Sunday, 19 October 2014

Three weeks into third year

It's now three weeks into 3rd year and I've just about survived all my clinics without killing, hurting or mentally scarring my patients (I think I have anyway).

I'll start with the lectures, they've been challenging, interesting and scary at the same time. From the sheer amount of detail in abnormal ocular conditions to the real life knowledge of occupational optometry via the life changing low vision and special assessment. First year is all about bringing everyone up to the same level and getting people used to the university way of teaching whilst instilling basic principles and some background knowledge. Second year builds on this and you start to learn practical applications such as binocular vision and contact lenses. Third year is where it all comes together, it's all about applying principles in practice and smoothing out the rough edges in knowledge and patient interaction. It is knowledge gained in third year is what I will be using on a daily basis in my future career, assuming it actually goes into my brain.

Onto clinics, which are the main part of the third year, I've had 2 primary care patients, 1 contact lens patient, sat in on 3 special assessment clinics, done 2 dispenses and 1 collection. What have I learnt from all that? That at the moment I am nowhere near ready to see patients unsupervised or finish my degree. Have they really been that bad, probably not but they have certainly shown how much more I have to learn. The main problem has been me getting myself into a flap and not following a logical order with tests or allowing small little things to throw me and knocking my confidence for the rest of the test. Both my first contact lens and primary care were a bit of a fluster and whilst I recovered in primary care, I was still a mess at the end of my contact lens clinic. Thankfully I had a really nice patient who knew what they were doing for the teach but it still really annoyed me that I was such a mess. The plan, is to create a little crib sheet so that I have something to refer to if I lose the plot again. I don't intend to constantly refer to it, that would ruin the flow of the test but at least it gives me a fallback and hopefully writing it out will settle things in my mind better. The other main learning I have taken away from primary care is the need to refine my funduscopy technique with Volk style lenses, I should have plenty of time for that during my dissertation (more on that in a bit).

Special assessment has been the most challenging clinic but the most rewarding at the same time. I've seen three very different patients, a young child with Down's, a 44 year old with severe learning difficulties and a 14 year old who really didn't need to be in the special assessment clinic. The tests have shown just how much a simple eye test can vary based on the patient, from using glowing gloves as a fixation target for ophthalmoscopy to having music on to calm a patient down so you can test them.

Finally my dissertation: "Can an everyday mobile phone camera be used to image the retina instead of an expensive commercial retinal camera?". This was my first choice based on my previous history with mobile phones and I'm really looking forward to the challenge and gaining the experience with Volk style lenses. I've got lots of ideas where to take this, possibly too many for the time and word count I have for the project but it's going to be fun.

Sunday, 28 September 2014

Third year begins

So after a busy summer of working various placements I do have an offer for a pre-reg position, a new weekend job and a slightly healthier bank balance even if I would have preferred to have a little more time to relax. Now however it is almost time for third year to begin.

Last week was Freshers week, my 7th in total, and I managed to survive (just) despite having a cold develop and being knackered the entire week. Wednesday especially I was walking round like a zombie for no real reason. The week was spent organising OPSOC and signing up members, new merchandise launches on Monday and then getting and trying to decipher my clinic timetable.

To be fair it's not that bad once you figure out the pattern and know which group you're in but just a bit scary the first time you see it. Overall mine isn't too bad apart from a few Thursdays towards the end of term when I go 9-6 straight with no breaks - it's going to hurt!

I am looking forward to starting back again, seeing real patients and learning more, although the first few weeks maybe a bit sketchy. The main thing I want to know is what I am going to write my dissertation on, get that in a week or two, as I actually want to start writing it mainly as I have a feeling the second semester is going to get hectic. I will probably not be saying this once I have the title and started it but that's life.

Friday, 8 August 2014

It's not easy being green

Today I have been helping out as a victim, sorry volunteer, for a summer research project at Cardiff university. These projects are undertaken by students between second and third year to help gain an insight into research ready for third year projects and to see if a PhD or Masters would be something they would be interested in. The projects also help to keep Cardiff at the leading edge of eye based research that the school of Optometry and Vision Science is so renowned for.

