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Making Eye Health a Population Health Imperative: Vision for Tomorrow (2016)

Chapter: Appendix F: Eye and Vision Care Professionals and Education

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Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
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F

Eye and Vision Care Professionals and Education

Profession Definition Education and Training Requirements (all) Examples of Professional Responsibilities
Ophthalmologist An allopathic (M.D.) or osteopathic (D.O.) medical physician who specializes in the medical and surgical treatment of ophthalmic disorders (AAPOS, 2011).
  • 4 years of medical school (same education as primary care physicians, pediatricians, surgeons, etc.) (required).
  • Medical licensure examination by the U.S. Medical Licensure Examination by the Federation of State Medical Boards and the National Board of Medical Examiners.
  • 1 year of internal medicine or surgery residency (same as surgeons and other medically trained physicians) (required).
  • 3 years of ophthalmology residency with required volumes of surgical procedures performed and patient examinations (required).
  • Provide the full spectrum of eye care, ranging from primary care to the surgical care of patients with complex ophthalmic disorders in all 50 states.
  • “Diagnoses and treat all eye diseases, [and] perform eye surgery” (AAO, 2013).
  • “Prescribe and fit eyeglasses and contact lenses to correct [additional] vision problems” (AAO, 2013).
  • Conduct scientific research on the causes and cures for eye diseases and vision disorders (AAPOS, 2011).
  • May specialize in a specific area of medical or surgical eye care, such as glaucoma,
Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Profession Definition Education and Training Requirements (all) Examples of Professional Responsibilities
  • Board certification by the American Board of Ophthalmology of American Board of Medical Specialties.
  • Eligible for Federal Drug Enforcement Agency license.
  • State licensure (AAO, 2011).

cornea and external disease, low vision, neuro-ophthalmology, plastic surgery, or pediatrics, among others (AAO, 2013).

