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Ophthalmology ( ) is a surgical subspecialty within
medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a medical degree, a doctor specialising in ophthalmology must pursue additional postgraduate residency training specific to that field. This may include a one-year integrated internship that involves more general medical training in other fields such as internal medicine or general surgery. Following residency, additional specialty training (or fellowship) may be sought in a particular aspect of eye pathology. Ophthalmologists prescribe medications to treat eye diseases, implement laser therapy, and perform surgery when needed. Ophthalmologists provide both primary and specialty eye care - medical and surgical. Most ophthalmologists participate in academic research on eye diseases at some point in their training and many include research as part of their career. Ophthalmology has always been at the forefront of medical research with a long history of advancement and innovation in eye care.


Diseases

A brief list of some of the most common diseases treated by ophthalmologists: * Cataract * Excessive tearing (tear duct obstruction) *
Proptosis Exophthalmos (also called exophthalmus, exophthalmia, proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit. Exophthalmos can be either bilateral (as is often seen in Graves' disease) or unilateral (as is often seen i ...
(bulged eyes) * Thyroid eye disease * Eye tumors * Ptosis * Diabetic retinopathy * Dry eye syndrome *
Glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
*
Macular degeneration Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred or no vision in the center of the visual field. Early on there are often no symptoms. Over time, however, so ...
*
Retinal detachment Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blin ...
*
Endophthalmitis Endophthalmitis is inflammation of the interior cavity of the eye, usually caused by infection. It is a possible complication of all intraocular surgeries, particularly cataract surgery, and can result in loss of vision or loss of the eye itself. ...
* Refractive errors * Strabismus (misalignment or deviation of eyes) * Uveitis * Ocular
trauma Trauma most often refers to: *Major trauma, in physical medicine, severe physical injury caused by an external source *Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event *Traumatic inju ...
* Ruptured globe injury * Orbital fracture


Diagnosis


Eye examination

Following are examples of examination methods performed during an eye examination that enables diagnosis *
Visual acuity Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an examinee's ability to recognize small details with precision. Visual acuity is dependent on optical and neural factors, i.e. (1) the sharpness of the retinal ...
assessment *
Ocular tonometry Tonometry is the procedure eye care professionals perform to determine the intraocular pressure (IOP), the fluid pressure inside the eye. It is an important test in the evaluation of patients at risk from glaucoma. Most tonometers are calibrated ...
to determine intraocular pressure * Extraocular motility and ocular alignment assessment * Slit lamp examination * Dilated fundus examination * Gonioscopy *
Refraction In physics, refraction is the redirection of a wave as it passes from one medium to another. The redirection can be caused by the wave's change in speed or by a change in the medium. Refraction of light is the most commonly observed phenomen ...


Specialized tests

Optical coherence tomography Optical coherence tomography (OCT) is an imaging technique that uses low-coherence light to capture micrometer-resolution, two- and three-dimensional images from within optical scattering media (e.g., biological tissue). It is used for medica ...
(OCT) is a medical technological platform used to assess ocular structures. The information is then used by physicians to assess staging of pathological processes and confirm clinical diagnoses. Subsequent OCT scans are used to assess the efficacy of managing diabetic retinopathy, age-related macular degeneration, and glaucoma. Optical coherence tomography angiography (OCTA) and Fluorescein angiography to visualize the vascular networks of the retina and choroid. Electroretinography (ERG) measures the electrical responses of various cell types in the
retina The retina (from la, rete "net") is the innermost, light-sensitive layer of tissue of the eye of most vertebrates and some molluscs. The optics of the eye create a focused two-dimensional image of the visual world on the retina, which the ...
, including the photoreceptors ( rods and cones), inner retinal cells ( bipolar and amacrine cells), and the ganglion cells. Electrooculography (EOG) is a technique for measuring the corneo-retinal standing potential that exists between the front and the back of the human eye. The resulting signal is called the electrooculogram. Primary applications are in ophthalmological
diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine "cause and effect". In systems engin ...
and in recording
eye movements Eye movement includes the voluntary or involuntary movement of the eyes. Eye movements are used by a number of organisms (e.g. primates, rodents, flies, birds, fish, cats, crabs, octopus) to fixate, inspect and track visual objects of inter ...
. Visual field testing to detect dysfunction in central and peripheral vision which may be caused by various medical conditions such as
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
,
stroke A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...
, pituitary disease, brain tumours or other neurological deficits.
Corneal topography Corneal topography, also known as photokeratoscopy or videokeratography, is a non-invasive medical imaging technique for mapping the anterior curvature of the cornea, the outer structure of the eye. Since the cornea is normally responsible for som ...
is a non-invasive medical imaging technique for mapping the anterior curvature of the
cornea The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical ...
, the outer structure of the eye. Ultrasonography of the eyes may be performed by an ophthalmologist.


Ophthalmic surgery

Eye surgery, also known as ocular surgery, is surgery performed on the eye or its adnexa by an ophthalmologist. The eye is a fragile organ, and requires extreme care before, during, and after a surgical procedure. An eye surgeon is responsible for selecting the appropriate surgical procedure for the patient and for taking the necessary safety precautions.


