Optometry 101 | The Crash Course

Before I impart my - admittedly, slightly biased - wise words of wisdom, you should know (if you don't already) a couple of things about my personal experience with optometry that makes it a little less conventional than your own journey.

I did my A-Levels in biology/chemistry/mathematics, then went on to study medical biochemistry at the University of Leicester. I applied for dentistry at the start of my final year at uni, but failing to secure a place, I applied for optometry at Aston University through the Clearing process and it was a successful application. I graduated in the summer of 2015, and it was that September that I jumped straight into my optometry degree and that's when the real fun began.

It should therefore be noted that: my A-Level subjects and grades had no relevance to my application, I simply had to graduate with a 2:1 or above in a science-related degree; I had no previous work experience in the optometry field; and my experiences/advice are somewhat subjective not just because they are, naturally, tailored to Aston University, but also because my journey beforehand has inevitably shaped my experience with optometry.

My year was the last year at Aston to have an application process that didn't require an interview - it has since changed (you have the sub-par quality of my year to thank for that) and an interview is now mandatory once your academic profile has been studied and approved. As far as I'm aware, every other university that offers optometry already had, and still do, have the interview stage in place. Sadly, for obvious reasons, I can't give much advice on it except to simply prepare for it as you would any interview, and go in with a strong knowledge of the field, the university itself, and the future of optometry in relation to advancing technology and developments in research. 

If two of your three A-Levels are science subjects, you need AAA to apply. If all three are science, AAB. Your science subjects have to be Biology, with either Maths or Physics, and Chemistry is accepted as an alternative.

Please, for the love of God, have done some work experience. Not just so that you can waffle your way through the interview, but because it will do you the world of good in terms of knowing what to expect. My perspective completely shifted once I entered the working world of optometry so if you can shadow optometrists, or even get a part-time job as an optical assistant, make it a priority. I promise you that it plays a huge role in cementing the decision of pursuing it as a career.

As any other job, and at the risk of sounding like a broken record, the more extra-curricular activities you can add to your CV, the better. Because when you're applying for a pre-reg or an optical assistant job with no experience, it's the extra-curriculars that demonstrate you're capable of such a job that will help you bag it. Whether it's sports, or volunteering, or a retail job, anything that makes you a well-rounded person and will help you to grow into a professional, go out there and do it. Trust me when I say that your future self will thank you.

The degree is a bloody nightmare. I'm not going to sugarcoat it; it is an absolute nightmare. Your first year will be hell. It's all physics and complicated equations and foreign concepts that will make no sense to you whatsoever and will make you reconsider every life decision you've ever made. If I'm truly honest, first year of optometry has virtually nothing to do with the career itself. It is hands down the worst year of the degree. But if you can pass it and get into second year, the myth that "it gets better" is no myth. It becomes more clinical and relevant to life, and while the content is so much more intense, it is miles better than first year.

They cram everything into second year. Just a heads up. Every clinical test that you have to know and the biological theory behind it, every contact lens type with their pros and cons, every type of spectacle lenses that exist, every research method that is employed in ocular research, every damn thing you have to know as part of your career, will be thrown at you in the space of six months and believe me when I say that you have to know every damn thing. 

Start your lecture notes early. You can get away with minimal effort in first year, but especially in second year, the content is so heavy that you have to stay on top of your lecture notes. If there's one piece of advice you heed, let this one be it. Don't leave it till exam leave. You will suffer and struggle to cram it all in. Get your notes to speed by April because learning it is a mission and a half and you will need all the time you can get come exam period.

Record lectures - especially ophthalmic optics. They will save your life.

Practise the ophthalmics equations over and over and over again. And practise them again. Blind memorising will be your downfall in the exam.

Know the stupid facts that are seemingly irrelevant. They will trip you up when they turn up in the multiple choice section of the exam.

Don't skip topics in a module. It takes just one 12m question on a topic you didn't have time to revise, to take you from a pass to a fail. 

Know your mental maths. Make sure you're able to count up, and down, in 0.25 steps in the space of a heartbeat. It sounds easier than it is, believe me. You can't afford to make mistakes when you have to calculate a prescription in ten seconds.

Have a working knowledge of basic physics and ocular anatomy. There's a module called Clinical Visual Biology which is quite literally, an encyclopedia on every muscle, nerve and gland that exists in the eye. Know them. Know the names, the locations, what links to what. Know the pathways and the pathology. Know your normal from the abnormal. You can afford to skip the lectures and get away with it come exam time, but my God will you regret it when second year, final year, pre-reg arrives and you know none of it. Take my word for it - I skipped it, and I'm suffering for it. Don't screw yourself over like all 145 of us did.

