Q&A: Professor Julie-Anne Little

Optometrist, AOP chairman and lecturer, Julie-Anne Little, was appointed professor at the University of Ulster in April.

Professor Little leads the centre for optometry and vision science. Her research seeks to optimise vision through application of techniques for early detection and monitoring of ocular conditions across the life span. This is reflected in her work with children with special educational needs and visual impairment.

OT talks with Professor Little about the future of optometric education, her advice to her younger self and the rewards of research.

How did you find out about your appointment? What significance does becoming a professor have for you?

I got a call out of the blue from the executive dean of my faculty – I was wondering what she was phoning me about and that was the news. You put these things to the back of your mind because academic promotions are a slow process, but it is a really nice recognition of the work I have been doing in terms of research, teaching and helping to move forward the profession of optometry. It certainly doesn’t feel like the end of a chapter but just a continuation of a journey.

There’s not that many female professors within optometry. Kez Latham, at Anglia Ruskin University, has just given her professorial lecture recently – and I loved the title of her talk: You can’t be what you can’t see, which underlines how important it is that we show there are opportunities for everybody within academia. Inspirational female professors in the UK include my colleague and former PhD supervisor, Kathryn Saunders, Shahina Pardhan and Nicola Logan at Aston University – just to namecheck a few.

These are all fantastic academics and it is really nice to be following in their footsteps. And I’ve been lucky to have strong female role models throughout my career, including my fantastic pre-registration supervisor, Dr Gillian Rudduck.

What do you find rewarding about research?

My research tends to be focused on things that hopefully make a difference and that are clinically relevant. It is rewarding to see that work move forward our knowledge and evidence base for practice. I have a longstanding interest in trying to improve the visual outcomes, and in turn the educational outcomes and quality of life, of people with Down’s syndrome. When I reflect on what the level of care and knowledge was 25 years ago, I think that has really expanded.

There is so much that we don’t know. There is so much unmet need still out there – we are not at the end of our knowledge or living in a perfect healthcare system. If I can help contribute to casting a spotlight, making a difference and changing practice or policy to improve visual outcomes for people, that is something that I feel is very important.

What research are you working on at the moment?

I have an ongoing interest in hyperopia. As clinicians, we still don’t really know which children will benefit from correcting low to moderate magnitudes of hyperopia and which children it doesn’t make too much of a difference for. We just don’t have the evidence to develop prescribing protocols at present.

I am involved in a study in Zimbabwe where we are looking at a large sample of children in schools. We are not only evaluating the refractive profile of these children but also prescribing spectacles and returning to see what effect that has on educational outcomes. We are looking at the impact it has on daily life and education. This work is funded by the Wellcome Trust and is a part of a suite of global public health studies, led by Professor Nathan Congdon, investigating the benefit of spectacle interventions across the life span. It’s really exciting to be part of this.

I’m also thrilled about a project we recently launched, funded by the Alzheimer’s Society, that we are undertaking in collaboration with Queen’s University Belfast. The project is looking at the eye in people with Down’s syndrome as a window to understanding early onset of dementia and Alzheimer’s disease.

People with Down’s syndrome are at increased risk of dementia, and establishing ocular biomarkers would be exciting to aid early detection and monitoring of this condition, not only for people with Down syndrome, but the wider population too.

We are looking at that population and also taking some biological samples – tears, saliva, blood – and looking at inflammatory markers. Hopefully with imaging, sample analysis and cognitive assessments we will build a comprehensive picture of what this condition looks like in the Down’s syndrome population.

I have also a number of really interesting PhD projects, on topics including the investigation of sports classification for athletes with visual impairment and investigating the impact of reduced vision on driving performance.

I strongly believe the most effective research happens in teams, and I’m lucky to work with great post-docs, PhD researchers and academics in all this work.

We need to respond to advancements in artificial intelligence and what the role of optometry will be. We can’t ignore these changes – if we don’t harness them, they will eclipse us

How do you think optometric education will evolve over the next five years?

I think the implementation of the Education Strategic Review by the GOC, and now the Education and Training Review, will really change the landscape of how universities implement their programmes. Over the next five years, we will see the first graduates come through this new format.

There are really good elements to this refresh of the education system. I think it will increase the focus of the universities to implement clinical reasoning and clinical skills. The changes will hopefully create clinicians who are less wedded to a formula of ‘here is what I do in an eye examination’ and more flexible in their approach to critical thinking skills.

But there is a tension between delivering robust higher education to BSc and Masters levels while also fulfilling the role of training optometrists. As universities we want to continue to challenge our graduates to achieve their academic qualification. So, there is a vital role the wider profession have to play here in becoming more involved in training our future optometrists.

Unlike other health professions, we don’t have a system where this is embedded as part of our roles across the sector, but we need to move towards a framework where it is custom and practice for all optometrists to contribute and be recognised throughout their careers in the mentoring and training of the next generation of our profession.

 

What have you learned about optometry that you would like to share with yourself when you were a student?

You really do keep on learning throughout your life. Your profession doesn’t stand still. The things that are custom and practice now were not what I was trained in. I think it is having an openness and appetite for learning new things. The more afraid and defensive you are the more disconnected you will get. It is fantastic to see post-graduate students coming back and see that spark ignite in them when they are excited about what they are learning. It is about being open to developing new knowledge and applying their skills in a new way.

What would you say are some of the most exciting developments in optometry at the moment?

I think for the profession there is a chance to develop our roles, so we are decreasing the burden in secondary care. In terms of technological developments, we are seeing the pace of growth accelerating. We need to respond to advancements in artificial intelligence and what the role of optometry will be. We can’t ignore these changes – if we don’t harness them, they will eclipse us.

It is not just tools and instrumentation though – we are sitting on a lot of data that is very fragmented. There are means by which we could be a very powerful source of primary care information if the connectivity was better. We need to become better at considering our contribution in the wider public health needs of our populations. I think there are real opportunities for the future.

What has motivated you to contribute to the AOP through your roles on Council and the AOP Board?

I have always felt strongly about getting involved and giving back. My work with the AOP has kept me very strongly connected to the profession. I am proud to be part of the profession of optometry and want to continue to see our profession continue to flourish and move in the right direction. It was important to me to be part of ensuring that the AOP continues to serve our membership.

The AOP performs such an important role in protecting the profession. I have had a window into some of the difficult situations that come up for some of our members. It is really important to me that our profession is supported by the AOP during those times.