Subspecialties

Ophthalmology includes subspecialities that deal either with certain diseases or diseases of certain parts of the eye. Some of them are: *
Anterior segment The anterior segment or anterior cavity is the front third of the eye that includes the structures in front of the vitreous humour: the cornea, iris, ciliary body, and lens.Cassin, B. and Solomon, S. ''Dictionary of Eye Terminology''. Gainesvil ...
surgery *
Cornea The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical ...
, ocular surface, and external disease *
Glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
* Neuro-ophthalmology * Ocular oncology *
Oculoplastics Oculoplastics, or oculoplastic surgery, includes a wide variety of surgical procedures that deal with the orbit (eye socket), eyelids, tear ducts, and the face. It also deals with the reconstruction of the eye and associated structures. Training ...
and orbit surgery *
Ophthalmic pathology Ophthalmic pathology is the subspecialty of surgical pathology and also a subspecialty of ophthalmology which deals with the diagnosis and characterization of neoplastic and non-neoplastic diseases of the eyes. Ophthalmic pathologists generally wor ...
* Paediatric ophthalmology/ strabismus (misalignment of the eyes) * Refractive surgery * Medical retina, deals with treatment of retinal problems through non-surgical means * Uveitis * Veterinary specialty training programs in veterinary ophthalmology exist in some countries. * Vitreo-retinal surgery, deals with surgical management of retinal and posterior segment diseases Medical retina and vitreo-retinal surgery sometimes are combined and together they are called posterior segment subspecialisation


Etymology

The Greek roots of the word ophthalmology are ὀφθαλμός (, "eye") and -λoγία (-, "study, discourse"), i.e., "the study of eyes". The discipline applies to all animal eyes, whether human or not, since the practice and procedures are quite similar with respect to disease processes, although there are differences in the anatomy or disease prevalence.


History


Ancient near east and the Greek period

In the Ebers Papyrus from ancient Egypt dating to 1550 BC, a section is devoted to eye diseases. Prior to
Hippocrates Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history o ...
, physicians largely based their anatomical conceptions of the eye on speculation, rather than
empiricism In philosophy, empiricism is an epistemological theory that holds that knowledge or justification comes only or primarily from sensory experience. It is one of several views within epistemology, along with rationalism and skepticism. Empir ...
. They recognized the sclera and transparent cornea running flushly as the outer coating of the eye, with an inner layer with pupil, and a fluid at the centre. It was believed, by Alcamaeon (fifth century BC) and others, that this fluid was the medium of vision and flowed from the eye to the brain by a tube.
Aristotle Aristotle (; grc-gre, Ἀριστοτέλης ''Aristotélēs'', ; 384–322 BC) was a Greek philosopher and polymath during the Classical period in Ancient Greece. Taught by Plato, he was the founder of the Peripatetic school of ...
advanced such ideas with empiricism. He dissected the eyes of animals, and discovering three layers (not two), found that the fluid was of a constant consistency with the lens forming (or congealing) after death, and the surrounding layers were seen to be juxtaposed. He and his contemporaries further put forth the existence of three tubes leading from the eye, not one. One tube from each eye met within the skull. The Greek physician Rufus of Ephesus (first century AD) recognised a more modern concept of the eye, with
conjunctiva The conjunctiva is a thin mucous membrane that lines the inside of the eyelids and covers the sclera (the white of the eye). It is composed of non-keratinized, stratified squamous epithelium with goblet cells, stratified columnar epithel ...
, extending as a fourth epithelial layer over the eye. Rufus was the first to recognise a two-chambered eye, with one chamber from cornea to lens (filled with water), the other from lens to retina (filled with a substance resembling egg whites). Celsus the Greek philosopher of the second century AD gave a detailed description of cataract surgery by the
couching In embroidery, couching and laid work are techniques in which yarn or other materials are laid across the surface of the ground fabric and fastened in place with small stitches of the same or a different yarn. The couching threads may be eith ...
method. The Greek physician
Galen Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be o ...
(second century AD) remedied some mistaken descriptions, including about the curvature of the cornea and lens, the nature of the optic nerve, and the existence of a
posterior chamber The posterior chamber is a narrow space behind the peripheral part of the iris, and in front of the suspensory ligament of the lens and the ciliary processes. The posterior chamber consists of small space directly posterior to the iris but anterior ...
. Although this model was a roughly correct modern model of the eye, it contained errors. Still, it was not advanced upon again until after Vesalius. A
ciliary body The ciliary body is a part of the eye that includes the ciliary muscle, which controls the shape of the lens, and the ciliary epithelium, which produces the aqueous humor. The aqueous humor is produced in the non-pigmented portion of the ciliar ...
was then discovered and the sclera, retina, choroid, and cornea were seen to meet at the same point. The two chambers were seen to hold the same fluid, as well as the lens being attached to the choroid. Galen continued the notion of a central canal, but he dissected the optic nerve and saw that it was solid. He mistakenly counted seven optical muscles, one too many. He also knew of the
tear duct The nasolacrimal duct (also called the tear duct) carries tears from the lacrimal sac of the eye into the nasal cavity. The duct begins in the eye socket between the maxillary and lacrimal bones, from where it passes downwards and backwards. The o ...
s.


Ancient India

The Indian surgeon
Sushruta Sushruta, or ''Suśruta'' (Sanskrit: सुश्रुत, IAST: , ) was an ancient Indian physician. The '' Sushruta Samhita'' (''Sushruta's Compendium''), a treatise ascribed to him, is one of the most important surviving ancient treatises o ...
wrote the '' Sushruta Samhita'' in
Sanskrit Sanskrit (; attributively , ; nominally , , ) is a classical language belonging to the Indo-Aryan languages, Indo-Aryan branch of the Indo-European languages. It arose in South Asia after its predecessor languages had Trans-cultural diffusion ...
in approximately the sixth century BC, which describes 76 ocular diseases (of these, 51 surgical) as well as several ophthalmological surgical instruments and techniques. His description of cataract surgery was compatible with the method of
couching In embroidery, couching and laid work are techniques in which yarn or other materials are laid across the surface of the ground fabric and fastened in place with small stitches of the same or a different yarn. The couching threads may be eith ...
. He has been described as one of the first cataract surgeons.


