Optometrist

Optometrists examine patients' eyes, give advice on visual problems and prescribe and fit spectacles, contact lenses and low-vision aids

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

You'll use your skills to improve patients' vision and can, with higher qualifications, 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:

• community independent
• community multiple - large companies that have multiple branches in the UK and sometimes abroad
• domiciliary - going to patients' homes, care homes and day care centres to carry out eye examinations. Patients may have dementia, learning needs or physical disabilities.

Other types of optometrist include:

• academic
• community ophthalmology and hospital
• locum and portfolio
• research and industry
• third sector.

Many of the settings in which optometrists work enable part-time or flexible working.

Responsibilities

Depending on your area of work, you may:

• speak to patients to get detailed case histories from them
• examine patients' eyes 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 addition, you may:

• manage and train staff, including other optometrists, dispensing opticians and optical assistants
• 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
• 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

Your salary will vary, depending on whether you're working in a community practice or for the National Health Service (NHS). Salaries and benefits may also vary between independent and chain practices.

Community practice

• There's no set minimum salary for the pre-registration year in community practice, but most employers pay at least the National Living Wage (if you're 23 or over) or the National Minimum Wage (if you're under 23). For rates of pay, see GOV.UK. Many employers in community practice pay additional expenses such as pre-registration fees.
• Salaries for qualified optometrists starting in high street practice are typically around £30,000, depending on your employer and location.
• With experience you can earn from around £28,000 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 consisting of nine pay bands. Typical salaries for the pre-registration year start at £22,549 (band 4) but you'll need to meet costs such as pre-registration fees yourself.
• Once qualified, you can earn between £32,306 and £39,027 (band 6).
• Salaries for specialist optometrists can go up to £45,839 (band 7). At principal optometrist level, you could earn between £47,126 and £63,862 (8a-8b), with salaries for consultant optometrists and heads of service rising to £90,387 (band 8c/8d).

Income figures are intended as a guide only.

Working hours

Working hours are usually 9.00am to 5.30pm, Monday to Friday, and you'll typically work between 37 and 40 hours per week. 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.

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 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.
• Some optometrists prefer to work in different practices throughout the week but for others most work will be undertaken in one location. You'll usually need to travel for training purposes or to attend conferences. Some optometrists, however, prefer to do domiciliary work, travelling to examine people in their own homes or in care homes. They carry portable equipment with them to do this.
• 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 GOC, the regulator for the optical professions in the UK. In order to do this, you must pass two stages of training.

To pass Stage 1, you must get a minimum of a 2:2 honours degree in optometry from a GOC-approved optometry course and achieve all of the clinical requirements and Stage 1 competencies required to enter stage 2 of training. Degree courses typically last three years 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. Entry requirements vary between universities but you'll typically need a minimum of AAB at A-level, or equivalent, with at least two science subjects. Graduates with a 2:1 degree or above in a science-related subject may also be considered for entry on to an approved undergraduate course. See GOC - What to study and where for a list of approved course providers.

Stage 2 consists of undertaking a pre-registration placement, which typically lasts 12 to 18 months and takes place under the supervision of a qualified registrant. 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 a training placement. These range from one to two years and are often advertised on:

• The College of Optometrists - Jobs board
• university noticeboards
• the websites of major companies
• adverts in publications such as Optician and Optometry Today (OT).

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.

You must successfully achieve a 2:2 or above, as well as the clinical and competency requirements at Stage 1, before entering a pre-registration placement. In the event that you do not achieve one or more of these, or you have allowed more than two years to elapse before commencing your stage 2 pre-registration placement, you will need to resit this part of your training. Some GOC-approved providers offer tailored or short courses specifically for students falling into this category. Check with your university in the first instance to identify what options are available to you.

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 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
• a willingness to undertake continuing professional development (CPD) to keep up to date
• 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.

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 domiciliary work. 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 (as opposed to retail) 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. Details can be found in the optometry press.

Professional development

As a qualified optometrist, you must renew your registration with the 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.

Membership of The College of Optometrists 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.

They also accredit 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.

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 corporate 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.