Optometrists, Chiropractors and Other Health Diagnosing and Treating Professionals - What They Do

Optometrists examine eyes to assess and diagnose ocular diseases and disorders. They prescribe and fit eyeglasses and contact lenses and recommend treatments such as exercises to correct vision problems or ocular disorders. They work in private practice, clinics and community health centres.

Job duties

This group performs some or all of the following duties:

Examine patients' eyes, conduct tests and use ophthalmoscopes, biomicroscopes and other specialized instruments to determine ocular health and visual efficiency
Prescribe and provide treatment (excluding surgery) to maintain, improve and correct vision and manage other ocular diseases and disorders
Prescribe, dispense and fit eyeglasses, contact lenses and other visual aids
Educate, counsel and advise patients on contact lens use and care, ocular hygiene, surgical and non-surgical options, and preventive care and maintenance related to occupation and lifestyle
Refer patients to ophthalmologists or other physicians and surgeons for treatment of ocular diseases or conditions such as cataracts, glaucoma and macular degeneration and systemic conditions such as diabetes and high blood pressure
May prescribe from a limited list of medications.
Optometrists may specialize in fitting visual aids for people who are partially blind, fitting contact lenses or correcting special vision problems.

Job titles

doctor of optometry (OD)
optometrist

Employment Requirements

This is what you typically need for the job:

Three years of university undergraduate studies in mathematics and sciences and A four-year university program in optometry are required.
Licensing by the provincial or territorial regulatory governing body is required.

Essential Skills

Reading

Read e-mail from colleagues, suppliers and patients. For example, they read e-mail from other optometrists about continuing education events, and from suppliers informing them about optometry equipment features. (2)
Read product descriptions from contact lens manufacturers, pharmaceutical companies and optical laboratories to stay informed about new products. For example, they read brochures about anti-glare and anti-scratch contact lenses. (2)
Read users' manuals when they experience difficulties with diagnostic or office equipment. They skim sections that they think will help them fix their equipment. (2)
Read instructions, warnings and other text on the labels of products such as contact lenses. (2)
Read short reports from family physicians and specialists to whom they have referred patients for information on patients' general health, test results, diagnoses, medications, prognoses, recommended treatments and follow-up plans. (3)
Read notes and comments on patients' history, intake and assessment forms. They review patients' health histories, clinical notes, test results, prescriptions and treatment programs prior to and during their appointments. (3)
Read short articles in professional association newsletters to find out about topics such as continuing education opportunities and insurance coverage. (3)
Read optometry legislation, regulations and standards. For example, they read Canadian Association of Optometrists' policy statements and International Organization for Standardization 9001 protocols to keep abreast of professional regulations and standards and apply them to patient care. (3)
Read articles in optometric journals such as Review of Optometry, The Canadian Journal of Optometry and The American Journal of Ophthalmology to learn about new optometry research, eye health trends, new procedures and treatments. They require considerable background knowledge to integrate their learning and apply it to patient care. (4)
Read pathology, optometry and drug reference manuals such as the Atlas of Clinical Ophthalmology and Compendium of Pharmaceutical Specialties to confirm diagnoses, ensure the correctness of prescriptions and identify the potential side effects of medications. (4)
Read optometry, ophthalmology and medical textbooks, such as the Merck Manual, Wills Eye Manual and the Textbook of Internal Medicine to learn about medical conditions and eye diseases, search for treatment alternatives and identify eye care procedures for uncommon cases. For example, optometrists may research multiple sclerosis to understand the effects of this condition on the eyes and on visual acuity. (4)

Document use

Scan product and equipment labels for a variety of data. For example, they read eye drops container labels to identify proper administration procedures and examination equipment labels to identify how to use the equipment. (1)
Refer to appointment books to see who is scheduled and what assessments or treatments they have to carry out. (1)
Complete and verify the data on claim forms sent to insurance companies and government agencies. For example, they may verify the types of optometry services performed and enter patients' names, costs of services rendered and visual acuity data on provincial social services and Ontario Health Insurance Plan claim forms. (2)
Complete optical prescription forms. They enter data such as patients' prescriptions for each eye including the sphere, cylinder, axis, prism and type of lenses required. (2)
Refer to data in tables and lists. For example, they use conversion tables to determine required prescriptions when switching patients from eyeglasses to contact lenses. They scan product lists to identify the most appropriate brands of contact lenses to meet patients' needs. They review the water content, oxygen permeability, diameter, available prescription power and care instructions for various brands and types of contact lenses. (3)
Take information from graphs. For example, they refer to graphs illustrating Morgan's Norms to find out patients' expected lens flexibility. (3)
Enter data on intake and assessment forms. They record patients' health histories, diagnoses, clinical observations, eye health and visual acuity test results, recommended treatments and follow-up plans. They may mark eye diagrams to indicate patients' fields of vision, types of sight and corneal thickness. (4)
Interpret pictures and drawings of the eye in textbooks, journals, manuals and retinal cameras. For example, they may refer to illustrations of specific eye diseases such as cataracts and macular degeneration to assist with diagnosing and treating patients, and explaining conditions to them. (4)

