An eye-opening job

July 24, 2018 | Luxembourg’s business sectors | Bettina Opretzka

Interesting and complex work with patients of all ages

A visit to the ophthalmologist should be a regular occasion for all ages and social classes, and not just for individuals with known sight defects, existing eye socket damage, eye muscle deficiencies, or eye lid or tear duct diseases.

Even the lucky ones with great vision may have undetected eye problems that can only be seen during a complete examination, a so-called screening. Timely – and regular – eye doctor appointments can help prevent tragic consequences such as amblyopia, a squint (strabismus), eye fatigue (asthenopia), or even loss of sight.

Studying abroad

Before an ophthalmology specialist can practice their profession in Luxembourg, they must complete several years of study abroad, since the grand duchy unfortunately doesn’t offer this degree. Students first complete a standard medical degree before specialising in ophthalmology. This specialisation generally takes five years and is taught at university hospitals or city hospitals, but sometimes also with an established doctor.

The prospective optometrist now learns various examination and treatment methods for recognising anatomical and functional changes of the visual organ. The lesson plan also includes the basics of prevention, rehabilitation, ophthalmological optics, as well as plastic-reconstructive surgery. Additionally, specialisations in laser surgery, laboratory examinations, or eye muscle surgery are also possible. Ophthalmology is a varied field that overlaps with neurology and internal medicine. Its complexity requires intelligence, meticulousness, patience, and endurance, as well as a strong interest in people and their needs – both during the degree programme and the subsequent practical training.

To obtain a licence to practice ophthalmology in Luxembourg, students must submit all diplomas acquired abroad, assuming they correspond to local requirements, to the Ministry of Health. After completing their exams, the ministry either grants or rejects a licence in conjunction with the evaluation created by the “Collège Médical”. However, it should be noted that a registration fee must be paid beforehand, the amount of which depends on the qualifications and the applicant’s desired title. Those who want to obtain a doctorate must submit a corresponding application to the Ministry for Higher Education and Scientific Research.

The prospective optometrist now learns various examination and treatment methods for recognising anatomical and functional changes of the visual organ.

Independent profession

Back in 2001, a report on the demography of doctors in Luxembourg, published by the Ministry of Health, mentioned that the number of ophthalmologists employed by Luxembourg’s hospitals is declining: Most of the approximately 80 eye doctors licenced in the grand duchy work in private practices. Additionally, a few foreign ophthalmologists work in the country, who only partly or sporadically make use of their local licence.

The density of ophthalmologists in Luxembourg is relatively high in a Europe-wide comparison, so that patients benefit from shorter waiting periods for receiving appointments than in France, Germany, or Belgium. Many cross-border commuters use this to their advantage and opt for treatment here as opposed to waiting for months to get an appointment at home.

The following list gives an overview of the different areas an eye doctor deals with in their profession, as well as the diversity and wide age range of their patients:

Babies and toddlers should be introduced to an ophthalmologist if their parents have noticed abnormalities in their eyes, changes in the eye lids, an ocular tremor, or deviations in the visual axis (squint). Older children may experience difficulty reading or copying from the board. An ophthalmologist’s job entails recognising visual disorders early through specific eye exams as well as treating patients in an empathetic, patient way.

Nearsightedness, farsightedness, and astigmatism belong to most common visual defects. As a result of the use of smartphones and tablets as well as everyday work in front of a screen, more and more younger people are affected. Regular check-ups, which should ideally take place every six months up to the age of 21, constitute the largest portion of an eye doctor’s work.

From the age of 40, presbyopia may set in, and glare sensitivity increases. This age group is also more susceptible to ocular diseases, loss of nerve fibres (glaucoma), or clouding of the lens, so-called cataracts. While classical visual defects can be corrected with glasses or contact lenses, cataracts are removed through an operation. Recognising and treating glaucoma requires comprehensive methods: ranging from the initial glaucoma screening to a visual acuity test, a microscopic eye examination, eye pressure measurement, analysing the ocular fundus, and creating an eye pressure day profile. Glaucoma treatments can take place with medication or an operation. Again, early recognition is the first step and key to retaining sight.

Approximately 80% of all diabetics suffer from a diabetic retinal disease caused by diabetes mellitus. Ophthalmologists who operate on retinas offer specially tailored treatment methods together with the patient’s other doctors (general practitioner or paediatrician, internists…). As early as in the initial stages of retinal damage, laser therapy has proven to be efficient.

Athletes are often also regular visitors. Ophthalmologists treat weak-sighted athletes, make potential decisions on sports capability, provide advice on selecting sports glasses or contact lenses, and treat sport injuries and bruises.

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