Wednesday, June 17, 2009

An optometrist might be the first doctor a person sees in 10 years!

I got to shadow a rather interesting optometrist today. He owns two clinics: one in Westminster/Huntington Beach and the other in Costa Mesa/Newport. The reason I call him "interesting" is because he is not the type of optometrist I get to see at my eye examination appointments.

I go to Kaiser every six months or less often, but I do not get to talk to the optometrist much, except when I need to tell him/her if lens 1 or 2 is better and then if 3 or 4 is more crisper,etc. It's probably because Kaiser is a big corporation and they deal with so many patients in a day. 
I like the way this guy dealt with his patients. He was very friendly and talkative. And the patients enjoyed that. At my last Kaiser appointment, I tried to engage the optometrist in conversation. I started with, "If someone was diagnosed with glaucoma, would you be the one who treats it?" The doctor just looked at me and said, "You do not have glaucoma." I already knew that, but since I was interested in pursuing a career in optometry, I wanted to know more about what they did or did not do, and what they could and could not do. I told her this. She smiled. Then she told me that they (optometrists) provided the pre- and post-operative care for glaucoma, but an ophthalmologist did the actual surgical stuff.

Ever since my interest in optometry grew, I wanted to know more about what they did and what made them different than ophthalmologists. I knew the basic difference: optometrists go to Optometry School and ophthalmologists go to Medical School. But this information is not sufficient. It provides no insight about the capabilities of an optometrist. Instead, it actually hurts the image of the profession. What this deviation from the original topic has to do with meeting the "interesting" optometrist, I will get to that in a minute. But let's just say that meeting with him gave me a new perspective on the profession of optometry.

But the doctor that I saw for my own eye exam was not at all interested in discussing anything other than "You have a new prescription" and " Let me take you to the eyeglass area, where you can pick a frame and order the lenses." And as you can see, that was not an invitation to discuss much. All I could say was, "Alright, thanks doc!" But I did get a tiny bit out of her: she applied to both SCCO (Southern California College of Optometry) and UCBCO(University of California Berkeley, College of Optometry). I could not, however, find out which school she attended to become an optometrist.

Meeting with this "interesting" optometrist today made a huge difference on my impression of optometry. Dr. R.G. went to SCCO and has been practicing for 22 years. I got to sit with him through three patients and between the second and third patient, we got to talk a little about his view on optometry, both present and future. He said that the difference between optometry and ophthalmology is surgery. Optometry is a specialty that provides primary vision care, just short of surgery. Optometrists deal with the functioning of the eye while an ophthalmologist deals with the anatomical fixings. Ophthalmologists come in when all else does not work. When ophthalmologists provide primary vision eye care, they are actually practicing optometry.
He also talked about how an optometrist might be the first doctor a person sees in 10 years. Someone can notice a decrease in vision and get their eyes checked, but other problems might not be as apparent. He gave an example of a patient who visited him after he noticed his visual acuity drop. When Dr. R.G. checked him, he had a swelling in his optic nerve behind his eye. "Only two things can cause this: either a tumor in the brain, in which case he has no chance to survive because it has gotten too far, or malignant hypertension (severely high blood pressure)." So, the doc checked the patient's blood pressure. It turned out that his systolic over diastolic reading was 300/125! This was a cause of alarm. Hence, Dr. R.G. sent this patient to see a family doctor and was immediately admitted to an emergency room. If Dr. R.G. had not sent him, he would have been dead in 24 hours!

The point from his story was that optometrists play an important role in the health care industry and they will continue to do so. His prediction was that in a decade or less, optometry will be merged within the medical field, but he did not sound too optimistic about that.


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