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Ophthalmology (, ) is the branch of medicine that deals with the diagnosis, treatment, and surgery of eye diseases and disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a
medical degree A medical degree is a professional degree admitted to those who have passed coursework in the fields of medicine and/or surgery from an accredited medical school. Obtaining a degree in medicine allows for the recipient to continue on into special ...
, a doctor specialising in ophthalmology must pursue additional postgraduate residency training specific to that field. In the United States, following graduation from medical school, one must complete a four-year residency in ophthalmology to become an ophthalmologist. Following residency, additional specialty training (or fellowship) may be sought in a particular aspect of eye pathology. Ophthalmologists prescribe medications to treat ailments, such as 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. A former term for this medical branch is oculism.


Diseases

A brief list of some of the most common diseases treated by ophthalmologists: *
Cataract A cataract is a cloudy area in the lens (anatomy), lens of the eye that leads to a visual impairment, decrease in vision of the eye. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colours, blurry or ...
* Excessive tearing (tear duct obstruction) * Proptosis (bulged eyes) * Thyroid eye disease * Eye tumors * Ptosis * Diabetic retinopathy * Dry eye syndrome *
Glaucoma Glaucoma is a group of eye diseases that can lead to damage of the optic nerve. The optic nerve transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of ...
* Macular degeneration * Retinal detachment * Endophthalmitis * Refractive errors *
Strabismus Strabismus is an eye disorder in which the eyes do not properly align with each other when looking at an object. The eye that is pointed at an object can alternate. The condition may be present occasionally or constantly. If present during a ...
(misalignment or deviation of eyes) * Uveitis * Ocular trauma * Ruptured globe injury * Orbital fracture The most valued pharmaceutical companies worldwide whose leading products are in Ophthalmology are Regeneron (United States) for Macular degeneration (AMD) treatment and Bausch Health (Canada) for Front of eye.


Diagnosis


Eye examination

Following are examples of examination methods performed during an
eye examination An eye examination, commonly known as an eye test, is a series of tests performed to assess Visual acuity, vision and ability to Focus (optics), focus on and discern objects. It also includes other tests and examinations of the human eye, eyes. ...
that enables diagnosis *
Visual acuity Visual acuity (VA) commonly refers to the clarity of visual perception, vision, but technically rates an animal's ability to recognize small details with precision. Visual acuity depends on optical and neural factors. Optical factors of the eye ...
assessment * Ocular tonometry 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 transmission medium, 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 commo ...


