Excellence in eye care

“I’m amazed at the way that the profession has moved forward” 

OT  caught up with Professor David Whitaker, recipient of the AOP’s Lifetime Achievement Award 2024, to discuss his career highlights, the potential of a revamped optometry curriculum, and how the profession has developed over four decades

Professor David Whitaker, head of the School of Healthcare Sciences at Cardiff University and newly crowned winner of the AOP’s Lifetime Achievement Award, almost did not end up in optometry at all.

In the late 1970s, with A-levels in maths, chemistry and physics, Whitaker explained: “My teacher at school wanted me to become a chemical engineer. Chemical engineering was a big thing in those days. But I wasn’t overly impressed with that.”

He added: “It was actually my father who suggested that optometry would be a good career.”

Perhaps unsurprisingly, Whitaker has no regrets about his road not taken. Chemical engineering’s loss was optometry’s gain, and the native Bradfordian started his ophthalmic optics degree in his home city in 1980.

When he started university, he did not even have an O-Level in biology, Whitaker explained: “That was a steep learning curve. It [his optometry degree] didn’t come about by having an interest in the anatomical or biological side of the eye. I certainly had to brush up on my knowledge of anatomy early in the programme.”

His early career would see him complete a PhD at the University of Bradford, before he moved to Aston University, where he remained until the mid-1990s. After a handful of years at Aston University, he returned to his alma mater.

“A job at Bradford came up, and I was delighted to go back. It’s got a special place in my heart,” Whitaker said. “I’ve got a love for the place. It’s a great university, [and] a great optometry school. Lots of really good people have come through Bradford.”

His early interests were in spatial vision and hyperacuity, which he describes as “a very fine ability of the eye and the brain to determine the spatial arrangement of the world around us.”

Whitaker also made an early foray into cataract research, explaining that, “in the 80s, cataract surgery was relatively underdeveloped in comparison to now.”

“Cataract was a big issue in those days, in particular trying to establish what the quality of the neural system behind the cataract was before a cataract operation took place,” Whitaker said.

He added: “I had a lot of interest in how vision changes across the normal lifespan – not thinking about disease, just changes in vision as we grow older, and measurements such as how visual acuity changes. We also looked at changes in pupil size as a function of age.”

Vision, including the influence of glare and peripheral vision, was another important area of interest in the early years of Whitaker’s career.

His work led him to realise that sometimes research has more of an impact than might be expected, even if it doesn’t always turn out as planned.

Whitaker highlights an Aston University experiment that looked at how pupil size changes as a function of age, which he freely admits did not have a strong hypothesis behind it.

“We just got a few hundred people in, across various age groups, and measured pupil size,” he said. “But it’s become the definitive go-to piece of evidence as to how pupil size changes with age, and it has [had] so many implications for optics, and quality of the visual image. It has been cited almost 500 times by other people in their studies.”

A lesson in unexpected success, then?

However well-cited, Whitaker isn’t quick to claim this particular experiment as one of his most accomplished.

“Because it didn’t have a fantastic hypothesis behind it, I wouldn’t class it as my best piece of work,” he said. “It has simply happened to rise to a level that I never expected it to.”

Professor David Whitaker
Noah Da Costa

The human perception of time

In more recent years, Whitaker has found an interest in multisensory perception – how the senses work together.

“I’ve become interested in how visual auditory and tactile stimuli are put together, and how the brain makes sense of all the different pieces of information that come to it, and how it puts it together,” he said.

He explained that his career is no longer focused entirely on vision, but has expanded into the other senses too – part of which is the human perception of time.

“Historically, researching vision has been preoccupied with space: how we analyse the visual world around us, which is essentially spatial,” he said. “An under-developed area of research has been how humans perceive the temporal aspects of the world.”

To illustrate this, he described “the visual flash of a firework, or the sound of it, exploding and how the senses are put together in a logical order in the in the brain.”

The relationship between cause and effect can be manipulated, Whitaker said: “You can fool people to change the order of their actions and effect.”

He explained: “Normally when we press a button on the keyboard, we can see something happening on the screen and it reflects the button that we’ve pressed.

“But you can fool people into thinking that the screen has reacted before they’ve actually pressed the button. It’s a spooky feeling, in that it is a reversal of cause – what we’ve done – and the actual effect of our causes.”