Optometry clinics are the bane of my existence. But with a few hidden gems of knowledge, hopefully it won't be yours.

Have good control over your hands. Manual dexterity is, sadly, not just for the medics and dentists. Handling the equipment, from the ophthalmoscope and retinoscope to using the slit lamp with one hand while holding a Volk lens against the eye with the other, inserting and removing contact lenses, inverting patients' eyelids, and handling all the clinical tests involved in eye examinations requires a steady hand and steady mind. 

Know your left from your right. And flip it. Because your patient's right, is your left, and vice versa. Some equipment also flips the image round so what you see in the bottom right, will actually be at the top left in real life. Your mind will be messed with more often than you like.

Be ready for your difficult patients. And yes, that could very well be your best friend. You will have friends who are a nightmare in clinics because their reflex reactions are hyperactive and their uncontrollable flinching will make you curse (mentally, of course) a hundred times over. Don't be afraid to manhandle them and grip their eyelids tight while shoving a contact lens in. You gotta do what you gotta do!

Prepare yourself for the countless times you will have dilation drugs instilled in your eyes - the blurry vision and headaches are, unfortunately, a weekly discomfort. You will have your cornea numbed, you will have stupidly bright lights directed at your eyes for an uncomfortable number of minutes, and you will have an array of weird and wacky instruments experimented on you by a bunch of inexperienced amateurs. You'll get used to it.

Roughly know certain distances; e.g. distances of 50cm/67cm/40cm/33cm/1m - these are the baseline distances that are used for most, if not all, clinical tests so have a rough idea of where you should be situated relative to the patient when conducting them.

Know how to wink with both eyes!!! You will always use your right eye when examining the patient's right eye, and vice versa and that means knowing how to wink with both. I fast learnt that a) it's a requirement and that b) I couldn't do that shit to save my life. So now I have to carry out eye exercises in the mirror to train my ocular muscles so that I don't look stupid in practice. If it makes you feel better, and I say this from experience, you won't be the only one who can't do it.

Know what you're looking for. Know the "landmarks" of the eye. Know normal from abnormal. Try to practise on different people as much as you can; you'll pick up on common and rare differences between eyes that will make assessments - and testing in real clinics - that much easier.

Completely contradicting my previous point, find a good partner, and stick to them like glue. Someone who you're comfortable practising on time and time again, and who will let you repeat what you need to as many times as you have to until you get it right. Also someone who kinda, sorta knows what they're doing. The bouncing back and forth of knowledge helps.

PRACTISE. Practise, practise, practise. It's true, practise truly does make perfect. I can't tell you the number of things I struggled with, and have now perfected simply by doing them over and over again. If you can't pick something up, especially at the start of the second year, don't panic. I did, and it demotivated me so much that just making the journey to uni was a battle. It made me feel like I wasn't cut out for it. But with practise, it all came together. Use your spare time wisely, and if you don't know how something works, or you need help, ask.

Leading on from that point, talk to your peers. It's strange almost, that we're all taught the same stuff in the same way, and yet everyone will operate a little bit differently. You'll pick up so many tips and tricks just by watching how other people carry out their tests and techniques. Believe me, it just takes one neat trick to completely transform how easy clinics become.

Talk to people in the profession. If you have family in the field, if you're working in optometric practice, if you have friends who are optoms, talk to them. Their advice and experience is invaluable. They'll give you a certain insight into the profession and also into companies (which is super important when it comes to making decisions for your pre-reg) that you can't get anywhere else.

Pre-registration year; the most important and stressful year of any optometrist's life, from applying for a pre-reg position, to eventually qualifying, but hopefully I can make it a little easier for you. I remember right at the start of first year, the mere mention of pre-reg would fill me with dread because I had zero optical experience and the idea of applying to huge, reputable companies to fight for a place with hundreds of other students up and down the country sent me into a panic, bordering on meltdown. 

I am now on the other side. I'm holding a pre-reg place and I am, for better or for worse, #TeamSpecsavers. Am I biased in telling you that it's arguably the best company to do it with? Maybe. But I'm not going to sit here and convince you of it. The truth is, you will never truly know which company is best to do your pre-reg with; each has their pros and cons with their pre-reg programmes and you just have to judge which one sits best with you. 

1. Research, apply, decide. Again, talk to people. Get their advice on what it's like to work certain companies. Gather your information; find out how different places manage their pre-reg students. Be prepared with your CV at the beginning of second year and start browsing online for vacancies because applications should start going out before November. Apply absolutely everywhere. Don't underestimate how difficult it is to secure a pre-reg place; you need to cover yourself. Specsavers, Vision Express and Boots are the three big guns but apply to the smaller organisations such as Asda and Tesco, and independent practices as well.

