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Optometry: Then and Now

Need to visit the optometrist? In today’s time, you schedule your appointment, come in for a comprehensive exam, and leave with a prescription and often even glasses in-hand. However, this wasn’t always the case. Optometry has a long and substantial history. Here is a quick look at some of the most interesting developments!

The Beginnings

Optometry’s formal beginnings date back to 1263 when Roger Bacon first mentioned lenses as “useful for those with a weakness of sight,” but it wasn’t until 1286 when the first pair of “prescription” glasses were created in Italy.

Some other advancements include:

  • The Book of Optics, written by Arab scholar Ibn al-Haytham in 1040 AD, was translated to Latin in the 13th century. This extensively affected the development of optics, physics and vision science in Europe between the 13th and 17th centuries.

  • Johannes Kepler describes the function of the retina and demonstrates that concave lenses correct myopia and convex lenses correct hyperopia in 1604.

  • The first book on optometric principles, The Use of Eyeglasses, published in Spain by Daza de Valdes in 1623.

  • In 1692, William Molyneux wrote a book on optics and lenses where he stated his ideas on myopia and problems related to close-up vision.

The term optometry didn’t officially appear until 1759 when it was used in the book A Treatise on the Eye: The Manner and Phenomena of Vision by Scottish physician William Porterfield.

Scope of Practice

In the 17th and 18th centuries, the rapid evolution of optometry yielded a number of critical developments in eye health. However, visits to the optometrist remained primarily reactive rather than preventative. Some examples of treatment include:

  • Cataracts: Surgery (without anesthesia or aseptic technique) was performed by “needling” the cataract or pushing it back into the vitreous.

  • Glaucoma: “Couching” was the official treatment of glaucoma until the 1940s. Couching is a technique whereby a sharp instrument, such as a thorn or needle, is used to pierce the eye either at the edge of the cornea. The lens is pushed downwards, allowing light to enter the eye. Once the patient sees shapes or movement, the procedure is stopped.

  • Vision Tests: Before the standardized eye chart, each optometrist had a chart they preferred. This meant that a person could go to two different eye doctors and receive two different results. Earlier eye tests were done using the double star of the Big Dipper. The second star from the end of the handle of the Big Dipper is an optical double star. If you could perceive the separation of these two stars, you passed the test!

Fast forward to 1862 when Dr. Herman Snellen found that an efficient way to test someone’s eyesight was to have them read an ever-shrinking line of random letters from across the room. It’s actually the chart created by Snellen that you will still find in your optometrist’s office today.

The eye chart came along during a time of rapid industrialization, when good eyesight was needed for an increasing number of jobs, from railroad engineers to factory workers. Thus beginning the comprehensive eye exam.

Optometry in the 20th Century

As the years progressed optometry became tied to the development of:

  • Vision science

  • Optics

  • Optical aids

  • Optical instruments

  • Imaging techniques

By 1914, optometrists felt confident enough in their discipline to go on record both encouraging vision testing before drivers were licensed and creating regulations against the operation of vehicles by persons with poor eyesight. This paved the way for Charles Sheard to introduce the concept of annual eye examinations.

The 20th century also saw the greatest technological and legal advancements. These include:

  • In 1928 Charles Sheard introduced the routine examination concept, later developed into the “case analysis” approach to refractive problems.

  • Theo Obrig and John Mullen introduced the plastic contact lens in 1938, which relied on polymethyl methacrylate to hold its shape.

  • A corneal contact lens of thin plastic was developed by Kevin Tuohy in 1947.

  • Between 1953 and 1962, soft contact lenses were gradually introduced by Otto Wichterle.

  • The National Eye Institute (NEI) was established in 1968, leading to innovative eye research and improved vision care throughout the world.

  • New legislation in 1973 allowed optometrists to use pharmaceuticals for diagnostic purposes, and prescribe drug therapy.

  • In 1981, Congress included optometry services under Medicare coverage.

  • Oklahoma passed the first state law authorizing the use of lasers by optometrists for certain treatment purposes in 1988.

Today, Optometry has evolved from a niche field to a respected discipline. Doctors of Optometry can now:

  • Prescribe corrective lenses (glasses and contacts) to aid refractive errors (e.g., myopia, hyperopia, presbyopia, astigmatism).

  • Manage vision development in children including amblyopia diagnosis and treatment and vision therapy.

  • Choose to specialize in a specific aspect of eye care (ie. specialty contact lenses, vision therapy, ocular disease, etc).

  • Treat and manage a multitude of vision issues and ocular diseases.

Schedule Your Modern Day Comprehensive Eye Exam With Eden Prairie Eye Care

While optometry’s past remains colorful, Eden Prairie Eye Care represents the current standard for modern day treatment! Using the latest in vision technology, the friendly staff at Eden Prairie Eye Care will help diagnosis vision issues, prescribe appropriate treatments, and help you manage your vision health.

Schedule an appointment today at (952) 944-2792 or via the online platform!


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