Today I have been helping with a project funded by Coopervision being conducted by one of my friends comparing the effects of over the counter blepharitis treatment compared to baby shampoo. In particular it is looking at the effects of the scrubs on ocular comfort and staining. This has resulted in me having fluoroscein and lissamine green put into my eyes, leading to me having a fetching shade of green eyeshadow for most of the day.

Still it's a small price to pay to help for driving research forward.

Friday, 1 August 2014

From blue to green

So after 6 weeks at Boots in Swansea last week I started a 4 week placement at Specsavers to see how the two companies compare and which one I would prefer to do my pre-reg with if I am lucky enough to get offers.

The first thing that struck me was the similarities in pre-tests and the handover coming out of the room, then the differences in offers - both lens types and the pricing. Learning all the lens types will be tricky and having done some dispensing with Boots I thought I would be good to go with Specsavers. WRONG! Single vision is fairly similar but the differing offers and types of varifocal mean there is still a lot to learn especially with the lab instore. I am actually looking forward to spending more time in the lab looking at how glasses are made and what the differing tolerances are which I feel is going to be a good start to third year.

So far I have been enjoying this placement just as much as my first in a different way. The staff are really friendly and have been nice enough to invite me out on the staff night out on Saturday and I've seen a lot more pathology, which has been good. I even managed to successfully diagnose a patient's sub-conjunctival haemorrhage this afternoon (I didn't tell patient but checked with optom afterwards and I was correct).

Wednesday, 23 July 2014

That's all folks!

So on Saturday I finished my placement at Boots. It was a mixed day, good as I don't have to get up early in the morning to go to work (7am is too early for me) and sad to leave all the lovely staff and customers I had met in my time working there.

So what did I learn from my time there:
1. I talk too much - not something I ever thought I would get told, but seems I try to convey too much information at times which results in wasted time and the point not being made properly.
2. Customers love me :-) always good to hear that from customers and staff. It seems 10 years of retail experience has paid off, as communication is a key part of optometry. Although point 1 means I still have areas to improve.
3. Optics is definitely where I want to work, it was so interesting to work in a proper store and see the difference glasses made to how people felt about their lives, and the difference referrals for cataracts or emergencies can make.
4. There are lots of good links between different parts of health care (both within Boots and others) but more could be done to help customers get the most benefit from one provider.
5. As I mentioned in first week round-up, optical consultants do a lot more work than I previously gave credit for them.

I received some very useful feedback from my time with Boots and was really glad I did the placement, now to wait and see if it leads anywhere. Many thanks to all at Swansea, Carmarthen Road - Sharron, Sam, Adele, Michelle, Chantelle, Jordanna, Abigail, Renee, Erin, Philip, Rhys, Mark, Sian, Sabera, Paul, Danielle, James and Karen for putting up with me and my random questions for 6 weeks.

Saturday, 28 June 2014

Halfway through

I am now halfway through my summer school placement with Boots, and learning more and more every day. Over the last couple of weeks I have had some challenging but constructive criticism, met last years summer school student and been to cover in a different store.

The great thing about the placement and the job is you never know who or what is going to walk through the door of your practice every day. The store I am at has a wide ranging customer base, lots of over 60's NHS patients (often with cataracts, glaucoma or another age related condition), to middle aged people who like the range of styles available, to people on benefits and children coming in for first few eye tests with a few emergency cases thrown in for good measure. Because of the wide range of customers it is important to be able to adapt your questioning style when doing check-ins and how you talk to customers when they collect glasses, I'm glad I've got 10 years retail experience as otherwise it can be very daunting.

I have started dispensing, just single vision at the moment, but everything has to start somewhere. Dispensing is that final stage in the customer's first visit to the store (second visit is collection) and the point when all the lifestyle questions and the recommendation from the optometrist all come together. This is when a good demonstration of all the upgrades is key, and whilst I haven't sold any yet I have done well with glasses cover. Whilst some people may see these upgrades as pushing unnecessary products to make money I have yet to see anyone promote anything that wouldn't be of use to a customer. I am really glad I can say that as pushy sales staff who slam customers with unnecessary products to hit targets or lie their own pockets really annoy me and I've seen a few.

Going to cover another branch was a good experience as it showed the consistency of approach throughout the company, even if the other branch did have an even more temperamental NCT than my usual one. Those things really are the bane of my existence at the moment. Port Talbot was small and quiet with just 2 of us and a locum in which was vastly different to Swansea with 2 optoms and about 6 of us on the shop floor. I made the most of it by having a look at other parts of the systems that I hadn't used before, like Glasses Studio, which I look forward to using soon.

