The American way

One week after graduating from Aston University with a BSc (Hons) Optom, I boarded a one-way flight to New York to begin a four-year Doctor of Optometry course at the State University of New York College of Optometry.
Studying optometry for another four years wasn't what I expected to do when I first considered moving to the US to be with my family. When I looked into the profession in the US I realised that it wouldn't simply be a case of taking PQE-style exams and being qualified.
I applied to a few US universities during my final year at Aston, and chose SUNY College of Optometry - located in New York City, one block from Times Square - because I was impressed by the facilities: a small class size (76) and the structure of the curriculum was similar to that at Aston.
SUNY also has a wide array of patient services, which includes over 120,000 patient encounters a year, taking in paediatrics, vision therapy, a head trauma unit and a Lasik clinic. Students get exposure to all these areas throughout the four-year OD programme, which comprises three years in lectures with clinic time added throughout, and then a final year of rotations through the clinics.

how the systems differ
The education system in the US is much different to the UK. A typical student wishing to study optometry would graduate from high school at the age of 18 and enter a four-year undergraduate programme. There they would take a variety of courses and 'major' in a particular area, such as biology. In the final year of the undergraduate degree they would apply to an optometry school, of which there are 17 nationwide.
The application process involves individual applications to each school and submission of their scores in the optometry admissions tests (OATs) - luckily, I was exempt from taking these.
Another major difference in the two systems is the cost. My first year here will cost more than my three years at Aston put together. Qualifying requires that the student passes the National Board exams. These are in three parts: the first is taken after the second year and covers basic science; Part II consists of a written clinical exam, and then Part III is a practical assessment.
Some states also require state boards to be taken, which may test on clinical science and state laws.
The syllabus differences vary between different universities in both countries, so all I can really compare is the content of the Aston course and the SUNY course.
The first major difference is the level of study. In the US there is a much larger emphasis on detail in the biological sciences. Courses in the first quarter of the year include biochemistry and molecular genetics, histology, gross human anatomy, optics and Optometry I (taught by fellow Aston graduate Dr Mark Rosenfield), as well as some others. The anatomy course is one that is definitely not included in the UK courses, with human cadaver material.

medical-based approach
The whole course does seem to have a more medical-based theme to it than in the UK, not surprising given the 'Dr' title that optometrists have. This is also why prescribing rights have moved faster here than in the UK.
Also in the first year at SUNY there is a course titled 'Optometric orientation and ethics'. This is an interesting course, covering various aspects of US optometry from history to current affairs regarding health insurance and new legislation. A variety of external lecturers also come in and give an insight into different modes of practice in optometry, commercial or hospital, for example.
Another area of the syllabus is 'Introduction to clinic care'. This involves a weekly attendance at one of the university's clinics observing a third- or fourth-year student. This helps to give the first-year students an insight into the different areas of optometry. One hour of observation is followed by an hour's discussion in small groups led by a member of the clinic's staff. A lot can be learnt in the discussions, although sometimes observing students may not be the best way to do it. At Aston, first years sit as patients for third years to experience what an eye examination is like.
A very noticeable difference between the two courses is the timetable. SUNY has a very demanding timetable with 25-30 hours of lectures and practicals a week.

Wider scope
The experience of studying here has been a great one so far. As well as the optometric differences there are many social differences at the university. There's a good interaction between all the different years, with weekly social events being planned by all classes.
The question of which education system is better is a difficult one to answer, but the scope of practice in the US is much greater and so does require more study. However, many of my classmates have said that a lot of the courses they took in their undergraduate programme have no benefit in the courses here.
Optometrists in all 50 states now have prescribing rights for topical medication, and over half have oral medication rights. In addition, Oklahoma has passed a state law allowing optometrists to carry out retinal laser surgery operations, as long as no surgical incisions are made.