Finding an Ophthalmologist – Subspecialties

It may be surprising to many patients that almost all ophthalmologists complete a subspecialization within the field of ophthalmology. Despite being such a small organ, the eye is quite important, thus ophthalmology is a field with various subspecialties. While an ophthalmologist is trained and capable of treating all diseases of the eye once he or she finishes an ophthalmology residency and passes their board certification test, many go on to focus to a fellowship which provides training in one of a number of subspecialties. Under many circumstances, especially any eye disease that involves surgery, patients often find it necessary to seek out the services of an ophthalmologist subspecialist. While it may be onerous, finding an ophthalmologist first requires knowing something about each of the subspecialists.

 

There are eight major subspecialties in ophthalmology that patients should know. Each subspecialty requires special training at the end of an ophthalmology residency. The subspecialties are Cataract and Refractive Surgery, Cornea and External Disease, Glaucoma, Neuro-ophthalmology, Ophthalmic Plastic Surgery, Pediatric Ophthalmology, Uveitis and Ocular Immunology, and Vitreoretinal Disease. 

Cataract and Refractive Surgery is one of the newest subspecialties in ophthalmology and deals primarily with diseases of refraction. Many ophthalmologists pursue this track to receive training in laser eye surgery but techniques performed in this subspecialty promise to correct a patient’s vision permanently or for an extended period of time without the need for glasses.

Cornea and External Disease encompasses surgery to replace the cornea (corneal transplant) but also surgical removal of tumors affecting the eye.

Glaucoma is a disease in which excessive pressure builds up with in the eye. Subspecialists that treat glaucoma may use medical (pills and eye drops) and/or surgical treatments. Surgical correction usually involves releasing the excess pressure within the eye but also taking corrective steps to prevent increased pressure buildup in the future.

Neuro-ophthalmologists specialize in the treatment of diseases that affect the optic nerve and visual pathways in the brain. Since the visual pathway extends from the retina to the occipital cortex in the back of the brain, neuro-ophthalmologists treat a wide variety of diseases. In fact, many lesions within the brain involved the neural pathways that underlie vision and movement of the eye. Neuro-ophthalmologists can receive training in neuro-ophthalmology after a residency in neurology, neurosurgery or ophthalmology. Their treatments may include surgeries within the brain itself.

Ophthalmic plastic surgeons are trained in the cosmetic reconstruction of the eye and surrounding tissues. These subspecialists may reconstruct areas that have been ravaged cancer or remove “bags” from under the eye, a delicate surgery indeed. Ophthalmic plastic surgeons are also called in to reconstruct the eye after facial trauma.

As the name states, pediatric ophthalmologists treat diseases of the eye that occur in children. Two common reasons to seek out a pediatric ophthalmology are for retinoblastoma and correction of “lazy eye.”

Uveitis and ocular immunologists are trained to treat diseases that cause an inflammation is the eye. Some of these diseases can rapidly lead to blindness and usually require a specialist’s care.

Vitreoretinal disease specialists treat diseases of the vitreous humor and retina and would be called upon, for example, to secure a detached retina.

Given the amount of subspecialization within ophthalmology, it is best to ask your primary care doctor to help focus your ophthalmologic illness and recommend subspecialists in the field. Certain ophthalmologic illnesses require the care of a general ophthalmologist that is able to specifically diagnose the disease and recommend subsequent subspecialist care.