“I was always drawn to clinical aspects of optometry”

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

Rewarding – working in multidisciplinary teams with opportunities in advanced clinical roles make for a very fulfilling job.

How long have you worked as a hospital optometrist?   

Since 2002. I completed my pre-registration year at Sunderland Eye Infirmary, where I had a very influential team of supervisors – they definitely shaped my career. I am now deputy head optometrist in NHS Grampian’s Aberdeen Eye Clinic. I have been here for around 20 years, working in age-related macular degeneration, diabetes and cornea clinics. I am also a member of the AOP Hospital Optometry Committee and am in my second term.  

When and why did you decide to become a hospital optometrist?  

When applying to university. I was always drawn to clinical aspects of optometry, enjoying these modules the most. I only applied to hospitals for my pre-registration year, as knew it was to be my direction of travel.  

Do you do any other work or volunteering alongside hospital optometry?

I do some ad-hoc work for National Education Scotland (NES) and independent prescribing exam work for The College of Optometrists. I also volunteer as a school sports coach.  

What is the biggest challenge facing hospital optometry currently and why?

With more and more advancements in treatment options and the chronic nature of many eye conditions requiring ongoing follow up, there is more demand than ever on ophthalmology services, thus the biggest challenge facing hospital optometry currently is the increased demand for ophthalmology services with limited capacity.      

I can see first-hand in Scotland, and certainly in Grampian, that work streams have been re-designed, post-COVID-19, and there is now very little ‘waste’ in the system. With the Scottish General Ophthalmic Services system and continued work of local boards, many patients are now being managed very competently in primary care. The right patients are definitely being seen by the right people – although maybe not at the right time, with the current secondary care waiting lists.  

As a result, many of the patients we now see in secondary care are much more complex to manage, so appointment times are longer than they were pre-COVID-19. This also makes capacity and demand more of a challenge.   

I do not know if this capacity/demand problem will ever be sorted, but hospital optometrists have shown that they are well placed to expand their roles. Continued recruitment and upskilling, with the right support and governance structures in place, would certainly help the cause. 

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

The increase in the scope of practice, the increase in the number of hospital optometrists working in extended roles, and the increase in the numbers of units employing hospital optometrists. Professor Robert Harper’s published scope of practice study in 2022 showed that it continues to develop, with many optometrists working in roles historically performed by medical practitioners. This has improved job satisfaction and routes of progression.  

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

The continued balance, alongside the development of professional networks. I have an incredibly busy home and work life – I am the proud mother of three children (each with social lives better than mine – I am the taxi), with my husband working away on rotation.  

I balance family life with my busy day job at Aberdeen Royal Infirmary, along with my professional involvement in many committees and meetings. I am a big believer in paying it forward – my many supervisors and mentors over the years took time and care to teach and train me, and I see it as my duty to pass this on to the next generation.  

My continued professional growth, supporting colleagues and continued development of professional relationships across hospital optometry networks, is what I continue to work at – bridging any divides, and attempting to make positive changes to policy and practice at a local and national level.     

I have a good network of hospital optometry contacts up and down the country and I am often emailed for advice and opinions. I am friendly but also known for voicing some quite strong opinions – but I think this has actually helped me increase and develop professional networks. 

“The camaraderie involved in working as part of a large multi-disciplinary team is wonderful – a work family, all pulling together to do the best by the patient”

What is the most surprising case you have seen in the hospital setting?

An Ozurdex implant found in an anterior chamber.  

Claire Melvin

An Ozurdex implant, found in an anterior chamber in a patient at Aberdeen Royal Infirmary and witnessed by Claire Melvin

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

It would depend on whether they were looking for a change or wondering whether they should try something new. If this was the case, I would l tell them how much I love my job.

The camaraderie involved in working as part of a large multi-disciplinary team is wonderful – a work family, all pulling together to do the best by the patient. The respect shown to hospital optometrists by ophthalmology is high and is mutual. The support and training you get from senior clinicians and peers is fantastic and the opportunities to extend your practice go a long way to help job satisfaction.   

It is a very rewarding career, and I am genuinely glad to be doing what I do. I would wholeheartedly encourage anyone thinking about working in hospital optometry to try it.  

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

Something that currently restricts my personal hospital optometry practice is the legislation around independent prescribing (IP). I am unable to prescribe anti-VEGF injections despite having the skills, knowledge and competence to do so, having worked in degenerative and vascular retina clinics for over 12 years.  

Recently, at our hospital optometry heads of department meeting at our annual conference, we discussed this issue and how it restricts so many hospital optometrists’ practice. We would like to progress this and attempt to make a change to IP legislation in the future.