Kumell Rizvi: “Hospital optometry is about the people that you encounter”

Here, Rizvi tells OT about his two most defining moments in hospital optometry – and why the colleagues he encounters in the hospital setting make his job exceptional.

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

For me, it’s where I’ve felt able to have the most direct clinical impact.

How long have you worked in the hospital setting?

I started in 2020, just as COVID-19 hit. So, around six years now.

Why did you decide to start working in the hospital?

It was only two years after I qualified, and it was for a mix of reasons. I realised early on that I personally preferred an environment where clinical decision-making felt more central to my role.

During COVID-19, I began working part-time in the hospital and started to feel that my work allowed me to exercise my clinical mind more than what I was doing in the community. That was specific to the practice I was in, which was quite sales-focused – it’s not that community optometrists don’t do meaningful work.

That’s when I started working part-time in the hospital. I switched to full-time about a year later.

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

Hospital optometry is what I do throughout the week, but I also spend time writing, including creating continuing professional development articles for the optical press.

My baby at the moment is an artificial intelligence (AI) agent that I have been building over the past year. It helps guide and inform patients undergoing eye surgery in a more interactive way than the leaflets we often provide. I am hoping to get it to a hospital trial stage soon, which will give it more legitimacy. 

Anyone who has entered into hospital optometry has already established that their moral compass is well calibrated

What would you say is the biggest challenge facing hospital optometry currently, and how can the profession help to resolve it?

I think different settings bring different pressures. In some High Street environments, there can be a greater emphasis on performance metrics and commercial targets, which can sometimes make the patient relationship feel more complex.

Looking ahead, I think hospital optometry may begin to experience some of these pressures too, particularly within cataract services. At the moment, many of these services are largely NHS-funded, but as demand and competition increase, there may be more focus on private pathways and lens options.

That isn’t necessarily a negative in itself, but it will be important to ensure that patient-centred care remains at the core of decision-making. Maintaining that balance will be one of the key challenges for the profession moving forward.

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

When I started, there was very little information available on hospital optometry. When applying for roles, you didn’t know if you would make the cut. I applied and got rejected constantly, because I didn’t have experience.

Now, I think that there are so many providers that offer roles for optometrists: there is Spamedica, Newmedica, Optegra, CHEC, and there are so many specialist roles. For example, you don't have to solely focus on cataract assessment – you can work in teleoptometry, or academia. You can treat age-related macular degeneration and glaucoma. There are tonnes of possibilities, and they’re accessible. I think that’s the biggest strength: allowing more optometrists to become part of it.

What is your own biggest achievement in the past three years?

The role that I left two years ago was really cool. I was a lead optometrist at SpaMedica, looking after five hospitals, training optometrists, and working from home, which as an optometrist is unheard of. 

When I left, everyone wondered what I was doing. But it was really to take a bet on myself. I wanted to do more, and I didn’t want my career to be confined just to one particular company or one role. I wanted to see what I could do. 

When I look back over the past two years, I’ve got my locum hospital optometry jobs through the relationships that I’ve built with people. As well as SpaMedica, I’ve also built relationships with teams across different providers. I’m also generating income from things that are completely unrelated to clinic, including writing and my AI project, which hopefully gets trialled. So, I think it’s starting from basically nothing again, and slowly building up my own little path.

It’s better to learn on the job than to try and prepare yourself for many years and then lose the opportunity or experiences that you could have had in that time

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

A month into joining SpaMedica, I found out my granddad had passed away. I already felt like I just needed to get through the day and go home.

At 4pm, as I was winding down, an emergency patient came in. She was in intense pain, and her eye was really red. She had had an expulsive haemorrhage, which is where you have such a massive bleed in your eye that everything pops out. Her eye looked like someone had stabbed it, and she was in insane pain.

I stayed with her. We left at 10pm that day, because we were trying to make sure that she was comfortable, and we could limit the damage that had already been done. Although an amount of her vision had already been lost, you still want to make sure you preserve what you can, so that even if the eye needs to be unnucleated, there’s no further damage to the brain.

I’ve never seen anything like that, before or since. For me, it was right place, right time. It was one of those situations where I thought, ‘I would never see this in the community. I’m glad that I’m here, and that I get to look after her.’

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

I’d say it’s within reach. Don’t wait for some sort of arbitrary hurdle that you’ve put in front of yourself, like you want to be qualified for a certain amount of time, or you want to get a certain professional certificate first. Just go for it, because it’s better to learn on the job than to try and prepare yourself for many years and then lose the opportunity or experiences that you could have had in that time.

Is there anything else you would add on the subject of working as a hospital optometrist?

I would emphasise that hospital optometry is about the people that you encounter. Anyone who has joined a hospital won’t have done so because of the pay. You get paid more as a High Street optometrist. Hospital roles aren’t necessarily the highest-paying option.

Hospital optometrists are people who aren’t comfortable in their comfort zone, so you meet some incredible people in this field. It brings together so many different types of people. You’re working with surgeons and, if you get to management level, you’re working with CEOs and board directors, just so many different people from so many walks of life.

I’ve encountered some amazing and inspirational people within hospital optometry. When you first join a hospital, you don't necessarily consider the experiences you will have with colleagues, but you will be be pleasantly surprised at how amazing some of these people are.