An ophthalmologist is a licensed physician THE F who specializes in the eye, while an optometrist is not a physician but is trained to treat eye defects. Ophthalmologists can receive Medicare funds for many services that optometrists cannot, even when the latter are considered qualified to perform the tasks. And that, naturally, has angered optometrists.

In July, 1981, the Health and Human Services Department started reimbursing optometrists with Medicare funds for examinations related to aphakia -- the absence of a natural lens. The condition most commonly results from cataract operations. Optometrists cannot perform the operation but can prescribe replacement lenses. HHS's Health Care Financing Administration said that the change in policy was mandated by Congress in 1980. But HCFA only recently got around to proposing the regulations to implement the new policy.

The American Academy of Ophthalmology has responded with an angry letter to HCFA. First, the academy said that HCFA acted improperly by changing the reimbursement policy before changing the regs. It charged that HHS had misinterpreted the legislation and that the change could endanger the vision of their patients.

The American Optometric Association, naturally, disagreed. The proposal "does not expand the scope of optometry," said association staffer David Lewis. "It merely gives a person under Medicare the same options" that those in the private sector have. Lewis said ophthalmologists are afraid the change will mean a drop in their business, adding that Florida optometrists have reported an increase in business since the July, 1981, change.