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Introducing Patients to the OD-MD Relationship

Make sure patients understand the nature of a collaborative relationship.

We’ve come a long way since the days of the war between optometry and ophthalmology, but how do we get patients today onboard with our increasingly common collaborative OD-MD relationships?

Optometrists now deliver some of the care previously provided by ophthalmologists. In fact, in the minds of our patients and the general public, the distinction between the two professions is often not clear. But collaborative arrangements can ultimately benefit patients cared for by both types of clinician. It is important for us to let our patients know that, and to explain how the relationship works and why. They need to know that, in the case of a collaborating optometrist and ophthalmologist, two doctors can be better than one.


Some patients may call an optometry office and request to see an ophthalmologist when all they want or need is a comprehensive eye examination. Patients should perceive optometrists as primary eye care providers who can perform comprehensive eye health and vision examinations; diagnose and treat eye diseases and vision disorders; detect general health problems; prescribe glasses, contact lenses, low vision rehabilitation, and other vision therapy and medications; perform certain procedures; advise about surgical alternatives; and provide vision needs related to occupations, avocations, and lifestyle.

When optometrists encounter an issue that is beyond the scope of their practice, and patients require secondary or tertiary care, they should refer to an ophthalmologist they know and trust. Patients should understand that ophthalmologists are physicians who are qualified by lengthy medical education, training, and experience to diagnose, treat, and manage all eye and visual system problems and are licensed by a state regulatory board to practice medicine and surgery. Ophthalmologists are medically trained specialists who can deliver total eye care, including primary, secondary, and tertiary care services and diagnose general diseases of the body.


It is essential to send a cohesive message to patients, to enhance their confidence and facilitate interprofessional referrals. Consider a situation in which an optometrist tells a patient that she may need cataract surgery but never mentions that she has astigmatism. When the ophthalmologist who receives the referral begins discussing the benefits of a toric IOL with femtosecond laser, the patient may infer that the referring optometrist knows little about cataract surgery and be less enthusiastic about returning to that optometrist—or any optometrist—for postoperative care.

Optometrists and ophthalmologists should be respectful, responsive, and accessible to one another. Good perioperative communication is key. The ophthalmologist should let the referring optometrist know how the procedure went, and the optometrist should communicate back regarding the patient’s satisfaction with the result.

Patients should understand that referral to another clinician does not mean that the referring clinician is abandoning them. They are simply being referred for treatment that is better (or only) performed by this other provider.

Patients should never doubt our willingness and ability to help them. They should understand that they are being referred to an ophthalmologist for a specific reason but will eventually return to the referring optometrist for continuing eye and vision care. In other words, their care is not being transferred to the ophthalmologist because the optometrist was not sufficiently competent to handle it, but rather because the specialist is better suited to diagnose and/or treat their current condition.


By working as a team, optometrists and ophthalmologists can provide better overall continued care. Working collaboratively, we can show patients how a team approach can optimize their care. Collaborating optometrists and ophthalmologists who share their knowledge and expertise can benefit from and enjoy these partnerships and, more important, team up to provide optimal care for their patients.

Elise Kramer, OD, FAAO, FSLS
  • Optometrist and Contact Lens Specialist, Miami Contact Lens Institute, Miami, Florida
  • Residency Coordinator, Scleral Lens Education Society
  • elise@miamicontactlens.com
  • Financial disclosure: Consultant (Euclid Systems Corporation, Spectrum International)
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