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A career in the hospital

As the head of optometry at Moorfields Eye Hospital, Dan Ehrlich, retires, he shares insight into his career with OT 

21 Jan 2019 by Emily McCormick

What made you opt for a career in hospital optometry?

During my final year at university, John Storey addressed students with an inspirational lecture on ultrasound. He so obviously loved his work, was passionate about his patients and wanted to share his knowledge. He was principal optometrist at the Manchester Royal Eye Hospital and during that lecture the first seeds were sown for what went on to become a passion for hospital optometry. 

The people who went on to inspire me in my career were Janet Silver, my first mentor, who encouraged me to specialise in low vision assessments (LVA) and to teach. She also supported me in volunteering and teaching abroad. Later in my career, Professors Geoffrey Woodward and Roger Buckley inspired me, as did John Dart, who fostered my interest in contact lenses.

Can you describe your career in three words? 

I am not very good at brief and succinct, I have a more rambling style. However, I will try by saying: rewarding, varied and challenging.

What have you most enjoyed about your career and why?

I have really enjoyed working alongside such wonderful people who are not only experts in their fields, but have been so supportive of me. Having had the opportunity to see those who I have taught go on to become experts in their own fields, has been particularly rewarding.

I have also enjoyed working with my patients; in particular, several patients with severe ocular surface disease who I got to know well over the years and, in both my successes and failures, learned so much from.

“Optometrists will need to continue to develop their roles through higher qualifications and work closely with ophthalmologists to develop patient pathways and stratification of patients”

What are the main changes you have seen occur in the hospital setting during your career?

When I first started in 1984 some consultants would not allow ophthalmic opticians (as we were then known) to refract their patients. A hospital optometrists’ starting pay was also less than one third of that those in High Street practice received and it was difficult to recruit to posts. 

Janet Silver and Geoff Woodward became international experts in low vision assessment and contact lenses, and in their very different ways created close working relationships with ophthalmologists. This has led to the situation that we have now where optometrists work alongside ophthalmologists and in optometrist-led clinics – in not only core optometry, but in cataract and glaucoma clinics, in A&E, paediatrics, external disease, medical retina, and even uveitis and adnexal clinics.
 
The other transformation is in technology. I was fortunate to start just as automated visual fields were introduced and gas permeable contact lenses were being used. Developments in medical surgical treatment, together with optical imaging, computer-controlled lathes, and much more has transformed our ability to treat patients.

How do you see the hospital eye care setting evolving in the future?

The rapid developments in research into stem cell, gene therapy, big data and technology, together with the increasing demand for eye care, the drive towards prevention and delivering care locally are all likely to transform hospital eye care. Optometrists will need to continue to develop their roles through higher qualifications and work closely with ophthalmologists to develop patient pathways and stratification of patients.

What is your career highlight?

I have two. The first, which was also the most scary, was being asked to present at the joint meeting of the International Ocular Surface Society and the Medical Contact Lens Association where all the eminent experts were assembled.

The second was when the limbal diameter rigid lens that I designed was being successfully worn by patients with severe ocular surface disease.

What would you say to encourage practitioners to consider a career in hospital optometry? 

If you want to work with great colleagues, if you want to work with patients who have the greatest need of your expertise and if you want to keep on learning to ensure you are trying to deliver the best care for those patients, then come and work in hospital optometry.

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