Specialized tests

Optical coherence tomography (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 Optical coherence tomography angiography (OCTA) is a non-invasive Medical imaging, imaging technique based on optical coherence tomography (OCT) developed to visualize Retina#Blood supply, vascular networks in the human retina, choroid, skin and va ...
(OCTA) and
Fluorescein angiography Fluorescein angiography (FA), fluorescent angiography (FAG), or fundus fluorescein angiography (FFA) is a technique for examining the circulation of the retina and choroid (parts of the fundus) using a fluorescent dye and a specialized camera. ...
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 (; or retinas) is the innermost, photosensitivity, light-sensitive layer of tissue (biology), tissue of the eye of most vertebrates and some Mollusca, molluscs. The optics of the eye create a focus (optics), focused two-dimensional ...
, 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 (: diagnoses) is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in a lot of different academic discipline, disciplines, with variations in the use of logic, analytics, and experience, to determine " ...
and in recording eye movements. 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 can lead to damage of the optic nerve. The optic nerve transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of ...
,
stroke Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
, pituitary disease, brain tumours or other neurological deficits.
Corneal topography Corneal topography, also known as photokeratoscopy or videokeratography, is a Non-invasive (medical), non-invasive medical imaging technique for mapping the anterior curvature of the cornea, the outer structure of the human eye, eye. Since the cor ...
is a non-invasive
medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to revea ...
technique for mapping the anterior curvature of the
cornea The cornea is the transparency (optics), transparent front part of the eyeball which covers the Iris (anatomy), iris, pupil, and Anterior chamber of eyeball, anterior chamber. Along with the anterior chamber and Lens (anatomy), lens, the cornea ...
, 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 surgery *
Cornea The cornea is the transparency (optics), transparent front part of the eyeball which covers the Iris (anatomy), iris, pupil, and Anterior chamber of eyeball, anterior chamber. Along with the anterior chamber and Lens (anatomy), lens, the cornea ...
, ocular surface, and external disease *
Glaucoma Glaucoma is a group of eye diseases that can lead to damage of the optic nerve. The optic nerve transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of ...
*
Neuro-ophthalmology Neuro-ophthalmology is an academically-oriented subspecialty that merges the fields of neurology and ophthalmology, often dealing with complex systemic diseases that have manifestations in the visual system. Neuro-ophthalmologists initially comple ...
* Ocular oncology * Oculoplastics and orbit surgery * Ophthalmic pathology * Paediatric ophthalmology/
strabismus Strabismus is an eye disorder in which the eyes do not properly align with each other when looking at an object. The eye that is pointed at an object can alternate. The condition may be present occasionally or constantly. If present during a ...
(misalignment of the eyes) *
Refractive surgery Refractive surgery is an optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea ( keratomi ...
* 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 (; ; ), also known as Hippocrates II, was a Greek physician and philosopher of the Classical Greece, classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referr ...
, physicians largely based their anatomical conceptions of the eye on speculation, rather than
empiricism In philosophy, empiricism is an epistemological view which holds that true knowledge or justification comes only or primarily from sensory experience and empirical evidence. It is one of several competing views within epistemology, along ...
. 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 (; 384–322 BC) was an Ancient Greek philosophy, Ancient Greek philosopher and polymath. His writings cover a broad range of subjects spanning the natural sciences, philosophy, linguistics, economics, politics, psychology, a ...
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 In the anatomy of the eye, the conjunctiva (: conjunctivae) 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 gobl ...
, 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 Celsus (; , ''Kélsos''; ) was a 2nd-century Greek philosopher and opponent of early Christianity. His literary work '' The True Word'' (also ''Account'', ''Doctrine'' or ''Discourse''; Greek: )Hoffmann p.29 survives exclusively via quotati ...
the Greek philosopher of the second century AD gave a detailed description of cataract surgery by the couching method. The Greek physician
Galen Aelius Galenus or Claudius Galenus (; September 129 – AD), often Anglicization, anglicized as Galen () or Galen of Pergamon, was a Ancient Rome, Roman and Greeks, Greek physician, surgeon, and Philosophy, philosopher. Considered to be one 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. 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 Andries van Wezel (31 December 1514 – 15 October 1564), Latinization of names, latinized as Andreas Vesalius (), was an anatomist and physician who wrote ''De humani corporis fabrica, De Humani Corporis Fabrica Libri Septem'' (''On the fabric ...
. A ciliary body 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 ducts.


Ancient India

The Indian surgeon Sushruta wrote the '' Sushruta Samhita'' in
Sanskrit Sanskrit (; stem form ; nominal singular , ,) is a classical language belonging to the Indo-Aryan languages, Indo-Aryan branch of the Indo-European languages. It arose in northwest South Asia after its predecessor languages had Trans-cultural ...
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 Cataract surgery, also called lens replacement surgery, is the removal of the natural lens (anatomy), lens of the human eye, eye that has developed a cataract, an opaque or cloudy area. The eye's natural lens is usually replaced with an artific ...
was compatible with the method of couching. 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-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 ( – 22 June 1037), commonly known in the West as Avicenna ( ), was a preeminent philosopher and physician of the Muslim world, flourishing during the Islamic Golden Age, serving in the courts of various Iranian peoples, Iranian ...
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,
microscope A microscope () is a laboratory equipment, 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 ...
s by Leeuwenhoek, 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, and the nature of the retina. Unaware of their functions, Leeuwenhoek noted the existence of photoreceptors, however, they were not properly described until Gottfried Reinhold Treviranus in 1834. Jacques Daviel performed the first documented planned primary cataract extraction on Sep. 18, 1750 in Cologne. Georg Joseph Beer (1763–1821) was an Austrian ophthalmologist and leader of the First Viennese School of Medicine. He introduced a flap operation for treatment of
cataract A cataract is a cloudy area in the lens (anatomy), lens of the eye that leads to a visual impairment, decrease in vision of the eye. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colours, blurry or ...
(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 The United Kingdom