Next week I have a visit to another Boots store planned, this time to see the links between a pharmacy and the opticians, and hopefully I will get a chance to speak to an audiologist as well so really see how the one health idea all comes together. I also look forward to dispensing multifocals, which at the moment seem a little daunting but then so did single vision before I did that.

Monday, 16 June 2014

Week 1 thoughts

Last Monday I started a 6 week programme with Boots on their Future Optometrist Programme. The scheme is designed to give students a flavour of retail optics and how Boots works in particular. It also acts as a 6 week interview from point of view of company and allows the student to get idea of whether Boots is right for them and how they get on with the staff where they may well be working on the pre -registration year (pre-reg for short).

My placement is in Swansea so involves a nice little train journey in the morning, although this gives me a chance to catch up on TV or books I've missed out on and catch a nap if needed.

The first impressions were good, the store is reasonably well equipped and more importantly the staff are really friendly and seem to put up with all the random questions I've been throwing at them all week. It's very strange for me to not know anything about the system or how anything works, after doing the same job for over 10 years I've worked out exactly how the systems in my current job work.

Although I had received and read the student guide to the programme I was a little surprised about doing so much work as an optical consultant and it wasn't until I went to the introductory conference in Birmingham on Thursday which put the programme into context. I'd been thinking too literally that it was all about optometry but it isn't; the optometrist is not alone - they are working as part of a team and to understand the team you need to understand the other roles. To this end I have been welcoming patients into the practice, answering the phone, adjusting glasses, running though collections, making appointments and helping with pre-screening. The amazing thing is that this isn't all optical consultants have to do; there is extra paperwork for NHS and PEARS forms, asking lifestyle questions as part of pre-screening to aid the 3 moments of truth, helping with referrals, managing emergency patients, checking in glasses and of course dispensing, with the aid of a dispensing optician for tricky dispenses. I apologise to all optical consultants and assistants I may have unwittingly looked down on, they have a vital role to play and put in a lot of hard work to ensure the branch runs smoothly.

The highlight of the week was the welcome conference in Birmingham on Thursday. This highlighted Boot's purpose "We commit to enrich the life of every person. We are a health led optician, yet care about a whole lot more." It also highlighted the 3 moments of truth which are used within the customer journey to ensure the customer gets the best possible service. I look forward to seeing the results from the customer metrics and working out ways to improve them, over the next few weeks.

I had my first review on Saturday which was a bit nerve wracking, I was confident I had done okay but am always worried that there is something I've done wrong or missed. However it passed without a hitch, I got some good feedback and a plan for the next few weeks is developing so I am looking forward to the rest of the placement, if not the early starts.

Saturday, 7 June 2014

End of second year musings

So walked out of final exam on Tuesday and it felt like a great weight had been lifted from my shoulders. The first years looked a little confused as to what had just happened, but that's normal after a dispensing exam whilst the third years were a mixture of elated that they had finished and disbelief that they had finished.

Library books went back on Thursday and it was time to relax for a little while before I start my summer placements on Monday - no rest for the wicked. I'm doing two placements with Boots first and then Specsavers so it will be interesting to see how the two compare.

So what have I learned over the last year:

Contact lenses are interesting, the materials aren't that much fun (although tours round factories are) but there is so much you can do with them to help patients in a slightly different way from normal spectacle use. There is a big market out there that can really help businesses but at the same time there are risks that need to be managed.

Pharmacology offers a lot of further training paths that I may well want to explore later on in my career but there is a lot to learn for exams about drugs, doses, uses, contraindications, side effects... This made it one of the most engaging courses of the year but also one of the scariest exams.

Binocular vision really isn't that scary, maybe it's because one of my friends has a squint so I am so used to testing them that it doesn't throw me off from usual routine. Yes there are a lot of conditions that need to be managed especially in young children but if you know the risks you know what needs to be done.

Neurophysiology is a bit of an odd one, whilst I can see the uses of some of it in practice particularly the links with visual fields and agnosias, not sure how much of it I will use in future, likewise with perception.

