An ophthalmic nurse is a nurse who has the education and expertise to provide holistic nursing care for people with a visual impairment or related conditions, temporary or permanent, wherever they may be.  

Ophthalmic nurses have unique skills relevant to their practice as adviser and promoter of eye health. They support the wellbeing of visually impaired people and those with eye conditions across the age spectrum. Ophthalmic nurses also practise in sub-specialist areas and  many are practising at an advanced level in clinical practice. In 2023, the RCN updated its definition of nursing, see: Definition and Principles of Nursing.

The primary aim of ophthalmic nursing care is to promote and to enhance a high standard of ocular health.

For further information about the ophthalmic nursing roles, see: Health Education England (HEE) Roles Explorer. The HEE Roles Explorer is hosted on the Future NHS platform platform. This is a membership only site and you can use your nhs.net account details to login.

The nature of ophthalmic nursing is to provide specialist care to a defined group of people and is continually evolving to meet the needs of patients. It is a multifaceted and a complex speciality where nurses use their expertise to forge close relationships with patients (including their families/carers, and other healthcare professionals involved in their care) to support, maintain and enhance their eye health and wellbeing.

Ophthalmic nursing focuses on preventing ill health, maintaining and enhancing (where possible) ocular health, and this is encouraged and achieved through the continuing development of specialist skills, whilst promoting a positive therapeutic relationship with patients (and their families/carers).

Ophthalmic nurses are particularly aware that people live with sight impairments/loss in a range of health and social care settings, including acute care in the community or care homes. They should develop sound relationships to collaborate across health and social care, including voluntary groups and charities, to enhance care provision. Collaboration includes raising awareness of ocular health among healthcare colleagues and the wider community.

A key principle of knowledge and skills development is continuing to promote the person, not the condition. This includes developing a two-way relationship based on mutual trust that provides continuity of care. This in turn encourages shared decision making and enables the nurse to discuss the patient’s ideas, expectations and concerns when it comes to eye health (Burggarf et al, 2019).

To enhance this, ophthalmic nurses, draw on and make best use of the evidence-based resources available to them and are mindful of the positive value of collaborative working by signposting to other members of the wider multidisciplinary team. It is important to note that to fulfil their role effectively, wide knowledge base, will include, not only a sound physiology base, but the ability to effectively relate and impart information to patients, as well enabling informed decision making with patients around care choices. This will ensure nurses are working to incorporate current evidence-based literature and guidelines into their everyday practice.

The nature, value and scope of ophthalmic nursing aims to encourage nurses to engage in lifelong learning, ensuring the highest standards of care. Working together with service leads in both primary and secondary care, it creates an environment that sees the benefit of how education inspires nurses to participate in programmes such as the Ophthalmic Practitioner Training (RCOph, 2016, 2019). This in turn will enhance the knowledge skills and attitudes required to improve patient access to eye care (NHS, 2022). The nurse and the patient should work collaboratively to ensure that eye care is individualised, and patient empowerment is essential in healthcare (Marsden 2016).

The value of ophthalmic nursing has been identified through initiatives such as the national outpatient pathway (NHS England, 2022) and NHS Futures eye care hub (NHS England, 2019), which offer alternatives where the skills and expertise of ophthalmic nurses can be developed proactively in response to changing needs and service delivery. All nurses work to the standards in their code of conduct (NMC, 2018).

Adhering to these values ensures ophthalmic nurses are competent and confident to provide patient centred, evidence-based, and cost-effective care. This in turn is improves efficiency and clinical effectiveness for patient as well as the ophthalmic service. Demonstrating leadership skills is linked to quality of care and patient satisfaction, as well as better staff wellbeing and morale. 

The RCN Ophthalmic Nursing Forum believes in raising the profile of ophthalmic nurses by:

• encouraging all nurses working in ophthalmic nursing to find a voice through developing education
• to ensure all ophthalmic nurses see their own value and uniqueness in providing holistic care, and
• that all ophthalmic nurse are encourage to influence future practice, policy and guidance surrounding it by getting involved with the ONF and other national societies.

The scope of ophthalmic nursing continues to evolve as a consequence of drivers such as an ageing population (Raymond et al, 2021), a diminishing number of ophthalmologists currently within post (RCOphth, 2018), and the long-term costs of emerging treatments (Boxell et al, 2017; RCOphth, 2017). It also needs to keep pace with new treatments, including genetic eye conditions that may affect the population, in particular those with a learning disability.

The psychosocial care of the ophthalmic patients is very important in clinical practice (Williamson et al, 2023). The feelings of fear, anxiety, loneliness, depression and altered body image are real emotions experienced by the ophthalmic patients. Ophthalmic nurses should be educated to embrace the importance of psychosocial care as part of holistic, patient centred approach.

Ophthalmic nurses have a unique oversight of the patient pathway, acting as a link between health care professionals and third sector organisations. Recent data (Rattanasiriivilai and Shirodkar, 2021) indicates that 73 per cent of ophthalmic nurses take on more than one active role within their clinical practice, with over 59 per cent working autonomously in nurse-led clinics and in accident and emergency department as Enhanced or Advanced Nurse Practitioners.

Ophthalmic nurses now support patients in both an interventional and educative capacity across an ever-increasing range of clinical pathways such as oculoplastics (Dunlop et al, 2020), cataract (Stanford & Ewing, 2020), wet Age-Related Macular Degeneration (AMD) (Gallagher, 2017; Mohamed et al, 2018), glaucoma management (Bubb et al, 2021), and YAG Laser capsulotomy (Moussa et al, 2022), as well as paediatrics. Furthermore, as more ophthalmic nurses continue to achieve master’s and doctoral level qualifications, the increased knowledge and expertise that such education provides, empowers nurses to act as change agents, contributing more fully to the shaping of health and social care policy, as well as carry out primary research to further advance the evidence base required for enhanced practice in this field.

With the advent of remote monitoring using digital and technological solutions such as virtual clinics, digital hubs and apps, ophthalmic nurses who are usually based in secondary care, are presented with a unique opportunity to deliver person-centred care to patients in their own homes.

Ophthalmic nurses should challenge their care patterns, in particular, with new and advancing technology and treatments. They should also consider how best to support the patients’ needs and expectations, (and those of their family) in the treatment of ophthalmic diseases, and always within the values of the NMC Code (NMC 2018). In this way, nurses can continue to expand their scope of practice whilst retaining the central values of nursing to support and empower those continuing to live with ophthalmic disease.