Optometry FAQ

a. Optics

There is evidence that lenses for decoration existed a few thousand years BC.

The ancient Greek author Aristophanes wrote in 434 BC about a burning glass.

The Greek mathematician Euclid in about 280 BC wrote about light traveling in straight lines and the equality of the angles of incidence and reflection. He also talked about the concept of the visual cone which is the equivalent of our concept of visual angle today.

Claudius Ptolemy in about 150 AD measured angles of incidence and reflection from air to water but did not discover the exact mathematical relation.

Johannes Kepler (1571-1630) - In Kepler=s 1611 book ADioptrics@ there are descriptions of the mathematics of lenses, prisms, and mirrors. Kepler presented many of the concepts taught today in geometric optics.

Sir Isaac Newton showed how white light could be split into component colors and then recombined into white light.

Snell discovered the law of refraction in 1621. Snell died at 35 years of age, and his contribution was not widely recognized until after his death.

Inventor of the term diopter - Monoyer, 1872.

b. Image formation by the eye

Empedocles (c. 450 BC) - extromission theory, visual ray.

Leucippus, Democritus (5th century BC) - intromission theory, eidola.

Aristotle (4th century BC) - mediumistic theory

Alhazen (965-c.1041 AD) - proved intromission

Johannes Kepler - first accurate description of image formation on the retina

Thomas Young (1773-1829) - first to measure astigmatism (1801) George Biddell Airy - English astronomer credited with being the firs to design and wear a spherocylindrical lens to correct astigmatism (published 1827). An optician named Fuller made the lenses. At about the same time the McAllister family of opticians in Philadelphia made a cylinder lens for a Rev. Goodrich. Goodrich obtained minus lenses, but as he explained in a letter to the McAllisters, vertical lines appeared clearer without his glasses and horizontal lines appeared clearer with his glasses. Based on their corresopndences, the McAllisters made a planoconcave cylindrical lens which Goodrich started wearing in May of 1828.

c. Sensory physiology

Visual illusions were discussed by the ancient Greeks.

Christoph Scheiner (1611) described several observations about the eye, including the size of images reflected from the cornea. His double aperture principle is used in most present-day autorefractors.

The mathematician Aguillon published one of the first significant analyses of binocular vision in 1613.

William Porterfield made an optometer in the mid 1700s and noted the existence of a relationship of accommodation and convergence.

Thomas Young - trichromatic theory of color vision and crystalline lens as source of accommodation

Johannes Purkinje, Czech physiologist, published books on sensory physiology in 1823 and 1826. His name is attached to many phenomena - Purkinje images, Purkinje tree, etc.

Charles Wheatstone invented the mirror stereoscope and in 1838 used it to experiment on binocular vision and stereopsis.

Hermann von Helmholtz (1821-1894), physiologist and physicist, wrote AHandbook of Physiological Optics.@

According to Hofstetter, the background sciences for early optometry were stronger than for any other profession.

Optometry has incorporated knowledge of optics, mathematics, psychology, and other sciences. And optometry has developed its own literature in clinical practice and vision science. Optometry has been the leader in investigations on clinical lens application, non-strabismic binocular vision problems, contact lenses, low vision, role of vision in learning, etc.

The exact origin and inventor of spectacles are unknown.

Roger Bacon in the middle 13th century talked about placing a planoconvex lens on text for magnification.

Spectacles probably originated in the late 13th century in Italy. In a manuscript from 1305 AD, a monk from Pisa named Rivalto wrote, “It is not yet 20 years since there was discovered the art of making eyeglasses.”

Most likely, the first person to make spectacles was an unknown artisan, who tried to keep his methods secret to avoid economic competition. By 1300 AD, there were spectacle manufacturing businesses in Italy, Germany, and the Netherlands. Some of the first spectacle frames were made from leather and wood.

MYTH – Optometry began about 100 years ago when the first optometry licensure laws were passed in the US.

Another extreme viewpoint - Chester Pheiffer suggested that optometry began with the pronouncement “Let there be light.” (Genesis 1:3)

A reasonable time of origin for optometry is when spectacles appeared. Conventional wisdoms for use of spectacles developed after the advent of spectacles.

