Hospital optometry community gathers in Manchester

Visual hallucinations, new strategies for optometry teaching, and the future potential of oculomics were just some of the subjects discussed during the AOP’s Hospital and Specialty Optometrists Conference (HSOC) 2024.

The event was held at Emirates Old Trafford in Manchester on 21 and 22 September, and saw 255 optometrists attend across the two days.

HSOC is organised annually by the AOP and its Hospital Optometrists Committee, which is chaired by Dr Vijay Anand, head of optometry at Moorfields Eye Hospital.

Anand also hosted the conference, which he called "fantastic.”

In his welcome, Anand noted the importance of the venue for cricket fans, telling delegates that the pitch outside the conference hall had played host to the first Ashes tournament, in 1884, as well as five cricket world cups.

He also highlighted that 2024 marks the 50^th year of AOP hospital optometry conferences, and acknowledged consultant optometrist, Andrew Tompkin, who has been involved in their organisation for “decades.”

Optometry is at an important moment, Anand said, emphasising that whilst monetary spend on healthcare is increasing, there is a shortfall of consultants within eye departments across all four nations of the UK.

He referenced the newly-published Darzi Report into the state of the NHS, calling its findings “damning.”  

“Before the Labour government was elected, they said that they would move some of [the tasks traditionally completed in] secondary care into primary care,” Anand said.

“We’ll try and work towards cataract and glaucoma [services] moving into primary care. That is really where we need to look to develop, because we haven’t got enough ophthalmologists, and we know that there is a good, trained staff of optometrists out there.”

Health secretary, Wes Streeting, has emphasised the need for prevention and a move from analogue to digital, as well as the importance of moving from secondary to community care, Anand said.

This is “where primary care and secondary care optometry can really work together, to build on that and show that we are the people who can take this work on for ophthalmology,” he believes.

The optometry community will be looking to those attending HSOC to take the profession forward in the coming years as many existing consultants reach retirement, Anand said.

He also acknowledged primary care colleagues as vital in the future of optometry, as this is where “the direction of travel is moving.”

A packed schedule

Saturday morning saw 10-minute presentations of published papers, on subjects including digital clinical safety, investigating the optimal perimetric stimulus for detecting gradients in retinal ganglion cell density, contact lens fitting in keratoconus, and the barriers to implementing the Ophthalmic Practitioner Training programme in a London A&E department.

Delegates then attended a lecture on eye disease and visual hallucinations, presented by consultant clinical psychologist, Daniel Collerton.

Afterwards, reader in optometry education at the University of Manchester, Will Holmes, introduced attendees to the concept of ‘entrustable professional activities’ – an alternative way to assess student progress, which Manchester is adopting for its optometry students alongside changes integrated through the General Optical Council’s new education and training requirements.

Holmes used footballer Lionel Messi missing a penalty at the 2024 Copa America final to demonstrate why he believes the current objective structed clinical examination system might not be the most appropriate way to decide who qualifies as an optometrist.

“I would suggest that if was all you knew about Messi, that one-off penalty, you wouldn’t necessarily think he’s a very good footballer. And yet, this is how we usually determine whether somebody is competent to access the register to be an optometrist,” Holmes said.

The third lecture of the morning was given by NHS ophthalmologist, Sunil Mamotra, who discussed how advances in telemedicine, particularly through the use of video slit lamps, have the potential to transform community eye care.

Afternoon breakout sessions saw delegates split into groups for discussion workshops, peer reviews and lectures around anterior eye, contact lenses, glaucoma, and medical retina. Attendees were able to collect CPD points for all sessions attended.

Delegates then came together for drinks and a networking dinner, also held at the cricket ground, on Saturday evening.

Day two began with the presentation of papers on retinal disease management, the role of optometrists in rheumatology oncology, and visual fields in relation to glaucoma in the Research and Evaluation of Area-Modulation Perimetry (REVAMP) study.

The Paul Spry Memorial Lecture, delivered by Dr Robert Harper, an optometrist consultant at Manchester Royal Eye Hospital, focused on ‘Glaucoma, optometry, and the interface of primary and secondary care.’

Medical ophthalmologist Nima Ghadiri then introduced delegates to the concept of oculomics – the system of predicting markers of systemic disease, for example Parkinson’s, through ophthalmic imaging.

Sunday afternoon saw breakout sessions on red eye presentations to the emergency department and on changes to optometry education that have been implemented throughout 2023 and 2024, alongside CPD-accredited glaucoma, contact lens, medical retina and anterior eye streams.

In his closing remarks, Anand outlined changes to nominations and voting for the next delegation of AOP Hospital Optometrists Committee members.

Instead of nominations and voting taking place at HSOC itself, the decision has been taken to open the process to the wider hospital optometry community, of which there are 1200 members.

“It makes sense to open this up to anybody who is a hospital optometrist who wants to stand, so they don’t need to be present here to do so,” he said. “That also gives the voting rights to all those people who aren’t hospital optometrists, so we can truly represent the optometry community.”

The timeline will be adjusted to align with AOP Council recruitment, the results of which are announced annually in June, he said.

He also presented the award for best research project poster, which was won by the team at Oxford Eye Hospital.

Delegates were invited to submit posters outlining their research projects when booking, and 18 posters were on display throughout the conference.

An optometry family

One of those attending HSOC was Lynne Allard, a hospital optometrist from Perth, Western Australia.

Allard told OT that she travelled to HSOC because hospital optometry in the UK is far more developed than it is in Australia.

“There aren’t that many of us over there,” Allard said.

Professor Jonathan Jackson, head of optometry at the Royal Victoria Hospital in Belfast, told OT that he attends HSOC because it is his “professional family.”

“I always learn new things, whenever I come here,” he said. “It’s the opportunity to engage face-to-face with other colleagues, who are doing new, exciting things. It’s a fantastic conference.”

Adam Smith, a community optometrist in Chester, explained that he was attending HSOC whilst studying for his independent prescribing qualification, in order to “dip his toe into hospital optometry.”

“It has been a learning experience,” he said. “It’s at a more advanced level than I was expecting, but in a good way.”

Nizz Sabir, a glaucoma specialist at Barnsley Hospital, told OT: “I’ve found it really nice to hear from leaders in the sector about their innovations, looking at how different hospital trusts and specialists practise in different ways.

“Difference of opinion is there, and it gives you a different way of understanding techniques, and management of patients.”

It is important to get out of the practice, network, and meet other practitioners, Sabir said.

His clinical highlight was the oculomics lecture given by ophthalmologist Nima Ghadiri, he shared, because looking at how eye health can have an impact on wider health is close to his heart.

Optometry has “always been the small cousin,” in terms of healthcare, Sabir said, “but maybe there’s a way of transforming that relationship going forward.”

He added: “People forget that it is a simple game of dot-to-dot. We are all working for the patient and trying to improve patient care – but do we know what each other does, and are we at the right place at the right time? In primary care especially, I think it’s an important aspect of optimising that care.

“I think this is a good opportunity for primary care optometrists, as well as secondary care optometrists, to work better, and have a bigger role in the healthcare of people.”

Sabir added: “The opportunities for career development, now, are vast. Seeing what other people are doing is amazing.”

HSOC 2024 was headline sponsored by Bausch + Lomb, with workshops sponsored by Thea, Roche and NuVision.

CPD certificates for points gained at HSOC 2024 will be emailed to members by Friday 4 October.