2. My advice to you is apply for an optical assistant (OA) job and cross your fingers that you'll be favoured to get the pre-reg. I tell you that because getting the pre-reg is (almost) easy; it's getting the location that is damn near impossible. If you get a job close to home, it means you're likely to also be doing your pre-reg close to home. Note the word likely. Some places will screw you over by giving you a part-time OA job with the "promise" of a pre-reg, then when the time comes, it'll have no sway. So be wary, be smart. If, by an unlucky twist of fate, you don't get the pre-reg at the place you're working at, at least you have the experience under your belt. It's completely different, seeing how theory translates to practice. You'll see it a new light. Believe me, the experience you'll get by working part-time in practice is invaluable; it helped me in lectures, it helped me in clinics, and it helped me as a person.

I applied for a Specsavers OA job halfway through my first year and have been working there since; I just signed my pre-reg contract with them two weeks ago and I feel so lucky because a) it's only a 25 minute commute b) I have months of first-hand experience with patients, certain pieces of equipment, and pretty much the different areas of the store that make it run and c) I'm so settled at the store I work at; I'm familiar with how it works, I'm so comfortable with my team and managers and my future pre-reg pals, and it means that when my pre-reg does start next year, the only transition I'm making is into the testing room.

Get that job.

3. Be prepared to travel. You can't afford to be fussy with your opportunities, not at this stage anyway. Obviously try for something close by, but you might get placed pretty far out and chances are, you'll have to compromise and make it work somehow. And if you're in the Midlands - and it's likely that you are - the likelihood of getting it in your city is pretty damn low.

4. Be aware of the tie-ins. It may seem like early days, but it's something to think about. Most places will have you contracted to work for a certain number of years after your pre-reg, and if you want to leave before then, you have to pay your way out (which isn't cheap - it's over half the pre-reg salary). So when taking a place, don't think "it's just a year" - essentially, it's at least three, four years of your life that you're committing to a workplace and I can't stress enough how important it is that you're happy at the store you're hoping to practise at.

VISION EXPRESS

Vision Express are the first to hold their interviews in November. Applications are sent off online, and they then come to uni to interview you if that initial application is successful. You'll be split into three groups, and each group is given a task to do and naturally, you have to work as a team to complete it. You'll be silently observed by a member of the VE team who'll take notes on each member in the group and you then have a five minute one-to-one interview with your observer. You'll find out two weeks later whether or not you were successful in securing a guaranteed pre-reg, and although you'll be asked to select regional preferences, availability is limited so it'll be at a store that they allocate to you, and not necessarily one that you specified.

BOOTS

Boots, arguably, have the smoothest and easiest interview process. It is purely competency based; you'll be given a list of "typical" scenario-type questions at uni that Boots are likely to use and which aim to root out skills and qualities you possess that are essential in being an optometrist. Compared to VE and Specsavers, it's a very straight-forward, structured interview which lasts between fifteen and twenty minutes. Again, location isn't guaranteed and unlike other companies, working part-time for Boots doesn't guarantee you a pre-reg position with the store you're at, if at all. Be aware that they've displaced students from stores at which they work, to stores in other cities at which to do their pre-reg. If Boots do offer the pre-reg, it's a guaranteed position not subject to trial days or a placement, though a two-week summer placement is optional if you want to start settling in and to get a feel for the store and your future team.

SPECSAVERS

Specsavers have their selection process last. Applications go off online, after which every single optom student is invited to attend a Specsavers event around February time. At the event, you'll have three "stations" that you go to in groups: a clinical station at which you'll have a go at talking through various clinical skills with professional optoms; a "social" station in which you'll have a chance to talk to optoms that work for Speccies and you can ask them whatever the hell you want (within reason of course...); and a "personal skills" station where you discuss personal and professional skills that you need, and the types of people you'll encounter throughout your professional life. Everyone who attends the Specsavers event is then guaranteed a summer placement at a Specsavers store, though location is not guaranteed and keep in mind that getting one in the Midlands is almost impossible because of the sheer volume of people applying for that region. Once you've done your summer placement, the store will then decide whether or not to offer you the pre-reg.

The summer placement isn't as daunting as it sounds; you simply work at the store for a couple of weeks just to get a feel for their system and the team that you'll potentially be working with for the next few years. It's not just a chance for them to feel you out; it's also your chance to feel them out. Remember that that store will be your home, and that team will be your family for at least three years. If you're not comfortable with your placement and you have certain qualms about the store or staff, or their pre-reg programme, don't settle for it - have a back up in mind.

