How I got here

Eye care at home

Optometrist and director of professional services at OutsideClinic, Nick Wingate (pictured), discusses his career and passion for providing domiciliary eye care

Nick Wingate

I was first introduced to optics when I went to have my eyes tested as a teenager.

I never realised that I was mildly short-sighted until I couldn’t see anything anymore. I went to my local opticians and was prescribed my first pair of spectacles. I went back regularly thereafter. My optometrist was an independent practitioner who was interested in doing more than just a sight test. He enabled me to see optometry as a whole and as a profession.

When it came to applying for university, optometry was the only option for me.

My grandfather was a surgeon and wanted me to be a doctor, but I didn’t fancy it. Optometry fitted me as a person better and that’s what I went for.

With a desire to be an optometrist working in a clinical environment rather than a High Street one, I completed my pre-reg placement at Oxford Eye Hospital, qualifying in 1993.

My pre-reg year was spent learning more about the clinical side of optometry. It was hands-on, with exposure to ophthalmology clinics and following through referral pathways.

Afterwards, I applied for and secured a role as a research optometrist on a study funded by the Medical Research Council and performed at Oxford and Moorfields eye hospitals.

The study was on phaco cataract surgery and I was based at Moorfields. I worked on the study from 1994 to 1998 under clinical lead, Professor John Dart. It was exciting to be a part of such a large ground-breaking study and have my name published with the paper.

When it came to applying for university, optometry was the only option for me


When my contract was close to ending, I saw an advert for an optometrist with OutsideClinic and applied. I have been with the company ever since.

Having dealt with older patients in a hospital setting for four years prior to joining OutsideClinic, I knew that it was a patient demographic that I preferred testing, so being a domiciliary optometrist was the perfect role for me. It was an easy transition that was halfway between hospital and High Street optometry.

Having been with the company for over 20 years, a highlight has been overseeing the development of the services it offers.

We are fortunate to have an owner who is both clinical and entrepreneurial, always looking at ways to innovate and ensure a fantastic service to our patients. That, coupled with becoming director of professional services and being a significant contributor when inventing and developing the company’s electronic record keeping system, EYEris, in order to really push the boundaries of patient care, has been amazing.

A lot of people are still unaware that domiciliary eye care as a service exists and are therefore absolutely delighted when an optometrist visits them at home.

Providing eye care to people in their own home is all about understanding their needs and requirements and doing the best for them. The environment that you find yourself in should not affect the quality of service that you provide. A patient’s home may not necessarily be how you keep your own, and that should not be a barrier to providing a fantastic eye care service.

When it comes to providing domiciliary eye care, it is not as difficult as everyone may think.

Optometry, whether you offer it in a High Street practice, hospital setting or domiciliary environment, is very much the same. You can control lighting in most patients’ homes, and as long as you treat everybody with dignity and respect, whilst appreciating that you are in someone’s personal space, you can provide high quality eye care effectively.

Optometry, whether you offer it in a High Street practice, hospital setting or domiciliary environment, is very much the same


Being a domiciliary optometrist can be physically more challenging as you have your equipment to carry with you on an appointment.

We ensure that our optometrists have everything required to provide high quality eye care. Our optometrists’ comprehensive equipment includes fundus cameras, portable slit lamps and Icare tonometers. In my role as director of professional services, I have recently started investigating portable optical coherence tomography devices. While they are expensive right now, as a company we have embraced investing in new technology, often working with manufacturers and developers to make sure new equipment is right for us.

Thinking about the future, I certainly want to keep testing.

I don’t think that I can give my colleagues the best advice without continuing to test, dispense and use referral pathways. I have been fortunate enough to have had a great university education and this is why I am personally invested in ensuring our local university optometry students have every opportunity to experience domiciliary optometry. For the last couple of years, I have had small groups of students visit us to try out our equipment and look at our clinical audits. For 2020 we will be running a two-day schedule for a cohort of students to accompany our optometrists at patient visits. This is a huge step forward for us as currently, because of the nature of the way we work, we are unable to employ pre-reg optometrists.

  • As told to Emily McCormick.