I'll second what TomOD said. General (or "comprehensive") ophtho v. optometry is definitely a turf battle, but an ophtho who specializes can get referrals from both OD and general ophtho.
As for the surgical future of optometry, the mere mention of this topic can throw both sides into a tantrum. But believe me, the surgical future of optometry is a long way off, and if it ever happens, will not be much of a market force. Although almost all states allow optometrists to treat glaucoma and prescribe meds for anterior segment diseases, there is still a very healthy amount of referral to ophthos going on in this arena. Most of the older optometrists will only treat the simplest of anterior seg disease, and will refer anything that doesn't respond to treatment within a few days. There are a lot of optometrists who, although licensed to do so, will NOT treat glaucoma. Why? Glaucoma is a downward spiral. At best you can delay the onset of blindness beyond the life expectancy. But if an optometrist treats a glaucoma patient, and that last optic nerve fiber snuffs out long before the patient assumes room temperature, it could end up in court. Every optometrist has a voice in their head that says "don't be the last one to see the patient before they go blind." If a patient goes blind under an optho's care, they can argue that everything medically possible was done for the patient. Period. If the same patient were to go blind with the same treatment by an optometrist, the plaintiff's attorney is going to want to know why an MD wasn't consulted, and the optometrist will go down, regardless of their skill, experience, or competence.
As for surgical care, I highly doubt optometry is going to take over. Refractive surgery? Maybe, but I doubt it. Think about the term "refractive surgery." Who does refractive care best? Optometry. Who does surgery best? Ophthalmology. Ideally, it should be a team approac, as it usually is. But in the real world, the surgeon gets the dough and the glory, and the optometrist does the pre-op, post-op, and contact lens care when needed for a modest salary and little or no glory. Will optometrists take over cataract surgery? No way. The risk of retinal detachment, endophthalmitis, etc. are too high for the average optometrist to stomach, especially considering that ophthalmologists would be falling all over themselves to testify against an optometrist in a case that went bad. Furthermore, optometrists are not trained in pre-operative H&P, nor are they trained to handle intraoperative anesthesia, and very few optometrists have ever even tied a suture. These changes in scope of practice would require a dramatic shift in optometric education, which will not likely happen any time soon, if at all.
MDs get pretty concerned about the scope of practice of optometry, but most of it is unfounded. All optometrists know what the legal scope of their licensure is, and most of them refer patients far below the maximum scope of their licensure. Yes, some optometrists treat minor eye disease, and it may have a slight dampering effect on a market that was once dominated by general ophthos. But for the future generation of ophthos, rest assured that optometry can handle the blepharitis, meibomianitis, dry eye, and contact lens overwear. You will still get the chalazion removals, blepharoplasties, central ulcers, narrow angles, and anything that looks remotely wrong with the retina, plus all the cataracts, macular holes, diabetic retinopathy, macular degeneration, and central retinal vein occlusions you can handle. Added bonus: the optometrist that refers them will most likely have already done the refraction for you. If you ever worry about an optometric takeover, remember that even the optometrists you worry about the most cannot imagine life without you.
