Ophthalmologists are medically trained doctors who care for patients who have eye conditions. They manage those with acute and long term eye disease and treat patients of all ages.
This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.
Nature of the work
Ophthalmologists diagnose, treat and prevent disorders of the eyes and visual system.
Ophthalmology is a mixed medical and surgical specialty. There are many diverse ophthalmological problems encountered in the UK, particularly in an increasingly aged population. Ophthalmology practice is very diverse, dealing with a variety of issues and clinical conditions.
Common conditions encountered include:
corneal pathology (diseases of the cornea, the thin transparent surface that forms the front of the eyeball)
cataracts (where the lens of the eye loses transparency)
glaucoma (where the fluid pressure insides the eyes increases, causing visual problems)
squints (where there is a problem with the alignment of the eyes)
retinal problems (such as oedema[1] within, bleeding, tears or detachment of the retina, the back inner surface of the eye that receives light)
intraocular inflammation (inflammation within the eye)
eye-related neurological problems
Ophthalmologists also manage patients with the following conditions:
major and minor eye injuries
infectious eye disease
chronic diseases of the eye such as diabetic retinopathy (disease affecting the retina caused by diabetes) and age-related macular degeneration (deterioration of the macula, the central area of the retina)
Ophthalmic patients encompass the whole age range, from premature babies to the most senior members of the population. Patients are generally well and their conditions and are only rarely life-threatening. However, eye symptoms and disorders are very common and can cause considerable anxiety. Sympathetic advice and reassurance is often required in addition to diagnosis and treatment.
Ophthalmologists undertake eye surgery, which is usually performed with the aid of an operating microscope and may involve lasers.
Types of surgery include:
cataract surgery – the most frequently performed operation, which is very successful and provides high patient satisfaction
glaucoma surgery
surgery for retinal disorders
strabismus surgery (for squints)
corneal transplantation
oculoplastic surgery (plastic surgery around the eye)
orbital surgery (relating to the eye socket)
Ophthalmic surgical procedures have benefited from huge improvements in technology in the last ten to fifteen years, resulting in earlier surgery with vast improvements in patient lifestyle. Further improvements have occurred in the delivery of eye surgery, with most operations dealt with as day cases.
A surge in exciting new technology and treatments in recent years have allowed ophthalmologists to manage patients with eye diseases in a much more effective way, and this trend is likely to continue as services expand.
"the clinical challenge each patient poses means that no two days are ever the same” Kavita Aggarwal ST1 Ophthalmology John Radcliffe Hospital, Oxford
Ophthalmologists can develop sub-specialty interests in a number of different areas. For example, ophthalmologists with a paediatric interest deal with eye development and diseases in children.
Medical retinal specialists deal with retinal disease, including its onset in patients with such diverse conditions as diabetes, age-related macular degeneration, eye disease due to systemic conditions and inherited retinal diseases.
Sub-specialty interests, which can be surgical or non-surgical include:
cornea and anterior segment
medical retina
glaucoma
oculoplastic surgery (plastic surgery around the eye)
This section provides useful information about the pay for junior doctors (doctors in training), specialty doctors, consultants and general practitioners.
NHS employers[9] provides useful advice and guidance on all NHS pay, contracts terms and conditions.
Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.
Read about consultant and non-consultant roles in ophthalmology, flexible working and about wider opportunities.
Consultant roles
You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training[10] (CCT[11]). You will receive your CCT[11] at the end of your ophthalmology training.
Managerial opportunities for consultants include:
clinical lead - lead NHS consultant for the team
clinical director - lead NHS consultant for the department
medical director - lead NHS consultant for the Trust
Most NHS consultants will be involved with clinical and educational supervision of junior doctors.
Here are some examples of education and training opportunities:
director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training[12] programme director. This role will be working within the LETB/deanery
associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the LETB/deanery
SAS doctor
There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor.
SAS surgeons (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for Specialty Doctor roles. Find out more about SAS doctors roles.[13]
The role of an SAS surgeon can vary greatly. Depending on your experience, you might work on complex surgery or relatively minor diagnostic and outpatient work. SAS doctors will frequently participate in routine and elective[14] surgery rather than emergency work. They also train other staff.
Some surgeons are attracted to the SAS role as the hours are more regular than those of the consultant, and any on-call work and overtime beyond 7am-7pm is paid.
Other non-training grade roles
These roles include:
trust grade
clinical fellows
Academic pathways
If you have trained on an academic ophthalmology pathway or are interested in research there are opportunities in academic medicine.
For those with a particular interest in research, you may wish to consider an academic career in ophthalmology. Whilst not essential, some doctors start their career with an academic foundation post. Entry is highly competitive. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.
Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) at ST1-2 and may progress to a Clinical Lectureship (CL) at ST3 and beyond. Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.
After completion of the academic foundation trainees can then apply for academic core training posts (instead of normal core training). A PhD is often taken, either during core or specialty training.
There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine.[17]
The Clinical Research Network [18](CRN) actively encourages all doctors to take part in clinical research.
Other opportunities
Ophthalmologists may undertake research, which includes collaborating with colleagues in the UK and overseas, writing papers and presenting work at conferences.
Ophthalmologists are always in demand.
There are also be opportunities to work in the private sector and overseas.
This section provides useful information about the availability of jobs, how to find vacancies and sources of further information.
Job market information
NHS Digital regularly publish workforce statistics which show the number of full time equivalent consultants and doctors in training for each specialty: NHS Digital workforce statistics[19].
Ophthalmology training is open to those who may want to train flexibly on a less than full-time [24]basis (LTFT). You can request and apply for this after you have been offered the job. Restrictions apply. Link to our new article on LTFT
Registration and applications for ophthalmology training is online via Oriel.[25]