Colour vision seems to be remarkably easy, and visual fields is useful. The main thing to remember from visual fields is that the answer isn't always glaucoma but there is a pretty good chance it is.

So lots to take forward and look forward to starting third year in a few months. Now just need to go back to waiting for exam results. Fingers crossed.

Saturday, 17 May 2014

Dissertation thoughts

First off, sorry for not updating this for a while, I've been busy with revision as it's exam season which is typical just as the weather improves. I've also started blogging for the university undergraduate team, you can read my uni based thoughts and those of fellow students here.

So far I've had one exam on Tuesday which I think went okay but just need to wait and see. Two more coming up this week.

The other major thing that happened this week was that we were given the methods of choosing our dissertation and the range of possible titles there are. The method of selection is a little complicated but at least we have an element of choice over what we get rather than just a complete lottery. The topics range from some that interest me immensely, to ones that I would prefer not to touch with someone else's 10 foot barge-pole. Without wanting to curse things and get my hopes up there are some titles that play to my strengths and interests from outside optometry and some that I don't even understand the title of. Still I have 2 1/2 months to try to put together a list of preferences and then have to wait until October to actually find out what I've been given.

I'm excited to start writing it but at the same time a little apprehensive about how much work is involved, it's been over 10 years since I last did a research project, did two in last degree, and didn't particularly enjoy them. The other thing that scares me is how quickly time it passing, it doesn't seem like a year since I was chatting with the then 2nd years about how early they were choosing their titles and it means I am coming towards the end of my course :-(

Wednesday, 16 April 2014

The Eyeball

After a hectic couple of weeks with practical exams and resits (resit passed, fingers crossed on the other practicals) it was time for Cardiff to let its hair down with the annual Eyeball. Other universities may hold them but Cardiff is the biggest and the best. This year it was held at the National museum. As people turned up they were greeted by fire breathers and jugglers.

After a drinks reception, where I didn't get a drink, we headed out onto the balcony to see the tables all set up below with a carnival theme, so we walked down past a coconut shy, test of strength and picked up some popcorn and candy floss to keep us going until food arrived.

Food was a lovely leek and potato soup followed by a stuffed chicken breast and then a chocolate cheesecake which was very nice, I could easily have eaten another portion (or two or three) of that.
After that it was time for the raffle, I didn't win anything but it did raise lots of money for charity, the awards - some funny and some serious before it was time to reveal who had won the elections and would be the faces of OPSOC for the next year. I was lucky enough to be re-elected as treasurer so will be in charge of the purse strings for another year. Well done to everyone else who was elected and commiserations to those that weren't.
After that it was time to party the night away first at the museum and then onto the after party at Tiger Tiger. At half two it was time to go home to bed, and I was glad I had booked the following day off work.

Wednesday, 2 April 2014

Open day fun

Today was a university wide open day so I was helping out by taking prospective students round the building, showing them where Doctor Who and Sherlock were filmed (see here for Dr Who); answering questions; using a slit lamp and demonstrating simulation spectacles which simulate the wearer having various optical conditions like glaucoma or cataracts.

Optometry tends to be a lesser known subject and because we are little away from the main campus we don't get a massive number of people but it does mean that the ones we do get are generally interested in the subject or at the very least thinking about it. Prospective student open days are a little different from offer open days in that you need to convince the student that optometry is the career and course for them rather than convincing them that Cardiff is the best place to study the subject. This requires a slightly different approach but the main similarity is to just be friendly and talk to everyone. If you can't do that then optometry possibly the subject for you anyway.

I always enjoy helping out with open days as I know I didn't know what I wanted to do the first time I went to university. Having a look at different options and seeing what people think of the course and whether you could see yourself in their shoes is a great help in my opinion.

Tuesday, 18 March 2014

Coopervision tour

A couple of weeks ago, I was lucky enough to go on a trip with some fellow students to the Coopervision manufacturing centre near Southampton.So after getting up at the crack of dawn, the coach left at 8am, we were on our way.

When we got there, after a slight delay on the M4, we were treated to some nice pastries (I may have eaten quite a few) and a short talk from Mark, a member of the professional services team who had helped arrange the trip, about the company and how lenses are made.

