Optometrist

The examinations carried out by optometrists are crucial for detecting vision and eye health problems and providing the necessary adjustments, treatments or referrals

As an optometrist, you'll be trained to recognise vision defects and abnormalities, injuries to the eye, eye diseases such as glaucoma and macular degeneration, and serious health conditions such as diabetes, brain tumours or high blood pressure.

You'll use your skills to improve patients' vision and will prescribe and fit spectacles, contact lenses or low-vision aids. You will also make referrals to specialists as necessary to deal with diseases of the eye or other health conditions.

Within an eye clinic or hospital you’ll share the care of patients with chronic conditions or manage patients with low-risk eye conditions. Most of these activities involve the use of specialist equipment.

Patients range from very young children to the elderly. You may see both NHS and private patients.

Types of optometrist

Most optometrists work in community practice. This may be:

• high street practices - either independent practices or regional or national brands that have numerous practices
• community practice - going to patients' homes, care homes and day care centres to carry out eye examinations. Patients may have dementia, learning needs or physical disabilities.

You could also work within:

• hospitals or eye clinics
• academic research centres
• research and industry
• third sector
• locum and portfolio work.

Responsibilities

As an optometrist you'll:

• speak to patients to get detailed case histories from them
• examine patients' eyes using specialist equipment to detect vision defects and signs of injury, disease or abnormality
• manage and monitor some eye conditions, either autonomously or alongside other healthcare professionals
• detect signs and symptoms of general health conditions such as diabetes
• fit spectacles or contact lenses
• discuss vision-related matters with patients, and offer advice and reassurance
• offer help and advice to patients when choosing frames and lenses
• liaise with and write referral letters to doctors and other optometrists with higher qualifications
• meet sales targets with regard to selling spectacles or contact lenses.

In some roles you may:

• manage and train staff, including other optometrists, dispensing opticians and optical assistants or medical students
• manage the retail aspects of spectacles, contact lenses and other vision care products
• administer, organise and plan the development of the practice
• liaise with sales representatives from vision care product suppliers
• own or manage a practice
• treat, manage and prescribe medicines for people with eye conditions
• advise NHS England or local clinical commissioning groups on the development of eye care services.

Salary

Salaries vary depending on whether you're working in a high street practice in the community or for the NHS. Salaries and benefits may also vary between independent and chain practices.

Community practice

• You will be paid during your pre-registration year but there are no set salaries for that position. Many employers in community practice pay additional expenses such as pre-registration fees.
• Qualified, registered optometrists starting in high street practice are typically on salaries of £30,000, depending on the employer and location.
• With experience you can earn from £33,000 to in excess of £65,000. Earnings for company directors, partners and sole practitioners depend on business performance.

Salaries depend upon supply and demand, so you may earn more in areas where there are fewer optometrists.

Additional benefits can include commission, a bonus scheme, health insurance, life insurance, a company car and discounted eyewear.

NHS

• Jobs in the NHS as a hospital optometrist are usually covered by the Agenda for Change (AfC) pay rates. Typical salaries for the pre-registration year start at £25,147 (band 4). You may need to meet costs such as pre-registration fees yourself.
• Once qualified and registered, you can earn between £35,392 and £42,618 (band 6).
• With experience, you can start to work up through other bands. Salaries for specialist optometrists can go up to £50,056 (band 7). At principal optometrist level, you could earn between £50,952 and £68,525 (8a-8b), with salaries for consultant optometrists and heads of service rising up to £96,376 (band 8d).

Income figures are intended as a guide only.

Working hours

In a full-time role, you'll typically work between 37 and 40 hours per week across standard office hours. However, in community practice, weekend and evening work is common, particularly in larger chains.

Part-time and temporary locum work is popular, often working in a variety of practices and this may allow you to be more flexible with your hours.

Career breaks are possible, but unless you're intending on taking a significant amount of time off you may wish to remain on the General Optical Council (GOC) register, which means doing a certain amount of continuing professional development (CPD) during your break.

What to expect

• If you work in community practice, you'll work alone when carrying out eye examinations but will probably be part of a wider team that includes dispensing opticians and optical assistants. Optometrists in hospitals work as part of a large team of eye specialists that includes ophthalmologists, nurses, orthoptists and healthcare assistants.
• Jobs are available throughout the UK in hospitals and all types of practice. If working in community practice, you'll usually work in a shop comprising a retail section and private consulting rooms, while hospital or clinic work is carried out in consulting rooms or cubicles in hospital trust buildings.
• Practice ownership through a franchise, partnership or sole trader operation is possible.
• Your work setting will depend on your specific role. Within a high street practice or hospital you'll usually work in the one location, however within community work, you'll typically travel to people's homes or to care homes where you'll carry out the eye exams using portable equipment.
• Travel for training and conferences may be required.
• UK-registered optometrists may find work abroad. Some countries require you to take further examinations.

Qualifications

To work as an optometrist you must be registered with the General Optical Council (GOC), the regulator for the optical professions in the UK. In order to do this, you must pass two stages of training.

Stage 1: consists of successfully completing a GOC-approved optometry degree (minimum of 2:2) and demonstrating you have achieved the required GOC learning outcomes. Degree courses typically last three years (four years in Scotland) and are full time. However, there are a small number of four-year Masters degrees available. There are a number of universities currently running approved degree courses and you can find a list of these at GOC - What to study and where.

Stage 2: consists of undertaking a salaried pre-registration placement, which typically lasts 12 to 18 months and takes place under the supervision of a GOC-registered optometrist. Stage 2 includes work-based assessments and a final objective structured clinical examination (OSCE) assessment. These assessments help you to build on the knowledge that you gained at university and apply it to real practice in the workplace.

