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Ophthalmology
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Warren Hill, M.D.
Patient Information
What is an Ophthalmologist?
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For Your Appointment, Call: 480.981.6111 |
What is an Ophthalmologist?
Neal A. Nirenberg, MD, FACS
Board Certified Ophthalmologist
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The human body is a vastly complex interelated system, requiring more than a fix-by-the-part approach.
An ophthalmologist is a medical doctor, an M.D., possessing a competence that is both general and unique. It is general in that it encompasses the huge measure of medical knowledge of the entire human body, and unique in that it further specializes in the eyes. This competence allows the ophthalmologist to diagnose and treat disorders of the complete visual system, as well as to recognize and appropriately manage their associated systemic diseases.
An ophthalmologist receives a minimum of twelve years of post-high school education, which typically includes four years of college, four years of medical school, one or more years of general clinical training, and a
minimum of three years of residency (hospital-based training) in
ophthalmology. During that residency, ophthalmologists receive intensive training
in all aspects of eye care, including prevention, diagnosis, management and medical and surgical treatment of ocular diseases and disorders.
Many ophthalmologists then spend an additional one to two years training in a
subspecialty, that is, a specific area of eye care (such as glaucoma,
retinal diseases, or pediatric ophthalmology.) For most, education is an
ongoing, permanent part of their lives.
Many, but not all, ophthalmologists are "Board Certified." A Board Certified
ophthalmologist has passed a rigorous two-part examination given by the
American Board of Ophthalmology, designed to fully assess his/her knowledge,
experience and skills. Some ophthalmologists also have sub-specialty Board Certification by the American Board of Eye Surgeons in specific areas of eye surgery.
The letters F.A.C.S. ( Fellow of the American College of Surgeons) after a surgeon's name are a further indication of a surgeon's qualifications.
Surgeons who become "Fellows of the College" have passed a comprehensive evaluation of their surgical training and skills; they also have
demonstrated their commitment to high standards of ethical conduct. This evaluation is conducted according to national standards that were
established to ensure that patients receive the best possible surgical care.
FURTHER EDUCATION:
Education for ophthalmologists consists of undergraduate education in science and humanities, graduation from an accredited four year medical school, and a minimum of four post-graduate years of training, at least one year of which is applied to general medical disciplines.
Three or more of these years are spent in specialized training in the art and science ophthalmology - a specialized discipline of caring for the eyes and the visual system based on medical principles.
Comprehensive medical training and experience permit and foster recognition of the spectrum of normal physical variation, understanding of normal physiologic and pathophysiologic reactions (including cause/effect relationships), knowledge of the boundaries of medical science, judgement to apply accumulated wisdom appropriately, and humanity to attend with honesty and empathy.
Medical conditions affecting the eye require a comprehensive understanding of medical diagnostic and therapeutic principles.
Systemic diseases of particular concern include those revealed by the eye, those whose management and course may affect the eye, and conversely, those potentially affected by management of ocular disease.
The former relationship is exemplified by two conditions: hypertension and diabetes mellitus. These conditions may be observed in the eye and the eye affected by their treatment.
Specifically, hypertensive retinal vascular changes require monitoring and appropriate and timely diagnostic evaluations, and laser treatments and other surgical intervention may be required to preserve sight in those suffering from diabetes mellitus.
Glaucoma management illustrates the systemic effects of treatment of ocular disease. Various medications are used in the treatment of glaucoma including beta-blocking agents; carbonic anhydrase inhibitors, and strong miotics (echothiophate).
Among the many systemic effects of these agents are respiratory depression, cardiac failure, impotence, blood electrolyte imbalance, profound anemia, kidney stones, psychic and emotional changes, severe fatigue, risks with anesthesia and death.
The spectrum of ophthalmologic disease includes such complex medical conditions as uveitis, glaucoma, degenerative retinal disease, infectious disease, ocular and adnexal tumors, neuro-ophthalmic syndromes including strabismus, central nervous system tumors and vascular disease (stroke), congenital anomalies and disorders, and genetic syndromes.
While others may observe signs of complicated medical ophthalmic disease, only the qualified ophthalmologist will comprehensively evaluate, promptly diagnose and appropriately manage these conditions.
Surgical ophthalmic conditions require a unique competence. Ophthalmic surgical procedures alter, remove, replace, and/or reshape ocular and adnexal tissue for beneficial therapeutic effect by the use of instruments and applied physical forces.
Through education and experience, qualified ophthalmologists apply to surgical endeavors a comprehensive understanding of ophthalmic and systemic disease and trauma.
The ophthalmologist applies this knowledge through a comprehensive eye examination, appropriate diagnostic testing and interpretation. Then, with applied surgical judgment (including avoidance of unnecessary procedures and complications), the ophthalmologist subsumes understanding of the natural history of disease, potential risks, and treatment options.
Further, the ophthalmologist possesses highly trained surgical skill and understands the evolution of the healing process. He/she also diagnoses, monitors and manages complications in an appropriate and timely manner.
The care a patient gets with an ophthalmologist includes the preoperative and postoperative periods - those times when the patient is at risk from all aspects of the procedure. This sets a standard for special competence in ophthalmic surgery.
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