The first soft hydrogel contact lens was manufactured by Otto Wichterle in 1961 using a spin casting machine made from Merkur, a Meccano type kit. After patenting the process he was able to make 5500 in the first few months, before the licence to the patent was sold without his knowledge to the USA.
There are currently 5 main methods of contact lens manufacture:
  • Spin casting - still used mainly by Bausch and Lomb
  • Lightstream technology - used by Alcon which uses UV light to cure the monomer
  • Lathing - old fashioned method, mainly used for rigid gas permeable lenses
  • Hybrid - a Coopervision exclusive with front surface moulded and back surface lathed
  • Cast moulding - main technique used for mass production of soft contact lenses
The first stop for my group was a trip round the DK128 Biofinity manufacturing process, or part of it anyway, so after getting dressed up in a funky gown, hat, shoe covers and static strips we were allowed in. There we were shown some of the 12 operating lines that manufacture over 250-280,000 lenses between them every 12 hours, with each line only needing 10 people, several robots and a giant sunbed - a long tunnel lit by UV light to help set the monomer and remove impurities.

One interesting fact that came up from this part is that due to the use of colour to help track batches and individual cavities within each batch people with colour vision defects can't work in this section of the business.

After a tasty lunch, including more cake, it was time for a trip round the second part of the factory, the lathing section. In here we got to see how a button of monomer is lathed down to a thin RGP or in the case of the new hybrid methods, half moulded and half lathed. This is a slower (and more expensive) method but better for RGP and allows tints to be applied and for a very particular level of quality control. The production rate can vary between 20 and 5000 per day depending on the method and order. A custom order can be made and sent out in as little as 2 days.

We then had a talk about the summer scholarship programme, the values of the company - dedication, inventive, partners and friendly and got to here the opinion of the UK MD of manufacturing. He believes that the factory will increase production from 1.6 to 2.5 million within the next 3 years and that the market is moving more towards silicone hydrogel as this becomes feasible for daily disposables, and that drug dispensing and smart lenses will be a niche market. (I'm not so sure about this last point, I believe there is a large potential there and can see it growing as the technology develops). A quick run through some of Coopervision's lens technologies including Proclear for dry eye and presbyopic patients and multifocal lenses and it was time to go home (with extra cakes and goody bags).

After a quick trip home I was lucky enough to wind up with all the spare cake, so all it leaves me to do is thank our hosts; Mark, Lee, Ben, Carly, Elaine, Tracy and Steve for their time and for organising the trip. I found the trip fascinating seeing how a liquid polymer is transformed into a thin lens that we put into a patient's eyes. 

In the last couple of weeks I have had the opportunity to use the Coopervision Biofinity lenses that we saw made, okay not the exact same ones but you get the idea. The lenses were fairly easy to insert, even with my kack-handed insertion skills; and whilst I only occasionally wear coloured lenses (joys of being emmetropic) but found the Biofinity very comfortable for the short period I had them in. It will be really interesting to try them with real patients next year and compare what they found to what I found. At least now if a patient asks how lenses are made I can give them a full answer, knowing me probably more than what they want.

Monday, 3 March 2014


This last weekend was Opfest weekend. A weekend where optometry students from the different universities that offer the course come together to compete in a variety of sports for the optic cup. This year it was held in Cardiff.

We had teams from City, Aston, Bradford, Anglia Ruskin, Manchester, Glasgow Caledonia and Plymouth. Only Ulster weren't able to make it over. Teams started arriving from 5 o'clock on Friday and got ready for the emergency services themed night out at Oceana.

After an all too brief amount of sleep everyone assembled for the first sport of rounders. The support was loud (too loud for those with a hangover) with a special mention to the City cheerleading squad led by the Carrot. (Apparently their sports teams used to get around by horse drawn carriage with a carrot to get the horse to go faster).

A mention should also go out to Keith from Glasgow who played all the matches wearing a shower cap and drinking from a can of strongbow and despite getting hit in the head by the ball from his own player he carried on without spilling a drop.
Next up was touch rugby with some misunderstanding of the rules but play continued merrily on regardless. After a brief break for lunch the rugby concluded with a Cardiff vs Bradford final, won by Bradford.
So we moved onto the final two sports, football for the boys and netball for the girls and some boys up for a laugh, including me. Having me play goal keeper against a 5' 4" shooter was possibly a little mean though but everyone saw the funny side.

