[7ontheline]

As for the whole MD vs. OD thing. . .

For people who are not aware, optometrists (OD) go to school for 4 years after college and then can open up shop. Some go a residency for further training, which is generally 1 year. Normally the main scope of the optometric practice involves refractions, glasses, contact lenses and the like. Optometrists are licensed to prescribe a limited set of medications (most eye medications) in most states. It is not as hard to get into optometric school as it is to get into medical school by far.

Ophthalmologists (MD) go to medical school for 4 years after college to become a physician with all other MDs. They then go to a 1 year internship for more general medical training as a doctor and then 3 more years specialized only in ophthalmology to learn to treat the eye. After this they may do a 1-2 year fellowship for further training, usually in a specific subset of eye surgery/disease. Ophthalmologists tend to have been among the top students in their medical schools, as it is a selective and competitive specialty. Over all, MDs will have seen many more patients than ODs during their training and MDs are the only doctors trained to perform surgery on the eye, which includes LASIK and other procedures.

As an MD, I have mixed feelings about ODs. They are well trained within their defined range of focus. As for the issue of being a "primary care eye doctor" I would say this varies. I have been around very capable ODs who I would definitely trust with basic eye care. I have also seen referrals from ODs that have seemingly no clue what they are doing. This has been in many aspects of ophthalmology, whether it be management of chronic diseases like glaucoma or in acute eye injuries. I feel that some ODs (not all) have over-reached and are attempting to get more privileges than they are trained for. There are states in which they are fighting the laser/surgical privileges, or perhaps the right to prescribe a broader range of medications. Given the inconsistent level of training within the optometric community I think this is really deplorable. In the states where they are trying to get surgical rights (Oklahoma in particular) they are not doing it by showing a need for more surgeons but by trying to do a legislative end-around that gives optometric boards the right to determine which optometrists can do surgery. A little bit of the blind leading the blind, if you will.

Wow, long-winded post.

Cliff notes: ODs have less training than MDs. Not all are truly capable of being a "primary eye doctor" although some definitely are. Personally, I would go to an MD with any eye problem more significant than refractive/glasses/contact lens issues. MDs have better general medical training as well.