optometry ASAP help

seen this thread that looked into how optom is a highly saturated and dying career, alot of cons with optometry which i agree with all of them. however, i really don't know what else to do if not optom...i really like science but don't want to work in a lab nor medicine as thats too much. ive already sent applications off through UCAS and im getting really scared that i havent made the right decision and i am unsure of what to do...

Hey! I’ve applied to the same unis but city of london too. Which unis have you got offers from? Also which uni are you considering of going to?

I’ve gotten offers from Bradford + Cardiff, interview from Cardiff and a video/questionnaire type thing from UWE Bristol. What about u? Still waiting on Aston which is my first choice, what’s yours

Aston’s gonna be my top choice, just struggling to choose between that or Manchester. What’s your insta lol (only because I don’t know anyone else going Aston and I’m lowkey nervous)

Yeah sure, I don’t know anyone else too 😬 @aisha_aqdis, where are you from anyway

Optometry is a highly saturated and dying career. It is the reason why I, as an optometrist, am in the process of leaving the profession. The problems I experienced which has driven me out of the profession:
- The commercial pressures applied by the large multiples is increasing year on year. Optometrists are judged by 'conversion rate' (i.e. the amount of patients they sell glasses to) and not by their clinical competence.
- Optometrist salaries are relatively poor. It was the worst hit profession during the 2009 financial crash.
- According to the Optical Workplace Survey, nearly 20% of the profession is considering leaving within the next 5 years.
- There has been a massive increase in the number of optometry schools to drive down salaries. Since I applied in 2008, the following schools and courses have opened: Plymouth, Portsmouth, UWE, Teeside, Huddersfield, Hertfordshire, UHI. The number of courses has literally doubled in a decade. There wasn't a shortage of Optometrists before these opened. This is going to mean that the employment rate is inevitably going to drop below 100%
- The Association of Optometrists, College of Optometrists and General Optical Council do not adequately support optometrists.

From my year alone, nearly 25% have left the profession already within 6 years of qualifying.

Optometry has a significant identity crisis. It is a healthcare profession which has been infected by commercial pressures. I would not recommend anyone to enter the profession.

There are pro's and con's to Optometry. From my experience working in the profession:

Pro's:
- Professional respected field
- Stable employment
- Get to work with people
- Good work life balance

Con's:
- Little to no career progression
- Significant commercial pressures
- Stagnant/Declining salaries
- Gradually increasing clinical responsibility
- Limited remit

The way I see it, is that I do not want to spend the next 30 years of my life in a profession with no career progression, stagnant salaries, increasing commercial pressures, and increasing clinical responsibility. Which I why I have chosen to pursue medicine instead.

The profession is advertised as a healthcare clinically focused field. Unfortunately the reality for many is that they end up working day in day out for a big company selling glasses, and not doing much else. I have personally experienced a non-qualified (i.e not a healthcare practitioner) manager knocking on my door at lunch time telling me that I wasn't selling enough glasses. You would never have that at a dentist or pharmacy. So why optometry?

If I were you, I would be asking myself if I would be happy being in a guaranteed job post university, with a relatively low ceiling. Or do I go into another field where it may be a lot more competitive to get into a job post university, but the long term career prospects are better?

Orthoptists are almost exclusively based in the hospital setting, and are employed by the NHS. You won't experience the commercial pressures that you would in Optometry. Orthoptists generally work alongside the Ophthalmologists at the hospital.

You are correct in that the pay is lower than that of an Optometrist, but that is due to the fact that the responsibility, and expertise is less than that of an Optometrist. You are however not correct on the other aspects.

Optometry is substantially more varied than Orthoptics, and the courses would be more biology based than Orthoptics.

One benefit of studying Orthoptics however, is that I believe you are entitled to NHS funding and an NHS bursary.

Orthoptists are almost exclusively based in the hospital setting, and are employed by the NHS. You won't experience the commercial pressures that you would in Optometry. Orthoptists generally work alongside the Ophthalmologists at the hospital.

You are correct in that the pay is lower than that of an Optometrist, but that is due to the fact that the responsibility, and expertise is less than that of an Optometrist. You are however not correct on the other aspects.

Optometry is substantially more varied than Orthoptics, and the courses would be more biology based than Orthoptics.

One benefit of studying Orthoptics however, is that I believe you are entitled to NHS funding and an NHS bursary.

Optometrists don't 'only do the eye tests'. Optometrists can dispense in the same way that a Dispensing Optician (DO) can. We can also fit and assess contact lenses, assess binocular function (who do you think the Orthoptists get their patients from?), and most importantly perform ophthalmic examinations (who do you think refers to the Ophthalmologist?). There are Optometrists who perform intra-vitreal injections at the hospital, and those who are now independent prescribers, so have a prescription pad in the same was as a doctor so they can manage eye diseases like Glaucoma.

