What Is an Ophthalmologist?

An Ophthalmologist is both a Physician and Surgeon (MD or DO) who specializes in the treatment of diseases, conditions, and injuries of the eye. An ophthalmologist has the highest level of training of any clinician who specializes in eye care, which allows an Ophthalmologist to perform surgery of the eye in Texas.

Following a four-year undergraduate degree, an Ophthalmologist completes four years of medical school. The purpose of medical school is to prepare a Physician to understand all aspects of the human body and how different systems interact with each other. 

Medical students also participate in two years of patient care rotations through different specialties, which allows them to gain direct experience in managing patients in all aspects of medicine. This training becomes valuable when a patient presents with an eye issue that is not necessarily due to a source found in the eye. 

Following medical school, an Ophthalmologist completes a one-year internship and then a three-year Ophthalmology residency, all of which is hospital-based training. The eye is complicated, which is why an Ophthalmologist’s training is intense. Ophthalmology residency programs are very competitive – for example, Baylor College of Medicine in Houston received 479 applications for six residency slots in 2018.

Following residency, many Ophthalmologists complete a one or two-year fellowship in a sub-specialty such as retina or cornea.

It is only after all of this training that an Ophthalmologist is deemed prepared to practice Ophthalmology in an independent setting. According to the American Academy of Ophthalmology:

It is estimated that at least 17,280 of the total hours that ophthalmologists spend in medical school, internship, and residency are spent in gaining experience and taking care of patients who enter hospitals, tertiary care centers, and academic medical centers. This is based on an estimate of an average of 60 hours per week (including on-call duty, the maximum duty hours for residents is 80 hours per week) multiplied by 48 weeks and by six years. During training, the ACGME requires that ophthalmologists manage a minimum of 3,000 outpatient visits with a broad range of disease presentation, and that they assist at and then personally perform under supervision a specified minimum number of various surgical procedures.

Click here to watch “Ophthalmologists: We Do Everything.”


Is Some Eye Surgery Less Risky?

No. Do you remember when Cpt. Sully Sullenberger saved his passengers after a flock of geese hit his airplane? The important part of that story is not that Cpt Sullenberger knew how to fly under normal circumstances, it is that he knew what do to when everything went wrong. Think about that the next time you consult with a Surgeon. 

Whether you are undergoing open-heart surgery or having “lumps and bumps” removed from around the eye, remember that every surgery is serious. Every surgery leaves a scar, and every surgery involves risk. To put it bluntly, there is no such thing as a simple surgery.

Like Sully, a medically trained, experienced Surgeon knows what to do when disaster strikes. Emergencies can and do happen. As a patient, you deserve to know that your Surgeon has the necessary years of training and experience to perform the surgery and handle emergencies.  

During medical school and residency training, a future Surgeon learns to have a deep reverence for the body and for the diseases that can harm it. A skilled Eye Physician can make surgery look deceptively easy, but it never is easy. 

Per Texas law, any breach of the tissue qualifies as surgery. This includes the use of scalpels, lasers, and needles. And per Texas law, only physicians such as Ophthalmologists may perform scalpel, laser, or needle surgery on or around the eye. The eye and eyelid are delicate organs – there is little margin for error. 

Don’t underestimate a stye or cyst – that little “lump or bump” should be taken seriously as it could be masking a deeper disease such as a cancerous tumor. Only Physicians have the education, training and experience to safely perform surgery such as removing and examining tissue from around your eye. Remember that there is no such thing as a simple surgery. 

The idea that one type of eye surgery is not serious is a myth. All surgery is serious.


What About Those Lumps and Bumps on My Eyelid?

Don’t downplay a lump or bump – it could indicate a medical problem. The eyelid is the thinnest skin on your entire body. It is less than one millimeter thick – less than the thickness of a credit card. Yes, your eyelid is thin and delicate, but it is also a complex, impressive organ that protects your eye from harm.

Even though it is thin, the eyelid has seven layers and even contains miniscule muscles that open and close the lid – this can be voluntary (such as sleeping) or involuntary (blinking).  It is extremely important that your eyes remain moist. When the eyelid closes, it spreads a tear film evenly across the surface of the eye (the cornea).

When it comes to treating this delicate organ, there is little room for error. But what can go wrong with the eyelid? Some of the most common conditions are:

  • Ptosis – drooping of the upper eyelid.
  • Styes – a gland infection usually indicated by a red, painful or swollen bump.
  • Chalazion – caused by inflammation of a blocked oil gland. This is often mistaken for stye but it is a more chronic condition.
  • Eyelid tumors – Benign or malignant (cancerous) tumors on the eyelid are more common than you might think. They must be removed and assessed for malignancy by a physician.

An Ophthalmologist has been trained to diagnose and treat eyelid conditions. Again, there is little room for error when treating such a small but important organ. For instance, a tumor can be mistaken for a stye or a chalazion to the untrained eye. It is imperative that a tumor is removed as soon as possible by a trained physician. An untreated tumor will only come back and in extreme cases, can result in the loss of an eyelid.

Some Ophthalmologists complete additional years of training specifically in the eyelid and tear ducts to become oculoplastic surgeons. These specialists treat a multitude of complex eye conditions including reconstructive surgery. Click here for a list of these types of conditions and treatments.  Click here to learn even more about the fascinating eyelid.

Without properly working eyelids, you would not only be extremely uncomfortable, but your vision would be in danger. Protect this small but vital organ by alerting your Ophthalmologist to any eyelid problems.


What Else Should I Know About the Eye?

The eye is an extremely delicate organ, and every aspect of it must be in perfect working order to function properly. As a result, there is little room for error when it comes to treating the eye. The retina, for example, is the most specialized and delicate part of the eye. While some retinal injuries can be fixed, the few that can be fixed are unlikely to return to normal.

A poor eye surgery outcome or improper management of glaucoma can be devastating to a patient’s retina and eyesight. Fortunately, Texas features the nation’s model patient protection laws related to laser surgery and glaucoma management. By rejecting past attempts to weaken those laws, Texas’ lawmakers recognized the intricate nature of the eye and the need to protect Texans by recognizing the state’s current laws.