GENERAL INTERVIEW ADVICE

Be yourself. Don't pretend to be someone you're not. Leave the arrogance, cocky attitude, and over-confidence behind. These people have seen it all; believe me when I say that they'll see right through you.

Don't be robotic, especially with the Boots interview because you'll have had time to review the questions. Be prepared, but make sure your answers are relaxed and smooth.

Dress smart. You would be surprised how many people do not know what this means. Suit up; wear the smartest trousers you own, or dress it up with a skirt and tights.
Boys: smart shirt with a tie.
Girls: blouse and/or a blazer (with full length sleeves, avoid 3/4 length sleeves) and wear heels - it adds height, confidence, and a certain level of professionalism.
Smell nice.
A little bit of make up doesn't hurt.
And smile. Lots. A smile can sway interviewers more than you think...

In any group task, contribute as much as you can. I'm someone who closes up when surrounded by people but try to ignore the fact that you're being watched and ignore that little voice in your head that tells you that your ideas are irrelevant or stupid or unwanted. You're competing with the people you're working with, many times your friends, so tune out the bossy, overruling personalities, switch off that "nice" side of you and make yourself heard.

Let your personality do the speaking. In the scenario questions, you could rattle off a hundred qualities, but if you're speaking in a dead and dull voice, the interviewer won't give a shit. No one wants to employ an optometrist with no personality, who won't engage with their patients and make them want to come back. And don't think you don't have a personality; just simply being a super lovely person who can hold a conversation long enough to make people like you and engage with you, goes a long way.

THE PERKS

• There's a nice balance of scientific (biological and physical) theory and clinical work; if you're looking for a profession that isn't as intense as medicine or dentistry, with a strong medical foothold and the chance to work in clinical practice, while helping people and having a job that involves building a relationship with patients, optometry is the one
• It's a 9-5 job, without the long shifts and scarring experiences and the mentally draining workload
• You leave your job when you walk out the door; the hours are sociable and unlike so many other professions out there, optometry isn't one where you bring your work home and carry it into your personal life
• Career progression is possible; whether that's working in a hospital, lecturing, or going into research
• For you business-minded folk, you have the option of becoming a partner/director for a store, or even go on to open up your own
• If/when you have to start thinking about family life and finding that work-life balance, it has its flexibility, whether that's working part-time or even just working as a locum optometrist from time to time
• It pays well
• It comes with security and stability; like most medical professions, you come out on the other side pretty much with a guaranteed job in hand, knowing that optometrists will always be in demand - and you can take that with you across the globe

• It's boring as hell. It's no secret that optometry is tedious and dull, and working 9-5, five days a week in a testing room can make you want to pull your hair out
• You have to work the weekends
• It can get really repetitive - and for those of you who want a different day every day, you're unlikely to find that with optometry, at least in high street practice
• The pay isn't as good as it once was, or as good as it can be with other degrees (dentistry is the one if you want amazing pay with all the pros I mentioned above)
• Career progression is limited. Aside from lecturing or working in different settings, you're still stuck in doing the same thing, day in, day out

Remember your difficult patients (or customers). What I find really handy is recording the times I've had to deal with tricky patients at Specsavers or customers at work. Trust me when I say it'll be so useful when the time comes to apply for jobs or a pre-reg position

You will need to buy your own equipment for the start of second year; it will cost you a fortune and empty your bank account, but don't cut corners and try to buy your stuff from eBay or Amazon or other cheap websites. You'll be using that equipment for the rest of your professional career so make sure you buy top quality products (Keeler and Louis Stone are the top recommended brands to buy from). It's a worthy investment.

If you do get an OA job, or even when you start your pre-reg, make a conscious effort to fit in seamlessly with your team. Be extra nice, be sociable, and treat them as friends rather than colleagues. Your team make the job - they'll either make it an enjoyable one, or they'll make it a living hell

Requirements for a female optometrist:

High heels

Chewing gum

Perfume

[you have no idea just how intimate a profession optometry is]

Don't panic if you don't know shit. Most of us are winging it anyway and make it out on the other side alive.

And lastly, for those of you who are going to be our patients, remember that being a nice patient is just as important as us being a nice optometrist. We really don't need to take your shit and when it's 4:50pm on a Saturday, the last thing we need is a shitty patient. Just be a nice person. It's really not rocket science.

If you want a more personal insight into my journey with optometry, you can find it here and you can find general A-Level advice here