You had me at hospital

“Hospital optometry was a natural pull for me”

Specialist optometrist and lecturer at Anglia Ruskin University, Dr Jane Macnaughton, on her passion for low vision and paediatrics

A woman in a purple t-shirt with a blue lanyard around her neck. She is standing next to a large Amsler chart.
Jane Macnaughton

Jane Macnaughton

Dr Jane Macnaughton

Occupation:Specialist optometrist at Leicester Royal Infirmary


Hospital optometrist since:1990.

Can you describe working as a hospital optometrist in one sentence?

Challenging, but very rewarding.

How long have you worked as a hospital optometrist?

I’ve been in hospital optometry since my pre-reg, so that has been quite some time now. I qualified in 1990. I stayed at Moorfields for several years full-time afterwards, then moved up to Scotland briefly when my dad died, and then came back again. For the past 15 years I have been part time. I’ve always mixed it with teaching.

Why did you decide to become a hospital optometrist?

I was a mature student, and I was sharing a house with a couple of people, one who did High Street optometry and one who did hospital. I realised that the area that one of my flatmates was in was maybe a little bit more challenging. Hospital optometry was a natural pull for me. I wanted something with a lot more variety. But I had no idea, until I started, what it was all about.

You also teach at Anglia Ruskin University. How does that balance with your hospital work?

I enjoy being able to tell the students about what hospital optometry is. I think it’s a great advantage for me, because I’m only one of two hospital optometrists who work in my department. It’s looking at it from a different angle. We teach the students how to work in primary care, but we also need to explain to them what happens after they refer their patients into hospital optometry.

Thankfully, nowadays more students go into hospital optometry on maybe a one-day basis. There are more of us in hospital optometry than there was 30 years ago. I think it gives them a great advantage, to see the process of having a patient in primary care, and what happens next if you refer them.

What is the biggest challenge facing hospital optometry currently? How can this be resolved?

We need to upskill, which most of us in the hospital have already done. I don’t want it to become too disparate from primary care, though. Primary care optometrists need to upskill so that they can take a lot of the burden from hospital optometry too. Whilst within hospital optometry we need to upskill to be able to do a lot of the procedures, because there are not enough ophthalmologists, it’s all about the long-term care of that patient within the system. That can be done outside the hospital. Glaucoma monitoring and diabetes monitoring can be done in practices. High Street optometrists have the qualifications, and there are the potential higher qualifications as well. That, I think, is the major shift change that should happen. It is already happening, to be fair, but it’s not being recognised.

University lecturers need to be very aware, going forward, of how the profession is changing. It’s all down to education and training. Most of the universities now are up-stepping to a Master’s degree level, which I think is timely. To push that out through the new curriculum will be really important.

As university lecturers, many of us are in our mid-50s. We’re all going to be retiring on the same day. We need to be pulling more people into education. Education at undergraduate level is key, without a doubt.

It’s all about the long-term care of that patient within the system. That can be done outside the hospital


Has your experience working on the High Street benefited your hospital role?

Very much so, because it meant I could see it from the other perspective. I worked as a locum on the High Street, off and on, until about 15 years ago, in independent practice primarily. It made me realise I couldn’t criticise certain things, because actually, this is how it works.

In the hospital I work primarily in paediatrics and low vision. In the paediatric clinic, I can see how we need to improve our referrals from primary care. Having worked in both primary care and secondary care, I can see how it could be improved. Seeing the whole process, from one end to the other, has been a great advantage.

What is hospital optometry’s biggest success in the last three years and why?

I can only speak for Leicester, but the majority of optometrists working in our department are now working in different disciplines, alongside our ophthalmology colleagues, and are able to support a service in far greater capacity than we were 10 years ago.

What is your biggest success in the past three years and why?

Being a keynote at the Hospital and Specialty Optometrists Conference was probably one of them. I had the opportunity to review how low vision services have increased or improved over the past 30 years, and how they have become more interdisciplinary and more holistic.

It was huge for me to be able to report that back, as somebody who has been working in low vision for 30 years. It was a great opportunity to highlight that we’ve come a long way, but we’ve still got a long way to go. Services for low vision have significantly improved in the last 30 years, and it’s lovely to have been part of that. We’re more integrated with other professionals, such as vision rehabilitation specialists, and that’s been a long time coming. That, for me, is a huge success.

Services for low vision have significantly improved in the last 30 years, and it’s lovely to have been part of that


What would you say to optometrists working on the High Street about working in a hospital environment?

I would encourage you, if you have the opportunity and the time, to do some work in hospital. I think it’s really important to see the other side – to see what happens in secondary care, to really understand what happens to your patients next. Also, it’s very enjoyable. It certainly will improve your referrals. You’re not doing it for the money, though.

Anything else to add on the subject of working as a hospital optometrist?

It’s a great place to be. But the important thing is that it’s going through major change at the moment, and we need better recognition.