World Optometry Day: The Evolution of Optometry

World Optometry Day was started in 1986 by the International Optometric and Optical League to celebrate the growing profession of optometry in the world. Currently optometry is practiced at different levels in the world with some countries still not having the profession.  Looking at the history and development of optometry, I would say that the reason optometry has grown so quickly is that it simply was the right solution to address a substantial and growing need.

While the practice of ophthalmology goes back some thousands of years starting with couching[1] and evolving to the modern cataract surgery procedures and the diagnosis and treatment of hundreds of ophthalmic diseases. Opticianry in its two or three hundred years existence has also evolved, optometry offers a professional who understands optics, ophthalmic optics, eye anatomy and physiology, and all the diseases and conditions that affect the eye. In the early and middle 20^th century, optometrists mastered the art of refraction and concentrated on prescribing the proper spectacles, tailor made for each patient, based on their specific optical and binocular vision needs. By the mid to late 20^th century it was clear that optometrists could and would learn, not only to refract and prescribe, but to evaluate for all types of ophthalmic disease, many of which could be treated without surgery. In the 1970s in a few countries, optometrists earned the privilege to use diagnostic medications to evaluate the eyes. In the 1980s and 90s some of us earned the privilege to treat eye diseases with topical and oral medications. Thus, optometrists became the primary eye care practitioners, and the profession spread around the world with this idea in mind.

The success of optometry in many parts of the world can be traced to excellent education and licensure standards to build public trust. In the US, where I practice, we are much more numerous than ophthalmologists, and better spread across rural and urban settings.   Optometrists are more accessible, affordable, patient-focused and good communicators; which enable us to assess the medical and ophthalmic history, apply a wide base of optometric and medical knowledge, and then recommend a treatment or refer to ophthalmologists as needed. We apply our knowledge to prevent eye disease and injury.  As technology progresses, our scope of practice is also evolving.

Of course, as President of Volunteer Optometric Services for Humanity (VOSH/International) I know that optometrists in many countries are working hard to ensure recognition and to get optometric education and practice to international standards. It is not always easy, but I celebrate their resilience and commitment to offer top quality primary eye care to their patients. During our humanitarian clinics -that target communities in need -we often have US and international optometrists working together, sharing knowledge and skills for the benefit of their patients.  In several such clinics, collaboration with ophthalmologists offers a comprehensive intervention to the patients who need it. At VOSH, we believe in the power of collaboration and learning together and that is why our education initiatives seek to maximise opportunities to support the development of optometry across the world.  There is still a long way to go to generate public awareness about the importance of good eye health, prevention and the role each of the eye health professionals play within. In face of the billion-vision impairment challenge the world faces, we must support optometry as an independent primary health well educated and licensed profession that can deliver more efficient, accessible and equitable care to our communities.  So, Happy World Optometry Day everyone! Support your optometrists, optometry schools, and let your local and national leaders know how much you value the profession. Together we can deliver change.

[1] Medical doctors learned to treat cataracts, inevitable in old age, by penetrating the cornea with a sharpened tool to dislodge the crystalline lens into the bottom of the vitreous chamber.