“Hospital optometry is as varied as you want it to be”

Can you tell me about your hospital optometry role?

I’m based in the optometry department, mostly undertaking contact lens and paediatric refraction work. I’ve also recently taken over running the polymethylmethacrylate (PMMA) scleral clinic. The service is quite unique in the country, and I feel privileged to be continuing in the footsteps of my predecessors. When there are no other solutions available for patients, PMMA sclerals are fitted for sighted and cosmetic purposes, made in our workshop from an impression, although the need for sighted PMMA sclerals has reduced significantly over recent years.

When I’m refracting, I do paediatric cycloplegic refractions and have a dedicated clinic for children with special educational needs. I also do a monthly pediatric clinic at special educational needs schools around Birmingham, in conjunction with the orthoptic department.

Can you describe working as a hospital optometrist in one sentence?

Hospital optometry is as varied as you want it to be – you can be highly specialist in one area, or you can do a little bit of everything, and that’s the beauty of it.

How long have you worked as a hospital optometrist?

For 22 years, since I did my pre-reg at Birmingham Midland Eye Centre (BMEC) in 2002. The hospital itself has changed, the role has changed, and the staff have changed, although not everyone. I have some colleagues who I have worked with since the start.

It really suits me. I think the fact that I have done it for 22 years is a reflection of how varied the job can be and how interesting it is.

When and why did you decide to become a hospital optometrist?

I secured my hospital pre-reg placement through luck, really. A friend of mine was interested in doing a hospital pre-reg, and she suggested a road trip to Oxford, for one of their open days. A couple of us tagged along. As I got chatting to the pre-regs who were there at the time, I realised how interesting it was. I thought that I might as well give the application process ago. I did, and was offered the job at BMEC, and the rest is history.

The fact that I have done it for 22 years is a reflection of how varied the job can be and how interesting it is

Do you do any other work or volunteering alongside hospital optometry?

In the past, I’ve been lucky enough to be involved in the Lions Club International Opening Eyes programme at the Special Olympics. I started as a second-year student, when the games were in Cardiff. I was tutored by the incredible Dr Maggie Woodhouse, who was part of the organising team for the Opening Eyes programme. She encouraged students to go aong and help.

I’ve been back, since I qualified, to the Glasgow, Leicester and Sheffield games, where they also had Opening Eyes programmes, for testing the vision of the athletes. It has been brilliant, and is the best thing I’ve done professionally. I think the last one was in 2017. I’m hoping that post-pandemic, they manage to arrange another games.

What is the biggest challenge facing hospital optometry currently?

I’m not involved in any of the background, or any management, but from a street level, I would say capacity. The sheer number of patients waiting to be seen is staggering.

Do you have any thoughts on how the profession can support that, or how that can be resolved?

Greater collaboration between primary and secondary care and further extending the roles of optometrists in both sectors.

What is your biggest success in the past three years and why?

As a specialist optometrist, I was involved in setting up the special educational needs schools programme. That has been one of my proudest achievements. We initially set up the service 10 years ago, and the uptake from the schools wasn’t so good at the time. The service was re-established three years ago and this time around, it has worked really well.

I’ve been really pleased with seeing how the service benefits special needs children. It’s one less appointment for the parents to have to take their children to, and less time for the children to be out of school. It’s better for the children, because they are in a familiar setting. We’re more likely to get a better result, because they’re more comfortable. It’s win-win for all concerned.

I lead and manage the PMMA scleral clinic on my own now, and it has been reassuring that the latest rigid gas-permeable (RGP) scleral lens designs have worked well with the most complicated corneas, allowing sighted PMMA sclerals to be replaced with RGP sclerals. It has been really rewarding to develop my skills in both these areas.

What is the most surprising case you have seen in the hospital setting?

I saw a fantastic Boston keratoprosthesis artificial cornea on a patient once. I was only seeing them for a bandage contact lens, so my part of their care was very straightforward, but it was really cool.

The patient also had an artificial eye, and they had chosen to have an Aston Villa football badge design on their iris. My husband and kids are both big Villa fans.

What would you say to optometrists working on the High Street about working in a hospital environment?

To give it a go. It’s not an all or nothing choice. One of the best things about optometry is that it works really well part-time, so you can do different things. I’ve got friends and colleagues who, alongside hospital optometry, have worked in High Street optometry, research, or teaching; have locumed or worked on their Local Optical Committee, have owned their own businesses – a whole spectrum of different things. Hospital optometry can fit in very well alongside that, whilst also enhancing your skills and supporting and improving the other areas of your career.