Writing

Write e-mail to colleagues, suppliers and patients. For example, they write short messages to colleagues on professional issues such as legislation, and queries to suppliers about products such as contact lenses. (2)
Write short instructions for patients. For example, they write instructions for eye drop administration and treatment procedures for eye infections. (2)
Write clinical notes on patients' intake and assessment forms to record their concerns, health histories, clinical observations, visual acuity test results, diagnoses, treatment plans and recommendations for follow-up. (2)
Write reports to insurance companies, government agencies and schools describing how patients' conditions affect their ability to read, work and drive. They explain patients' eye conditions, detail vision restrictions and impairments, and make recommendations such as appropriate seating arrangements for visually impaired students. (3)
Write letters to other health professionals such as ophthalmologists and family physicians to request consultation and follow-up for specific cases or to inform of findings and observations. They detail patients' cases, diagnoses and services requested. Optometrists must be concise and present all necessary medical information to allow appropriate actions and follow-up. (4)
May write research articles for peer reviewed scientific journals such as the Canadian Journal of Optometry. For example, they may present findings from studies of conditions such as ocular histoplasmosis syndrome. Optometrists require expert clinical knowledge to synthesize study results and the articles must adhere to well-established scientific writing standards. (5)

Numeracy

Money Math

Approve the payment of invoices for equipment such as retinoscopes and transilluminators. They verify amounts and tax calculations on invoices they receive. (2)
May prepare invoices and accept payments for services and the purchase of eyeglasses, contact lenses and optometry supplies. They calculate line amounts, sale discounts, sales taxes and totals on invoices presented to patients. (3)

Scheduling, Budgeting & Accounting Math

Schedule work hours for clerical staff and appointments for patients. (2)
May establish and monitor budgets and assess the profitability of the practices they own. For example, they may project annual revenues and allocate money for rent on reception suites and treatment rooms, and payroll for a small staff of receptionists and assistants. They monitor monthly and annual income and expenses, and make operational and financial adjustments to ensure adequate profit levels. (3)

Measurement and Calculation Math

Measure patients' visual acuity using the Snellen Chart. They ask patients to identify which lines they can read to assess how well they can see. (1)
Take measurements with millimetre rulers. For example, they measure the distance between patients' pupils when fitting corrective lenses and the height of bifocal segments for their glasses. (1)
Convert between SI and imperial units depending on which units are easier for patients to understand. For example, they may convert clients' weights from kilograms to pounds and convert the distances between patients' eyes and their computer monitors from centimetres to inches. (2)
Take precise measurements using ocular instruments to evaluate the eye and vision systems and prescribe eyeglasses and contact lenses. For example, they measure the size of patients' optical nerves using slit lamp biomicroscopes; document the progression or improvement of eye disorders with retina lenses; measure visual field loss with visual fields testers; measure eye pressure with tonometers; measure eye glasses prescriptions with lensometers; determine eye prescriptions with retinoscopes; measure the curvature of patients' corneas with keratometers to accurately fit contact lenses; and determine lens power with phoropters. (4)

Data Analysis Math

May control inventories. For example, they may monitor contact lens sales to make sure they are stocking the best selling brands. (2)
Compare patients' test results to norms to establish diagnoses and treatment plans. For example, they compare patients' amplitude of accommodation to Morgan's Norms to identify normal lens flexibility at different ages. They compare abnormalities to accepted standards and normal anatomy to diagnose conditions and plan treatments. (2)
Interpret research data in optometry journals. For example, they may assess the efficacy of surgical procedures for reducing intraocular pressure in glaucoma patients by interpreting statistical analyses. (3)
Monitor patients' progress by examining data from health histories, clinical notes, prescriptions and treatment program intake and assessment forms. For example, they may compare ocular measurements from one eye examination to another to identify changes and assess treatment needs. They compare eye pressure measurements to determine if fluctuations are within normal ranges, eye shape measurements to detect complications with contact lenses and the appearance of the optic nerve contours to detect changes that may suggest glaucoma. (3)