A brief interlude led to an impromptu Cardiff vs Cardiff half which descended rapidly into complete anarchy but was rather amusing. The final of the netball was again Cardiff vs Bradford with Cardiff running out 10-0 winners.

At this point I retreated home for a quick nap, I'm a bit older than most of the students and can't survive on that little sleep for long. Feeling refreshed I headed off to Red Hot World Buffet for a lovely dinner, all you can eat is good, before the awards were given out, with the optic cup heading back up to Bradford (booo!). A massive thank you goes to Shai, Luke and Nina for organising it all.
A great weekend was had by all, this is evidenced by the fact that most of us here in Cardiff and people I know on twitter are still recovering from all the aches and pains from the weekend.

Saturday, 22 February 2014

Show them the money

Earlier this week I saw my last paid patient. I say this with slightly mixed emotions, I like the paid patients as they give me a chance to test my skills on a "normal" person (someone who isn't a student), they have some interesting conditions in their eyes and they are lovely people to have a chat with. However I am slightly scared that they have finished because it means the next time I'm testing a member of the public they won't be being paid for their time and they will expect me to know what I am doing. Thankfully that won't be until October so I have 6 months to practice and stew.

I remember what I was like before I saw my first paid patient back in November - slightly nervous and resigned to my fate. This feeling didn't get much better when I discovered my first patient was low vision due to being aphakic and had nystagmus (the eyes keep moving all the time). However once I got into the routine it was fine, the patient has been through it so many times before, the supervisors are very helpful and I started to believe in my own abilities.

Thanks to the paid patients I have dealt (at least semi) successfully with low vision, nystagmus, small pupils (the bane of optometrists); have used a slit lamp in anger, tried Volk on real patients, been confused by contrast sensitivity and why reading adds don't add up to what they should.

I have also seen pinguecula, the beginning of a corneal ulcer, a patient with bitemporal hemianopia (who had had a pituitary tumour removed),asteroid hyaltosis (think a snowglobe in the eye) and all sorts of variations of normal.

I would like to thank all the patients, staff and supervisors for their time and help.

Friday, 14 February 2014

Eyes wide shut

The last few weeks have mostly been spent going through lots of data writing up a report on the effects of mydriatics and cycloplegics, in particular tropicamide and cyclopentolate. I am sure most optometry students and practitioners will be familiar with what they are used for but for those who don't here is a quick recap:

Tropicamide is mainly used to dilate the pupil to allow the practitioner a better view of the retina at the back of your eye especially to see the periphery, to check for haemorrhages, detachments and other serious pathologies. It works by relaxing the iris muscle sphincter.

Cyclopentolate also dilates the pupil but it's main function is to relax accommodation, the ability to focus on close up objects. This is needed to determine full refractive error in young children who have high accommodation levels; in latent hypermetropes - people who are unable to fully relax their accommodation and for preliminary testing for laser surgery. Cyclopentolate works in a similar way to tropicamide but also paralyses the ciliary muscle which controls accommodation. The downside is that it takes longer to wear off so patients are unable to read for several hours afterwards and may be sensitive to bright lights.

Here is a great video of someone looking at their own fundus using a lens and a mobile phone after they have been dliated. This is just the central fundus but can view periphery with other techniques.
Self fundus exam video

The drugs do sting a little bit when they are put in but they are only put in when they are needed, so if an optometrist suggests you are dilated it is for a good reason and it is advised you go ahead with it.
Before these drugs were invented other methods were used primarily to make the eyes look wide and beautiful, these included cocaine - dilated peoples are one of the more obvious signs that someone has taken cocaine. The plant Belladonna, also known as deadly nightshade, was also used by women in the Middle Ages to dilate their pupils to make them look more attractive. Personally having dilated pupils doesn't feel attractive, it gives me a slightly wide eyed and scary look.

Not all dilated pupils are due to drug use, either illegal or ophthalmic. Some are also caused by nerve damage, like the case of David Bowie, whose left eye is permanently dilated after he suffered an injury in a fight when he was young.

Thursday, 30 January 2014

How many is too many?

As some of you may have seen Hertfordshire university recently announced it's intention to launch a 4 year optometry course within it's School of Life and Medical Sciences. If you haven't seen it you can find the information here.

