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Case study: Developing a path in research

An interview with Daniel Osborne, Research Orthoptist, University Hospital Southampton NHS Foundation Trust

Developing a path in research

An interview with Daniel Osborne, Research Orthoptist, University Hospital Southampton NHS Foundation Trust

Orthoptists are rare in the UK, in fact there are just 1,400 of us. A research orthoptist is even rarer, which makes my position somewhat unique.

I’d been at University Hospital Southampton as an orthoptist for 18 months when a new role was created as a research orthoptist. I’d had some exposure to research during my degree and really enjoyed it, so decided to apply. The role would allow me to spend 50% of my time researching and 50% still doing clinical practice, which to me sounded like the best of both worlds.

After getting the job, my first taste of research was being involved in a project investigating the eye condition, nystagmus, in children – a rare condition that causes the eyes to make repetitive, uncontrolled movements. Over ten years, the study has looked at around 670 children assessing all sorts of aspects of their eye health, in order to help us understand the condition.

My role was focused on looking at the eyes’ movement, using tracking equipment and recording the patterns. The study was a great introduction to research and working in amongst a big team of researchers from the university and the hospital in Southampton.

As there is currently no cure for nystagmus, and we don’t know what causes it, being involved with the study taught me a lot about how to connect and talk to patients. It’s opened me up as a clinician to being vulnerable and open with my patients, getting them to understand that sometimes we don’t have all the answers and we need their help to find them. In this situation, it can also help patients to feel a little more in control of their conditions, they have a say in their treatment options and can make more decisions.

I’ve recently been awarded an Health Education England and NIHR Pre-doctoral Clinical Academic Fellowship which provides research training awards for healthcare professionals looking to develop careers combining clinical research and research leadership, with continued clinical practice and professional development.

I applied back in 2018, but didn’t get awarded the first time round. In 2019 I got the award, the first orthoptist to do so, and this enables my role to continue to be funded with a split function between research and clinical practice – something that’s really important to me.

I have begun developing my own study that looks at the treatment of children with lazy eye. Traditionally, we give children an eye patch to wear up to six hours a day and then see them in clinic every six weeks to test their eyes and check their progress.

The way we assess children and treat them hasn’t really changed since Victorian times, so my study looks at how we can bring assessment and treatment into the 21st century. By using technology like iPads to get parents and children to test and monitor progress at home, I’m hoping to reduce the frequency of clinic visits but also to encourage them to make consistent progress.

Wearing the eye patch can present a challenge for children – other children can say cruel things which can then make them reluctant to wear it and hinder their progress, making their treatment times longer than they need to be. It also becomes a nuisance having to wear it for large parts of the day.

I’m still in the development stage of the project but it has been a positive experience of collaboration. I’m working with a team in Cambridge and the charity Fight Against Blindness has donated iPads for us to use during the trial. I’ve also been experiencing the processes of building a study from the ground up – gaining funding, learning about research practice and ethics, recruitment and controls and then analysing and publishing the results.

Getting involved in research has unlocked a keenness in me to challenge and change things, wherever I can see potential for improvement. During a recent internal audit as a department, we saw that 15- 20% of children who have been referred to see us don’t attend their clinic appointment, so I’m looking for ways to reduce that. There can be a fear for children around the administering of eye drops at the clinic, so I want to explore whether changing our approach could have an impact on the number of missed appointments.

I would say to anyone who is early in their career, to consider research as part of it. I continue to suffer from imposter syndrome, where I think that I perhaps don’t know as much as others, so shouldn’t be getting involved in research. But I’ve discovered it’s been a fantastic way to collaborate with other people, make fantastic connections and that the people who you’re probably afraid of approaching are grateful to have your help. Just go for it.