Pre-reg focus
“I am finding this stage both rewarding and challenging”
Zak Saleem, pre-registration optometrist at Nottingham University Hospitals NHS Trust, tells OT about pathology in the hospital setting as he progresses through Visit 4
15 May 2026
I am currently at Stage 1, Visit 4 of the Scheme for Registration.
Overall, I am finding this stage both rewarding and challenging. Working within a secondary care setting has provided exposure to a wide range of complex pathology and multidisciplinary working, which has been incredibly valuable for my development. However, one challenge is gaining experience in certain competencies that are less commonly encountered in a hospital setting.
Visit 3 went well overall, and I found the feedback particularly constructive.
My assessor highlighted several areas where I was performing confidently, while also identifying specific gaps that I can continue to work on and refine.
Before my next assessments, I want to focus on developing a more consistent revision routine. Balancing work with revision can sometimes be challenging, so establishing regular study habits is something I am actively trying to improve.
Working within a secondary care setting has provided exposure to a wide range of complex pathology and multidisciplinary working
I recently observed a case involving a patient with fungal keratitis, which led to corneal perforation and required corneal glue.
During the consultation, the ophthalmologist performed in vivo confocal microscopy to assess the cornea at a cellular level.
It was fascinating to observe such an advanced imaging technique being used in practice, especially as this technology is only available in a select number of NHS trusts.
Following qualification, I would definitely like to continue working within the Hospital Eye Service.
Alongside this, I hope to pursue my interests in public health, governance, and industry representation. I am particularly interested in the wider impact optometrists can have through improving access to eye care, promoting patient education, and contributing to service development and professional advocacy.
The most important thing I have learnt in the past 60 days is…
That progress comes from being reflective. Constructive feedback, even when challenging, has been one of the most valuable parts of my pre-reg journey so far, as it helps identify areas for growth.
About the author
Zak Saleem 
Pre-registration optometrist
Zak Saleem is a pre-registration optometrist at at Nottingham University Hospitals NHS Trust
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