The first ophthalmic surgeon in the UK 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 by Rahere, and is currently run by Barts Health NHS Trust. History Early history Barts was founded in 1123 by Ra ...
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 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 University College London (Trade name, branded as UCL) is a Public university, public research university in London, England. It is a Member institutions of the University of London, member institution of the Federal university, federal Uni ...
) 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, officially the Republic of Türkiye, is a country mainly located in Anatolia in West Asia, with a relatively small part called East Thrace in Southeast Europe. It borders the Black Sea to the north; Georgia (country), Georgia, Armen ...
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 in Medford and Somerville, Massachusetts, United States, with additional facilities in Boston and Grafton, as well as Talloires, France. Tufts also has several Doctor of Physical Therapy p ...
. 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 (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; "von" since 1883) was a German physicist and physician who made significant contributions in several scientific fields, particularly hydrodynamic stability. The ...
(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.


Bibliography

* Christopher Leffler (ed.), ''Biographies of Ophthalmologists from Around the World: Ancient, Medieval, and Early Modern'', 2024, pp. 384, ISBN 9798342679220 Available from: https://www.researchgate.net/publication/392094663_Biographies_of_Ophthalmologists_from_Around_the_World_Ancient_Medieval_and_Early_Modern


Professional requirements

Ophthalmologists are
physicians A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis ...
( 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 country comprising mainland Australia, the mainland of the Australia (continent), Australian continent, the island of Tasmania and list of islands of Australia, numerous smaller isl ...
and
New Zealand New Zealand () is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and List of islands of New Zealand, over 600 smaller islands. It is the List of isla ...
, 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 List of countries and dependencies by population, eighth-most populous country in the world and among the List of countries and dependencies by ...
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 Provinces and territories of Canada, ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, making it the world's List of coun ...
, 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,
cornea The cornea is the transparency (optics), transparent front part of the eyeball which covers the Iris (anatomy), iris, pupil, and Anterior chamber of eyeball, anterior chamber. Along with the anterior chamber and Lens (anatomy), lens, the cornea ...
,
glaucoma Glaucoma is a group of eye diseases that can lead to damage of the optic nerve. The optic nerve transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of ...
, vision rehabilitation, uveitis, oculoplastics, medical and surgical retina, ocular oncology, Ocular pathology, or
neuro-ophthalmology Neuro-ophthalmology is an academically-oriented subspecialty that merges the fields of neurology and ophthalmology, often dealing with complex systemic diseases that have manifestations in the visual system. Neuro-ophthalmologists initially comple ...
. 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 exam in either English or French.


India

In
India India, officially the Republic of India, 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 by population (United Nations), most populous country since ...
, 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, officially the Federal Democratic Republic of Nepal, is a landlocked country in South Asia. It is mainly situated in the Himalayas, but also includes parts of the Indo-Gangetic Plain. It borders the Tibet Autonomous Region of China Ch ...
, 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 (, ; ; Ulster Scots dialect, Ulster-Scots: ) is an island in the North Atlantic Ocean, in Northwestern Europe. Geopolitically, the island is divided between the Republic of Ireland (officially Names of the Irish state, named Irelan ...
, the Royal College of Surgeons of Ireland 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 The Health Service Executive (HSE) () is the publicly funded healthcare system in Ireland, responsible for the provision of health and personal social services. It came into operation on 1 January 2005. The current director-general is Berna ...
-funded hospitals in
Dublin Dublin is the capital and largest city of Republic of Ireland, Ireland. Situated on Dublin Bay at the mouth of the River Liffey, it is in the Provinces of Ireland, province of Leinster, and is bordered on the south by the Dublin Mountains, pa ...
,
Sligo Sligo ( ; , meaning 'abounding in shells') is a coastal seaport and the county town of County Sligo, Ireland, within the western province of Connacht. With a population of 20,608 in 2022, it is the county's largest urban centre (constituting 2 ...
,
Limerick Limerick ( ; ) is a city in western Ireland, in County Limerick. It is in the Provinces of Ireland, province of Munster and is in the Mid-West Region, Ireland, Mid-West which comprises part of the Southern Region, Ireland, Southern Region. W ...
,
Galway Galway ( ; , ) is a City status in Ireland, city in (and the county town of) County Galway. It lies on the River Corrib between Lough Corrib and Galway Bay. It is the most populous settlement in the province of Connacht, the List of settleme ...
,
Waterford Waterford ( ) is a City status in Ireland, city in County Waterford in the South-East Region, Ireland, south-east of Ireland. It is located within the Provinces of Ireland, province of Munster. The city is situated at the head of Waterford H ...
, and Cork. A minimum of 8.5 years of training is required before eligibility to work in
consultant A consultant (from "to deliberate") is a professional (also known as ''expert'', ''specialist'', see variations of meaning below) who provides advice or services in an area of specialization (generally to medium or large-size corporations). Cons ...
posts. Some trainees take extra time to obtain MSc, MD or PhD degrees and to undertake clinical fellowships in the UK, Australia, and the United States.