Medieval Islam

Medieval Islamic Arabic and Persian scientists (unlike their classical predecessors) considered it normal to combine theory and practice, including the crafting of precise instruments, and therefore, found it natural to combine the study of the eye with the practical application of that knowledge. Hunayn ibn Ishaq, and others beginning with the medieval Arabic period, taught that the crystalline lens is in the exact center of the eye. This idea was propagated until the end of the 1500s.
Ibn al-Haytham Ḥasan Ibn al-Haytham, Latinized as Alhazen (; full name ; ), was a medieval mathematician, astronomer, and physicist of the Islamic Golden Age from present-day Iraq.For the description of his main fields, see e.g. ("He is one of the pr ...
(Alhazen), in his
Book of Optics The ''Book of Optics'' ( ar, كتاب المناظر, Kitāb al-Manāẓir; la, De Aspectibus or ''Perspectiva''; it, Deli Aspecti) is a seven-volume treatise on optics and other fields of study composed by the medieval Arab scholar Ibn al- ...
explained that vision occurs when light lands on an object, bounces off, and is directed to one's eyes. Ibn al-Nafis, an Arabic native of Damascus, wrote a large textbook, ''The Polished Book on Experimental Ophthalmology'', divided into two parts, ''On the Theory of Ophthalmology'' and ''Simple and Compounded Ophthalmic Drugs''.
Avicenna Ibn Sina ( fa, ابن سینا; 980 – June 1037 CE), commonly known in the West as Avicenna (), was a Persian polymath who is regarded as one of the most significant physicians, astronomers, philosophers, and writers of the Islamic ...
wrote in his Canon "rescheth", which means "retiformis", and Gerard of Cremona translated this at approximately 1150 into the new term "retina".


Modern Period

In the seventeenth and eighteenth centuries, hand lenses were used by
Malpighi Marcello Malpighi (10 March 1628 – 30 November 1694) was an Italian biologist and physician, who is referred to as the "Founder of microscopical anatomy, histology & Father of physiology and embryology". Malpighi's name is borne by several ph ...
,
microscope A microscope () is a laboratory instrument used to examine objects that are too small to be seen by the naked eye. Microscopy is the science of investigating small objects and structures using a microscope. Microscopic means being invisi ...
s by
Leeuwenhoek Antonie Philips van Leeuwenhoek ( ; ; 24 October 1632 – 26 August 1723) was a Dutch microbiologist and microscopist in the Golden Age of Dutch science and technology. A largely self-taught man in science, he is commonly known as " the F ...
, preparations for fixing the eye for study by Ruysch, and later the freezing of the eye by Petit. This allowed for detailed study of the eye and an advanced model. Some mistakes persisted, such as: why the pupil changed size (seen to be vessels of the iris filling with blood), the existence of the
posterior chamber The posterior chamber is a narrow space behind the peripheral part of the iris, and in front of the suspensory ligament of the lens and the ciliary processes. The posterior chamber consists of small space directly posterior to the iris but anterior ...
, and the nature of the retina. Unaware of their functions,
Leeuwenhoek Antonie Philips van Leeuwenhoek ( ; ; 24 October 1632 – 26 August 1723) was a Dutch microbiologist and microscopist in the Golden Age of Dutch science and technology. A largely self-taught man in science, he is commonly known as " the F ...
noted the existence of photoreceptors, however, they were not properly described until
Gottfried Reinhold Treviranus Gottfried Reinhold Treviranus (4 February 1776, Bremen – 16 February 1837, Bremen) was a German physician, naturalist, and proto-evolutionary biologist. His younger brother, Ludolph Christian Treviranus (1779–1864), was also a naturalist an ...
in 1834. Approximately 1750,
Jacques Daviel Jacques Daviel (11 August 1696 – 30 September 1762) was a French ophthalmologist credited with originating the first significant advance in cataract surgery since couching was invented in ancient India. Daviel performed the first extracapsula ...
advocated a new treatment for cataract by extraction instead of the traditional method of couching.
Georg Joseph Beer Georg Joseph Beer (23 December 1763 – 11 April 1821) was an Austrian ophthalmologist. He is credited with introducing a flap operation for treatment of cataracts (Beer's operation), as well as popularizing the instrument used to perform the sur ...
(1763–1821) was an Austrian ophthalmologist and leader of the First Viennese School of Medicine. He introduced a flap operation for treatment of cataract (Beer's operation), as well as having popularized the instrument used to perform the surgery (Beer's knife). In North America, indigenous healers treated some eye diseases by rubbing or scraping the eyes or eyelids.


