Case studies : Orthoptist: Alexa

Alexa studied orthoptics at university. She is now an orthoptist for the NHS.

Originally I wanted to do medicine but didn’t get the right grades at A-level. Luckily I’d also applied for orthoptics as a fall back plan because I felt it combined working with children with a medical job. In the end I was glad I’d chosen orthoptics, particularly as the training takes three years, not five years like medicine.

My orthoptics degree was definitely vocational; you do learn what you need to do the job, particularly from the 30 weeks of clinical placements in various parts of the country. You do three placements a year and are usually told where to go – it may include Scotland. The hospitals organise where you stay, usually in nurses’ or university accommodation. You have to pay for accommodation and travel costs up front, but you can claim some of it back. I think most people get their accommodation costs back but not everyone gets travel costs reimbursed: it depends on your means tested bursary.

It was very easy to get my first job: I started work within four weeks of qualifying. If you want a job in a specific area of the country, you may find some competition for vacancies, especially in the northwest, where both the orthoptics degrees are based. However, if you’re geographically mobile there are plenty of jobs at the moment. There were about 35 students on the course in my year and I think everyone who wanted a job had got one by September of the year we graduated. So with the two degree courses there are only about 70 people looking for jobs each year. It’s quite a close knit career, so if you are looking for work somewhere specific, you’ll often know of someone from your course who can look out for potential vacancies for you. You could also do locum cover work in the area until something permanent comes up - jobs are advertised on NHS Jobs. It is worth sending out speculative CVs. Orthoptics is such a female-dominated career that there are often maternity cover vacancies and you could get your foot in the door that way.

Most of our patients - about 80% - are children and we assess them for eyesight problems, a need for glasses, lazy eye, eyes that have problem moving, or follow up unusual prescriptions that opticians don’t feel comfortable with. We go into schools and assess four- and five-year-olds for lazy vision, squints and problems with using their eyes as a pair. We deal quite a lot with children with special needs.

We also work with adults who have had damage to the nerves that control eye movement, as a result of trauma, a car accident or being a victim of a fight, or people with diabetes, high blood pressure or thyroid problems. Depending on the hospital, you may run specialist clinics, like specific learning difficulties clinics for dyslexics, neurology clinics for young people with head traumas, Botox clinics for treating squints, or work alongside the stroke team to help with vision loss or nerve damage. We work closely with neurologists, maxilla-facial teams and paediatricians. Generally we see a wide variety of patients, but in the peripheral clinics we run in the surrounding area, we tend to see the same patients over a period of weeks.

I enjoy the varied nature of the job and I love working with children. You can really make a difference to these children’s lives and help reassure their parents. I also enjoy teaching placement students, both orthoptic and medical students. As orthoptics is such a specialist area, you might also be involved in teaching junior doctors, GPs, optometrists and trainee opticians.

You do need a lot of patience in this work, and in rare cases you may have to deal with conflict with members of the public. A slight frustration is that, in the NHS, you have to wait until there’s a vacancy before you can progress upwards and this can be a bit limiting.

In the future I’d like to get more involved in stroke and neurology work and eventually be in charge of that type of service.