Careers in Ophthalmology the Science of Eyes

Nidhi Prasad

Eyes not only perform the major function of sight but also banish darkness out of a person’s life and fill it with colour. Conversely they are also believed to be the mirror of a person’s soul. Optometry is a healthcare profession of measuring vision.

WHAT IS OPHTHALMOLOGY?

Ophthalmology is a medical branch which deals with the diagnosis and treatment of eye conditions. The term ophthalmology comes from the Greek language, ophthalmos means "eye" and luke means "doctors." It handles both medicinal and surgical solution of the diseases related to the physiology and anatomy of the human eye.

WHO IS AN OPHTHALMOLOGIST?

An ophthalmologist is a doctor specializing in the diagnosis and treatment of eye disorders." An ophthalmologist differs from optometrists and opticians depending on their level of training and what they can treat. There are different types of eye care professionals: optometrists, ophthalmologists and there is a third "O" among eye care providers: the optician.

Optometrist: Optometrists examine eyes for both vision and health problems, and correct refractive errors by prescribing glasses and contact lenses. Some optometrists also provide low vision care and vision therapy. They do everything from prescribing glasses or contacts for patients, to diagnosing eye problems and disease. Optometrists may also participate in your pre- and post-operative care if you have eye surgery performed by an ophthalmologist.

Ophthalmologist: An ophthalmologist is a medical doctor (MD) who specialises in eye and vision care. Ophthalmologists are trained to perform eye tests, diagnose and treat disease, prescribe medications and perform eye surgery. They also write prescriptions for glasses and contact lenses.

Optician: Opticians are technicians trained to design, verify and fit eyeglass lenses and frames, contact lenses, and other devices to correct eyesight. They use prescriptions supplied by ophthalmologists or optometrists, but do not test vision or write prescriptions for visual correction. Opticians are not permitted to diagnose or treat eye diseases.

 If your eyes are healthy and don't require specialised medical or surgical treatment you should see an optometrist. If you already have a medical eye condition - such as glaucoma, macular degeneration or cataracts -it is important to seek care from an eye care professional who is highly trained and skilled in monitoring and treating your condition. In many cases, this may mean that medical or surgical eye care by a specially trained ophthalmologist is required.

HOW TO BECOME AN OPHTHALMOLOGIST?

Aspirants who wish to specialize in Ophthalmology will first have to complete an Undergraduate course in MBBS (Bachelor of Medicine and Bachelor of Surgery), followed by a postgraduate degree in Ophthalmology like MD (Doctor of Medicine) and MS (Master of Surgery), depending on what practice they would like to build a career in

For MBBS (UG-level): Aspiring candidates must have passed their 12th Board examination with a minimum aggregate of 50%. The core subjects in the said examination must be Physics, Chemistry, and Biology.

For MS/MD/other PG courses in Ophthalmology: Aspiring candidates must possess an MBBS degree. Also, they must sit for PG-level entrance examinations and procure a good score in the same.

Courses available in Ophthalmology are:

• Diplomate of National Board of Examination (DNB) Ophthalmology (3 Years)
• Diplomate of National Board - 2 years Postdoctoral Vitreoretinal Fellowship
• Fellowship in General Ophthalmology, Cornea, Uvea, Oculoplastis, Glaucoma and Vitreoretinal - Session starts April & Oct every Year
• Ph D Programmes in Ophthalmology, Biochemistry & Microbiology

After acquiring the MBBS degree, students can opt to pursue a postgraduate course in Ophthalmology, typically in either the Master of Surgery / Doctor of Medicine domain. Usually, either of these courses has some common curriculum which is aimed at equipping the student with knowledge and skills such as:

• Basic knowledge of the human body structure and functions related to the visual system, along with factors which may disrupt/cause harm to these mechanisms
• Ability to handle day-to-day ophthalmology problems independently, with full recognition of the limitations of one's clinical knowledge
• Understanding of environmental effects on health and familiarity with the epidemiology of common diseases in the ophthalmology field.
• Ability to integrate promotive and preventive methods with curative and rehabilitation measures in disease treatment
• Familiarity with and understanding of common eye related problems occurring in rural areas where facilities are limited
• Familiarity with current developments and research topics in the field

National Eligibility cum Entrance Test (NEET): This is a medical entrance examination conducted at the national level for granting admission to students who wish to study medical/dental courses in the top government and private medical colleges in India.

WHAT DOES AN OPHTHALMOLOGIST DO? WORK DESCRIPTION

The roles and responsibilities of an ophthalmologist include diagnosing and treating all eye conditions. There are several ophthalmologists who are involved in scientific research on the causes and cures of an eye ailment. Several times ophthalmologists recognise other health problems irrelevant to the human eye and refer those patients to the concerned doctor for treatment. The responsibilities of an Ophthalmologist include

• Providing routine care such as vision testing and prescribing glasses and contact lenses.
• Performing corrective surgeries, such as repairing injuries and corneas, and removing cataracts.
• Performing advanced surgical procedures, such as keyhole or laser surgery.
• Diagnosing and treating eye diseases and injuries. 
• Managing emergency eye clinics, outpatient clinics, or other specialist eye clinics. 
• Treating medical disorders that affect the vision through a holistic approach.
• Using therapeutic procedures and performing biopsies

There are various kinds of ophthalmologists who are supposed to perform different roles for their patients and they are all responsible for distinct aspects of their patients' care. An ophthalmologist's employment can be divided into sub-specialties based on the topic matter. Cornea, Retina, Neuro-Ophthalmology, Paediatric, Uveitis, Strabismus, Cataract, Ocular Immunology, and Oculoplastic are some of the sub-specialties available. Aside from these specialties, ophthalmologists can be found undertaking a variety of jobs, as defined by the organisation with which they work. The authorities hire professionals based on the needs of the organisation. A teacher, a researcher, a technician, a sales and marketing professional or a pharmaceutical expert are examples of these roles.

