Ophthalmology: What other specialties should know

If you could only keep one of your five senses, which one would it be? Sight, smell, touch, taste or hearing? According to a JAMA study of 250 participants, 88% reported that sight is their most important sense. There are estimated to be at least 2.2 billion people globally who have vision impairment. Almost half of those people suffer from a preventable condition.

Of the roughly one billion people who have vision impairment that could have been prevented, 94 million have vision impairment from cataracts, 88.4 million from refractive error, 8 million from macular degeneration, 7.7 million from glaucoma and 3.9 million from diabetic retinopathy, according to the World Health Organization.

Presbyopia, the gradual loss of your eye’s ability to focus on nearby objects, has caused vision impairment in roughly 826 million, reported The Lancet. Ophthalmologists aim to prevent further loss and restore what many consider to be their most important sense.

What do ophthalmologists do?

Ophthalmologists diagnose and treat eye disease and vision-impairing pathologies with a mix of medical and surgical therapies. After medical school, ophthalmology training includes a one-year internship followed by a three-year surgical residency in ophthalmology.

Many ophthalmologists further subspecialize with a subsequent one-to-two-year fellowship. Some of the common subspecializations focus on pediatrics, glaucoma, neuro-ophthalmology, retina, cornea and oculoplastics. With a wide array of possible subspecialties, there is something of interest for every aspiring ophthalmologist.

Ophthalmologists’ instruments of choice are the slit lamp and the indirect ophthalmoscope. These tools allow them to properly visualize structures at the front of the eye as well as the nerves, blood vessels and tissues in the back of the eye. Many times, ophthalmologists are the first to diagnose early diseases such as diabetes, thyroid disease, brain tumors, and hypertension due to the changes they can have on the nerves, blood vessels, and connective tissues of the eye.

In addition to medical management of ocular diseases, cataract and basic glaucoma surgeries are two of the most common procedures ophthalmologists provide.

The best aspects of ophthalmology

One of the most alluring aspects of ophthalmology is the versatility required to become a skilled ophthalmologist. Ophthalmology requires the diagnostic and healing skills of a general physician as well as the dexterity and precision of a microsurgeon.

The physical exam is a critical component of the diagnosis of ocular pathologies. By using cutting-edge technology and highly skilled eyes, ophthalmologists can directly see disease processes early on in their course, allowing them to intervene with precise treatments.

Ophthalmologists can impact patients’ health outcomes and quality of life across all ages and in different capacities. Ophthalmology offers an opportunity to build lifelong relationships through the medical management of chronic eye diseases such as glaucoma and macular degeneration.

Ophthalmologists are also able to provide immediate vision-restoring treatment for patients with vision-impairing cataracts. The life-changing impact and short duration of cataract surgery lends itself to medical mission work to provide care for patients with little or no access to health care.

Another appealing aspect of ophthalmology is the potential for a great work-life balance. Ophthalmologists work, on average, 47 hours per week, according to Ophthalmology Times. In addition, most ophthalmology specialties have limited call and few emergencies that require immediate attention (i.e., lacerated globe).

Ophthalmology is also reported to be a specialty with high compensation, notes Medscape. Between the work-life balance, compensation and positive patient outcomes, it’s no wonder 93% of ophthalmologists say they would choose their specialty again if given the choice.

The challenges of ophthalmology

While there are numerous desirable aspects to ophthalmology, the specialty does come with its own set of challenges. Performing surgery on an organ as small and delicate as the eye can have life-changing ramifications if not done properly.

Ophthalmic surgeries have margins of error on the scale of several microns (a micron is one-millionth of a meter!) and require an extreme amount of concentration and attention to detail. While most ocular surgeries such as cataracts are typically short in duration, they can be very stressful due to the high stakes of each procedure.

Additionally, many ophthalmology procedures are aesthetic in nature. Whether it is repairing a drooping lid or correcting strabismus, there is a component of subjective patient satisfaction. Many patients have very high expectations for outcomes that involve their faces, and it can be difficult to navigate a less-than-perfect outcome. This leaves a low margin of error for procedures that can alter a patient’s appearance.

Lastly, ophthalmology is a specialty that is constantly on the cutting edge of innovation with the continual introduction of new lasers, diagnostic tools and techniques. Ophthalmologists can find themselves repeatedly at the bottom of steep learning curves or needing to invest in expensive machinery. However, advancements in technology, techniques and disease management are all fundamental in improving patient outcomes and are part of what makes ophthalmology so special.

Overall, ophthalmology is a highly rewarding field that consistently challenges physicians to grow. It offers numerous avenues to create a positive impact on a patient’s quality of life. There is no other specialty quite like it!

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