Pakistan

In
Pakistan Pakistan, officially the Islamic Republic of Pakistan, is a country in South Asia. It is the List of countries and dependencies by population, fifth-most populous country, with a population of over 241.5 million, having the Islam by country# ...
, 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, in
Lahore Lahore ( ; ; ) is the capital and largest city of the Administrative units of Pakistan, Pakistani province of Punjab, Pakistan, Punjab. It is the List of cities in Pakistan by population, second-largest city in Pakistan, after Karachi, and ...
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, 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 Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
, three colleges grant postgraduate degrees in ophthalmology. The Royal College of Ophthalmologists (RCOphth) and the Royal College of Surgeons of Edinburgh grant MRCOphth/FRCOphth and MRCSEd/FRCSEd, (although membership is no longer a prerequisite for fellowship), the Royal College of Glasgow grants FRCS. Postgraduate work as a specialist registrar and one of these degrees is required for specialization in
eye disease This is a partial list of human eye diseases and disorders. The World Health Organization (WHO) publishes a classification of known diseases and injuries, the International Statistical Classification of Diseases and Related Health Problems, or ...
s. 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 Continuing medical education (CME) is continuing education (CE) that helps those in the medical field maintain competence and learn about new and developing areas of their field. These activities may take place as live events, written publications ...
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 (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 (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 (1696–1762) (France) performed the first documented planned primary cataract extraction on Sep. 18, 1750 in Cologne. * Franciscus Donders (1818–1889) (Dutch) published pioneering analyses of ocular biomechanics, intraocular pressure,
glaucoma Glaucoma is a group of eye diseases that can lead to damage of the optic nerve. The optic nerve transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of ...
, 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 optical instruments, instruments that use or Photodetector, detect it. Optics usually describes t ...
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 Cataract surgery, also called lens replacement surgery, is the removal of the natural lens (anatomy), lens of the human eye, eye that has developed a cataract, an opaque or cloudy area. The eye's natural lens is usually replaced with an artific ...
, became popular during the
First French Empire The First French Empire or French Empire (; ), also known as Napoleonic France, was the empire ruled by Napoleon Bonaparte, who established French hegemony over much of continental Europe at the beginning of the 19th century. It lasted from ...
, healing, among many, personalities such as the minister Jean-Étienne-Marie Portalis and the poet Ponce Denis Lebrun; he was nominated by
Napoleon Napoleon Bonaparte (born Napoleone di Buonaparte; 15 August 1769 – 5 May 1821), later known by his regnal name Napoleon I, was a French general and statesman who rose to prominence during the French Revolution and led Military career ...
"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'') * L. L. Zamenhof (b.1859) (Poland) was a Polish ophthalmologist who created the constructed international auxiliary language known as
Esperanto Esperanto (, ) is the world's most widely spoken Constructed language, constructed international auxiliary language. Created by L. L. Zamenhof in 1887 to be 'the International Language' (), it is intended to be a universal second language for ...
