Last month I had the good fortune of attending both annual Academy meetings in eye care, the Academy of Ophthalmology in San Francisco and then, a week later, the Academy of Optometry in Orlando. It’s perhaps fitting that the conferences happened in opposite corners of America because the views of optometry presented at each were just as far apart.

Up in San Francisco, optometrists were portrayed as greedy opportunists reaching beyond their skill set to recklessly expand their scope of practice, endangering the populace as a result. Most of the major sessions ended with the speaker imploring the attendees to donate to the Academy of Ophthalmology’s political action committee for the express purpose of fighting the progress of optometry legislatively. 

This wasn’t just an occasional cheap shot here and there: it was built into the meeting’s program to close the talks with an anti-optometry diatribe and a passing of the collection plate.

Down in Orlando the following week, representatives of the World Health Organization headlined the plenary session to highlight the vital role optometry must play in combating eye health deficiencies around the globe and to fire up the troops. The WHO had just released a comprehensive report detailing shortcomings in the delivery of eye care and the ensuing misery of the one billion or so people who hang in the balance. 

In Orlando at least, optometry’s rise was presented as not just welcome but necessary—in fact, long overdue.

Concerning optometry’s place in the world, the message from these back-to-back meetings was clear: It was the best of times, it was the worst of times. 

Neither, of course, is true. 

Optometry isn’t the boogeyman I heard about in San Francisco. Data on clinical outcomes in states with scope expansion laws consistently show optometric care is safe, reliable and cost effective. The ODs who take on newer procedures like lasers and injections do so with a humility and respect for the gravity of their responsibilities.

And perhaps optometry’s not quite the savior touted in Orlando either. Optometric capabilities vary plenty throughout the US—and wildly in Europe. Public confusion over such a hodge-podge profession is understandable. Not all optometrists have taken on some of the clinical responsibilities open to them in disease diagnosis and management. International differences are so vast that it’s hardly even fair to call it the same profession overseas.

That the medical lobby seizes on this heterogeneity and seeks to turn it to its own advantage comes off as petty, not pious. What’s needed is cooperation and education—not demonization. Many individual ODs and MDs work great together, for mutual benefit and without acrimony. Would that it were so simple for the rest to follow their examples.