To over simplify things, an Optometrist can do everything that a Dispensing Optician (DO), Contact Lens Optician (CLO) & Orthoptist do, but these roles cannot do each others roles, and collectively do not cover all of the skills an Optometrist have.

The reason DO's are on the shop floor is that their remit does not extend to within the test room, so it makes sense that they are on the shop floor dealing with the glasses side of things. It makes financial sense as only the Optometrist can issue prescriptions for glasses, so why waste their time with people choosing glasses when they can get more people out ready to get glasses?

Optometrists get the biggest pressure for sales. Ultimately, as a healthcare practitioner, patients will trust your recommendations above that of any colleague on the shop floor.

Think about it, if a doctor said to you all was well, but the receptionist said you needed to get some medication, who would you trust?

Stores want Optometrists who are good salesmen, as ultimately, if they recommend glasses, people will buy them. A DO will also have sales pressure, but this will be to upgrade to designer frames, thinned down lenses, second pairs etc.

Orthoptists are almost exclusively based in the hospital setting, and are employed by the NHS. You won't experience the commercial pressures that you would in Optometry. Orthoptists generally work alongside the Ophthalmologists at the hospital.

You are correct in that the pay is lower than that of an Optometrist, but that is due to the fact that the responsibility, and expertise is less than that of an Optometrist. You are however not correct on the other aspects.

Optometry is substantially more varied than Orthoptics, and the courses would be more biology based than Orthoptics.

One benefit of studying Orthoptics however, is that I believe you are entitled to NHS funding and an NHS bursary.

seen this thread that looked into how optom is a highly saturated and dying career, alot of cons with optometry which i agree with all of them. however, i really don't know what else to do if not optom...i really like science but don't want to work in a lab nor medicine as thats too much. ive already sent applications off through UCAS and im getting really scared that i havent made the right decision and i am unsure of what to do...

Friendly question here, in what way is the role of an Orthoptist a lot more varied than that of an Optom? I have heard this banded around several times before, but no one has ever explained why this is the case!

Hello Alisha,

Thank you for the well written response. So just wanted to respond to a few things really:

"Obviously this (Orthoptics being more varied than Optometry) is down to personal experience but has been mentioned many times by clinicians and lecturers when students are deciding between the two courses"

I find this to be curious, as I recall the exact same thing being mentioned by lecturers and clinicians when I attended open days! The only exception of course being that they said Optometry was more varied than Orthoptics. Both cannot be true, and I would accept that each would be biased (after all, if you want students to apply for your course, you would never say a similar course is better elsewhere!).

In my experience as an Optometrist (Private, Hospital and in Academia), I have generally observed that Optometry is more varied than Orthoptics, plainly due to the breadth of responsibilities. There is significant crossover between both professions.

"An Orthoptists role is more varied in the sense that patients who come to the clinic are being referred for a multitude of conditions all of which can have a multitude of aeitiologies"

These patients don't solely exist in secondary care, and more often than not are referred to secondary care from Optometrists.

In regards to your original quote (which itself was from the British and Irish Orthoptic Society's own website), I would point you towards another quote from the same page regarding Optometrists:

"Optometrists are trained to examine the eyes to detect defects in vision, signs of injury, ocular diseases or abnormality. They also identify the signs of problems with general health, such as diabetes of high blood pressure. All Optometrists are able to offer clinical advice, prescribe glasses or contact lenses and refer patients for further treatment. They typically work in high street opticians, carrying out eye examinations, but some also work in hospitals or community clinics.

Whereas an Orthoptist is concerned with how the eyes work together and interact with the brain to create vision, Optometrists are primarily focused on the examination of the eye itself."


We are legally obliged to perform an Ophthalmic examination. For example with myself, in a 30 minute appointment at least 20 minutes will be spent examining the eye. Not what I would call a 'brief assessment of visual health'.

--------------------------------------------------------------------------------------------------------------------------------

Orthoptists play a crucial role in secondary care, especially with complex BV issues and visual rehabilitation. I have no doubt that any reasonably competent Orthoptist has a greater knowledge of treating and managing BV issues than most Optometrists. But Orthoptics is inherently less varied as a profession than Optometry, through specialising in BV and working in secondary care. We have the same patient base after all, what we do with them is different.

As an Optometrist I can choose to manage BV issues in house without referring into secondary care. I can prescribe glasses, prisms, patching therapy and convergence exercises. I can assess fusional reserves, ocular motility, saccades, stereopsis, depth of suppression etc. In fact I quite regularly do. There will be times of course that I refer into Orthoptics for their expertise regarding a BV anomaly beyond my competence.

As an Optometrist, in addition to my legal requirements to prescribe and perform ocular examinations, I can undertake further accreditations (in low vision/paediatrics/medical retina/glaucoma), provide emergency eye care examinations, contact lens fitting, perform domiciliary work, administer intra-vitreal injections and become an independent prescriber. Most of these I currently do, or have done previously.