. * Allvar Gullstrand (1862–1930) (Sweden) was a
Nobel Prize The Nobel Prizes ( ; ; ) are awards administered by the Nobel Foundation and granted in accordance with the principle of "for the greatest benefit to humankind". The prizes were first awarded in 1901, marking the fifth anniversary of Alfred N ...
-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 in the visual system that reacts to light, visible light allowing eyesight. Other functions include maintaining the circadian rhythm, and Balance (ability), keeping balance. The eye can be considered as a living ...
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; "von" since 1883) was a German physicist and physician who made significant contributions in several scientific fields, particularly hydrodynamic stability. The ...
(1821–1894), a great German
polymath A polymath or polyhistor is an individual whose knowledge spans many different subjects, known to draw on complex bodies of knowledge to solve specific problems. Polymaths often prefer a specific context in which to explain their knowledge, ...
, 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 (likely copper) wound into a electromagnetic coil, coil. A current through the wire creates a magnetic ...
to remove metallic foreign bodies from the eye and in 1886 developed the Hirschberg test for measuring
strabismus Strabismus is an eye disorder in which the eyes do not properly align with each other when looking at an object. The eye that is pointed at an object can alternate. The condition may be present occasionally or constantly. If present during a ...
* Peter Adolph Gad (1846–1907), Danish-Brazilian ophthalmologist who founded the first eye infirmary in São Paulo, Brazil * Rosa Kerschbaumer-Putjata (1851–1923), Russian-Austrian ophthalmologist who was the first female doctor in Austria, headed "mobile ophthalmological troops" in Russia and reduced the above-average number of blind people in
Salzburg Salzburg is the List of cities and towns in Austria, fourth-largest city in Austria. In 2020 its population was 156,852. The city lies on the Salzach, Salzach River, near the border with Germany and at the foot of the Austrian Alps, Alps moun ...
where she ran a private eye clinic. * Socrate Polara (1800–1860, Italy) founded the first dedicated ophthalmology clinic in
Sicily Sicily (Italian language, Italian and ), officially the Sicilian Region (), is an island in the central Mediterranean Sea, south of the Italian Peninsula in continental Europe and is one of the 20 regions of Italy, regions of Italy. With 4. ...
in 1829, as a philanthropic endeavor; in 1831 he was appointed as the first director of the ophthalmology department at the Grand Hospital of
Palermo Palermo ( ; ; , locally also or ) is a city in southern Italy, the capital (political), capital of both the autonomous area, autonomous region of Sicily and the Metropolitan City of Palermo, the city's surrounding metropolitan province. The ...
, Sicily, after the Sicilian government became convinced of the importance of state support for the specialization * Herman Snellen (1834–1908) (Netherlands) introduced the
Snellen chart A Snellen chart is an eye chart that can be used to measure visual acuity. Snellen charts are named after the Dutch ophthalmologist Herman Snellen who developed the chart in 1862 as a measurement tool for the acuity formula developed by his profe ...
to study
visual acuity Visual acuity (VA) commonly refers to the clarity of visual perception, vision, but technically rates an animal's ability to recognize small details with precision. Visual acuity depends on optical and neural factors. Optical factors of the eye ...


