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An ophthalmologist is a specialist who focuses on diagnosing and managing conditions that affect the eye and its anatomy. The management of these conditions can be achieved both medically and through surgical interventions depending on the pathology.

Ophthalmologists are specialists who treat conditions of the eye including all its associated anatomy. Diseases and disorders that affect the eye can be managed either medically or surgically by an ophthalmologist. Ophthalmologists are medical doctors who specialise in medical and surgical disorders of the eye, and shouldn't be confused with optometrists who are healthcare professionals who provide primary eye-care by performing comprehensive eye examinations to diagnose and treat various visual problems.

Training 

A doctor wanting to specialise in ophthalmology first needs to complete their undergraduate training, in order to qualify as a medical doctor, and this programme takes 5-6 years to complete. Thereafter, a 1-2 year internship phase needs to be completed in order to qualify to apply for a specialist position in ophthalmology. The residency programme for this specialty takes 3-4 years to complete. If a qualified ophthalmologist wants to specialise further in a specific discipline, then they may apply for a fellowship position which can take 1-2 years to complete.

These fellowship programmes include specialties in the following areas: 

  • Glaucoma
  • Retinal ophthalmology - includes managing pathologies with laser treatment and surgery of the retina.
  • Medical retinal concentration - managing retinal issues medically.
  • Uveitis.
  • Anterior segment surgery.
  • Posterior segment surgery - this includes the surgical management of the retina, posterior segment diseases and disorders through vitreo-retinal surgery.
  • External eye diseases, the ocular surface and the cornea.
  • Refractory pathology.
  • Neuro-ophthalmology.
  • Oculoplastics.
  • Orbital surgery - overlaps with oral and maxillofacial surgery.
  • Ocular oncology.
  • Paediatric ophthalmology managing issues such as strabismus.
  • In some countries, a specialty training programme in veterinary ophthalmology exists.

Procedures 

The following are the most common surgeries performed by ophthalmologists.

  • Cataract surgery - removal of the lens of the eye due to it becoming opaque from illnesses or aging.
  • Laser eye surgery - used to manage refractive (correcting near-/far-sightedness and astigmatism) and non-refractive issues (repairing a tear in the retina).
  • Glaucoma surgery - this is done when a patient is diagnosed with glaucoma that causes increased pressure in the eye itself. The procedure then allows excess aqueous humour from the eye to escape, and this allows for the pressure in the eye to decrease.
  • Eye removal surgery - via enucleation (removing just the eye), evisceration (removing the eye and leaving the sclera behind) or exenteration (removing the eye and all its contents including the muscles and connective tissue in the orbit).
  • Orbital surgery - such as orbital reconstruction, placing of ocular prosthetics (false eyes) and orbital decompression.
  • Corneal surgery - includes corneal transplant surgery, keratoprosthesis, pterygium excision, penetrating keratoplasty and corneal tattooing.
  • Vitreo-retinal surgery - includes a vitrectomy, retinal detachment repair, macular hole repair, macular translocation surgery, posterior sclerotomy and radial optic neurotomy
  • Oculoplastic and eyelid surgery - includes reconstructive procedures of the eye such as repairing drooping eyelids, removal of tumours in or around the eye, repair of the tear duct and aesthetic procedures such as eye and brow lifts.
  • Eye muscle surgery - includes strabismus surgery, extra-ocular surgery and tightening and loosening procedures.
  • Canaloplasty - is a non-penetrating procedure that is done so that raised intra-ocular pressure (IOP) is reduced.
  • Surgery involving the lacrimal apparatus.
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