Optometrist A doctor of optometry (O.D.) who provides primary care of the eye and visual system (AAO, 2013).
  • 4 years of optometry school (required).
  • Optometric licensure examination by the National Board of Examiners in Optometry (NBEO) (National Board of Examiners of Optometry, 2016).
  • Additional board certification by the American Board of Optometry and/or NBEO board certification (optional).
  • Some optometrists complete an optional residency in a specific area of practice (e.g., pediatric optometry, vision therapy and rehabilitation, etc.) (ORMatch, 2016).
  • State licensure.
  • Examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system and the eye (AOA, 2012).
  • Prescribe medications and, as needed, low vision rehabilitation, vision therapies, and can, in two states, perform certain surgical procedures (AOA, 2012).
  • Prescribe and fit eyeglasses and contact lenses to correct vision problems.
  • Conduct scientific research on vision and the visual system.
Orthopist Accredited professional (C.O.) who generally works under ophthalmologists or neuro-ophthalmologists and focuses on the examination and treatment of eye movements abnormalities (AAPOS, 2016).
  • 2 years of training and clinical work at a program accredited by American Association of Certified Orthoptists (AOC).
  • National certification from AOC (AAPOS, 2016).
  • Liaison between the ophthalmologist and patient (AACO, 2015).
  • Assist with patient evaluation, formation of a differential diagnosis, and subsequent patient care (AACO, 2015). Engage in clinical research and the teaching of medical students, orthoptic students, and residents (AACO, 2015; AAPOS, 2016).
Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Profession Definition Education and Training Requirements (all) Examples of Professional Responsibilities
Optician A technician who designs, fits, and dispenses corrective lenses for the correction of a person’s vision (AAPOS, 2011).
  • Formal job training program, certificate program, or associate’s degree. Associate’s degree programs are accredited by the Commission on Opticianry (OAA, 2016).
  • Certification by American Board of Opticianry (optional).
  • Certification by National Contact Lens Examiners (optional).
  • State licensure required in 23 states (OAA, 2016). States may also require a state written exam, state practical exam, or certification exam.
  • Uses prescriptions supplied by ophthalmologists or optometrists to fit eyeglasses, contact lenses, and other eyewear (AAPOS, 2011).
  • Do not diagnose or treat eye diseases.
Neuroophthalmologists Allopathic or osteopathic physicians who complete residencies in either neurology or ophthalmology and a subspecialty (AAO, 2013).
  • In addition to the requirements for an ophthalmologist or neurologist, neuro-ophthalmologists must complete a fellowship. Fellowships approved by the Association of University Professors of Ophthalmology Fellowship Compliance Committee must be at least 12 months long, in addition to other requirements (FCC, 2013).
  • Specialists in visual problems that relate to the nervous system, usually by way of injury from “trauma, inflammation, strokes, tumors, toxicities, and infections” (Weill Cornell Medical College, n.d.).
Low Vision Therapist Develops and conducts vision functional assessment tests of everyday tasks for those with low vision (AHRQ, 2004).
  • Bachelor’s degree with emphasis on vision rehabilitation or bachelor’s degree with proof of basic competency in all core areas. Certification from Academy for Certification of Vision Rehabilitation & Education Professionals (ACVREP) (AHRQ, 2004).
  • Work under the direction of an ophthalmologist or optometrist to provide clinical low vision evaluation, assist with treatment plans, and provide instruction for use of adaptive equipment (ACVREP, 2015).
Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Profession Definition Education and Training Requirements (all) Examples of Professional Responsibilities
Low Vision Occupational Therapists An occupational therapy practitioner who helps people with low vision to function at the highest possible level (AOTA, 2011).
  • Master’s degree from a program accredited by the Accreditation Council for Occupational Therapy Education.
  • National Board for Certification in Occupational Therapy certification (AOTA, 2016).
  • State license.
  • Specialty certification in low vision occupational therapy from the American Occupational Therapy Association (optional) (AOTA, 2011).
  • Work with individuals with disabilities or medical conditions to help develop skills needed for independent, daily function (BLS, 2015).
  • For vision impairment, occupational therapists focus on the promotion of independence and participation in valued activities (AOTA, 2011) through task or environmental modification, education about use of adaptive devices and assistive technology, and assistance using remaining vision (AOTA, 2011).
  • May specialize in areas of practice such as environmental modifications or pediatrics upon certification (AOTA, 2016).
Orientation and Mobility Specialist Professional responsible for evaluating mobility capacity and teaching patients how to get oriented and navigate through their environments (AHRQ, 2004).
  • “Bachelor’s degree . . . with emphasis in orientation and mobility” or bachelor’s degree and completion of an orientation and mobility certification preparation program (AHRQ, 2004, p. 163).
  • ACVREP certified orientation and mobility specialist certificate.
  • Assist visually impaired individuals to use remaining vision and senses to determine their orientation and position and negotiate safe movement (ACVREP, 2014a).
Vision Rehabilitation Therapist Professional responsible for evaluating functional capabilities and teaching behavioral and environmental adaptations to overcome vision disabilities. (AHRQ, 2004).
  • Bachelor’s degree with emphasis in vision rehabilitation therapy or bachelor’s degree with post-secondary education demonstrating knowledge of ACVREP vision rehabilitation therapist knowledge domain areas (ACVREP, 2014b).
  • Certification from ACVREP.
  • Develop individualized rehabilitation plans and teach visually impaired individuals how to use compensatory skills and assistive technology in an effort to enhance opportunities for career and educational development and independent living (ACVREP, 2014b).
Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×

REFERENCES

AACO (American Association of Certified Orthoptists). 2015. Qualifications and training. http://orthoptics.org/become-an-orthoptist/qualifications-training (accessed January 11, 2016).

AAO (American Academy of Ophthalmology). 2011. Differences in education between optometrists and ophthalmologists. http://www.aao.org/about/policies/differences-education-optometrists-ophthalmologists (accessed March 29, 2016).