Numerical Estimation

Estimate the size and position of abnormalities noted during eye examinations. (1)
May predict when patients will require bifocals by considering their eye health histories and published statistics. (2)
May estimate the costs of treatments and certain types of corrective lenses when patients request this information. (2)
Estimate time. For example, they estimate the time required for individual appointments and for complete treatment programs. They consider factors such as patients' age, health and the presence of specific eye conditions. (2)
May make estimates for business planning purposes. For example, they estimate the quantity of products and supplies to order over specific periods. (3)

Oral communication

Interact with patients during eye examinations. They explain diagnoses and discuss the pros and cons of various treatment options. During optometric testing, they question patients about their lifestyles, general health status, medical history, occupations and hobbies to recommend the most appropriate types of glasses or contact lenses. Optometrists must reassure patients who are apprehensive, restless, upset or feel uncomfortable with the level of physical closeness required for most examinations. (2)
Interact with support staff to assign daily tasks, discuss work schedules, resolve conflicts and provide direction. For example, optometrists may instruct staff about scheduling follow-up appointments, ordering contact lenses and selecting eyeglass frames that best suit patients' prescriptions and lifestyles. (2)
Interact with suppliers to learn about new products and equipment and negotiate product prices and discounts. For example, they may negotiate the trade-in value of existing diagnostic equipment when purchasing new ones. (2)
Communicate with health professionals such as family physicians and ophthalmologists to discuss specific cases or to request consultations for patients. For example, they may discuss increases in intraocular pressure with patients' family doctors to determine appropriate treatments and follow-up plans. (3)
Ask other optometrists about clinical, professional development, financial and work matters. For example, they seek advice on specific cases, discuss changes in optometrist legislation, and discuss business management matters such as marketing and franchising. Optometrists who are not self-employed discuss similar topics with their managers. (3)
May make presentations to colleagues and other health professionals at seminars and conferences. For example, they may present a seminar on recent developments in glaucoma diagnosis and treatment at a provincial optometry association conference. The optometrist synthesizes the latest research and presents the analysis in technical language suitable for specialized audiences. (4)

Thinking

Problem Solving

Face conflicting demands for their time and attention. They assess needs, establish priorities and determine the best approaches to meet patients' needs. For example, optometrists may ask their assistants to conduct screening tests for emergency patients and try to fit them into appointment schedules. If patients' conditions are not urgent, they ask support staff to reschedule appointments. (2)
Find that staff are unhappy or dissatisfied with work schedules and duties. They assess the validity of their complaints and try to accommodate the changes requested without disturbing workflow and disrupting patient care. (2)
Lose members of their teams due to illness, terminations and sudden resignations. For example, when employees depart unexpectedly, self-employed optometrists may assume their departed employees' duties until replacement staff are hired. (2)
May treat patients who are uncooperative or have unreasonable demands. They ask for their cooperation, clearly explain treatments and expected outcomes and, in some cases, request assistance from family members. (3)
Are unable to conduct reliable patient assessments when equipment malfunctions or breaks down. For example, power outages may cause equipment malfunctions that result in inaccurate equipment readouts. Optometrists may contact repair technicians or consult manufacturers and suppliers to ensure that equipment is operating properly before proceeding with further assessments. (3)
May have difficulties conducting accurate assessments on children and patients who are restless or upset. Optometrists may ask caregivers to help calm the restless patients or may decide to reschedule the appointments. (3)
Find that clients are unhappy with their glasses and contact lenses. For example, some patients may claim they cannot see well with their new glasses or that their contact lenses irritate their eyes. Optometrists schedule follow-up examinations to investigate the causes of the patients' complaints. For adaptation complaints, they may suggest patients continue to use the new glasses or contact lenses. If there are measurement errors, optometrists write new prescriptions for the glasses and contact lenses. (3)
Treat patients who have unexplained symptoms or provide information that is inconsistent with optometric test results. They may repeat tests to confirm their accuracy, consult the Compendium of Pharmaceutical Specialties to see if patients' medications could cause the unexplained symptoms, consult colleagues or refer patients to their family doctors or specialists to reach reliable diagnoses. (4)

Decision Making

Make decisions about optometric methods and tools. For example, they follow established protocols and use their specialized knowledge to decide which tests to use. They consider best practices, patients' needs, the conditions of their eyes, costs and patients' preferences to select treatment options such as type of lens and degree of magnification. (2)
May decide which clinical materials, office supplies and equipment to buy. They frequently purchase or lease expensive new equipment and buy large quantities of supplies. Although they are guided by industry norms and their own experience, investment in new technology and new services may involve considerable risk. (2)
May set fees charged for examinations considering recommendations provided by provincial optometry associations, the complexity of the examinations, business costs and desired margin. (2)
Decide to refer patients to specialists. They consider the urgency and severity of patients' problems and the normal development of their diseases. Failure to refer patients appropriately can have disastrous consequences for them. (3)