Ophthalmic surgery in Great Britain

The first ophthalmic surgeon in Great Britain was John Freke, appointed to the position by the governors of
St. Bartholomew's Hospital St Bartholomew's Hospital, commonly known as Barts, is a teaching hospital located in the City of London. It was founded in 1123 and is currently run by Barts Health NHS Trust. History Early history Barts was founded in 1123 by Rahere (died ...
in 1727. A major breakthrough came with the appointment of Baron de Wenzel (1724–90), a German who became the oculist to
King George III George III (George William Frederick; 4 June 173829 January 1820) was King of Great Britain and of Ireland from 25 October 1760 until the union of the two kingdoms on 1 January 1801, after which he was King of the United Kingdom of Great B ...
of Great Britain in 1772. His skill at removing cataracts legitimized the field. The first dedicated ophthalmic hospital opened in 1805 in London; it is now called Moorfields Eye Hospital. Clinical developments at Moorfields and the founding of the Institute of Ophthalmology (now part of the
University College London , mottoeng = Let all come who by merit deserve the most reward , established = , type = Public research university , endowment = £143 million (2020) , budget = ...
) by Sir Stewart Duke-Elder established the site as the largest eye hospital in the world and a nexus for ophthalmic research.


Central Europe

In Berlin, ophthalmologist Albrecht von Graefe introduced iridectomy as a treatment for glaucoma and improved cataract surgery, he is also considered the founding father of the German Ophthalmological Society. Numerous ophthalmologists fled Germany after 1933 as the Nazis began to persecute those of Jewish descent. A representative leader was Joseph Igersheimer (1879–1965), best known for his discoveries with arsphenamine for the treatment of syphilis. He fled to
Turkey Turkey ( tr, Türkiye ), officially the Republic of Türkiye ( tr, Türkiye Cumhuriyeti, links=no ), is a transcontinental country located mainly on the Anatolian Peninsula in Western Asia, with a small portion on the Balkan Peninsula ...
in 1933. As one of eight emigrant directors in the Faculty of Medicine at the University of Istanbul, he built a modern clinic and trained students. In 1939, he went to the United States, becoming a professor at
Tufts University Tufts University is a private research university on the border of Medford and Somerville, Massachusetts. It was founded in 1852 as Tufts College by Christian universalists who sought to provide a nonsectarian institution of higher learning. ...
. German ophthalmologist, Gerhard Meyer-Schwickerath is widely credited with developing the predecessor of laser coagulation, photocoagulation. In 1946, Igersheimer conducted the first experiments on light coagulation. In 1949, he performed the first successful treatment of a retinal detachment with a light beam (light coagulation) with a self-constructed device on the roof of the ophthalmic clinic at the University of Hamburg-Eppendorf. Polish ophthalmology dates to the thirteenth century. The Polish Ophthalmological Society was founded in 1911. A representative leader was
Adam Zamenhof Adam Zamenhof (1888 – 29 January 1940) was a Polish physician known for his work on ophthalmology and the son of L. L. Zamenhof, the inventor of Esperanto. Before the Holocaust, Zamenhof had invented a device to check blind spots in the field of ...
(1888–1940), who introduced certain diagnostic, surgical, and nonsurgical eye-care procedures. He was executed by the German Nazis in 1940. Zofia Falkowska (1915–93) head of the Faculty and Clinic of Ophthalmology in Warsaw from 1963 to 1976, was the first to use lasers in her practice.


Contributions by Physicists

The prominent physicists of the late nineteenth and early twentieth centuries included Ernst Abbe (1840–1905), a co-owner of at the Zeiss Jena factories in Germany, where he developed numerous optical instruments.
Hermann von Helmholtz Hermann Ludwig Ferdinand von Helmholtz (31 August 1821 – 8 September 1894) was a German physicist and physician who made significant contributions in several scientific fields, particularly hydrodynamic stability. The Helmholtz Associat ...
(1821-1894) was a polymath who made contributions to many fields of science and invented the ophthalmoscope in 1851. They both made theoretical calculations on image formation in optical systems and also had studied the optics of the eye.


Professional requirements

Ophthalmologists are
physicians A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
( MD/DO in the U.S. or MBBS in the UK and elsewhere or DO/DOMS/DNB, who typically complete an undergraduate degree, general medical school, followed by a residency in ophthalmology. Ophthalmologists typically perform optical, medical and surgical eye care.


Australia and New Zealand

In
Australia Australia, officially the Commonwealth of Australia, is a sovereign country comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands. With an area of , Australia is the largest country by ...
and
New Zealand New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island coun ...
, the FRACO or FRANZCO is the equivalent postgraduate specialist qualification. The structured training system takes place over five years of postgraduate training. Overseas-trained ophthalmologists are assessed using the pathway published on the RANZCO website. Those who have completed their formal training in the UK and have the CCST or CCT, usually are deemed to be comparable.


Bangladesh

In
Bangladesh Bangladesh (}, ), officially the People's Republic of Bangladesh, is a country in South Asia. It is the eighth-most populous country in the world, with a population exceeding 165 million people in an area of . Bangladesh is among the mo ...
to be an ophthalmologist the basic degree is an MBBS. Then they have to obtain a postgraduate degree or diploma in an ophthalmology specialty. In Bangladesh, these are diploma in ophthalmology, diploma in community ophthalmology, fellow or member of the College of Physicians and Surgeons in ophthalmology, and Master of Science in ophthalmology.


