Pre-reg focus

“I can see a light at the end of the pre-reg tunnel”

Lizzie Shaw, pre-reg optometrist at Moorfields Eye Hospital, tells OT  about gaining confidence in contact lenses as she completes Stage 1


For Stage 2, I know that the scenarios could be anything. As such, when I encounter anything interesting in clinic, I am trying to learn around it. For example, I had a patient with pigment dispersion syndrome in for a sight test. This was not something I had looked into since university and at the time I was unsure what other signs I should be looking out for, as it isn’t very commonly encountered.

I had an observation session in the Glaucoma clinic later that day and saw another patient, who had pigment dispersion glaucoma, which helped me to solidify signs associated with the condition, such as Krukenberg’s spindle. Keeping on top of things like this will not only help with my theoretical knowledge, but crucially will make me a better clinician overall.

At the time of writing, I am about to start my Visit 4, so Stage 2, while becoming more prevalent in my head, doesn’t have my full attention yet. I am trying to focus on bettering my skills and getting more comfortable being directly observed before the hard revision starts. I am now picking up more things by myself that my supervisors could query, for example rechecking cylinder changes and calculating possible anisometropia in a new prescription, and I feel I am able to view things more holistically.

Contact lens confidence

The last few months have been very intense, which I have particularly noticed in my logbook numbers as I move towards the end of Stage 1.

I am able to do more and see more patients, which has been instrumental in growing my confidence. Contact lens fits, for example, I found intimidating, as we mainly fit rigid gas permeable lenses for keratoconic patients. In pushing for numbers recently for my logbook, I have done a lot more in a short space of time. Now I feel much more confident with choosing specialist lenses depending on the position and steepness of the cone, and even look forward to fittings. I have seen the correct contact lens improve visual acuity enormously, and it can be a very satisfying part of the day.

I have seen the correct contact lens improve visual acuity enormously, and it can be a very satisfying part of the day


Moving beyond supervision

I know I still have a long way to go, but I am now seeing patients where I think I will be capable of testing them unsupervised more often than previously. I often feel quite stressed when I think about practising by myself without supervision, so these moments are nice, because I can see a light at the end of the pre-reg tunnel. I have decided to extend my contract at Moorfields, so I know that even when I am qualified, I will be in an environment I am comfortable asking for help in.

It is really fulfilling to look back at the start of my pre-reg and see how far I’ve come. Sometimes it is easy to get caught up in what is still left to do, but my supervisor makes sure I keep remembering where I started.

Clinic leads are now starting to rely on us more, and it is very gratifying. Our pre-reg placement at Moorfields is always a little slower to start with, as we observe clinics first and get used to the environment and ways of working. Initially it can feel very overwhelming and daunting to imagine yourself practising in the same way, so now to see that I am a valued and useful part of the department is really fulfilling. I look forward to this continuing and developing in the rest of my career.

This is a really special year, and will probably be the fastest and most intense period of learning and development I will ever have, so I am trying my best to make the most of it and take in every opportunity I can.