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Ophthalmology

Ophthalmologists are physicians specializing in the comprehensive medical and surgical care of the eyes and vision. Ophthalmologists are the only practitioners medically trained to diagnose and treat all eye and visual problems including vision services (glasses and contacts) and provide treatment and prevention of medical disorders of the eye including surgery. The requirements to become an ophthalmologist in the United States are the completion of four years of college, four years of medical school, and four to five years of additional specialized training.

The length of training in ophthalmology must be at least 36 calendar months, including appropriate short periods for vacation, special assignments, or exceptional individual circumstances approved by the program director. Any program that extends the length of training beyond 36 calendar months must present an educational rationale that is consonant with the program requirements and the objectives for residency training. Approval for the extended curriculum must be obtained prior to implementation and at each subsequent review. Prior to entry in the program, each resident must be notified in writing of the required curriculum length.

For further information, visit the American Board of Ophthalmology and the American Academy of Ophthalmology.

The description of this surgical specialty was adapted from a description set forth by the American Board of Medical Specialties (ABMS).

Ophthalmology as a Career

Ophthalmology is an exciting surgical specialty that encompasses many different subspecialties, including: strabismus/pediatric ophthalmology, glaucoma, neuro-ophthalmology, retina/uveitis, anterior segment/cornea, oculoplastics/orbit, and ocular oncology.

To become a general ophthalmologist, the specialty requires four years of postgraduate specialty training after the completion of a medical degree (MD). This requirement includes a three-year residency in ophthalmology (eye surgery) in an approved surgical residency program, following at least a one-year internship. An ophthalmology residency involves training in the fundamentals of all the above subspecialty fields of ophthalmology. This training period prepares you for a thriving practice (academic or private) with surgical cases that involve fascinating and challenging microsurgery. Ophthalmic surgery requires exquisite hand-eye coordination and surgical skill. As ophthalmologists, one routinely uses sutures that can't easily be visualized with the unaided eye.

Cataract surgery and basic glaucoma surgery are two of the more common procedures an ophthalmologist routinely performs that requires such skill. However, one can further subspecialize after finishing an ophthalmology residency. This requires one to two years of additional training. Ophthalmic subspecialty fellowship programs are listed below.

Strabismus/pediatric ophthalmology deals with eye diseases in children, involving all intraocular surgery as well as strabismus (crossed eyes) surgery, which incorporate detailed eye muscle surgery [one-year fellowship].

Glaucoma is an area of ophthalmology that focuses on medical and surgical treatment of diseases that result in optic nerve damage and visual field loss [one-year fellowship].

Neuro-ophthalmology deals with the eye as it relates to neurological disease. It is a complex and intricate subspecialty that requires knowledge of the visual pathways, eye-movement patterns, optic nerve disease, and systemic neurological diseases with visual manifestations [one year fellowship].

Retina/uveitis concentrates on diseases, often systemic or inflammatory, involving the retina and vitreous (posterior aspect of the eye). This includes surgical and laser treatment of diseases such as retinal detachments, diabetic retinopathy, and others. It also requires proficiency of challenging microsurgical techniques [generally two-year fellowship].

In addition to routine cataract surgery, cornea/anterior segment specialists are skilled in corneal transplantation and one of the most exciting areas of medicine, refractive eye surgery (vision correction) [generally one-two years].

A final subspecialty field of ophthalmology is ophthalmic plastic and reconstructive surgery. This fellowship encompasses aesthetic, plastic and reconstructive surgery of the face, orbit, eyelids, and lacrimal system. This includes learning techniques to remove tumors in the orbit, and on the surface of the eye, such as conjunctival melanoma, as well as repairing bony fractures of the periorbital area and face [two years].

Ophthalmology is a broad surgical specialty, with avenues for further detailed subspecialty practice. This surgical field allows you to care for patients of all ages, treat and identify systemic diseases, and perform some of the most challenging of surgical procedures ranging from microsurgery around and inside the eye to facial surgery involving reconstructive and aesthetic surgery.

Kristen J. Tarbet, MD, Associate Fellow
Seattle, WA