Pre-reg focus

Myopia and contact lens clinics as a pre-reg

Hayley Smith, pre-reg optometrist at Peter Ivins Eye Care, on finding variety in specialist clinics and working with contact lens patients


Before starting pre-reg myself, I had heard many people saying the year goes fast. Now that I am five months into it, I can see why. It seems like yesterday that I was only seeing four patients a day. Now, I have a full diary with a range of different appointment types, from sight tests to contact lens checks to emergency appointments. I have gradually built up my diary and reduced my testing time to enable me to see more patients and meet my competencies.

At first, the thought of reducing my testing time seemed impossible, but it really does come with experience. I am also feeling more confident in my skills and knowledge after seeing such a wide variety of cases and learning from each encounter.

At first, the thought of reducing my testing time seemed impossible


Ticking off competencies

Seeing such a vast range of patients and different pathologies has allowed me to meet all my competencies fairly quickly. To do so, I had to stay on top of my diary and logbook and ensure the staff in the practice knew what to look out for so that those patients could be booked into my diary. I realised how important being organised was when preparing for my first visit, and I have now carried this awareness into my second visit.

Initially, it took some time to balance settling into my first 9am–5pm job with work itself and studying. However, I quickly learnt what worked for me, which has played a significant role in being successful so far. It was important to ensure I was keeping my knowledge at the front of my mind by, after work, looking over notes on any pathology I had seen that day or on techniques that I didn’t feel confident on. This meant that, as my Visits were approaching, I was still in the swing of studying, so it was easier to increase the hours in preparation for these.

Seeing such a vast range of patients and different pathologies has allowed me to meet all my competencies fairly quickly


Moving into specialist clinics

I am really enjoying doing my pre-reg at Peter Ivins Eye Care. The support that I receive is incredible, and the variety of specialist clinics has given me many interesting patient encounters. I have been able to observe visual stress and dry eye clinics, as well as assess patients in the myopia management clinic myself.

I have also been very lucky that my supervisor has organised several opportunities for me, including fitting real keratoconus patients in our practice with scleral contact lenses. This was such an interesting session, and I was amazed at how much the visual acuities of these patients improved with scleral lenses compared to glasses or soft lenses. I am looking forward to fitting more complex lenses in the future and broadening my skill set.

I have seen many interesting cases, including double elevator palsy, retinitis pigmentosa, and new onset nystagmus. It is good to be able to apply the theory learnt in university to real-life patients in practice with these cases, as they are not what we would typically have come across in university clinics. This has also helped solidify my knowledge as I now have experience with managing these cases, so I am better prepared for next time. I am excited to see what else is in store for me in the coming months, and am looking forward to adding more fascinating cases to my logbook.