Sound Optometry
Sound Optometry is a podcast from Docet offering continuing professional development (CPD) for UK-registered optometrists. Each month it explores relevant topics through case studies and in-depth conversations. Listeners can earn one CPD point by completing an exercise on docet.info after listening.
Episodes
Bonus 1: Papilloedema
Ahead of Sound Optometry’s return in January 2027, we’re revisiting some highlights from our sixty-episode archive. In the first bonus podcast, we’re exploring how to detect and manage papilloedema. Back in 2020, Michelle Hanratty was joined by Naz Raoof, a neuro-ophthalmologist at Moorfields Eye Hospital in London. They discussed the tell-tale signs of this potentially life-threatening condition
60: Glaucoma – Minimally Invasive Glaucoma Surgery
In recent years, there have been a number of exciting new treatments for glaucoma, a sight-threatening condition that is increasing in prevalence as the population ages. These innovations ensure that patients no longer face a binary choice between eye drops and invasive surgery. In this episode, Michelle Hanratty is joined by optometrist Matt Roney and ophthalmologist Neeru Vallabh at the Royal L
59: Vision and driving – Protecting the public and the patient
The UK government has recently finished consulting on proposals to introduce mandatory eyesight testing for drivers aged 70 and over as part of the licence renewal process. The current vision standards for driving have been in place since the 1930s, and several tragic cases in which poor eyesight has contributed to fatal collisions have highlighted why many believe reform is long overdue.No matte
58: TFOS DEWS III – A new chapter in DED management
Last year, the Tear Film & Ocular Surface Society (TFOS) released the DEWS III report — a clinical roadmap for managing dry eye disease (DED). TFOS DEWS III incorporates the latest research and is designed to give optometrists clarity on how to improve clinical practice. Reflecting a wealth of new evidence, the new guidelines have refined the definition of DED, changing some diagnostic criter
57: Adult Diplopia – Double the trouble?
When we think about binocular vision (BV), we typically focus on the paediatric cohort. But there are hundreds of thousands of adults across the UK who have developed BV issues later in life, including double vision. This can be a clinical challenge that not every optometrist is confident in managing. Many of these patients struggle with their daily activities. Some people lose hope that their vi
56: Cataract Surgery – Meeting challenges and reducing risk
More than 1,500 cataract operations are carried out every day across the UK, making it one of the most common types of elective surgery undertaken by the NHS. But there are significant challenges facing cataract service delivery, with many patients — especially those with co-morbidities — struggling to access timely care. Could innovations help?In this episode, Michelle Hanratty asks Dr David Loc
55: Vitreomacular conditions – When to monitor and when to refer
Vitreoretinal problems can arise as a natural part of ageing but in some patients, something more sinister could be at play. What are the signs of vitreomacular interface disorder pathogenesis that optometrists should be picking up on in practice? In this episode, Michelle Hanratty is in conversation with Mr Kam Balaggan, a consultant in cataract and vitreoretinal surgery at Wolverhampton Eye Inf
54: Headaches – Causes and clinical management
It’s thought that over half of the world’s population experience a headache disorder, and almost all of us have experienced the symptoms at some point in our lives. Headaches can be caused by many different factors — both visual and non-visual — and their severity can vary massively. When optometrists are examining patients, it’s not always clear how concerned to be or what to do next. After all,
53: Periorbital Skin conditions – What’s an optometrist to do?
Skin conditions are very common in the UK; for example, up to 30% of children and 10% of adults suffer from eczema. Dermatological problems can cause great discomfort or they could be the sign of a more serious underlying health condition. If the eye area is affected by a skin condition, optometrists are in a good position to help patients early-on, especially as it can sometimes be difficult to
52: Brain tumours, 2 – Red flags for referral
As we heard in episode 51, around a third of people affected by brain tumours report a problem with their vision. That’s why optometrists are uniquely placed to catch suspicious signs early and refer patients into hospital for further checks. In the second of two episodes on brain tumours and neuro-ophthalmology, Michelle Hanratty speaks to Lorcan Butler, an optometrist and the Optical Engagement
51: Brain tumours, Part 1 – A unique perspective
A brain tumour is an abnormal growth or mass of cells in or around the brain. They can be life-threatening and their incidence is increasing in the UK, as the population gets older. Around a third of people affected by a brain tumour report a problem with their vision. That’s why optometrists are uniquely placed to catch suspicious signs early and refer patients into hospital for further checks.