In 1623 Benito Daza de Valdes published a book which covered optics, ocular anatomy, and the use and fitting of spectacles. He included a system of lens grades for lens power, and he resented a table of lens grades according to age in presbyopia. He suggested that minus lenses for myopia should not be so powerful as to cause perceived reduction in image size. Daza de Valdes also included case reports.

William Molyneux published an optometry book in Ireland in 1692. He suggested uses the weakest lens that solves the problem and he discussed the occasional nearpoint problems of myopes when they get new glasses.

a. legally

Legal cases in the first half of the 20th century ruled that optometry was separate from medicine.

b. origins

Their origins differ both in the sciences from which they developed and in the shift of tradesmen into the professions.

scientific origins: optometry – optical sciences, medicine – biological sciences tradesmen who entered the respective professions: optometry – jewelers (they had the tools to work on spectacles), medicine – barbers (they had the equipment with which early surgeries could be done)

c. areas of primary expertise

optometry – optics, refraction, vision science, non-strabismic binocular vision and accommodative problems

medicine – surgery, anatomy and physiology, pharmacology, disease

It is said that Peter Brown, a Pilgrim, brought a pair of eyeglasses to North America in 1620 and thus became the first to wear glasses on this continent. There is little known about the use of spectacles in North America for more than another hundred years. During this period of time spectacles were obtained ready made from Europe. Spectacles were uncommon and expensive.

The year 1783, when John McAllister, Sr., a Philadelphia whip and cane maker, purchased a number of spectacles, is often considered the beginning of the American optical industry. Soon he was making spectacles. In 1811, his son, John McAllister, Jr., joined him in business. The McAllister family of opticians continued in business until the early 1900s.

Because there were few places to get glasses, there was no demand for vision testing. So spectaclemakers became the first refractionists. The McAllister famil taught refraction and the optical business to many people, notable among them James W. Queen, who started his own business in 1853.

Other notable early American optometrists were Banjamin Pike, who came to the US in the early 1800s, and James Prentice, who came to the US in 1847. They both were trained in optics in England, and they both trained their sons. James’ son, Charles Prentice, would have an important role in the development of American optometry.

Gradually two types of persons providing spectacles could be discerned: dispensing opticians and refracting opticians. The refracting opticians were essentially optometrists, because they were doing vision testing and writing lens prescriptions.

The first attempt was in 1897 in New York. This effort was a consequence of threats to Charles Prentice from ophthalmologists for charging a few for a vision examination. The first law was passed in 1901 in Minnesota. All states and the District of Columbia had optometry licensure laws by 1924.

In comparison, the first medical licensure law in the US was passed in the late 1700s, but it was 1895 before almost every state had its own medical licensure board. The first state dental licensure law was passed in 1868 and all sates had dental licensure laws by 1900.

First use of the term optometrists is thought to have been by Landolt in 1886 to describe the fitting of glasses. The term became popular in the first two decades of the 20th century. Before then optometrists were usually referred to as opticians.

In the 19th century there came to be a distinction between refracting opticians and dispensing opticians. Refracting opticians became known as optometrists.

It was formed in 1898 as the American Association of Opticians. In 1910, the name was changed to the American Optical Association. By this time, many of its members called themselves optometrists. In 1919, the name was changed ot the American Optometric Association.

Private schools:

• Illinois College of Optometry traces it roots to 1872 (some of its predecessor schools were Northern Illinois College of Ophthalmology and Otology, Needles Institute, Northern Illinois College of Optometry, Monroe College of Optometry, Chicago College of Optometry)

• New England College of Optometry traces its roots to 1894 as the Klein School of Optics (NEWENCO was at one time known as Massachusetts College of Optometry)

• Southern California College of Optometry started in 1904 as the Los Angeles Medical School of Ophthalmology and later known as the Los Angeles College of Optometry

• Pennsylvania College of Optometry, 1919

• Southern College of Optometry, 1932

University schools:

• Ohio State University, 1914

• University of California Berkeley, 1923

• Pacific University, 1945 (originally North Pacific College of Optometry, a private school founded in 1921)

• Indiana University, 1951 (pre-optometry started in 1951; first professional optometry class started in 1953)

• University of Houston, 1952

• University of Alabama Birmingham, 1969

• State University of New York, 1970

• Ferris State University (Michigan), 1974

• Northeastern State University (Oklahoma), 1979

• University of Missouri St. Louis, 1980

• Inter American University of Puerto Rico, 1981

• Nova Southeastern University (Florida), 1989

The first university optometry school was at Columbia University. It opened in 1910 and closed in 1954.

