The role of the optometrist in both community and hospital practice has undergone significant and progressive change over the past 30 years. Hospital optometrists, who traditionally performed adult and paediatric refraction, medical contact lens fitting and aftercare, low-vision rehabilitation or visual fields investigation roles within hospital clinics, are now likely to find themselves also managing and treating glaucoma, macular disease and acute ophthalmic conditions, or possibly undertaking procedures such as laser iridotomy or capsulotomy. These roles would arguably have seemed almost unimaginable a few years ago; however, this scenario is the reality for many UK hospital optometrists in 2014.