This has caused a bit of a debate in the optical community,you only need to look at the comments on the linked article to see that not everyone is in favour of it. In fact, a petition has been set up to ask the GOC not to accredit the new course and to put a cap in place on the number of places available to study optometry each year (here).
This raises a few questions about what having more qualified optometrists would do to the market for jobs and wages and what it would mean for patients. Up until recently there were only 8 places you could qualify as an optometrist in the UK, Plymouth were the 9th and their first set of students will graduate this summer so we don't know what effect that will have on the market yet.
More graduates means more pre-reg places are needed but Specsavers and others seem to have increased their intake and more places are now offering pre-reg schemes like Tesco. It will also open the course and profession up to more people - I can't see the entry requirements dropping but would give people more choice where to go, may raise awareness of the course and mean that people who just miss the grades are possibly more likely to be accepted on the course.
On the flip side, having more graduates will mean the top locations will become harder to get and may be harder to get onto pre-reg schemes. If everyone does get onto courses it will certainly mean there is more competition for jobs, which people fear may drive salaries down. However, if there is more competition it will mean the better candidates get the jobs which should mean better patient care in the long run.

A cap might work to solve this occurring again in the future with either another university wanting to start a course or a current university expanding its intake. However in other courses that have a cap eg. pharmacy which was the most recent to have a cap imposed, the jobs afterwards are funded by the NHS, whereas in optometry the vast majority of jobs are not NHS funded but private.

The thing is, at the moment all this is a moot point as the GOC doesn't have the ability to discriminate on whether a course is good for the profession or not, as long as the university meets the criteria set out the GOC has no choice but to accredit the course. As a spokesperson said "Changing this would be a matter for the government.", so maybe if people want to change it they should be petitioning the government to amend the Opticians Act (1989) so that they can take into account the views of the profession and what affect a new course would have on it.
What are your opinions on the proposed new course? Let me know in the comments below or on Twitter (@iaintheoracle)

There have been a couple of updates to this story appearing online since I published the blog. 

1. Optician magazine have added another news story reinforcing the point that the GOC can't make a decision based on market forces, just whether the course meets the required standards. They have also put up a comment article  about the situation in a similar fashion to this blog but wondering who is behind the campaign and why other people should be denied the chance to study optometry. However it is asking for the AOP and GOC to work together to create a sustainable workforce model - I don't think either has a say in this, it is down to government to put a cap on if it wants and market forces to balance supply and demand.

2. The AOP have put out a statement in their Blink newsletter:
"Recent years have seen optometrists’ salaries falling and some pressure on pre-registration places, so there is understandable concern from students and practitioners about the growth in numbers. It is interesting to note that this government, in 2012, introduced a cap on pharmacy student numbers. The argument put to the Health Minister, Lord Howe, was that a failure to restrict the increasing number of pharmacy places could leave graduates unable to complete the training needed to practise. It may be time for the government to consider whether the same circumstances apply to optometry. The AOP is working closely with the College of Optometrists to gather the hard evidence needed to protect the future of the profession and the patients it serves."

Tuesday, 14 January 2014

Do you know the colour of your loved one's eyes?

They say that eyes are the window to the soul, so that must make the iris the tint and if you look in detail you can see a fabulous stained glass window.
However how often do you notice what colour someone's eyes actually are? Think back to when you last had a chat with the one you love or a good friend, you must have looked at their face but what colour eyes do they have?

The answer is very rarely probably. The reason this has come to mind is that I have recently had some coloured contact lenses and been wearing them on nights out and at my parent's family do over Christmas to see if anyone noticed. In fact at my parent's I had one green lens in and one eye without lens so blue/grey. Total number people to notice on me being heterochromic - none.

Admittedly celebrities often disguise it with contact lenses but did you know that Benedict Cumberbatch, Mila Kunis and Simon Pegg all have different coloured eyes.
I would like to say I buck this trend but that would be a lie, I couldn't tell you the eye colour of some of my best friends or my wife and I failed to spot that one person I deal with regularly in the student's union has heterochromia until she told me (I then told her what it was called).

Science bit:
The colour of your eyes is determined by a complex interaction between the pigment melanin and other components of the iris including haemoglobin in the blood vessels and  collagen in the stroma and vessels. The full method is not understood and neither is the method of inheritance.