50: Diabetic retinopathy – Dots and blots of significance
Diabetic retinopathy is a leading cause of blindness among working age people worldwide. But thanks to the Diabetic Eye Screening Programme and an improved understanding of the impact of glycaemic control on diabetic retinopathy, there has been a significant reduction in the level of sight-loss in England and Wales. By catching the early signs of disease, eye care practitioners play a vital role i
49: Enhanced Optometric Services – Here, there and nearly everywhere
Since COVID-19, a greater number of enhanced optometric services have been rolled out across much of the UK. These pathways have been proven to reduce the burden on secondary care, reduce patient waiting times and have saved the NHS millions of pounds. As a result, Integrated Care Boards (ICBs) have commissioned optometric services far beyond CUES, MECS and pre- and post- operative cataracts. For
48: PACS – Management of primary angle closure suspects
Primary angle closure disease is more common in the UK than was initially thought and it is important for optometrists to understand the condition’s stages of progression; from primary angle closure suspect (PACS), to primary angle closure (PAC) and primary angle closure glaucoma (PACG). PACG is the stage we want to avoid, where structural damage to the optic nerve and loss of visual function have
47: Chronic Stress – The brain-body connection
Stress and burnout, which we explored in the last episode of Sound Optometry, is far from uncommon in optometrists. In this episode, Michelle Hanratty uncovers the severe implications that chronic stress can have on the health of optometrists in the future. How can we reverse its damage?Michelle is joined by Professor Anna Whittaker, a health psychologist at the University of Stirling, who highlig
46: Burnout in Optometry – Causes, challenges & solutions
A study conducted in Australia found that around half of optometrists experience burnout. One in every three optometrists also live with a mental health condition. We all know what workplace stress can feel like, but few of us can probably spot the signs of long-term stress turning into burnout. That can lead to even more serious mental health challenges and can affect how we care for our patients
45: Vision and Dementia – Modifying risk for better outcomes
One in three people born in the UK today will go on to develop dementia — a term used to describe a range of neurological conditions that cause the loss of cognitive functioning. It’s been established that dementia can affect vision and recently, researchers have realised that visual impairment is a modifiable risk factor for dementia, too. In other words, vision correction can, at the very least,
44: Corneal Conditions – Shape and clarity
Optometrists commonly encounter corneal conditions in practice—such as keratoconus, Fuch’s endothelial corneal dystrophy and recurrent corneal epithelial erosion syndrome. As Professor Sai Kolli explains in this podcast, the management of corneal dystrophies may involve monitoring, therapeutic treatment or onward referral, depending on their severity. Michelle Hanratty also hears from Christina an
43: Vision Standards – Colour perception and more
Vision standards and occupational eye testing can have profound consequences on patients and their families, especially when children are weighing up their career prospects. It’s therefore important that optometrists understand how tests are carried out and the implications of their results. In this episode, Michelle Hanratty takes a trip to the vision research centre at City St George's, Universi
42: Presbyopia – Refractive surgery solutions
As it is a condition that comes on with ageing, presbyopia is something that optometrists very commonly encounter in practice. For most people who develop long-sightedness, their eyesight is easily corrected with spectacles and sometimes contact lenses. But many patients seek to reduce their dependence on spectacles and that’s where refractive surgery can provide a welcome solution.In this episode
41: Gene therapy – Now and in the future
Gene therapy is one of the most exciting areas of modern medicine. In eye care, they promise to restore the vision of patients with both rare genetic eye diseases, such as a certain type of inherited retinal dystrophy, as well as more common conditions that have genetic components, like AMD. In this episode, Michelle Hanratty uncovers how gene therapies work with Omar Mahoo, a consultant ophthalmo
40: Menopause – Effect and cause
Half of the population experience menopause, but its effects are wide-ranging and poorly understood. In this episode, Michelle Hanratty investigates how menopause can affect the eye — from inflammatory changes, such as blepharitis, to dry eye disease and even an association with glaucoma. Michelle examines the scientific research with Stuti Misra, an Associate Professor in ophthalmology at Univers
39: Complaints – Taking the lead
Complaints are a normal part of a patient-facing industry, like optometry — from problems with prescriptions to quibbles about customer service. Therefore, handling complaints in a professional manner is an essential part of the GOC’s Standards of Practice. In this episode, Michelle Hanratty hears from Dawn Slocombe, a Complaints Resolution Manager at the Optical Consumer Complaints Service (OCCS)
38: Evidence-based practice – What, where, why?
