My job has been such an adventure!
I started out as a band 2 senior orthoptist in Norwich after I graduated in 1999, and I worked here for a year before I found a job closer to home in Middlesbrough. In Norwich I was learning how to be an orthoptist. I did lots of school screening and learned an awful lot from my colleagues there.
In Middlesbrough I progressed to be a senior 1 orthoptist, and eventually a band 6 when Agenda for Change came in. I had the opportunity to join the British Orthoptic Society (now the British and Irish Orthoptic Society) and be a regional rep which was very interesting. I developed a specialist interest in neuro-orthoptics and worked closely with the neuro ophthalmologist in managing patients in motility clinics with complicated eye movement disorders.
A tremendous amount of satisfaction comes from diagnosing a patient with a particular condition, identifying the site of a lesion just from their eye movements and eye signs, or putting a prism on a pair of glasses and giving someone single vision again.
Cath Williamson
Advanced Specialist Practitioner, Newmedica
While I was at Middlesbrough I was asked if I could help with the research programme the Medical Retina Team were setting up for one day a week. I took on the role of research coordinator for some of the landmark multicentre research trials for Lucentis and Eylea in the treatment of macular disease. I did my Good Clinical Practice training and assessed patients in accordance with strict study protocols, and did all of the data queries and data cleaning, liaising with trial coordinators in the UK, Ireland, America and Germany. I also got to travel to Prague and Berlin for research investigator meetings (funded by the research companies)!
When I had my third child I went part time for a while, working from home for an orthoptic supplies company as a medical representative. I learnt a lot about marketing, sales and how much orthoptists love patterned patches!
During COVID, I reassessed my working life completely and gave up the medical rep job to take on a part time orthoptist role at Leeds which complimented the hours I was working at Middlesbrough. I saw a range of interesting cases here, with a lot of complex paediatric squint and adult motility. Whilst at Leeds I was given the opportunity to do a masters module in neuro ophthalmology; I learnt so much that I could then apply to my practice and enhance my clinical skills.
I was still doing medical research at Middlesbrough at this point and was keen to take more of a role in research, but with no openings available at the time I applied for a job at York as the lead for their macular injection service, switching my occluder for a slit lamp and my fixation targets for a syringe!
At York I became proficient in injections and assessing patients with a range of macular disorders. I was given the opportunity to speak to the extended roles team within the trust and develop not just my role but pave the way for extended roles for nurses in our 70 person strong team. I was taught to administer Ozurdex implants; I was the first allied health professional (AHP) in the country to do this before the drug label was changed to include nurses and AHPs in its licensing). This was down to a lot of hard work and agreements between our extended roles team, pharmacy and the consulting body who put a lot of faith in me to treat their patients.
This ended up being a pivotal point in my career, and a move towards extending roles more generally for nurses and AHPs. I was invited to London to speak at the Royal College of GPs about my experience, and I continue to fly the flag for AHP and orthoptic injectors, and pass on my experience of developing AHP-led NHS injection services. I went on to work with Adam Mapani from Moorfields to set up an injection course for Nurses and AHPs which has been a huge success.
I have recently left the NHS altogether and joined Newmedica, who will be funding my Advanced Clinical Practice masters from September. Here I run a single handed medical retina clinic, as well as a joint new patient clinic with Professor Richard Gale where I inject and assess. I also do cataract pre-op and post-op assessment for the Newmedica surgical team, managing post op complications with medications as per Patient Group Direction (PGD). If orthoptists are given the right to independently prescribe I will be first in the queue to do my prescribing! In the meantime, my next goal is to learn to perform YAG laser capsulotomy, a method of treating cloudiness after cataract surgery and some cases of glaucoma.
I have had an incredibly fascinating career so far and I am still learning so much. I am honoured that Professor Richard Gale has offered to train me in medical retina via the medical retina fellow training programme, and I attend journal clubs, presentations and review research as part of my wider learning.
Even at the age of 47 I am not finished learning, and my degree in orthoptics has given me the very best foundation not just in orthoptics, visual development, and the neurology of eye movements, but in the whole of ophthalmology.
Cath Williamson
Advanced Specialist Practitioner, Newmedica
The most rewarding aspect of my career is knowing that the medical help, advice and treatment is making a real difference to people's lives, improving quality of life, reducing the risk of falls, and helping people maintain their independence.
It has been the most exciting journey, and I still love coming to work every day and love my job completely!