How to become an orthoptist

To become an orthoptist you need an HCPC-approved qualification in orthoptics, usually a three-year degree, followed by registration with the Health and Care Professions Council. Only a handful of UK universities teach the subject, and there is also a two-year postgraduate route for graduates and a degree apprenticeship in England. Newly qualified orthoptists in the NHS usually start at Agenda for Change band 5, which is £32,073 in England from 1 April 2026.

What orthoptists treat

Orthoptists diagnose and manage problems with eye movement and with the way the eyes and brain work together. A large part of the caseload is children: squints (strabismus), amblyopia (often called lazy eye) and reduced vision picked up at school-entry screening. Treatment might be glasses combined with patching or eye drops that make the weaker eye work harder, with careful measurements at every visit to see whether vision is improving.

Adults come with double vision after a stroke, head injury or nerve palsy, or with eye problems linked to thyroid disease. Because eye movements can reveal problems in the brain, orthoptists sometimes spot signs of neurological conditions such as multiple sclerosis and refer the patient on. Many departments now use orthoptists in extended roles in glaucoma, cataract and retinal clinics, doing assessments that used to fall to doctors.

Most orthoptists are based in hospital eye departments, working with ophthalmologists and optometrists, and in community clinics. Some run or oversee screening in schools. For a clinical NHS job the hours are fairly regular: mostly daytime clinics, with occasional evening or weekend sessions in some services.

Degree, postgraduate and apprenticeship routes

The usual route is an undergraduate degree in orthoptics. Universities typically ask for two or three A levels including a science, plus GCSEs in English, maths and science, or equivalents such as an Access to HE diploma or a relevant T level. Some courses add a foundation year for people without the standard entry qualifications. Because so few universities run the course, you may have to move to study. Access to HE diplomas explains the route for adults returning to education.

If you already have a degree, a two-year postgraduate programme leads to the same registration. In England, some NHS trusts also recruit orthoptist degree apprentices, who are employed and paid while studying at an approved university. Apprenticeship places are scarce, so watch NHS Jobs and the government’s apprenticeship search over a long period.

In England, eligible students on pre-registration orthoptics courses can apply to the NHS Learning Support Fund, a non-repayable annual payment on top of the usual student loan. Check the current amount and conditions with the NHS Business Services Authority. Funding works differently in Scotland, Wales and Northern Ireland.

Admissions tutors like to see that you know what the job involves. Shadowing an orthoptist for a day or two helps, and the British and Irish Orthoptic Society can point you to departments that take visitors. Hospital work experience covers how to ask.

HCPC registration

Orthoptist is a protected title, so you cannot practise under it until you are on the HCPC register. You apply after graduating, pay a fee and then renew every two years, keeping a record of your continuing professional development. The fee is on HMRC’s approved list for tax relief, along with some professional body subscriptions; tax relief on professional fees explains how to claim. HCPC registration covers the registration process itself.

Pay and grades

Newly qualified orthoptists start at band 5. Specialist orthoptists are usually band 6, highly specialist or advanced practitioners band 7, and heads of service band 8a or higher, depending on the size of the department.

Band	Typical orthoptic role	England pay from 1 April 2026
5	Newly qualified orthoptist	£32,073, £34,592, £39,043
6	Specialist orthoptist	£39,959, £42,170, £48,117
7	Highly specialist or advanced orthoptist	£49,387, £51,932, £56,515
8a	Head of orthoptic service	£57,528, £60,417, £64,750

In Scotland, the 2026/27 band 5 points are £34,494, £36,857 and £42,977. In London a high cost area supplement is added, so band 5 entry pay in inner London is £38,488. At the band 5 starting salary you would pay 8.3% of pay into the NHS Pension Scheme. The take-home pay calculator shows what is left after tax, National Insurance, pension and any student loan.

What the job asks of you

Much of the work depends on measuring small things accurately and recording them clearly, because treatment decisions turn on whether a squint or a visual acuity score has changed since the last visit. With young children you also need patience and some ingenuity: getting a reliable test result from a three-year-old means keeping their attention long enough to finish. Parents need clear explanations of why patching matters and what happens if it is skipped.

With adults the demands change. Someone with sudden double vision after a stroke may be frightened and struggling with daily life, and you will often work alongside stroke teams and neurologists. Many eye conditions improve slowly or not at all, so a fair amount of the job is explaining and reassuring.

Getting a first post

Jobs for newly qualified orthoptists appear on NHS Jobs, and it is worth setting up alerts during your final year. Applications need a supporting statement against the person specification, and new registrants usually get a period of structured support known as preceptorship. Private practice exists but is small; nearly all orthoptists start in the NHS. Current openings are listed under allied health jobs.