In optometry, exciting new products or treatments are constantly coming onto the market. As practitioners, we need to keep our knowledge up-to-date, so that we can offer solutions to our patients if they present with an ocular condition. But is the evidence strong enough to make a recommendation or to provide that treatment? In this episode, Michelle Hanratty taps into the expertise of IP optometr
37: Immunology and allergy – A not so obvious link
Ocular allergy can be more complicated than the seasonal conjunctivitis that optometrists see frequently in practice. To treat allergic reactions effectively, it’s important to understand how the immune system works. In this episode, Michelle and Dr Peter Frampton, an optometrist at Aaron Optometrists in the North of England, discuss the four types of immune reactions, or “allergies”, that can be
36: SEN – The path to lifelong eyecare
Children with special educational needs (SEN) are 28 times more likely to have a problem with their vision—or how their brains interpret vision—than their peers. It’s essential that optometrists understand how to make appointments as successful as possible for SEN children and their families. In this episode, Michelle Hanratty asks Ellie Hughes, Assistant Headteacher and Sensory Impairment Lead at
35: Dry AMD – Hope on the horizon
Age-related macular degeneration (AMD) is the most common cause of sight loss in the UK, and the dry form is the most common type of the condition. In this episode, Michelle Hanratty visits a community practice in Harborne, Birmingham, to meet optometrist Bradley Warwick. Brad specialises in dry AMD, so Michelle and Brad discuss how to manage and counsel patients with the condition that currently
34: YAG and SLT – Optometrist-delivered laser treatments
Laser treatments are a great way for optometrists to learn new skills and add some variety to day-to-day practice. In this episode, Michelle Hanratty brings us into her YAG laser capsulotomy clinic in Birmingham, where she treats posterior capsule opacification (PCO) following cataract surgery. Michelle walks us through an appointment with a patient, demonstrating how quick and effective the treat
33: Cataract surgery – Understanding risks and managing complications
Over 400,000 cataract procedures are done every year in England alone and the surgery is also one of the most successful in modern medicine. But complications can still occur, for a number of reasons. With optometrists becoming ever more involved with cataract surgery patient pathways — from direct referral to postoperative care — in this episode, Michelle Hanratty explores the risk and complicati
32: Managing Myopia – Now and for the future
Myopia can be much more than just shortsightedness. In this episode, Michelle Hanratty speaks to her friend Kathryn, who has severe myopia, to find out how the condition can cause further ocular health problems, like macular degeneration. Two years ago on the podcast, we explored how optometrists should play an active role in myopia management using contact lenses. Listen to that episode here.Sinc
31: Diabetic Retinopathy – Screening & Treatment
Regular eye screening for the more than 4 million people in the UK with diabetes is essential. The chronic condition is difficult to manage, but high blood sugar over time can damage the blood vessels in the retina. These changes to the eye can be detected by retinal photography, yet diabetic retinopathy is a leading cause of blindness, because it typically isn’t caught — and managed — early enoug
30: Glaucoma – ISNT it suspicious?