Canada

In
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by to ...
, after medical school an ophthalmology residency is undertaken. The residency typically lasts five years, which culminates in fellowship of the Royal College of Surgeons of Canada (FRCSC). Subspecialty training is undertaken by approximately 30% of fellows (FRCSC) in a variety of fields from
anterior segment The anterior segment or anterior cavity is the front third of the eye that includes the structures in front of the vitreous humour: the cornea, iris, ciliary body, and lens.Cassin, B. and Solomon, S. ''Dictionary of Eye Terminology''. Gainesvil ...
,
cornea The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical ...
,
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
, vision rehabilitation, uveitis,
oculoplastics Oculoplastics, or oculoplastic surgery, includes a wide variety of surgical procedures that deal with the orbit (eye socket), eyelids, tear ducts, and the face. It also deals with the reconstruction of the eye and associated structures. Training ...
, medical and surgical retina, ocular oncology, Ocular pathology, or neuro-ophthalmology. Approximately 35 vacancies open per year for ophthalmology residency training in all of Canada. These numbers fluctuate per year, ranging from 30 to 37 spots. Of these, up to ten spots are at French-speaking universities in Quebec. At the end of the five years, the graduating ophthalmologist must pass the oral and written portions of the
Royal College A royal college in some Commonwealth countries is technically a college which has received royal patronage and permission to use the prefix ''royal''. Permission is usually granted through a royal charter. The charter normally confers a constitut ...
exam in either English or French.


India

In
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest country by area, the List of countries and dependencies by population, second-most populous ...
, after completing MBBS degree, postgraduate study in ophthalmology is required. The degrees are doctor of medicine, master of surgery, diploma in ophthalmic medicine and surgery, and diplomate of national board. The concurrent training and work experience are in the form of a junior residency at a medical college, eye hospital, or institution under the supervision of experienced faculty. Further work experience in the form of fellowship, registrar, or senior resident refines the skills of these eye surgeons. All members of the India Ophthalmologist Society and various state-level ophthalmologist societies hold regular conferences and actively promote continuing medical education.


Nepal

In
Nepal Nepal (; ne, नेपाल ), formerly the Federal Democratic Republic of Nepal ( ne, सङ्घीय लोकतान्त्रिक गणतन्त्र नेपाल ), is a landlocked country in South Asia. It is ma ...
, to become an ophthalmologist, three years of postgraduate study is required after completing an MBBS degree. The postgraduate degree in ophthalmology is called medical doctor in ophthalmology. Currently, this degree is provided by Tilganga Institute of Ophthalmology, Tilganga, Kathmandu, BPKLCO, Institute of Medicine, TU, Kathmandu, BP Koirala Institute of Health Sciences, Dharan, Kathmandu University, Dhulikhel, and National Academy of Medical Science, Kathmandu. A few Nepalese citizens also study this subject in Bangladesh, China, India, Pakistan, and other countries. All graduates have to pass the Nepal Medical Council Licensing Exam to become a registered ophthalmologists in Nepal. The concurrent residency training is in the form of a PG student (resident) at a medical college, eye hospital, or institution according to the degree providing university's rules and regulations. Nepal Ophthalmic Society holds regular conferences and actively promotes continuing medical education.


Ireland

In
Ireland Ireland ( ; ga, Éire ; Ulster-Scots: ) is an island in the North Atlantic Ocean, in north-western Europe. It is separated from Great Britain to its east by the North Channel, the Irish Sea, and St George's Channel. Ireland is the s ...
, the
Royal College of Surgeons of Ireland The Royal College of Surgeons in Ireland (RCSI) is a medical professional and educational institution, which is also known as RCSI University of Medicine and Health Sciences, Ireland's first private university. It was established in 1784 ...
grants membership (MRCSI (Ophth)) and fellowship (FRCSI (Ophth)) qualifications in conjunction with the Irish College of Ophthalmologists. Total postgraduate training involves an intern year, a minimum of three years of basic surgical training, and a further 4.5 years of higher surgical training. Clinical training takes place within public, Health Service Executive-funded hospitals in
Dublin Dublin (; , or ) is the capital and largest city of Ireland. On a bay at the mouth of the River Liffey, it is in the province of Leinster, bordered on the south by the Dublin Mountains, a part of the Wicklow Mountains range. At the 2016 ...
, Sligo,
Limerick Limerick ( ; ga, Luimneach ) is a western city in Ireland situated within County Limerick. It is in the province of Munster and is located in the Mid-West which comprises part of the Southern Region. With a population of 94,192 at the 2 ...
,
Galway Galway ( ; ga, Gaillimh, ) is a City status in Ireland, city in the West Region, Ireland, West of Ireland, in the Provinces of Ireland, province of Connacht, which is the county town of County Galway. It lies on the River Corrib between Lo ...
,
Waterford "Waterford remains the untaken city" , mapsize = 220px , pushpin_map = Ireland#Europe , pushpin_map_caption = Location within Ireland##Location within Europe , pushpin_relief = 1 , coordinates ...
, and
Cork Cork or CORK may refer to: Materials * Cork (material), an impermeable buoyant plant product ** Cork (plug), a cylindrical or conical object used to seal a container ***Wine cork Places Ireland * Cork (city) ** Metropolitan Cork, also known as G ...
. A minimum of 8.5 years of training is required before eligibility to work in consultant posts. Some trainees take extra time to obtain MSc, MD or
PhD PHD or PhD may refer to: * Doctor of Philosophy (PhD), an academic qualification Entertainment * '' PhD: Phantasy Degree'', a Korean comic series * '' Piled Higher and Deeper'', a web comic * Ph.D. (band), a 1980s British group ** Ph.D. (Ph.D. al ...
degrees and to undertake clinical fellowships in the UK, Australia, and the United States.


