Ophthalmologists are physicians who, upon graduation from medical school, undertake several years of post-graduate training in the diagnosis and treatment of diseases of the eye.

This training begins with a broad exposure to general medical problem management, emergency services, pediatric care, and selected exposure to such disciplines as neurology and endocrinology.

It also includes very intensive training in clinical settings with exposure to acute and chronic disease and the important experience of follow-up over long periods of time for such important ocular conditions as glaucoma, diabetic retinopathy, cataracts and degenerative disorders.

Extensive surgical experience is also incorporated into the last 24 months of training. Many ophthalmologists continue their training for a further 12-24 months in a variety of subspecialties.

As the designated leader of the eye care team in his or her community or hospital, the ophthalmologist works closely with other members of the team including orthoptists, ophthalmic technicians and/or technologists, nurses and other physicians. The whole team also works closely with optometry in many communities.

Ophthalmologists offer a comprehensive approach to ocular symptoms and disease.

As well as diagnosing and treating ocular disease either by medical or surgical means, ophthalmologists can provide a comprehensive ocular-visual assessment, which may include the prescription of corrective lenses.

Ophthalmologists are also involved in kerato-refractive surgery using both surgical and laser techniques to correct a variety of ailments.

Family physicians play a pivotal role in the delivery of health care in Canada, including both the prevention and the treatment of eye disease.

Their comprehensive medical knowledge allows them to relate ocular symptoms and signs to systemic disease, and their knowledge of microbiology enables them to recognize and treat common eye infections.

Family physicians also play an important role in referring patients, when necessary, to the appropriate health care professionals. This might be to an ophthalmologist for diagnosis and treatment of ocular disease or to an optometrist for an oculo-visual assessment.

Many emergency physicians now staffing hospital emergency rooms are trained in emergency medicine. Others are family physicians who have developed a clinical expertise in emergency room care.

These doctors have the clinical skills to deal with acute eye injuries and disease in an emergency situation. After initial treatment, patients are then referred to ophthalmologists for follow-up.

Pediatricians are physicians with post graduate training which enables them to recognize and treat diseases in children and adolescents.

As an active member of the eye care team, the pediatrician plays a vital role in recognizing ocular signs and symptoms of disease in their young patients.

Also an important member of the vision care team, an internist is similar to a pediatrician but looks after an older age group.

Internists also recognize the signs and symptoms of ocular disease and work closely with ophthalmologists in the management of patients who suffer from neurological disorders or diseases such as hypertension, diabetes, kidney disease and others.

An orthoptist is specially trained to recognize and treat — by non-medical and non-surgical means — anomalies of binocular vision which are usually associated with the misalignment of the patient’s eyes.

Orthoptists play a vital role in working with the ophthalmologist in a standardized assessment of ocular motility, which is important in the diagnosis of strabismus and amblyopia (lazy eye) and in the long term follow-up during treatment with glasses or a post-operative surgical correction.

Orthoptists have a strong professional association, The Canadian Orthoptic Society, and are governed by the Canadian Orthoptic Council (COC), which sets standards for entry into the profession.

The COC also carries out accreditation visits of orthoptic training programs and administers the written and clinical examinations given to graduates of training programs before they are accepted into the profession.

There are various level of ophthalmic medical personnel, such as ophthalmic assistants, ophthalmic technicians and ophthalmic technologists. Ophthalmic medical personnel work with ophthalmologists to provide patient care by performing many eye-related clinical functions, such as patient work-ups and diagnostic and therapeutic procedures, under the direction and supervision of a qualified ophthalmologist. The ophthalmologist is responsible for the performance of the ophthalmic medical personnel. Absolute responsibility for the patient lies with the ophthalmologist.

Certification at the three levels can be obtained through the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO).

There are numerous educational courses for ophthalmic medical personnel across the country, including a yearly technicians meeting at the COS annual meeting and exhibition.

Ophthalmic Assistant distance education courses

• Centennial College of Applied Arts and Technology (Scarborough, Ontario)
• Southern Alberta Institute of Technology (SAIT)
• Northern Alberta Institute of Technology (NAIT)

Ophthalmic Technician program (1 year)

• Kingston Ophthalmic Training Centre at the Hotel Dieu Hospital, Kingston, Ontario

Ophthalmic Technologist programs (2 year)

• Rockyview General Hospital, Calgary, Alberta
• IWK Children’s Hospital, Halifax, Nova Scotia (a combination of Ophthalmic Technologist and Orthoptics)
• Kingston Ophthalmic Training Centre at the Hotel Dieu Hospital, Kingston, Ontario
• University of Ottawa/Ottawa Eye Institute, Ottawa, Ontario
• Stanton Eye Clinic, Yellowknife, NWT

Certification at the three levels can be obtained through the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO).

There are numerous educational courses for ophthalmic medical personnel across the country, including a yearly technicians meeting at the COS annual meeting and exhibition.

An Ophthalmic Nurse cares for people with eye disorders, including performing pre-operative assessments for patients before eye surgery.

Ophthalmic Nurses are essential during operations, assisting the surgical team and functioning as circulating or scrub nurses. They carefully and safely position patients for surgery, verify the surgical site, and help with the instrumentation.

An optometrist is a health professional, trained to assess the eye and the visual system, sensory and ocular motor disorders and dysfunctions of the eye and the visual system, and diagnose refractive disorders.

The optometrist identifies and assesses clinical findings and symptoms and offers the patient the appropriate response according to accepted optometric standards of practice.

The optometrist prescribes and dispenses corrective and preventative devices and works collaboratively with other members of the vision care team in assuring that patients are referred appropriately for diagnostic and therapeutic needs.

An optician supplies, prepares and dispenses optical appliances, interprets prescriptions prepared by ophthalmologists and optometrists, as well as fits, adjusts and adapts optical appliances.

Opticians are also known as ophthalmic dispensers or dispensing opticians.