Lifelong learning Practice owner reflects on her PhD journey

Optometrist and independent practice owner of Edwards & Walker Opticians, Pretty Basra, talks to OT  about her interest in children’s vision, her PhD and balancing work, study and family life

Pretty Basra

When did you decide to embark on a PhD and why?

It has been a lifelong dream for me since I was very young – I wanted to be an expert in eyes. It was also largely driven by my father, who used to tell me how much he would like to see his children do well in their education. My mother and father are originally from India where access to education is limited and I suppose that’s what made me fight to do it even more.

What does your PhD focus on?

As a child I was an uncorrected myope and self-reported to a local opticians for an eye exam.

However, I cannot thank the opticians practice enough for allowing this determined nine-year-old girl to have an eye exam (I took the GOS1 home for my mum to sign, before they carried out the eye exam). This experience literally changed my world. I understood first-hand what it felt like to not be able to see.

From that point, I knew that I wanted to specialise in children’s vision and understand it the best I could. This led the direction for my PhD: The importance of including a refractive error assessment in a vision screening programme. Currently the National Screening Committee guidelines state that a visual acuity assessment should identify uncorrected refractive error. I wanted to see how accurate that was and how detection improved with including a form of refractive error assessment. This would ultimately lead to ascertaining the importance of including a form of refractive error assessment.

My main findings were that children can have similar visual acuity levels at vision screening, but those same children can have a range of different refractive errors


As an optometrist, what are the main challenges that the profession faces when it comes to children’s vision screening?

I feel sometimes vision screening can be a barrier to parents bringing their child in for a routine eye exam, as a lot of parents assume because the child has passed the vision screening that they will be fine for the rest of their life.

Access to vision screening programmes varies across the UK; this includes the types of tests used, the age of the children screened and the personnel employed to carry out the screening. It is not a standardised approach, which is a concern, and the biggest challenge, in my opinion, is designing the perfect standardised vision screening programme to detect as many children as possible and not just target amblyopes.

What are the main findings from your project and why are they important?

My main findings were that children can have similar visual acuity levels at vision screening, but those same children can have a range of different refractive errors. This would only be known if a refractive error assessment was routinely carried out during vision screening. The studies highlight that visual acuity is not always a reliable indicator of refractive error due to an individual child’s accommodation ability, among various other factors.

This is important as a child’s visual world at the screening age of between four and five years is at desk level. Therefore, their distance visual acuity may not give a true representation of how the child performs at near tasks. Children learn so much in the early years and this forms the basis for their future education.

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What is a highlight from your journey to gaining your PhD?

A highlight was being able to deliver some of my preliminary findings at two conferences. This was a nerve-wracking experience for me as an amateur researcher at the time, but also made me realise how much I enjoyed delivering my findings to fellow academics and having them take an interest in my work – this felt really good.

What was the most difficult thing about completing your PhD?

Children. During the course of my PhD, I have been blessed with three sons. However, this makes things a lot trickier in terms of having time to work, be a mum, be a wife and try to be an academic. That said, I think a big barrier for optometrists on the whole carrying out PhDs is being equipped with the necessary skill sets to carry out literature reviews and statistical analysis. In our degree there is little focus on this, therefore it can be a struggle to learn these skills if adequate training is not provided by the universities.

How did you balance studying with running a business and family life?

It has been a big challenge, but I feel I can multi-task reasonably well. Anyone who knows me knows that I am super-organised and I plan what I am doing months and years in advance. This helps greatly. Having a supportive partner has also been key and after that it’s all about balance, organisation and a whole lot of determination.

How will you take this qualification and use it in practice?

I would like to champion children’s eye health and the importance of eye exams locally. I feel having this qualification under my belt adds more credibility to my cause. I would also like to explore the possibility of practice-based research further and would hope that it puts me in better standing when applying for grants.

Do you have any future educational ambitions?

I am someone who has a constant desire to learn and advance my skillset. I am going to be starting my professional certificate for glaucoma in the coming months and at some point in the future may look at independent prescribing. However, for now, I have plenty to keep me busy.