January 31, 2022
4 minute read

Optometrists vs. Ophthalmologists: Which One Is the Better Option for You?

You woke up this morning and there was a puffy, red something on your eyelid. You did a quick online search for what it might be, with no luck.

Your next line of attack? Scheduling an appointment with the proper eye care professional. But you may not be sure whether you should see an optometrist or an ophthalmologist.

Optometrist vs. Ophthalmologist

What’s the difference?

It mainly comes down to education. Ophthalmologists are medical (MDs) or osteopathic doctors (DOs) who specialize in eye and vision care.

Optometrists, on the other hand, become doctors of optometry (or ODs), but they are not considered medical doctors. They provide primary vision care, which can include vision testing and correction, diagnosis, treatment, and management of vision changes.

So, just because an optometrist isn’t a medical doctor doesn’t mean they can’t help you with your vision needs. For example, optometrists can provide preventive care such as eye exams—which can help you update a vision prescription—or diagnose and treat conditions like pink eye.

Below, learn more about what an optometrist does and when an ophthalmologist may be a better fit for your needs.

Need a vision plan? Contact a HealthMarkets licensed insurance agent at (800) 827-9990 or visit HealthMarkets to get started.

An optometrist can fit you for eyeglasses or contacts.

Part of the primary vision care an optometrist can offer you is writing you a new eyeglasses or contact lens prescription.

While any optometrist can write you the prescription, there is value in seeing the same one and establishing a relationship. They’ll get to know your eyes and their specific needs.

An optometrist can test your eyes for major health issues.

Even if you have perfect vision, you should see an optometrist to get your eyes tested annually.

According to the American Academy of Ophthalmologists, you should start getting screened for eye disease at age 40, even if you have no signs of eye trouble. You should get tested earlier if you have a family history of eye disease, high blood pressure, or diabetes.

Either eye care professional can check you for conditions like glaucoma, which is the leading cause of blindness in people age 60 and older, but only an ophthalmologist can perform surgery on it, if it comes to that.

Additionally, both can test you for cataracts, a condition that leads to blurry vision among older adults—but again, only ophthalmologists can perform cataract surgery if needed.

Need to find a vision plan so you can get your eyes checked? Contact a HealthMarkets licensed insurance agent at (800) 827-9990 or visit HealthMarkets to shop online.

An optometrist can help diagnose issues with your eyes and prescribe certain medications.

Have itchy, burning, or painful eyes? An optometrist can help diagnose and treat certain eye conditions. They can also refer you to an ophthalmologist if the condition is one that needs more advanced treatment or surgery.

In all 50 states, they are allowed to prescribe oral medications for eye-related conditions, as well as medications for glaucoma. Depending on which state you live in, they can also prescribe oral steroids, which are used to help treat eye inflammation.

An optometrist can provide you with vision support.

If you’ve recently suffered a stroke or if your child has weak eye muscles (i.e., a lazy eye), an optometrist can provide rehabilitation or vision therapy.

For example, some optometrists specialize in low vision, or eye issues that can’t be fixed with surgery or medication. You might have a permanent blind spot or partial sight in one eye.

If you need to see a specialist, your optometrist or ophthalmologist may need to identify the appropriate one for you.

An ophthalmologist can provide you with laser treatments.

Vision-correcting procedures such as LASIK, which involves the use of lasers to improve your eyesight, would likely be done by an ophthalmologist.

However, optometrists in four states can perform laser treatments. Those states are Alaska, Kentucky, Louisiana, and Oklahoma.

Even if you don’t live in one of those states, your optometrist can tell you whether LASIK might work for you. However, you’ll have to get the treatment done elsewhere.

An ophthalmologist can perform eye surgery.

Cataracts and glaucoma may require surgery, and it’s usually performed by an ophthalmologist.

But remember: Optometrists, who might be your first point of contact, can help by providing a referral to an ophthalmologist.

Does your vision plan cover one or both types of eye care professionals?

Most ophthalmologists and optometrists in the United States accept medical and vision insurance—but how your visit is covered may depend on what you get done.

Even services performed during the same visit may be billed in different ways. It all depends on your vision plan, which is why it’s helpful to read what your plan covers before you show up at the provider’s office.

Your medical insurance may cover a medical exam—maybe for that red puffy thing on your eyelid—but it may not cover a non-medical exam, such as the one you need to get a contact lens prescription.

Always ask questions prior to your visit—both to your provider and your insurance company. It can help you avoid any surprise bills.

Need a vision plan? Visit healthmarkets.com to schedule or call with a HealthMarkets licensed insurance agent today. Dial (800) 827-9990.

You could save on a visit to either eye care provider with a vision discount plan.

To further cover eyeglasses, contact lenses, or services like vision therapy, some people may turn to a vision discount plan.

Although a discount plan isn’t vision insurance, you can use it to receive a discount on everything from routine eye exams and contact lenses to laser surgery throughout the year.

Although a discount plan isn’t vision insurance, you can use it to receive a discount on things like routine eye exams and contact lenses to laser surgery, depending on the plan.

So should I see an optometrist or an ophthalmologist—or both?

Whether or not you’re having issues with your eyes, you should see an eye care professional and get your eyes checked regularly.

According to the Centers for Disease Control and Prevention (CDC), an estimated 93 million adults in the United States are at high risk for serious vision loss, but only half of them visited an eye doctor in the past 12 months.

The CDC also found that more than half of U.S. adults who don’t seek out eye care do so because of lack of awareness or fear of costs, which may be due to a lack of insurance.

If you can’t see as well as you used to, your optometrist is the first person to contact. If you have extreme symptoms—sudden loss of vision, pain, or an injury to your eye or in the area of your eye—head to the emergency room and follow up with an ophthalmologist.

footer logo
facebook logo

© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

48304-HM-0222

© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

48304-HM-0222

© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

48304-HM-0222