Whitaker added: “A common theme through a lot through a lot of my research has been to examine how not just visual illusions but multisensory illusions can tell us a lot – when you examine how the brain gets things wrong, what that tells you about the mechanisms within the brain. Timing illusions like that, I think, are really interesting.”

Revamped optometry education

As head of the School of Healthcare Sciences at Cardiff University, Whitaker is now heading up a school that, ironically, does not include optometry. Instead, he oversees subjects including nursing, physiotherapy, occupational therapy, diagnostic radiography, and radiotherapy.

“What defines them all is the amount of time students spend in clinical practice,” he explained, adding that between 35% and 50% of the students’ time is spent on placements, mainly in the NHS.

“Of course, optometry is undergoing a huge change at the moment, with the education and training requirements (ETR). Having experienced all these individual healthcare professions and their placement requirements, I look upon the changes that have taken place recently in optometry and believe that it is an interesting development,” he said.

These developments are not going to be without their challenges, Whitaker acknowledges.

“With placements, universities are so reliant on partners in placement delivering their side of the deal,” he said.

Whitaker highlighted one potential stumbling block that he believes still needs to be ironed out before optometry students undertaking the new degree courses go out on their placements.

“For optometry, the critical link is that the universities work together in partnership with the placement providers, which are the optometric practices. That relationship has to be a strong one. Both of those partners have to understand where they sit in terms of the overall delivery,” he said.

“There could be interesting times ahead, in terms of the new ETR: how it’s going to work, and particularly the link between the educational institutions and the placement providers. The students will be university students, but they will be based out in practice. That does raise potential difficulties and issues, in that the university is responsible for somebody who is almost outside of their immediate geographical control.”

The best students Whitaker has encountered in his career came through Bradford’s BSc (Hons) Career Progression Programme, he said – a degree that allows registered dispensing opticians to “progress to an optometry degree without them having to interrupt their career entirely and take three years out to start from scratch with an optometry degree.”

“This model was developed to allow qualified dispensing opticians to convert to optometry in a realistic timescale, via an accelerated route,” Whitaker explained, adding: “There was a lot of scepticism at first. [But] the outcome was absolutely staggering. That’s one of the big eye openers that I’ve experienced. These are probably the best students that I’ve come across in my teaching career, which goes back to the mid ‘80s. They were superb students, and it was an all-round success.”

Whitaker revealed that the combination of industry and academia coming together, with the knowledge that a talented pool of dispensing opticians existed and that they could be moved from one area of vision care into another, made the development of the programme at Bradford the number one highlight of his career.

Optometry four decades on

OT is interested in hearing about how Whitaker believes optometry has changed over the course of his career.

“It’s changed massively,” he said. “Optometry, back in the early 80s, was still junior, and rising out of what was more of a physics type of background. There weren’t many professors of optometry back then. In terms of its own academic reputation as a discipline, it probably hadn’t established itself. It was probably subservient to ophthalmology in those days.

“But as the years have gone by, I think we’ve really caught up with ophthalmology. It's been a fantastic progression that I've been able to witness, in terms of how the profession has developed into what it is today.”

He added: “It’s a small community, but it’s growing. Back in the 1980s, I think there were just five optometry schools. But it has grown in the right way, in that we’ve done a good job of developing academic staff, through staff getting their PhDs and becoming lecturers.

“I think we should be proud of how we have brought things on in the past 40 years or so. Optometry has grown enormously, in the right way, in those years. There are a lot of people – too many people that I could acknowledge in terms of those who have supported me to get to this this point.”

When asked about how he thinks optometry will change over the coming decade, Whitaker noted that, working in Cardiff, he is already seeing progress within the profession firsthand.

“I’m amazed at the way that the profession has moved forward in some areas of the country,” he said. “I’m seeing Wales and Scotland making great strides in terms of the treatment and the management of eye conditions, and links in pathways with ophthalmology. That has been fantastic, and has been driven incredibly well by those who have led it.”

Whitaker believes that “the rest of the UK has got to catch up with the initiatives that have been firmly established and validated as being the proper way to go, particularly in an NHS that is stretched of resource. In the next decade, it simply has to continue.”

He added: “We need to get rid of the blockers, whatever they are. It has to be accepted that it is a no brainer that optometry has to take more of a leading role in healthcare provision when it comes to the eyes.”

Professor David Whitaker received the AOP’s Lifetime Achievement Award at the Excellence in Eye Care reception, sponsored by CooperVision and hosted at the Andaz hotel, London Liverpool Street, on 25 February.