20th–21st centuries

* Vladimir Petrovich Filatov (1875–1956) (Russia) 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 Color blindness, color vision deficiency (CVD) or color deficiency is the decreased ability to color vision, see color or differences in color. The severity of color blindness ranges from mostly unnoticeable to full absence of color percept ...
; he also made major contributions to the study of
Trachoma Trachoma is an infectious disease caused by bacterium '' Chlamydia trachomatis''. The infection causes a roughening of the inner surface of the eyelids. This roughening can lead to pain in the eyes, breakdown of the outer surface or cornea ...
and Myopia. * Ignacio Barraquer (1884–1965) (Spain), in 1917, invented the first motorized vacuum instrument (erisophake) for intracapsular
cataract A cataract is a cloudy area in the lens (anatomy), lens of the eye that leads to a visual impairment, decrease in vision of the eye. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colours, blurry or ...
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 Radial keratotomy (RK) is a refractive surgery, refractive surgical procedure to correct myopia (nearsightedness). It was developed in 1974 by Svyatoslav Fyodorov, a Russian Ophthalmology, ophthalmologist. It has been largely supplanted by newer, ...
for myopia. * Jules Gonin (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. * Wajid Ali Khan Burki (1900–1989) (Pakistan), was the "father of medical services" in Pakistan and distinguished ophthalmologist widely recognized as an expert in the field of eye care. * 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 Harvard Medical School (HMS) is the medical school of Harvard University and is located in the Longwood Medical and Academic Area, Longwood Medical Area in Boston, Massachusetts. Founded in 1782, HMS is the third oldest medical school in the Un ...
and the Massachusetts Eye and Ear Infirmary, in
Boston Boston is the capital and most populous city in the Commonwealth (U.S. state), Commonwealth of Massachusetts in the United States. The city serves as the cultural and Financial centre, financial center of New England, a region of the Northeas ...
,
Massachusetts Massachusetts ( ; ), officially the Commonwealth of Massachusetts, is a U.S. state, state in the New England region of the Northeastern United States. It borders the Atlantic Ocean and the Gulf of Maine to its east, Connecticut and Rhode ...
. * Tom Pashby (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 The Order of Canada () is a Canadian state order, national order and the second-highest Award, honour for merit in the system of orders, decorations, and medals of Canada, after the Order of Merit. To coincide with the Canadian Centennial, ce ...
, inducted into Canada's Sport Hall of Fame. * Marshall M. Parks (1918–2005) (United States) 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 Radial keratotomy (RK) is a refractive surgery, refractive surgical procedure to correct myopia (nearsightedness). It was developed in 1974 by Svyatoslav Fyodorov, a Russian Ophthalmology, ophthalmologist. It has been largely supplanted by newer, ...
, 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. * Melvin L. Rubin (1932–2014) (United States) was a retinal surgeon and educator; he created the Ophthalmic Knowledge Assessment Program (OKAP) that changed ophthalmic education, and was author of leading textbooks ''Optics for Clinicians'' and ''The Fine Art of Prescribing Glasses'', as well as ''The Dictionary of Eye Terminology'' - currently in its 8th edition. Rubin served as president, and later chairman, of the American Academy of Ophthalmology; and chairman of the American Boards of Ophthalmology. * Helena Ndume (born 1960) (Namibia) is a renowned ophthalmologist notable for her charitable work among people with eye-related illnesses. *
Rand Paul Randal Howard Paul (born January 7, 1963) is an American politician serving as the Seniority in the United States Senate, junior United States senator from Kentucky since 2011. A member of the Republican Party (United States), Republican ...
(born 1963) (United States) worked as an ophthalmologist before becoming a US senator. * J. Morgan Micheletti (United States) is an ophthalmologist, researcher, inventor, and podcaster known for advancements in ocular health and recipient of the Outstanding Young Texas Ex Award. * Ron A. Adelman (United States) is an ophthalmologist at Yale New Haven Hospital whose research includes studies on treatments for wet macular degeneration, including investigating the effectiveness of intravitreal bevacizumab and ranibizumab


See also

* '' Book of the Ten Treatises of the Eye'' * Chinese ophthalmology * Copiale cipher * American Academy of Ophthalmology * European Board of Ophthalmology *
Association for Research in Vision and Ophthalmology The Association for Research in Vision and Ophthalmology (abbreviated ARVO) is an American learned society dedicated to ophthalmology and other Visual perception, vision-related topics. It is based in Rockville, Maryland, Rockville, Maryland. Ov ...
* EyeWiki *
Eye disease This is a partial list of human eye diseases and disorders. The World Health Organization (WHO) publishes a classification of known diseases and injuries, the International Statistical Classification of Diseases and Related Health Problems, or ...
* List of systemic diseases with ocular manifestations * Eye surgery *
Optometry Optometry is the healthcare practice concerned with examining the eyes for visual defects, prescribing corrective lenses, and detecting eye abnormalities. In the United States and Canada, optometrists are those that hold a post-baccalaureate f ...
* Orthoptics * Eye care professional


References


External links


EyeWiki



Aaojournal
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