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How I got here
“Having lots of people to support and push me has been really important”
Liz Cave, head of optometry at University Hospitals Plymouth, tells OT why having a village to support her career has been invaluable
01 August 2025
I wanted to study medicine, and that was where my headspace was.
When it came to applying, I really wanted to stay in Wales, but I wasn’t accepted into medical school. I’d only picked one geographic area, and they said they needed someone who was a bit more mobile. I was like, ‘Okay, what’s my plan B?’ I was flicking through the Cardiff University prospectus, and came across optometry. I thought, ‘well, that’s healthcare related – ideal.
I hadn’t had my eyes tested in seven years, so I thought I’d better go.
I popped in to see the local opticians, and had a chat with them. My father is blind in one eye, and my grandfather was blind, so I was like, ‘actually, that sounds like I’d be quite a good fit.’ I haven’t looked back.
During my second year at Cardiff University, myself and one of the other students went to Japan for a student placement.
I spent three weeks in Kyoto, where there is quite a lot of research in cornea taking place. We observed lots of surgeries and lots of outpatient appointments in the hospital setting. The language was definitely a barrier, so we could only take in so much. But that fuelled my desire to pursue the clinical, hospital side of things.
I did my pre-registration placement at Coventry and Warwickshire Hospital.
I was working alongside another pre-reg, and it was a great experience. It really does take a team to bring along a pre-reg in their journey, especially from the hospital perspective. We had a brand new building at the time, so I was really lucky. I had a really good placement.
It really does take a team to bring along a pre-reg in their journey
Unfortunately, they didn’t have a place for me after pre-reg, so I had to find somewhere else.
That happened to be Exeter, because I knew I wanted to remain in hospital optometry. I wanted full-time, but Exeter only had part-time hours, so I took the part-time position and locumed for the remaining couple of days in independent practices across Exeter and around Devon.
I locumed for about 10 years, on and off.
I built a good rapport with the staff, which was nice from a locum perspective. I found locuming helpful in maintaining the skills that you need to provide a full sight test. In the hospital, you only do component parts of a sight test. If that was all you were doing, the prospect of doing a full check could be quite daunting. It was a good mixture.
During this period, I also completed my independent prescribing (IP) qualification.
For me, having experience in the hospital setting and seeing the patients there, and having learnt from my medical colleagues already, helped me with the IP course, because I had a little bit of a foundational knowledge.
An opportunity came up at Exeter Hospital to be the head of the emergency eye service, which is a full-time role and then some.
It was a big responsibility, especially because it was my first management role. I had covered for the head optometrist when she was on maternity leave for a year prior to that, but at that point in my life I was not ready for anything longer. However, by this point, I was ready to throw myself into that role completely.
The head optometrist that I worked with, Louise Frost at Exeter Hospital, has been an excellent mentor and manager.
She saw something in me, in terms of leadership and management, before I saw it in myself. She was, without me knowing, guiding me in that direction anyway, and then when the opportunity came, she gave me the confidence to say ‘yes, I can do it. I’ve got it.’ She was then mentoring me alongside the position, so I had some good support.
I stayed as head of the emergency eye service at Exeter Hospital for two years.
I would have very happily stayed in that lane. I loved that job. But Dave Adams, who was the previous head of optometry down in University Hospitals Plymouth, was retiring, and so his post was advertised. I didn’t apply initially, despite Louise prompting me. When they brought the advert out for the second time, that’s when I thought, ‘I missed the boat the first time around, and I regret it. This is my sign to go for it.’
As of June 2025, I had been head of optometry at University Hospitals Plymouth for two years.
As head of the emergency eye unit, I was dealing with that one sub-specialty. Being the head of optometry, I’m dealing with multiple specialities all at the same time. It’s definitely a case of being able to prioritise, and having a good team around you, because you cannot do everything by yourself.
Being the head of optometry, I’m dealing with multiple specialities all at the same time. It’s definitely a case of being able to prioritise
When I started in the role, one of the first things I did was advertise for a pre-reg trainee.
We did it at really short notice, because I really wanted to train someone up internally. She stayed on, and we’ve got two pre-regs at the moment, who are just finishing their Stage one.
We’re also invested in promoting existing staff within the service.
For instance, we’ve got a contact lens optician who works in the hospital, who is excellent. I’m interested in working with the existing team, seeing what their abilities are, what their interests are, and how that aligns with the service need.
I have many projects on the go at the moment.
I’m trying as much as possible to promote relationships between the hospital and university. We’re very fortunate that we have an optometry school in Plymouth, so I’m trying to get students involved in hospital clinics.
I’m also trying to manage the backlog of patients that we have, unfortunately, within the hospital eye service.
It’s quite daunting, and it’s not something that changes overnight. But we’ve got a good team of optometrists who are going through their training in glaucoma and independent prescribing, really driving down the waiting lists.
Having lots of people to support and push me has been really important in my career.
That’s what I want to do for other people, now, either as an official or unofficial mentor – that’s the point in my career that I feel I am in.
One standout moment
“In my previous role, as the emergency eye service lead, what really struck a chord with me was where management can really make a difference. I wrote, alongside one of the consultants, a competency document for how, as a department, we would manage endophthalmitis when it presents. That was truly multi-professional, to get everyone's input: theatres, doctors, emergency eye care staff, and getting the whole competency together.
“It was signed off in governance, and literally the next day, someone walked in with endophthalmitis. Obviously, it was fresh in everyone’s minds. We ran through the entire procedure for the patient, and we got them injected within an hour, which was incredible teamwork. Having a part to play in that, of putting the pieces together, was really rewarding. Another stars aligning moment.”
About the author
Liz Cave 
Head of optometry at University Hospitals Plymouth.
Liz Cave manages and leads the optometry service at Plymouth's Royal Eye Infirmary, which serves patients from across Devon and Cornwall. She is dedicated to patient care, and to improving communication between the hospital eye service and primary care in the community.
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