Pakistan

In
Pakistan Pakistan ( ur, ), officially the Islamic Republic of Pakistan ( ur, , label=none), is a country in South Asia. It is the world's List of countries and dependencies by population, fifth-most populous country, with a population of almost 24 ...
, after MBBS, a four-year full-time residency program leads to an exit-level FCPS examination in ophthalmology, held under the auspices of the College of Physicians and Surgeons, Pakistan. The tough examination is assessed by both highly qualified Pakistani and eminent international ophthalmic consultants. As a prerequisite to the final examinations, an intermediate module, an optics and refraction module, and a dissertation written on a research project carried out under supervision is also assessed. Moreover, a two-and-a-half-year residency program leads to an MCPS while a two-year training of DOMS is also being offered. For candidates in the military, a stringent two-year graded course, with quarterly assessments, is held under Armed Forces Post Graduate Medical Institute in Rawalpindi. The M.S. in ophthalmology is also one of the specialty programs. In addition to programs for physicians, various diplomas and degrees for allied eyecare personnel are also being offered to produce competent optometrists, orthoptists, ophthalmic nurses, ophthalmic technologists, and ophthalmic technicians in this field. These programs are being offered, notably by the
College of Ophthalmology and Allied Vision Sciences College of Ophthalmology and Allied Vision Sciences (COAVS) ( ur, ) formerly known as Punjab institute of Preventive Ophthalmology (PIPO) is one of the finest Ophthalmic Institute in Pakistan. it is attached with Mayo Hospital which was built in ...
, in
Lahore Lahore ( ; pnb, ; ur, ) is the second List of cities in Pakistan by population, most populous city in Pakistan after Karachi and 26th List of largest cities, most populous city in the world, with a population of over 13 million. It is th ...
and the Pakistan Institute of Community Ophthalmology in Peshawar. Subspecialty fellowships also are being offered in the fields of pediatric ophthalmology and vitreoretinal ophthalmology.
King Edward Medical University King Edward Medical University (KEMU) () is a public medical university located in Lahore, Punjab, Pakistan. Founded in 1860, the university is named after King Edward VII. Established by the British Raj, named as Lahore Medical School. In ...
, Al Shifa Trust Eye Hospital Rawalpindi, and Al- Ibrahim Eye Hospital Karachi also have started a degree program in this field.


Philippines

In the Philippines, Ophthalmology is considered a medical specialty that uses medicine and surgery to treat diseases of the eye. There is only one professional organization in the country that is duly recognized by the PMA and the PCS: the Philippine Academy of Ophthalmology (PAO). PAO and the state-standard Philippine Board of Ophthalmology (PBO) regulates ophthalmology residency programs and board certification. To become a general ophthalmologist in the Philippines, a candidate must have completed a doctor of medicine degree (MD) or its equivalent (e.g. MBBS), have completed an internship in Medicine, have passed the physician licensure exam, and have completed residency training at a hospital accredited by the Philippine Board of Ophthalmology (accrediting arm of PAO). Attainment of board certification in ophthalmology from the PBO is essential in acquiring privileges in most major health institutions. Graduates of residency programs can receive further training in ophthalmology subspecialties, such as neuro-ophthalmology, retina, etc. by completing a fellowship program that varies in length depending on each program's requirements.


United Kingdom

In the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and ...
, three colleges grant postgraduate degrees in ophthalmology. The
Royal College of Ophthalmologists The Royal College of Ophthalmologists, founded in 1988, is an independent professional body and one of the Medical Royal Colleges. They set the standards and examinations for medical doctors aiming to become ophthalmologists, and provide surgical ...
(RCOphth) and the
Royal College of Surgeons of Edinburgh The Royal College of Surgeons of Edinburgh (RCSEd) is a professional organisation of surgeons. The College has seven active faculties, covering a broad spectrum of surgical, dental, and other medical practices. Its main campus is located o ...
grant MRCOphth/FRCOphth and MRCSEd/FRCSEd, (although membership is no longer a prerequisite for fellowship), the
Royal College A royal college in some Commonwealth countries is technically a college which has received royal patronage and permission to use the prefix ''royal''. Permission is usually granted through a royal charter. The charter normally confers a constitut ...
of Glasgow grants FRCS. Postgraduate work as a specialist registrar and one of these degrees is required for specialization in eye diseases. Such clinical work is within the NHS, with supplementary private work for some consultants. Only 2.3 ophthalmologists exist per 100,000 population in the UK – fewer ''pro rata'' than in any nations in the European Union.


United States

Ophthalmologists typically complete four years of undergraduate studies, four years of medical school and four years of eye-specific training (residency). Some pursue additional training, known as a fellowship - typically one to two years. Ophthalmologists are physicians who specialize in the eye and related structures. They perform medical and surgical eye care and may also write prescriptions for corrective lenses. They often manage late stage eye disease, which typically involves surgery. Ophthalmologists must complete the requirements of continuing medical education to maintain licensure and for recertification.


Notable ophthalmologists

The following is a list of physicians who have significantly contributed to the field of ophthalmology:


