oct ewj 24 online - Flipbook - Page 38
Professions in Eyecare
There is a lot of confusion between the various professions involved in eye care in the UK. This
is not helped by the postcode lottery that prevails in the ‘National’ Health Service. I will attempt
to explain the responsibilities of the professions as I have seen them over my almost fifty years in
the profession.
Orthoptists used to train for two years at college, but
now a degree is given at the end of training. They
then work primarily in the NHS, often with children,
getting their eyes to work together, thus hopefully
avoiding double vision and ‘lazy’ eyes in the future.
They usually work under ophthalmologists.
ferred to as ophthalmic medical practitioners but
these are a rarity these days.
Now things get more complicated, so a history lesson!
Please excuse any errors, some of this was before even
I was born!
In 1948, when the NHS was started, anybody who
had a shop premises with ‘Optician’ over the door, became a qualified optician. I met a man many years ago
whose father had taken out leases on five such
premises in the sixteen year old son’s name, and thus
he ran a surprisingly successful business for many
years! Thankfully these ‘opticians’ are all no longer
practicing.
Ophthalmologists are qualified in medicine and
undertake at least nine years post university training
before applying for consultant roles. It is very unlikely
that a patient will see a fully qualified ophthalmologist
unless there is something seriously wrong with their
eyes. Most work in hospitals, but many are now in the
private sector, lasering eyes to change the need for
other eye correction, or removing cataracts. The best
of them perform very delicate operations such as a
friend of mine who removed a tumour the same size
as the eye from the eye socket, taking seven hours to
do it!
In 1958, the title ‘optician’ became a protected title,
those who were already registered remained ‘qualified’, but new registrants needed a college diploma
( In the 1960’s this qualification became a university
degree) and to pass post graduate viva examinations.
Many ophthalmologists supervise clinics, making sure
that glaucoma patients are controlling their eye
pressures, checking whether cataracts are impairing
patients’ lives sufficiently to justify their removal,
injecting eyes to slow the progression of macular
degeneration, checking flashes and floaters for
retinal detachments and advising on any other eye
problems which patients report. They are assisted by
ophthalmic nurses.
The unfortunate thing about this was that there were
three different types of ‘optician’. There were manufacturing opticians, who made glasses, dispensing opticians (DO’s), who translated prescriptions into orders
for the manufacturers, and ophthalmic opticians
(OO’s) who generated prescriptions from eye examinations whilst also checking for disease of the eyes. I
should mention that some DO’s have taken an extra
course so that they can fit contact lenses after an OO
or optometrist has checked the eye for disease and
issued a prescription.
Some ophthalmologists work in high street locations
performing eye examinations, these doctors are reEXPERT WITNESS JOURNAL
36
O C TO B E R 2 0 2 4