Critical Thinking

Judge the suitability of prescribing contact lenses for particular clients. They reach judgements by gathering information from files and conversations with clients. They also take measurements and may consult parents and caregivers for their opinions. (2)
May judge the suitability of job applicants by considering their education, experience, attitudes and references. (2)
May judge the value of diagnostic equipment and other products. They consider possible improvements in patient care, costs, product life cycles and the potential for return on investment. (2)
Assess the appropriateness of glasses for children since many vision problems can be corrected if detected and treated early. They consider the children's ages, the complexity of their problems and the opinions of parents. (3)
Assess the health and functionality of patients' eyes and the severity of their conditions. They consider patients' case histories, external and internal eye examinations, and tonometry measurements. They also consider the results of vision tests such as retinoscopy and visual acuity. They determine whether patients have glaucoma by measuring the pressure within their eyes, examining the optic nerves of their eyes and measuring their visual fields. Optometrists may evaluate patients' abilities to change focus, perceive colour and depth correctly. They diagnose eye diseases, decide treatment plans and determine the need for consultation with specialists. (3)

Job Task Planning and Organizing Own Job Planning and Organizing

Optometrists organize routine patient visits within highly structured appointment schedules. They must accommodate tasks such as administrative work, phone calls to family doctors and specialists and look up information during breaks and missed appointments. Optometrists decide how to shuffle or reschedule appointments to deal with emergencies and unusually time-consuming investigations. They determine priority cases and decide how to adjust their schedules to provide efficient and quality patient care.

Planning and Organizing for Others

Optometrists may plan schedules for administrative staff and other eye care professionals. Self-employed optometrists take a leading role in setting business goals, developing business strategies and planning the work carried out by their employees.

Significant Use of Memory

Remember patients' names, interests and details of their cases such as eye defects, symptoms and medications to build rapport and trust.

Finding Information

Find information about patients by interviewing them, talking to their caregivers, parents and family physicians, reviewing their files and carrying out various tests and assessments. (2)
Find information about new products such as diagnostic equipment and software by searching the Internet, scanning trade publications and talking to colleagues. (2)
Find information on eye diseases and specialized topics by reviewing medical and optometry textbooks, reading clinical journals and trade magazines, conferring with colleagues and specialists and attending conferences and seminars. (3)

Digital technology

Use word processing. For example, they write referral letters to specialists and family physicians, and reports to government and insurance agencies. (2)
May use graphics software. For example, they may create slide shows to accompany presentations to other optometrists. (2)
May use databases. For example, they may enter patients' contact and procedural data into office management systems and provincial government databases to receive reimbursement for services performed. (2)
May use spreadsheets. For example, they document number and types of patient assessments to calculate monthly earnings. (2)
May use bookkeeping, billing and accounting software. For example, they may use financial software to monitor business expenses and revenues. (2)
Use communications software. For example, they use e-mail programs to communicate with colleagues, suppliers and patients. They may attach documents on professional development issues to colleagues. (2)
Use the Internet. They use search engines and bookmarks to access optometry resources on research and association web sites, search for data on specific eye conditions and locate product data at supplier web sites. For example, they may review web sites for information about new products and diagnostic equipment such as biomicroscopes. (2)
Use other computer and software applications. For example, they use computerized optometry equipment such as keratometers, phoropters, tonometers, visual field instruments and digital cameras to assess patients' visual acuity and eye health. (2)

Other Essential Skills:

Working with Others

Optometrists work independently when performing eye examinations, establishing diagnoses, prescribing treatments and lenses, writing reports and completing patients' files. Most however have administrative assistants who answer phones, schedule appointments, assist patients, and order lenses and frames.

Most optometrists are self-employed. Those working in clinics and community health centres may work in a team and with other health professionals responsible for patients' care. (2)

Continuous Learning

Optometrists work in a field that is constantly evolving. They require continuous learning to stay up-to-date with new research about eye diseases, new methods for diagnosing and treating eye problems, emerging diagnostic technologies and new products and medications. They identify their own learning needs and establish plans according to their interests and areas of practice. They attend conferences and seminars, and read optometry, ophthalmology and medical journals to keep up with current trends. They also participate in learning groups with other optometrists to discuss clinical, practice management and ethical issues.

Provincial optometry associations establish the number of continuing education hours required for optometrists to maintain provincial licensure. (3)