18th–19th centuries

*
Theodor Leber Theodor Karl Gustav von Leber (29 February 1840 – 17 April 1917) was a German ophthalmologist from Karlsruhe. Leber was a student of Hermann von Helmholtz (1821-1894) in Heidelberg, where he received his doctorate in 1862. He remained in Hei ...
(1840–1917) discovered Leber's congenital amaurosis, Leber's hereditary optic neuropathy, Leber's miliary aneurysm, and Leber's stellate neuroretinitis *
Carl Ferdinand von Arlt Carl Ferdinand Ritter von Arlt (April 18, 1812 – March 7, 1887) was an Austrian ophthalmologist born in Ober-Graupen, a village near Teplitz (Teplice) in Bohemia. He earned his doctorate in Prague in 1839, and later became a professor of oph ...
(1812–1887), the elder (Austrian), proved that myopia is largely due to an excessive axial length, published influential textbooks on eye disease, and ran annual eye clinics in needy areas long before the concept of volunteer eye camps became popular; his name is still attached to some disease signs, e.g., von Arlt's line in trachoma and his son, Ferdinand Ritter von Arlt, the younger, was also an ophthalmologist *
Jacques Daviel Jacques Daviel (11 August 1696 – 30 September 1762) was a French ophthalmologist credited with originating the first significant advance in cataract surgery since couching was invented in ancient India. Daviel performed the first extracapsula ...
(1696–1762) (France) claimed to be the founder of modern cataract surgery in that he performed cataract extraction instead of needling the cataract or pushing it back into the vitreous; he is said to have carried out the technique on 206 patients in 1752–53, of which 182 were reported to be successful, however, these figures are not very credible, given the total lack of both anaesthesia and aseptic technique at that time * Franciscus Donders (1818–1889) (Dutch) published pioneering analyses of ocular biomechanics, intraocular pressure,
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
, and physiological
optics Optics is the branch of physics that studies the behaviour and properties of light, including its interactions with matter and the construction of instruments that use or detect it. Optics usually describes the behaviour of visible, ultrav ...
and he made possible the prescribing of combinations of spherical and cylindrical lenses to treat astigmatism * Joseph Forlenze (1757–1833) (Italy), specialist in cataract surgery, became popular during the
First French Empire The First French Empire, officially the French Republic, then the French Empire (; Latin: ) after 1809, also known as Napoleonic France, was the empire ruled by Napoleon Bonaparte, who established French hegemony over much of continental E ...
, healing, among many, personalities such as the minister
Jean-Étienne-Marie Portalis Jean-Étienne-Marie Portalis (1 April 1746 – 25 August 1807) was a French jurist and politician in the time of the French Revolution and the First Empire. His son, Joseph Marie Portalis, was a diplomat and statesman. Biography Early years Por ...
and the poet Ponce Denis Lebrun; he was nominated by
Napoleon Napoleon Bonaparte ; it, Napoleone Bonaparte, ; co, Napulione Buonaparte. (born Napoleone Buonaparte; 15 August 1769 – 5 May 1821), later known by his regnal name Napoleon I, was a French military commander and political leader wh ...
"chirurgien oculiste of the lycees, the civil hospices and all the charitable institutions of the departments of the Empire", and he also was known for his free interventions, mainly in favour of poor people * Albrecht von Graefe (1828–1870) (Germany) probably the most important ophthalmologist of the nineteenth century, along with Helmholtz and Donders, one of the 'founding fathers' of ophthalmology as a specialty, he was a brilliant clinician and charismatic teacher who had an international influence on the development of ophthalmology, and was a pioneer in mapping visual field defects and diagnosis and treatment of glaucoma, and he introduced a cataract extraction technique that remained the standard for more than 100 years, and many other important surgical techniques such as iridectomy. He rationalised the use of many ophthalmically important drugs, including mydriatics and miotics; he also was the founder of one of the earliest ophthalmic societies (German Ophthalmological Society, 1857) and one of the earliest ophthalmic journals (''Graefe's Archives of Ophthalmology'') *
Allvar Gullstrand Allvar Gullstrand (5 June 1862 – 28 July 1930) was a Swedish ophthalmologist and optician. Life Born at Landskrona, Sweden, Gullstrand was professor (1894–1927) successively of eye therapy and of optics at the University of Uppsala. He ap ...
(1862–1930) (Sweden) was a
Nobel Prize The Nobel Prizes ( ; sv, Nobelpriset ; no, Nobelprisen ) are five separate prizes that, according to Alfred Nobel's will of 1895, are awarded to "those who, during the preceding year, have conferred the greatest benefit to humankind." Alfr ...
-winner in 1911 for his research on the eye as a light-refracting apparatus, he described the 'schematic eye', a mathematical model of the
human eye The human eye is a sensory organ, part of the sensory nervous system, that reacts to visible light and allows humans to use visual information for various purposes including seeing things, keeping balance, and maintaining circadian rhythm. ...
based on his measurements known as the 'optical constants' of the eye; his measurements are still used today *
Hermann von Helmholtz Hermann Ludwig Ferdinand von Helmholtz (31 August 1821 – 8 September 1894) was a German physicist and physician who made significant contributions in several scientific fields, particularly hydrodynamic stability. The Helmholtz Associat ...
(1821–1894), a great German
polymath A polymath ( el, πολυμαθής, , "having learned much"; la, homo universalis, "universal human") is an individual whose knowledge spans a substantial number of subjects, known to draw on complex bodies of knowledge to solve specific pro ...
, invented the ophthalmoscope (1851) and published important work on physiological optics, including colour vision. * Julius Hirschberg (1843–1925) (Germany) in 1879 became the first to use an
electromagnet An electromagnet is a type of magnet in which the magnetic field is produced by an electric current. Electromagnets usually consist of wire wound into a coil. A current through the wire creates a magnetic field which is concentrated in ...
to remove metallic foreign bodies from the eye and in 1886 developed the Hirschberg test for measuring strabismus * Peter Adolph Gad (1846 – 1907), Danish ophthalmologist who founded the first eye infirmary in São Paulo, Brazil * Socrate Polara (1800–1860, Italy) founded the first dedicated ophthalmology clinic in
Sicily (man) it, Siciliana (woman) , population_note = , population_blank1_title = , population_blank1 = , demographics_type1 = Ethnicity , demographics1_footnotes = , demographi ...
in 1829, entirely as a philanthropic endeavor; later he was appointed as the first director of the ophthalmology department at the Grand Hospital of
Palermo Palermo ( , ; scn, Palermu , locally also or ) is a city in southern Italy, the capital of both the autonomous region of Sicily and the Metropolitan City of Palermo, the city's surrounding metropolitan province. The city is noted for its ...
, Sicily, in 1831 after the Sicilian government became convinced of the importance of state support for the specialization * Herman Snellen (1834–1908) (Netherlands) introduced the Snellen chart to study
visual acuity Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an examinee's ability to recognize small details with precision. Visual acuity is dependent on optical and neural factors, i.e. (1) the sharpness of the retinal ...


