Orthoptics Interview Questions & Answers

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About this NHS interview question bank

To prepare for an orthoptics NHS interview, expect questions on assessing and engaging young children, amblyopia and squint management, acute diplopia and neuro-ophthalmic red flags, stroke-related visual problems, safeguarding, and how you work alongside ophthalmologists and optometrists. Build short spoken answers around real clinics and placements, and know the HCPC standards, BIOS guidance and how your target trust's eye service is organised.

This bank contains 40 original practice questions with first-person model answers written for orthoptists applying for Band 5 posts, with a selection pitched at Band 6 and extended roles. It covers paediatric clinics and school vision screening, adult motility and neuro-ophthalmology, stroke services, and glaucoma and medical retina work. Every question explains what the panel is really assessing, the points you must hit, the mistakes to avoid and the frameworks worth reading, so you can practise answers that sound like you rather than a textbook.

 

What this question bank covers

• Motivation for orthoptics
• NHS values in eye care
• HCPC standards and BIOS
• Children's vision screening
• Amblyopia and occlusion
• Assessing young children and engaging parents
• Squint and binocular vision
• Acute diplopia
• Urgent referral red flags
• Neuro-ophthalmology
• Stroke-related visual problems
• Driving and visual fields
• Glaucoma and medical retina extended roles
• Safeguarding children and adults
• Was not brought
• Equality and reasonable adjustments
• Confidentiality and record keeping
• Incidents, PSIRF and lost to follow-up
• Waiting list pressures
• Band 6 leadership
• CPD and resilience

 

40 NHS interview questions with full model answers. The first 8 are free to read below. Unlock the remaining 32 for £2.99 (12 months' access).

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why did you choose orthoptics, and what keeps you interested in it?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine, specific reason for choosing a small and specialist profession. They are listening for an understanding of the breadth of orthoptics, from children's vision to adult neurology, and some realism about the day-to-day work.

 

Model answer

I'll be honest, I didn't know orthoptics existed until a careers talk at sixth form, and when I looked into it I realised I'd actually met an orthoptist as a child. I had a patch for a lazy eye when I was five, and I can still remember the lady who made the whole thing a game with stickers. That memory is what made me go and shadow in an eye clinic.

What hooked me on that first day was how much detective work there is. In the morning I watched a four-year-old being tested with picture cards while the orthoptist chatted about her nursery, and in the afternoon the same orthoptist saw a man with sudden double vision and worked out, from a cover test and his eye movements, that this needed an urgent same-day review. It was the same core skills used in two completely different worlds.

Through training I've loved that mix. I enjoy working with children and families, and I've learned how much patience and play it takes to get a reliable result from a three-year-old. But I'm equally drawn to the neuro side, especially stroke, where a careful visual assessment can change someone's rehabilitation and their safety at home.

What keeps me interested is that the profession keeps growing. Orthoptists are now running glaucoma and medical retina clinics, doing visual fields on stroke wards and leading screening. I know the reality is busy clinics, long waiting lists and children who don't want to cooperate, and that doesn't put me off. I want to be the kind of orthoptist a nervous child and a frightened adult both feel safe with.

 

Why this answer works

The answer opens with a real, personal memory rather than a cliche, then shows the panel the candidate understands both the paediatric and adult sides of orthoptics. It ends with realism about the pressures, which makes the enthusiasm credible.

 

Key points to include

• A specific moment or experience that led you to orthoptics
• Understanding of the breadth: children, adults, neurology, extended roles
• What you enjoy about the clinical reasoning
• Realism about workload and difficult appointments
• The kind of practitioner you want to be

 

Common mistakes to avoid

• Saying you just like eyes or children without explaining why
• Describing only paediatric work and ignoring adult and neuro practice
• Confusing orthoptics with optometry
• Sounding unaware of how the role is developing

 

NHS values and standards

Compassion; Improving lives; Commitment to quality of care; HCPC Standards of conduct, performance and ethics

 

Further reading

• HCPC Standards of proficiency: Orthoptists
• British and Irish Orthoptic Society (BIOS) career and scope of practice information
• NHS Constitution for England

 

 

Question 2: Which NHS value matters most to you in orthoptic practice, and can you give an example of it?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel is checking that you know the six NHS values and can connect one of them to real behaviour in an eye clinic. They want an example, not a definition, and an understanding of why it matters for orthoptic patients.