Detecting and diagnosing suspect glaucoma isn’t an exact science, but the stakes are high—undetected or late-diagnosed optic nerve damage can lead to irreversible vision loss. Subtle changes in the optic nerve head can be confusing, though, so as an optometrist, being confident in your clinical decisions is essential. In this episode, Michelle Hanratty seeks advice on optic disc assessments with P
29: Hydroxychloroquine – Potentially toxic, potentially blinding
One of the side-effects for patients who take hydroxychloroquine, or chloroquine, can be retinal toxicity. The drug is usually taken to help treat rheumatic disorders, but around 7.5% of people who take hydroxychloroquine for over five years are thought to develop retinopathy. That’s why regular monitoring of the eyes is essential. Typically, monitoring takes place in secondary care, however prima
28: Leadership and accountability in optometry – Essential not optional
Leadership in optometry can take many forms - from solving a patient’s complaint successfully, to managing a team of optometrists, to dealing with our busy workflows. In this episode, Michelle Hanratty asks Mat Pickering, the General Manager of Optegra UK, how optometrists can become leaders in the workplace. Michelle is the Optometrist Lead at Optegra in Birmingham, and the pair discuss the multi
27: Dry Eye? Think MGD and beyond
The impact of severe dry eye or ocular surface disease on quality of life has been compared to someone who’s had a renal transplant or unstable angina. In this episode, we hear how dry eye disease affected both the ocular and mental health of patient Dave Cannell. For optometrists, dry eye can be tricky to manage and patients may need to be referred to hospital eye services. Michelle Hanratty ex
26: Patient Mental Health – Eyes and minds
Mental health isn’t usually the first consideration in optometrists’ minds when they see patients. But with conditions like anxiety and depression on the rise, optometrists, as primary healthcare providers, should be on the lookout for mental health concerns and how to point patients in the right direction. In this episode, Michelle Hanratty asks optometrist Sarah Farrant and her patient Christine
25: Visual Field Tests – When, why and what it can mean
Visual field tests can be invaluable when trying to explain a patient’s symptoms, like headaches, or detecting early disease, from glaucoma to stroke, or rarer neurological conditions, such as pituitary tumours. In this episode, Michelle Hanratty asks Stephen Freeman, an optometrist and lecturer at the University of Plymouth, when to be suspicious and what steps to take to investigate non-glaucoma
24: Mental Health – Optometrists, be well!
Mental health conditions can affect anyone and can have a negative impact on optometrists’ work. In this episode, Michelle Hanratty discusses these implications with Sheena Tanna-Shah, an optometrist who retrained in therapy after her own experience with anxiety. Also, avoiding stress and burnout at work can help to reduce the risk of mental health conditions – and makes working as an optometrist
23: Eyelid lesions – Look for the sign: Malignant or benign?
Coming across eyelid lesions is an everyday occurrence for optometrists, but distinguishing them from each other can be a challenge. In this episode, we hear from Nina, who had a basal cell carcinoma (BCC) on her lower eyelid. Michelle Hanratty then explores the various types of malignant and benign lesions that could present in practice, with Mr Raman Malhotra, a Consultant Ophthalmic Surgeon at
22: Corneal Disease – Big problems in young eyes?
Paediatric eye conditions can often leave optometrists concerned and confused about how to manage patients. In this episode, Michelle Hanratty explores both inflammatory and infectious causes of corneal disease in children. Consultant Ophthalmic Surgeon, Mr Michael O’Gallagher of the Royal Victoria Hospital, Belfast explains how vernal keratoconjunctivitis differs from blepharokeratoconjunctivitis
21: Uveitis – Detecting the rare and managing the obvious
Uveitis is thought to cause around 15% of severe sight loss in the UK. In this episode, Michelle Hanratty explores both punctate inner choroidopathy or PIC, a form of posterior uveitis, and the more common presentation of anterior uveitis, with Consultant Ophthalmologist Professor Alastair Denniston and Consultant Ophthalmic Surgeon Dr Balini Balasubramaniam, from University Hospitals Birmingham N
20: Sudden loss of vision - Time is sight!