Various doctor titles were awarded even before 1900. The Philadelphia Optical College may have been the first give a doctor’s degree to optometry graduates when it awarded the Doctor of Optics degree in 1889. Before about 1920, optometrist generally resisted using the term doctor, but this attitude gradually changed through the 1930s and 1940s.

In 1950, all ten of the optometry school in existence at the time required five years of study past high school. The private schools all offered the OD degree. Ohio State, University of California Berkeley and Indiana did not offer the OD degree until switching to a six year pre-optometry and optometry curriculum. IU graduate its first OD class in 1968 and Berkeley graduated its first OD class in 1970.

Original stimuli for optometry to move into the area of ocular disease:

a. interest of some optometrists

b. Optometrists were distributed more evenly across the country and were the only eye/vision practitioner in many rural areas and small towns. Optometrists had to refer eye disease to either the local general practice physician or to an ophthalmologist that may have been many miles away. Optometrists had more knowledge f the eye and had better instruments to view the eye (e.g., slit lamp biomicroscope) than the local GP MDs, so it was good for rural or small town patients to be treated for minor eye disease by the local optometrist than by the local GP MD

c. criticism by ophthalmologists - ophthalmologists sometimes had public campaigns that optometrists were poorly trained in eye disease

first DPA law – Rhode Island, 1971

first TPA law – West Virginia, 1976

Despite this change, practices of IU alumni average about 7% of their income from the treatment of eye diseases – see Goss DA, Grosvenor T. Summary of optometry alumni survey. Indiana Journal of Optometry 1998;1(2):26-28.

Oculists were eye care physicians who did not have residency training in ophthalmology.

Optometrists knew more about refraction and prescription of lenses. Ophthalmologists knew more about eye surgery and eye disease.

So as residency training in ophthalmology became more common, oculists were no longer needed.

Ophthalmologists were not greatly interested in refraction and eyestrain until the late 19th century and early 20th century.

Thomas Hall Shastid quotation in Borish article, IJO, Fall, 2001, p. 24:

AThe M.D.s generally would not recognize even the existence of such a thing as eyestrain....If there was any worse quackery than this of the regular medical profession, I do not know what it was. Yet they called >quacks those of us who fitted glasses to the eyes of the young....There were certain traveling >spec-peddlers= who went from house to house fitting glasses and unskillful though they were, relieving many of the simpler cases of eyestrain headache...Such men, speaking generally, excited extreme contempt and bitterness on the part of the >regular=profession, feelings which grew the more the >spec-peddlers= best these scientific M.D.s atr the treamtent of eyestrain and its numerous results....Hardly anything that now I can recall served so much to weaken the standing and influence of physicians in any community than this absurd, ridiculous, hard-headed, stubborn...opposition to the fitting of glasses.@

Along with the Aspec-peddlers@ that Shastid refers to, persons who provided people in need with spectacles included respectable and professional optometrists, but in the minds of many physicians, the optometrists weren=t much better than the specpeddlers.

As American ophthalmologists started realizing the importance of spectacles, they learned the methods of refraction from optometrists - quotation on pages 136-137 of Hirsch and Wick discusses how the McAllisters taught oculists how to do refractions

The emphasis on good refraction techniques by optometrists and the precedence of optometrists in refraction has resulted in our pre-eminence in this area to the present day.

