Medical retina is one of the most favoured optometry higher qualification courses in the UK, second only to glaucoma, and according to Andy Miller (pictured right), head of post-registration at the College of Optometrists, it is increasing in popularity. More than 140 optometrists gained a higher qualification in the subject last year alone.
Launched at the Universities of Cardiff and Ulster in 2014, optometrists can now study the College-accredited medical retina qualification on 10 part-time courses around the country.
‘The qualification enables optometrists to make accurate and appropriate referral decisions for patients with medical retina conditions and prepares them for supervised roles, new patient triage clinics and AMD treatment-retreatment clinics,’ explains Miller.
The qualification consists of a Professional Certificate in Medical Retina and a Professional Higher Certificate in Medical Retina. ‘These qualifications give optometrists the ability to do more things for their patients both in the hospital and in the community.
Upon completion, optometrists, in partnership with their medical colleagues, will be able to provide further help in the detection and management of sight-threatening medical retina conditions in the community and within the hospital eye service,’ he says.
Flexible learning
The Professional Certificate in Medical Retina is designed to expand practitioners’ knowledge of common medical retina conditions, such as macular degeneration, diabetic retinopathy and other retinal disorders. It covers screening, referral and treatment pathways with an emphasis on optical coherence tomography (OCT) interpretation and diabetic retinopathy grading.
Ziggy Shah (pictured right), a senior optometrist at family-run independent Glasses to Go in North West London, undertook the medical retina course at Ulster University in 2017, through blended e-learning. ‘I felt that the course would further my knowledge, keep me updated with the latest retinal conditions and advancements and, ultimately, provide better care and management to my patients,’ he says.
Through a flexible online programme with remote lectures and online assessments, Shah says that the tutors delivered enthusiastic teaching in a supportive and friendly environment. While the course was ‘tough, detailed and long’, he says: ‘I felt as if the department has your interests at heart and you don’t feel abandoned throughout your studies. Discussion boards were also great to connect with and learn from other students.’
Patient care
Shah says that the impact of the qualification was instant: ‘The knowledge gained from week to week was making a difference in my practice straight away. In terms of identification, management and referrals of retinal pathologies, I feel more knowledgeable and confident.
Additionally, there are now lots of retinal atlases, OCT forums and WhatsApp ophthalmology groups where you can discuss cases, refine referrals and learn together.’
Shah prefers to monitor ocular retinal conditions in practice at regular intervals rather than referring patients onwards. ‘Patients prefer this option, as they do not always have to attend hospital eye services. I ensure that patients are enabled, encouraged and involved in their diagnosis and management plan, which improves their experiences and outcomes, without unnecessary distress or panic,’ he says.
Enhanced communication with patients is the biggest benefit of completing the medical retina qualification for Cheshire-based Hazel
Baron (pictured right), a clinical governance optometrist for Boots Opticians. Baron undertook the medical retina course at City University in 2021, funded by Boots Opticians, with the goal of increasing her confidence in interpreting OCT to enhance patient care and ‘support other clinicians in more complex scenarios and share training with peers’.
She says: ‘You are able to support patients better with their journey if they are being referred and you are potentially more informed about treatment pathways and options, for example with macular degeneration.
‘Using OCT to help monitor ocular conditions within high street practice and being able to clearly explain the results has the added benefit of driving patient loyalty and, in turn, encourages recommendations to other family members and friends.’
Business benefits
For Natasha Kumar, an optometrist at Bayfields Opticians in Sunninghill, Berkshire, gaining the medical retina qualification at Moorfields Eye Hospital in 2019 was a game changer. It boosted her confidence to accurately interpret OCT and Optomap results, explain results to patients and discuss referral pathways and treatment options.
In addition to covering a mixture of macular conditions and retinal abnormalities, the course also ‘went into depth about previous and current treatment options, prevention methods and the studies used to make decisions in supplements and treatments.’
From a business perspective, Kumar says that clients are more inclined to opt-in for an OCT examination as they are ‘more confident in the service being provided when you have the qualification. You also start to build relationships with ophthalmologists, who will then recommend clients to come and see you, increasing your client base.’
At Glasses to Go, Shah says staff emphasise that patients will get enhanced optometry care for an extra fee. ‘Most patients do pay for these additional features and, crucially, provide positive recommendations to their friends. The practice has become locally known for providing clinical excellence, great dispensing products and newer technologies,’ he says.
Optical Express optometrist Shehzad Mahroof (pictured right), who works between Leeds and Meadowhall, says completing Cardiff University’s medical retina qualification in 2020 has been invaluable and helped him to develop into a more experienced and well-rounded optometrist.
‘Completing the qualification has expanded my knowledge in so many ways. I would recommend it to all other optometrists in the industry who are passionate about continuous learning and development,’ he says.
Evolving profession
As a profession, Mahroof says that optometry is always growing and developing: ‘Now, optometrists are providing a level of care that in years gone by was provided through secondary care establishments. It is important that as optometrists we take advantage of these opportunities to grow with the industry to benefit our patients,’ he says.
Shah adds that completing the qualification has been empowering. ‘The qualification is a practice builder and has enhanced my professional standing, with the recognition from medical practitioners and ophthalmologists that we are able to provide better clinically orientated eye care to patients and are not just purveyors of spectacles,’ he says.
Baron highlights that it is also ‘refreshing’ to be able to enhance your knowledge to work at the top of your skill set, support secondary care and add variety to your day job: ‘Whether that is higher certificates in medical retina or glaucoma or even IP accreditation, we are lucky that there are lots of opportunities within our profession.’