Many optometrists will have experienced a patient calling and saying that they suddenly can't see. In this episode, Michelle Hanratty travels to the Manchester Royal Eye Hospital to explore the loss of vision, focussing on artery and vein occlusions, with optometrists Helen Wilson and Amanda Harding. The discussion addresses how optometrists can ensure that people can access care in the most effic
19: Modern contact lens practice – The CLEAR way forward
Fitting contact lenses might be a straightforward task, but modern contact lens practice is constantly evolving. Last year, the British Contact Lens Association released a series of reports, called CLEAR, to help harness the most recent contact lens research and modernise contact lens practice, in an evidence-based manner. In this episode, Michelle Hanratty discusses the CLEAR reports’ findings w
18: Enhanced Optometric Services - Part 2 (Scotland & Northern Ireland)
The four nations of the UK each have their own Enhanced Optometric Services. This is the second of two episodes which explore how these pathways benefit patients, practitioners and the NHS. In this episode, Michelle Hanratty explores the services available in Scotland with Kathryn Trimmer, an IP optometrist based in Grampian, and in Northern Ireland with Mairead O’Kane, an IP optometrist based in
17: Enhanced Optometric Services - Part 1 (Wales & England)
The four nations of the UK each have their own Enhanced Optometric Services. This is the first of two episodes which explore how these pathways benefit patients, practitioners and the NHS. In this episode, Michelle Hanratty discusses the Enhanced Optometric Services in Wales with Clare Pearce, an optometrist based in Cardiff and in England with Kevin Liu, an IP optometrist based in Greater Manches
16: Binocular Vision - Managing convergence anomalies
Binocular Vision disorders present themselves frequently to optometrists but the most appropriate solution is not always obvious. In this episode, Michelle Hanratty discusses the path to single vision with Dr Aleks Mankowska, an optometrist and lecturer in the Bradford School of Optometry and Vision Science. We also hear about the experience of Eleanor, who was treated for excessive convergence.Th
15: Vitreomacular disorders - Smoothing wrinkles and mending holes
Vitreomacular conditions can be sight-threatening if they are not picked up by practitioners. In this episode, optometrist Michelle Hanratty speaks to Mr Kam Balaggan, consultant ophthalmologist and consultant vitreoretinal surgeon. They discuss how to recognise vitreomacular disorders and how to decide when referral is required. Also, to gain an insight from a patient’s perspective, they explore
14: Glaucoma – Assessing the risk to resolve referral dilemma
Glaucoma is a difficult condition to diagnose. Optometrist Michelle Hanratty discusses referral dilemmas and the impact of the NHS backlog with optometrist, Paddy Gunn, and consultant ophthalmologist, Mr Imran Masood. Paddy Gunn, Principal Optometrist Education and Training at Manchester Royal Eye Hospital, has a specialist qualification in glaucoma. Mr Imran Masood is director of the glaucoma ser
13: Infection control – Protect the patient, protect yourself
The COVID-19 pandemic has heightened awareness of infection control measures in all professions. As optometrists, there are particularly important precautions to take. In this episode, optometrist Michelle Hanratty discusses the mechanisms of transmission for respiratory infections, gastrointestinal pathogens and eye illnesses with microbiologist Dr Conor Meehan. They also discuss the recommended
12: Anterior Ocular Lesions – Benign or malignant? Change is significant!
Discovering a new ocular lesion whilst carrying out an eye examination can lead to a management dilemma for optometrists. Michelle Hanratty talks to Professor Heinrich Heimann, Consultant Ophthalmic Surgeon and Clinical Lead of the Ocular Oncology Unit at Royal Liverpool Hospital. They discuss what to look out for, when to monitor and when to refer patients that optometrists suspect might have a t
11: Myopia Management – Active not passive
Myopia is thought to affect half of the population by 2050, which is why management from optometrists is required, to potentially reduce the extent of myopic progression in patients. Michelle Hanratty talks to Professor Ed Mallen about the threat of this “epidemic”, before we hear from a patient, Elodie, and her mother, Elizabeth, about the impact that MiSight lenses have had on their lives. Miche
10: Keratoconus – Screening, surgery and saving sight
Early keratoconic corneal changes can start even before the age of 10 and those that are at risk are mostly not detected until the condition is moderately advanced. The only way to pick these patients up early is to routinely screen for keratoconus in the young population at their routine eye examinations and it could be as easy as using an autorefractor-topographer. Hear more about the detection
9: Suspicious Discs – When is a disc a disc at risk?