20th–21st centuries

* Vladimir Petrovich Filatov (1875–1956) (Ukraine) contributed the tube flap grafting method, corneal transplantation, and preservation of grafts from cadaver eyes and tissue therapy; he founded the Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, one of the leading eye-care institutes in the world * Shinobu Ishihara (1879-1963) (Japan), in 1918, invented the Ishihara Color Vision Test, a common method for determining Color blindness; he also made major contributions to the study of Trachoma and Myopia * Ignacio Barraquer (1884–1965) (Spain), in 1917, invented the first motorized vacuum instrument (erisophake) for intracapsular cataract extraction; he founded the Barraquer Clinic in 1941 and the Barraquer Institute in 1947 in Barcelona, Spain * Ernst Fuchs (1851-1930) was an Austrian ophthalmologist known for his discovery and description of numerous ocular diseases and abnormalities including Fuchs' dystrophy and Fuchs heterochromic iridocyclitis * Tsutomu Sato (1902-1960) (Japan) pioneer in incisional refractive surgery, including techniques for astigmatism and the invention of radial keratotomy for myopia *
Jules Gonin Jules Gonin (10 August 1870 – May 1935) was a professor of ophthalmology in Lausanne who pioneered the procedure of ignipuncture, the first successful surgery for the treatment of retinal detachments. Early life Jules grew in a family with cu ...
(1870–1935) (Switzerland) was the "father of retinal detachment surgery" * Sir Harold Ridley (1906–2001) (United Kingdom), in 1949, may have been the first to successfully implant an artificial intraocular lens after observing that plastic fragments in the eyes of wartime pilots were well tolerated; he fought for decades against strong reactionary opinions to have the concept accepted as feasible and useful * Charles Schepens (1912–2006) (Belgium) was the "father of modern retinal surgery" and developer of the Schepens indirect binocular ophthalmoscope whilst at Moorfields Eye Hospital; he was the founder of the Schepens Eye Research Institute, associated with Harvard Medical School and the Massachusetts Eye and Ear Infirmary, in
Boston Boston (), officially the City of Boston, is the state capital and most populous city of the Commonwealth of Massachusetts, as well as the cultural and financial center of the New England region of the United States. It is the 24th- mo ...
,
Massachusetts Massachusetts (Massachusett: ''Muhsachuweesut Massachusett_writing_systems.html" ;"title="nowiki/> məhswatʃəwiːsət.html" ;"title="Massachusett writing systems">məhswatʃəwiːsət">Massachusett writing systems">məhswatʃəwiːsət'' En ...
*
Tom Pashby Thomas Joseph Pashby (March 23, 1915August 24, 2005) was a Canadian ophthalmologist and sport safety advocate. He spent 46 years improving the safety of hockey helmets to prevent injuries in ice hockey, by developing visors and wire face masks ...
(1915–2005) (Canada) was Canadian Standards Association and a sport safety advocate to prevent eye injuries and spinal cord injuries, developed safer sports equipment, named to the Order of Canada, inducted into Canada's Sport Hall of Fame * Marshall M. Parks (1918–2005) was the "father of pediatric ophthalmology" * José Ignacio Barraquer (1916–1998) (Spain) was the "father of modern refractive surgery" and in the 1960s, he developed lamellar techniques, including keratomileusis and keratophakia, as well as the first microkeratome and corneal microlathe * Tadeusz Krwawicz (1910–1988) (Poland), in 1961, developed the first cryoprobe for intracapsular cataract extraction * Svyatoslav Fyodorov (1927–2000) (Russia) was the "father of ophthalmic microsurgery" and he improved and popularized radial keratotomy, invented a surgical cure for cataract, and he developed scleroplasty * Charles Kelman (1930–2004)(United States) developed the ultrasound and mechanized irrigation and aspiration system for phacoemulsification, first allowing cataract extraction through a small incision. * Helena Ndume (b.1960) (Namibia) is a renowned ophthalmologist notable for her charitable work among people with eye-related illnesses.


See also

* '' Book of the Ten Treatises of the Eye'' * Chinese ophthalmology *
Copiale cipher The Copiale cipher is an encrypted manuscript consisting of 75,000 handwritten characters filling 105 pages in a bound volume. Undeciphered for more than 260 years, the document was cracked in 2011 with the help of modern computer techniques. An ...
* American Academy of Ophthalmology * European Board of Ophthalmology * Association for Research in Vision and Ophthalmology * EyeWiki * Eye disease *
List of systemic diseases with ocular manifestations An ocular manifestation of a systemic disease is an eye condition that directly or indirectly results from a disease process in another part of the body. There are many diseases known to cause ocular or visual changes. Diabetes, for example, is th ...
* Eye surgery * Optometry * Orthoptics * Eye care professional


References


External links


EyeWiki



Aaojournal
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