a large proportion of them fit and dispense contact lenses.

OPTICIAN

An eye practitioner who is trained (usually for two years in an optician’s school) and is authorized to fill the prescriptions of ophthalmologists and optometrists (but not prescribe himself). In some states he or she may fit contact lenses.

If you have decided that you would like to wear contact lenses, I strongly recommend that you first go to an ophthalmologist for a medical eye examination. The next step is to choose the contact lens specialist (it may be the same ophthalmologist) who will fit and order your contact lenses, as well as provide you with follow-up care. For this it’s best to go to an ophthalmologist or optometrist in private practice who specializes in contact lenses. He or she is probably the most trustworthy, reliable, and knowledgeable source, and though you may spend ‘more initially than if you went to a different type of eye specialist, this is one case where you get what you pay for. An ophthalmologist can best detect any present, past, or latent eye diseases and potential problems of the eye that might not only interfere with contact lens wear, but may affect your vision in general. By examining your eyes he can also detect signs and symptoms of diseases elsewhere in the body. Diseases that exhibit early ocular symptoms include diabetes, high blood pressure, arteriosclerosis, kidney disease, blood disease, and certain neurologic disorders. Thus you not only save money by not buying lenses that you won’t be able to wear successfully, but you might also be saving your sight—and perhaps even your life. Even if your ophthalmologist doesn’t fit contact lenses himself, you should go to him for your initial medical ocular examination. He will then refer you to an eye practitioner who is specially trained to fit contact lenses. In all cases you should remain under the ophthalmologist’s care, supervision, and responsibility. An optometrist, although lacking the training of a four-year medical school, does have the background training to diagnose many eye disorders. However, he cannot treat any ocular diseases.

Then there’s the matter of prescription and fit. You simply stand a better chance for a successful fit under the care of a private contact lens specialist, be he an ophthalmologist or optometrist, because of his virtually unlimited choice of lenses. The contact lens specialist isn’t committed to any one manufacturer, and can therefore choose exactly the lens which will best suit your individual needs. Having access to hundreds of lenses manufactured by many different companies is important because no one brand can fit everyone; all brands were not created equal.

There are some “optical stores,” on the other hand, which may buy large quantities of contact lenses from one or two manufacturers in order to obtain volume discounts that they can pass on to their customers at low markup. While you may benefit from lower prices because of the large inventory, it may be the store’s policy to try to fit you with one of their stock lenses because of their financial commitment. You forfeit having the choice of all the types of lenses in order to choose the one that specifically meets your own visual correction needs. It is unlikely that these stores hire ophthalmologists. Therefore the all-important initial medical exam is missing. Usually cursory eye exams are often the rule as well as a quick and sometimes inadequate instruction session. These shortcuts are two of the most often-cited reasons for contact lens dropouts. 92 percent of past contact lens failures were refitted successfully when they went to optometrists and ophthalmologists who specialized in contact lenses. In another survey of contact lens dropouts 78 percent of the patients had gone to low-cost dispensers and almost that many admitted they hadn’t been thoroughly briefed on the importance of the meticulous care and handling the lenses required. Should you balk at the higher cost, remember that quality seems expensive at first. But when you can wear a comfortable pair of lenses that provides excellent vision, it is cheaper in the long run. What is the difference between a bargain contact lens and an expensive pair? You can liken the plastic of a contact lens to a bolt of fine silk. In the hands of a mass-production firm, the silk can be fashioned into an inexpensive shirt. By contrast, in the hands of a fine couturier, the raw silk material becomes an exquisitely made, well-fitting, good-looking article of clothing that, although expensive, you will wear with pride for many years. The silk, though it may be of high quality to begin with, accounts for only a fraction of the cost of the final product. The inexpensive shirt that may fit poorly and not look so great may turn out to be no bargain if not worn. On the other hand that expensive silk shirt that you wear frequently will, in reality, be the bargain!