Lesson for today: Every profession justifies its existence (in part) by being better at something than any other profession (a niche). We need to maintain our strength in the treatment of refractive problems and eyestrain.

a. American Optometric Association mentioned earlier

b. American Academy of Optometry - organized in 1922, serves to promote professionalism and high standards of patient care and to disseminate information through its journal, Optometry and Vision Science (previously known as American Journal of Optometry and Archives of the American Academy of Optometry and then later as the American Journal of Optometry and Physiological Optics) offers Fellowship status (FAAO) in general optometry and diplomate status in optometric specialties

c. Optometric Extension program traces its roots to a plan developed by the Oklahoma Optometric Association in 1928 for membership education.

It quickly became a nationwide organization. It developed a standardized system of testing with numbered tests that helped promote standardization of testing that was badly needed at the time.

Today OEP emphasized what is often referred to as behavioral optometry.

d. College of Optometrists in Vision Development developed in the early 1970s (see Wold history article in JOVD for correct details) by merger of three small organizations.

This is an organization of optometrists who practice vision therapy.

They offer a certification program. Optometrists who complete it are Fellows of the Colege of Optometrists in Vision Development (FCOVD).

References

Hofstetter HW. Optometry: Professional, Economic, and Legal Aspects. St. Louis: Mosby, 1948.

Hofstetter HW. Education in optometry. Higher Education 1950;7(3):25-29.

Rosen E. The invention of spectacles. J Hist Med Allied Sci 1956;11:13-46,183-218.

Gregg JR. The Story of Optometry. New York: Ronald Press, 1965.

Hirsch MJ, Wick RE. The Optometric Profession. Philadelphia: Chilton, 1968.

Tannebaum S. William Molyneux: Dioptrica, a 17th century classic. J Am Optom Assoc 1972;43:566-570.

Hofstetter HW. Optometry of Daza de Valdes. Am J Optom Physiol Opt 1988;65:354- 357.

Rosenthal JW. Spectacle and Other Vision Aids: A History and Guide to Collecting. San Francisco: Norman Publishing, 1996. Enoch JM. Early lens use: lenses found in context with their original objects. Optom Vis Sci 1996;73:707-715. Hofstetter HW. The OHS mission. Hindsight: Newsletter Optom Hist Soc 1996;27(3):17-18.

Park D. The Fire Within the Eye: A Historical Essay on the Nature and Meaning of Light. Princeton, NJ: Princeton University Press, 1997.

Koetting RA. The American Optometric Association’s First Century. St. Louis: American Optometric Association, 1997.

Borish IM. Optometry: Its heritage and its future. Indiana J Optom 2001;4(2):23-31.

Woodruff CE. The evolution of optometric education in America. J Am Optom Assoc 2001;72(12):779-786.

Review of Optometry : https://www.reviewofoptometry.com/department/optometric-history

Optometry is a health care profession which involves examining the eyes and applicable visual systems for defects or abnormalities as well as the medical diagnosis and management of eye disease. Traditionally, the field of optometry began with the primary focus of correcting refractive error through the use of spectacles. Modern day optometry, however, has evolved through time so that the education curriculum additionally includes intensive medical training in the diagnosis and management of ocular disease in countries where the profession is established and regulated. 

Optometrists (also known as Doctors of Optometry in the US and Canada for those holding the O.D. degree[1] ) are medical professionals who provide primary eyecare through comprehensive eye examinations to detect and treat various visual abnormalities and eye diseases. Being a regulated profession, an optometrist's scope of practice may differ depending on the location. Thus, disorders or diseases detected outside the treatment scope of optometry are referred out to relevant medical professionals for proper care, more commonly to ophthalmologists who are physicians that specialize in tertiary medical and surgical care of the eye. Optometrists typically work closely together with other eye care professionals such as ophthalmologists and opticians to deliver quality and efficient eyecare to the general public. 

The term "optometry" comes from the Greek words ὄψις (opsis; "view") and μέτρον (metron; "something used to measure", "measure", "rule"). The word entered the language when the instrument for measuring vision was called an optometer, (before the terms phoropter or refractor were used). The root word opto is a shortened form derived from the Greek word ophthalmos meaning, "eye." Like most healthcare professions, the education and certification of optometrists is regulated in most countries. Optometric professionals and optometry-related organizations interact with governmental agencies, other healthcare professionals, and the community to deliver eye- and vision-care.