Before starting your pre-registration training, you'll need to find and apply for a training placement. These are often advertised on:

• The College of Optometrists - Jobs board
• Optician Jobs
• Optometry Today (OT)
• university noticeboards
• the websites of major companies.

You can also contact local optometry practices to see whether they're willing to offer training placements. You have two years and three months to complete the pre-registration training and assessments, although many trainees complete them in around 15 months.

Successful completion of the Stage 2 components will allow you to register as an optometrist with the GOC.

Some course providers offer an integrated four-year undergraduate Masters of Optometry, which incorporates the pre-registration period and assessments. Students who successfully complete this course are fully qualified and able to register as optometrists with the GOC.

Skills

You'll need to have:

• clinical decision-making skills and an ability to use professional judgement
• excellent communication skills to deal with a range of people
• strong interpersonal skills, with the ability to put anxious patients at ease
• the ability to understand and apply scientific principles and methods
• confidence in using complex equipment
• teamwork skills
• manual dexterity, precision and accuracy
• good organisation and administrative skills
• attention to detail
• the confidence to feel comfortable working in close proximity to patients
• patience to carry out repetitive tasks.

Work experience

Competition for pre-registration positions is high so it's important to get some work experience, either paid or voluntary. Some students work in practices at weekends or during university holidays. Some of the larger chains also run summer programmes for students between their second and third year. Visit company websites for details of these schemes.

Voluntary work opportunities are available in both the UK and overseas with organisations such as Vision Care for homeless people and Vision Aid Overseas.

You can also become a member of The College of Optometrists as either a university student or pre-registration trainee. This will help you to make contacts to find out about relevant opportunities and will also provide you with useful resources and advice. Membership is free at this level.

Find out more about the different kinds of work experience and internships that are available.

Employers

Most optometrists work in high street practices, which may be independent or part of a regional or national chain. Others undertake community work, visiting people in their homes or care homes. If you have a strong interest in the medical side of optometry, you may decide to work in hospitals alongside other healthcare professionals such as ophthalmologists and orthoptists. Some hospital optometrists perform minor surgery.

Optometric practice is developing with more healthcare related work being conducted in community practice. This is facilitated by the increasing use of technology in community practice, which can help optometrists manage patients with certain eye conditions.

It's also possible to work in academic settings doing research and/or teaching, or in the optical manufacturing industry working for spectacle lens, contact lens and ophthalmic instrument manufacturers. This may be in research and development, or in a professional services role, giving technical support.

Companies offering laser refractive surgery also employ optometrists in a pre-operative consultation and post-surgical follow-up role. Other employers include charities, local government, the army and public health bodies.

Self-employment through a franchise or partnership, or as a sole practitioner, is also possible.

Look for job vacancies at:

• NHS Jobs
• NHSScotland Jobs
• Optician Jobs
• Optometry Today (OT)
• The College of Optometrists - Jobs board

You can also search the websites of major high street chains, or look to specialist recruitment agencies who will handle vacancies.

Professional development

As a qualified optometrist, you must renew your registration with the General Optical Council (GOC) annually in order to practise. Undertaking continuing professional development (CPD) is a statutory requirement for continued registration.

The GOC's CPD scheme is a points-based system, run over a three-year cycle, which ensures that you keep up to date with the knowledge and skills needed to practise safely throughout your career. You can gain CPD points through a variety of learning activities, including:

• attending lectures, conferences and workshops
• presenting papers at conferences
• supervising, teaching and assessing
• developing business skills
• studying for a postgraduate qualification.

You'll need to achieve a minimum number of CPD points by the end of each cycle to stay on the register.

Masters courses and opportunities for research at PhD level are available via the GOC-approved undergraduate degree providers. Search for postgraduate courses in optometry.

Gaining membership of The College of Optometrists can also help with career progression as it provides access to a range of benefits including free events, advice, the latest news, networking opportunities, and support and resources to become an examiner, assessor or supervisor.

The College of Optometrists also accredits a range of higher qualifications at Professional Certificate, Professional Higher Certificate and Professional Diploma level in the following subject areas:

• glaucoma
• low vision
• contact lens practice
• medical retina
• paediatric eye care.

Find out more about the higher qualifications.

With experience, you can train to become an independent prescribing optometrist by undertaking the independent prescribing qualification. In order to pass, you must attend a GOC-approved course, complete a clinical placement and pass the Therapeutics Common Final Assessment (TCFA) in Independent Prescribing.

Career prospects

Optometry has a flexible career structure and it's possible to move between sectors and also to combine a number of roles.

Opportunities for career progression within high street practice can include promotion within the clinical and/or management structure. Transfer between practices may help you to progress.

Some optometrists choose to go into practice management where salaries may be higher. You will usually be responsible for practice direction and overall business management, as well as the routine work of an optometrist (e.g. sight testing).

It's possible to buy into an optometry practice (either franchise or joint venture) so that you have a direct influence on the running of the business. You can also set up an independent practice, which may be of particular interest if you want to develop a specialist optometric service.

If you're working in an NHS hospital, there's a defined career structure and you can work your way up from basic optometrist to specialist and principal optometrist and then, ultimately, consultant optometrist.

With further study there are also opportunities to become an independent prescribing optometrist.

You may choose to develop your career by going into research and lecturing. Some optometrists become involved in supervision of pre-registration students and full training is provided by The College of Optometrists. It may also be possible to get involved in the education of ophthalmic nurses and medical students.