The sub-specialties are:

1) Cataract Specialist or Surgeon: These are experts who perform the surgery to remove the natural lens and replace it with an artificial lens to reduce the problem of opaque or blurred vision faced by the patient.

 (2) Cornea Specialist: This expert is supposed to perform a duty or performing treatments and surgeries to cure any injury, infection or disease caused in the Cornea, Conjunctiva, Eyelids and Sclera of the human eye. They must perform preventive measures to stop the damage any further and recover the injury affecting the patient's eyesight.

 (3) Retina Specialist: These experts deal with problems affecting the Retina of the human eye. These problems generally arise due to injury or damage caused in the retina which may be due to retinal detachment or sudden flashlight or floaters.

 (4) Neuro-Ophthalmology Specialist: An expert in this field handles eye problems linked with the human body's nervous system. Some major problems require the immediate attention of a NeuroOphthalmologist including optic nerve issues affecting visibility, the problem in controlling the movement of the eye, double vision, etc. For the study of both neurology and ophthalmology a specialist is required who is a master of Ophthalmology.

 (5) Paediatric Ophthalmologist: Experts of this field work with any ocular problem caused to the eyes of the children. Some of the major substantial problems that Paediatric Ophthalmologists treat include Strabismus, Genetic Abnormalities, Amblyopia, Neoplastic Disorders, Conjunctivitis and Misalignment of the eyes.

 (6) Ocular Immunology Specialist: The specialist is supposed to regulate problems affecting the immunity of the human body, due to which many eyes-related problem and diseases can turn up. These diseases may include corneal ulcers, uveitis, sclerosis, or any type of inflammation in the eye. Doctors of these specialisations work closely with general physicians.

(7) Oculoplastic Specialist: They are experts of this specialisation that work to repair and reconstruct the eye. They deal with the surgery done for the problems in the eyelids and problems in the area surrounding the eyeball, including the orbit and lacrimal system.

 WHAT ARE THE SKILLS REQUIRED TO BECOME AN OPHTHALMOLOGIST?

To build a successful career in Ophthalmology, a postgraduate degree is only one of many pillars necessary. For specialists in surgery, precision and plenty of practise are required, whereas in medicine, having a broad base of knowledge is necessary. Some of the other essential skills in ophthalmology include:

• Expert working knowledge of the diseases, functions, and anatomy of the eye.
• Strong physics and math skills and excellent medical knowledge.
• Good administrative and managerial skills.
• Good hand-eye coordination.
• Strong organizational, communication, problem-solving, and decision-making skills.

CAREER OPPORTUNITIES

People are terrified of losing their eyesight due to blindness. Nothing appears to be scarier than the prospect of going through life without the capacity to see. We all know that as people become older, their chances of developing eye disorders or other visual system difficulties skyrocket. This is no longer limited to the elderly. A profession in ophthalmology entails a great deal of responsibility. Ophthalmology is a medical discipline in which doctors and patients frequently establish long-term connections.

These connections are built on a great deal of trust. It's unlikely that a good ophthalmologist will ever run out of patients. The field is quite lucrative and offers a wide range of opportunities in specialist hospitals, research centres, government and private hospitals, nursing homes and private clinics, X-ray and ultrasound centres, government organisations, educational institutions and pharmaceutical companies.

 A person with interest and curiosity about the human eye can pursue a career successfully.

The Coronavirus pandemic has forced the entire world to go into lockdown, restricting people to their homes and relying solely on technology to keep them connected. As a result, the amount of time we spend looking at electronic screens has increased dramatically. Since the emergence of work-from-home, these screens have become the single most significant factor in keeping us connected to our employers, not only for sustaining virtual social lives.

The demand for optometrists is predicted to skyrocket in the next years as people become more reliant on technology and visual media, making it a profitable career choice.

Upcoming trends

Current ophthalmic trends include lens implantation and cataract surgery, corneal and external eye problems, oculoplastic and orbital surgery, glaucoma, neuro - ophthalmology, refractive surgery, and a variety of other procedures.

Top Recruiters in Ophthalmology

• SIMS Healthcare Pvt.Ltd.
• National Institute of Ophthalmology (NIO) – Pune
• Rotary Narayana Eye Hospital 
•  Violet rays, Bangalore
• Sri Ganesh Vinayak Eye Hospital, Dehradun
• L.V. Prasad eye hospital - Hyderabad
• Chacha Nehru Bal Chikitsalya

(The author is a counselling psychologist & career consultant. She can be reached at nidhiprasadcs@ gmail.com).

Views expressed are personal