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In many of the world's nations, optometry hardly exists because resources are not sufficient to educate optometrists nor to fund their services. In others, tradition and accommodation with other forces have rendered optometry incapable of change that would expand its scope of services. But, in a growing number of countries, there is an accelerating trend toward expansion of education and scope of practice. Optometry is coming to be defined in those parts of the globe as that independent primary health profession whose practitioners are educated in vision and health sciences, and who meet standards that qualify them to diagnose and treat visual problems and ocular disease. Review of this change, wherever it has transpired, leads to the conclusion that the scope of optometric practice expands only after corresponding expansion in optometric education. These goals are being achieved in a group of highly developed countries in which optometry has long been a major eye care provider, and in countries in which socio-economic and political conditions are improving, but where there is no significant source or tradition of primary eye care of any scope.

The authors express the opinion that optometry schools have obligations to the profession and the public which involve missions beyond their primary function of educating and training students. They identify those missions which they believe are highly important but only partially addressed. They are: clinical research; expansion of optometry's scientific base; specialized patient care; and education of practitioners. They offer explanations for lack of progress, but insist it is vital that these obligations be met by our schools, and offer suggestions toward this end.

This is a position paper which broadly states the role which, in the author's opinion, optometry should adopt as its goal and the educational environment in which we can best prepare graduates to fulfill that role. The role briefly stated, is that of first contact supplier of vision care and of certain aspects of primary health care. The appropriate educational milieu is held to be the academic health center.