In this episode, we hear about a clinical scenario where a case of idiopathic intracranial hypertension led to severe visual symptoms and bilateral optic disc swelling. Michelle Hanratty then recaps the key features of papilloedema, its presentation and causes with neuro-ophthalmologist Dr Denize Atan before looking at the differential diagnoses. The second part of the episode concentrates on the
8: Cataracts – A tale of two surgeons
In a special edition, optometrist Michelle Hanratty talks to Consultant Ophthalmologist, Arijit Mitra, about his personal experience of developing a unilateral cataract at a relatively young age and what it was like to be operated on by a friend.They are joined by Ajai Tyagi, who gives an insight into the preoperative surgical assessment and his thought process when operating on both colleagues an
7: Speaking Up – Putting patients first
What if you witness something that you feel puts patients at risk – an unsafe practice or procedure you’re not happy with? This month optometrist Michelle Hanratty discusses the concepts of Speaking Up and Whistleblowing with David Hewlett, Group Director at FODO. We also hear from someone unhappy with the current procedures and speak to Julie Breen, the first primary care Freedom to Speak up Guar
6: Medical Retina – Investigations and injections
Conditions of the retina can be genetic or acquired but, even with advanced imaging, it can be challenging for optometrists to decide when people need to be referred.This month optometrist Michelle Hanratty discusses diagnosis and treatment of wet AMD, dry AMD and retinitis pigmentosa with consultant ophthalmologist and specialist in medical retina, Rupal Mojaria. We also hear from Bryan, a patien
5: Acute Red Eye – Stay calm and keep it simple
Most cases of acute red eye are due to fairly benign conditions such as conjunctivitis. However, a small proportion are more serious and require urgent treatment. This month, Michelle Hanratty and consultant ophthalmologist David Lockington discuss the challenges of differentiating between the two. Plus, optometrist Robert Longhurst talks about the rise of viral conjunctivitis as COVID reached the
4: Binocular Vision – The trouble with double
Managing binocular vision is important. Eliminating the differentials requires a good theoretical knowledge so it’s essential to keep that knowledge fresh. This month, Michelle Hanratty speaks with specialist optometrist Janice McCrudden, from the Belfast Health Trust, to delve deeper into squints and assessing binocular vision in children. Plus, optometrist Neil Constantine-Smith talks about a ca
3: Flashes & Floaters – Retinal detachment waiting to happen
Retinal detachment is one of the most common reasons for “Fitness to Practice” complaints to the General Optical Council. This month, Michelle Hanratty is joined by vitreo-retinal surgeon Steve Lash, and Roshni Kanabar from the Association of Optometrists. The team explore the importance of taking history correctly, communicating with patients successfully, and how to treat those experiencing flas
2: Papilloedema – A swell of concern
In 2012, optometrist Honey Rose was convicted of gross negligence manslaughter for failing to detect papilloedema. Although later overturned, this conviction shook the optometry profession. This month, Michelle Hanratty and consultant neuro-ophthalmologist Naz Raoof from Moorfields Eye Hospital discuss the tell-tale signs of papilloedema and how to communicate these findings to the patient. Plus o
1: Ocular Allergies – Relieving the itch
It's hay fever season and Docet launches Sound Optometry with the timely topic of ocular allergies. Michelle Hanratty and Dr Peter Frampton explore the causes of ocular allergies, treating patients in lockdown, and how to keep them comfortable when the pollen count is high. With special thanks to clinical pharmacist Dharmesh Shah from Moorswalk Surgery.Docet - dedicated to providing quality optome
