Optometry as a career in Nigeria

This is written for students weighing their options, and for parents and teachers advising them. It is a practical account rather than a recruitment pitch.

The training

The Doctor of Optometry is a six-year undergraduate degree in Nigeria, entered from secondary school with a science background — biology, chemistry, physics and mathematics. Several Nigerian universities run accredited programmes.

The early years are basic and ocular sciences: anatomy, physiology, biochemistry, optics, ocular pathology, pharmacology. The later years move into clinical work — refraction, binocular vision, contact lenses, ocular disease, paediatric and low vision optometry — with increasing time in clinic. There is a period of internship after graduation, followed by registration with the Optometrists and Dispensing Opticians Registration Board of Nigeria, which is what makes you legally able to practise.

Registration is not the end of the training. Continuing education is a professional obligation, and the Association's Continuing Education Series is part of how it is met.

What the work is

The core is the comprehensive eye examination, and that is more varied than it sounds: refraction and prescribing, binocular vision assessment, glaucoma detection and co-management, diabetic retinopathy screening, anterior segment disease, contact lens fitting, paediatric vision and amblyopia, myopia control, low vision rehabilitation.

Alongside it sits the judgement of what to refer and how urgently — which develops with experience and is a larger part of the job than students expect.

A working day is mostly consultations, mostly in half-hour blocks, with a mix that depends entirely on where you practise. A practice near a large employer sees screen-related complaints and occupational screening; one in a residential area sees more children and more presbyopia; one near an industrial area sees injuries.

Where optometrists work

Private practice, either your own or employed. The commonest route, and the one with the most autonomy and the most business responsibility.

Hospitals, public and private, often working alongside ophthalmology.

Public health and NGO work — outreach, school screening programmes, community eye health.

Academia and research.

Industry — ophthalmic lenses, contact lenses, instruments.

Corporate and occupational optometry, screening employees in demanding visual environments.

Honest points

The confusion is constant. You will spend a career explaining the difference between optometry, ophthalmology and dispensing optics, to patients and sometimes to other health professionals. If that would frustrate you, it is worth knowing in advance.

Private practice is a business. Clinical excellence does not run a clinic by itself. Premises, equipment, staff, stock, pricing and records are your problem if the practice is yours, and nothing in the degree teaches them.

Equipment is expensive. Setting up independently requires real capital, which is why many graduates work employed for some years first.

It is a growing field. The population is ageing, diabetes is increasing, myopia is rising, and Nigeria has far fewer eye care practitioners per head than it needs. The demand is not speculative.

It suits a particular temperament. Careful, methodical, comfortable with precision instruments, and genuinely interested in explaining things to people who are anxious. Much of the clinical value lies in noticing a small asymmetry that someone less attentive would pass over.

What to do if you are interested

Arrange to spend a day with a practising optometrist. Most members would be glad to host a serious student, and a day in clinic answers more than any prospectus. The chapter's register lists practitioners across Lagos, and the secretariat can point you towards members who take students.