Physiological Sciences

Profile of an Ophthalmic Science Practitioner

Above: Ophthalmic Science Practitioner performing ocular angiography (left) which diagnoses many sight threatening conditions, while (right) visual field analysis assesses central and peripheral vision (see notes below).

What is Ophthalmic Science?
Ophthalmic Science and Vision Science studies disorders of vision, and
diseases of the eye and the visual pathway. This includes Perimetry
(measurement of the field of vision); Tonometry (measurement of intra-ocular
pressure); Electrophysiology (measurement of the small electrical signals by
which visual information is transmitted); Imaging of the eye & supporting
structures; and other physiological and psychophysical measures. Healthcare
Scientists in this area will measure, monitor & assess the various procedures, providing valuable information for diagnosis & treatment.

The role of the Ophthalmic Science Practitioner
The role of the ophthalmic science practitioner is to aid the ophthalmologist in the clinical management process, by providing accurate and repeatable imaging and physiological measurement test data. Test data can be used screen for eye disease such as diabetic retinopathy & glaucoma. Aid diagnosis of ocular disease and diseases affecting the visual system. Plan surgical or therapeutic procedures and treatment monitor outcome.

The three main disciplines within ophthalmic science are physiological testing and measurement, ocular angiography & imaging and electro-physiological measurement.

Above: Optical Coherence Tomography to diagnose and monitor conditions such as Diabetic Macular Oedema or Glaucoma (see notes below)

Career opportunities
The majority of ophthalmic science practitioners’ work within a clinical environment in the NHS, the work is often outpatient based working in close collaboration with a diverse group of health care professionals. There are opportunities to work in clinical and basic science research, both in a patient care and academic environment. This is a new profession that is growing to meet the increasing demand for ophthalmic services in the UK.

How do I become an Ophthalmic Science Practitioner?
At present most ophthalmic science practitioners, enter the profession with a relevant first degree and then embark on a local hospital trust based training route. In future a national training programme will be available in Ophthalmic Science Technology & Care (OSTC), offering Higher Level Qualification, Foundation Degree & BSc Honours Degree qualifications. An access course will allow prospective students to top up their existing qualifications before enrolling on the OSTC course. The programme will have a competence based assessment process built in at all levels of the course, to evaluate practical skills. The course will be available as a distance-learning programme and will be work place based.

The Career of One Ophthalmic Science Practitioner
”I have worked in field of ocular angiography and imaging for the last 21 years. I joined the specialty from a background in clinical photography. During this time my role has changed immeasurably, from one of clinical photography, to that of a diagnostic imaging specialist. Whilst I am still required to document ocular disease using conventional photographic techniques, these now represent a small part of my work and many of the techniques I now use are more closely related to physiological measurement.

“The techniques I utilise include ocular angiography, confocal scanning laser ophthalmoscopy, optical coherence tomography, slit lamp photography, retinal photography & imaging and diagnostic ultra-sonography. I have recently undergone training in venous cannulation and am hoping to start my trust’s IV drug administration course soon. The increasingly technological and scientific nature of the work I am involved in, mean that like my profession I too must evolve, so I plan to enrol on the Ophthalmic Science, Technology and Care Course next year.

“I administrate the Ophthalmic Imaging Service and am responsible for staff training and development, service planning and audit. I have been involved in a number of clinical research projects and have a particular interest in professional development and education, and chair the education committee of the Ophthalmic Imaging Association.”

Christopher Mody - Senior Ophthalmic Science Practitioner, Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield

Further information

Association of Ophthalmic Science Practitioners
PO Box 6548,
Burton on Trent,
DE13 0WS
www.aosp.org.uk

Ophthalmic Imaging Association
Clinical Sciences Building
Aintree Hospital
Longmore Lane
Liverpool
L9 7AL
www.oia.org.uk

Image notes

Ocular Angiography - there are 2 type of ocular angiography:

Fundus Fluorescein Angiography (FFA) - this procedure looks at the blood flow
within the retinal vasculature. A yellow dye called fluorescein sodium is injected intravenously into the arm or back of the hand and images are taken, through a dilated pupil, of the retina as the dye circulates. The dye can appear within 10 seconds and can remain in the retinal circulation for up to 10 minutes. Digital (or conventional film) images are taken using a specialisedfundus camera.

Indocyanine green (ICG) - This is very similar to fluorescein angiography except
the dye (indocyanine green) is used to look at the choroidal vascular system.
The choroid layer sits beneath the retina. Images are taken through the dilated
pupil and the dye can still be visible (by the camera) up to 30 minutes post
injection.

Ocular angiography is used to diagnose many sight threatening conditions and can
assist the ophthalmologist in determining the best form of treatment (usually
laser photocoagulation of the affected blood vessels).

Visual Field Analysis - the visual field test is an assessment of central and
peripheral vision, which can be affected by various disorders, the main one being Glaucoma. It is a vital test as the results help the doctors to plan and monitor the progress of certain treatments.

Optical Coherence Tomography (OCT) - this is a new imaging modality that is used
to image retinal tissue and the nerve fibre layer in high resolution
cross-section. It is a non-invasive procedure that does not require an injection
of dye. It is suitable for the diagnosis and monitoring of conditions such as:
Diabetic Macular Oedema
Macular Holes
Age-Related Macular Degeneration
Glaucoma