As an Optometrist, I can choose to work in a high street practice, a smaller independent practice, a hospital, and university. Currently I work in three.

---------------------------------------------------------------------------------------------------------------------------------

Which really brings me back to my original over simplification that an Optometrist can do what Orthoptists, Dispensing Opticians and Contact Lens Opticians can. For the most part we can, as it is within our remit and training. The breadth of our remit does not however allow us to have that depth which the other fields have, much like a GP compared to other specialities.

Which is why both careers are essential to form a competent and skilled multi-disciplinary team. If we did the same thing, there wouldn't be the need for both fields!

Hello Alisha,

Thank you for the well written response. So just wanted to respond to a few things really:

"Obviously this (Orthoptics being more varied than Optometry) is down to personal experience but has been mentioned many times by clinicians and lecturers when students are deciding between the two courses"

I find this to be curious, as I recall the exact same thing being mentioned by lecturers and clinicians when I attended open days! The only exception of course being that they said Optometry was more varied than Orthoptics. Both cannot be true, and I would accept that each would be biased (after all, if you want students to apply for your course, you would never say a similar course is better elsewhere!).

In my experience as an Optometrist (Private, Hospital and in Academia), I have generally observed that Optometry is more varied than Orthoptics, plainly due to the breadth of responsibilities. There is significant crossover between both professions.

"An Orthoptists role is more varied in the sense that patients who come to the clinic are being referred for a multitude of conditions all of which can have a multitude of aeitiologies"

These patients don't solely exist in secondary care, and more often than not are referred to secondary care from Optometrists.

In regards to your original quote (which itself was from the British and Irish Orthoptic Society's own website), I would point you towards another quote from the same page regarding Optometrists:

"Optometrists are trained to examine the eyes to detect defects in vision, signs of injury, ocular diseases or abnormality. They also identify the signs of problems with general health, such as diabetes of high blood pressure. All Optometrists are able to offer clinical advice, prescribe glasses or contact lenses and refer patients for further treatment. They typically work in high street opticians, carrying out eye examinations, but some also work in hospitals or community clinics.

Whereas an Orthoptist is concerned with how the eyes work together and interact with the brain to create vision, Optometrists are primarily focused on the examination of the eye itself."


We are legally obliged to perform an Ophthalmic examination. For example with myself, in a 30 minute appointment at least 20 minutes will be spent examining the eye. Not what I would call a 'brief assessment of visual health'.

--------------------------------------------------------------------------------------------------------------------------------

Orthoptists play a crucial role in secondary care, especially with complex BV issues and visual rehabilitation. I have no doubt that any reasonably competent Orthoptist has a greater knowledge of treating and managing BV issues than most Optometrists. But Orthoptics is inherently less varied as a profession than Optometry, through specialising in BV and working in secondary care. We have the same patient base after all, what we do with them is different.

As an Optometrist I can choose to manage BV issues in house without referring into secondary care. I can prescribe glasses, prisms, patching therapy and convergence exercises. I can assess fusional reserves, ocular motility, saccades, stereopsis, depth of suppression etc. In fact I quite regularly do. There will be times of course that I refer into Orthoptics for their expertise regarding a BV anomaly beyond my competence.

As an Optometrist, in addition to my legal requirements to prescribe and perform ocular examinations, I can undertake further accreditations (in low vision/paediatrics/medical retina/glaucoma), provide emergency eye care examinations, contact lens fitting, perform domiciliary work, administer intra-vitreal injections and become an independent prescriber. Most of these I currently do, or have done previously.

As an Optometrist, I can choose to work in a high street practice, a smaller independent practice, a hospital, and university. Currently I work in three.

---------------------------------------------------------------------------------------------------------------------------------

Which really brings me back to my original over simplification that an Optometrist can do what Orthoptists, Dispensing Opticians and Contact Lens Opticians can. For the most part we can, as it is within our remit and training. The breadth of our remit does not however allow us to have that depth which the other fields have, much like a GP compared to other specialities.

Which is why both careers are essential to form a competent and skilled multi-disciplinary team. If we did the same thing, there wouldn't be the need for both fields!

You said “can prescribe glasses, prisms, patching therapy and convergence exercises. I can assess fusional reserves, ocular motility, saccades, stereopsis, depth of suppression etc. In fact I quite regularly do.” Could you tell me more about this? It sounds so interesting about all the things you can assess as an optometrist! Also could you tell me more about “ further accreditations (in low vision/paediatrics/medical retina/glaucoma), provide emergency eye care examinations, contact lens fitting, perform domiciliary work, administer intra-vitreal injections.” It all sounds so interesting, I’d love to know more in detail!

What is the pay gap between a job within orphotics compared to an optometrist?