———. 2013. What is an ophthalmologist? http://www.aao.org/eye-health/tips-prevention/what-is-ophthalmologist (accessed January 12, 2016).

AAPOS (American Association for Pediatric Ophthalmology and Strabismus). 2011. Difference between an ophthalmologist, optometrist and optician. http://www.aapos.org/terms/conditions/132 (accessed January 12, 2016).

———. 2016. Orthoptist/orthoptics. http://www.aapos.org/terms/conditions/85 (accessed January 12, 2016).

ACVREP (Academy for Certification of Vision Rehabilitation & Education Professionals). 2014a. Orientation and mobility specialist certification handbook. Tucson, AZ: Academy for Certification of Vision Rehabilitation and Education Professionals.

———. 2014b. Vision rehabilitation therapist certification handbook. Tucson, AZ: Academy for the Certification of Vision Rehabilitation and Education Professionals.

———. 2015. Certified low vision therapist (CLVT) handbook, section 2—Scope of practice for low vision therapists. https://www.acvrep.org/ascerteon/control/certifications/clvt-scope (accessed January 12, 2016).

AHRQ (Agency for Healthcare Research and Quality). 2004. Vision rehabilitation for elderly individuals with low vision or blindness. Rockville, MD: Agency for Healthcare Research and Quality. https://www.cms.gov/Medicare/Coverage/InfoExchange/downloads/rtcvisionrehab.pdf (accessed June 29, 2016).

AOA (American Optometric Association). 2012. What is a doctor of optometry? http://www.aoa.org/about-the-aoa/what-is-a-doctor-of-optometry?sso=y (accessed January 12, 2016).

AOTA (American Occupational Therapy Association). 2011. Occupational therapy services for persons with visual impairment.https://www.aota.org/-/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/PA/Facts/Low%20Vision%20fact%20sheet.pdf (accessed June 29, 2016).

———. 2016. FAQ on OT education and career planning. http://www.aota.org/educationcareers/considering-ot-career/faqs/planning.aspx (accessed January 12, 2016).

BLS (Bureau of Labor Statistics). 2015. Occupational therapists. http://www.bls.gov/ooh/healthcare/occupational-therapists.htm (accessed January 12, 2016).

FCC (Fellowship Compliance Committee of the Association of University Professors of Ophthalmology). 2013. Program requirements for fellowship education in neuro-ophthalmology. http://www.aupofcc.org/subspecialties/neuro/neuro_guidelines.pdf (accessed June 29, 2016).

National Board of Examiners of Optometry. 2016. Welcome to the NBEO website. http://www.optometry.org/president.cfm (accessed March 29, 2016).

OAA (Opticians Association of America). 2016. Becoming an optician. http://www.oaa.org/opticianry-defined/becoming-an-optician (accessed January 12, 2016).

ORMatch. 2016. List of participating programs. https://www.natmatch.com/ormatch/instdirp/aboutproglist.html (accessed April 8, 2016).

Weill Cornell Medical College. n.d. Neuro-ophthalmology. http://weillcornelleye.org/services/neuro.html (accessed April 8, 2016).

Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×

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Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Page 520
Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Page 521
Suggested Citation:"Appendix F: Eye and Vision Care Professionals and Education." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult’s risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child’s social development, academic achievement, and better health across the lifespan.

The public generally recognizes its reliance on sight and fears its loss, but emphasis on eye and vision health, in general, has not been integrated into daily life to the same extent as other health promotion activities, such as teeth brushing; hand washing; physical and mental exercise; and various injury prevention behaviors. A larger population health approach is needed to engage a wide range of stakeholders in coordinated efforts that can sustain the scope of behavior change. The shaping of socioeconomic environments can eventually lead to new social norms that promote eye and vision health.

Making Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision health and health equity in the United States. Building on the momentum of previous public health efforts, this report also introduces a model for action that highlights different levels of prevention activities across a range of stakeholders and provides specific examples of how population health strategies can be translated into cohesive areas for action at federal, state, and local levels.

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