 

Model answer

The NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. The one I come back to most is everyone counts, because in eye clinics it's surprisingly easy for some patients to slip through.

On my final placement I was in a children's clinic where a seven-year-old boy was attending for amblyopia follow-up. His vision hadn't improved, and the notes suggested patching wasn't being done. The easy conclusion would have been that the family weren't bothered. When I spoke to his dad, it turned out he worked nights, the boy split his week between two homes, and nobody at the other home had been told about the patch at all. Dad also had a reading difficulty and hadn't been able to use the written leaflet.

With my supervisor's agreement, we went through the plan verbally, drew a simple chart with pictures for the fridge, and gave him a second set of patches and a copy of the instructions for the other household, with his consent. We also booked the next visit at a time that worked with his shifts. At the next review, the vision had started to improve.

What that taught me is that a poor result isn't always about motivation. Everyone counts means making the extra effort for families who find the system hard to use, because amblyopia has a window for treatment, and if we lose a child in that window, the effect can be lifelong. I try to remember that whenever a note says non-compliant.

 

Why this answer works

The candidate names the values accurately, then picks one and shows it through a realistic paediatric example. The answer challenges a common assumption about non-compliance and links the value to a real clinical consequence, the treatment window in amblyopia.

 

Key points to include

• Name the values accurately
• Choose one and show it through a specific example
• Explain why it matters for orthoptic patients
• Show reflection on assumptions you might otherwise make
• Keep the child or patient at the centre

 

Common mistakes to avoid

• Reciting all six values with no example
• Choosing an example with no link to eye care
• Blaming families for poor treatment outcomes
• Making the answer about yourself rather than the patient

 

NHS values and standards

Everyone counts; Compassion; Improving lives; Working together for patients

 

Further reading

• NHS Constitution for England
• HCPC Standards of conduct, performance and ethics
• Equality Act 2010

 

 

Question 3: A parent tells you they have stopped patching because their child cries every time. How would you handle this conversation?

Communication question  ·  Communication with families

 

What the interview panel is assessing

This tests whether you can listen without judgement, explain why treatment matters, and agree a realistic plan with a parent. The panel wants empathy, clear explanation and practical problem solving, not a lecture.

 

Model answer

First I'd want the parent to feel heard. Patching is genuinely hard for families, and a parent who stops because their child is upset isn't a bad parent. I'd say something like, 'That sounds really tough. Can you tell me what a normal patching day looks like?' That usually tells me a lot: whether it's happening before school, whether siblings are teasing, whether the patch is irritating the skin.

Then I'd explain, in plain words, why we're doing it. I might say that the brain has been ignoring the weaker eye, and the patch makes it use that eye so the vision can develop, and that there's a period in childhood when this works best. I'd be careful not to frighten them, but I'd be honest that if the vision doesn't develop now, it's much harder to improve later.

Then we'd problem solve together. Often the answer is starting with shorter periods during something the child loves, like a favourite programme or a game that needs close looking. Reward charts and stickers on the patch work well with younger children. If the skin is sore, I'd look at different patch types or a barrier product. If patching truly isn't working, I'd discuss alternatives within our protocol, such as atropine drops, with the consultant or senior orthoptist, because that isn't my decision to make alone as a Band 5.

I'd also check the glasses are being worn, because they're the foundation of treatment. Before they leave, I'd make sure they have written information and our contact number, agree a plan they think is achievable, and document the conversation clearly, including what was agreed and when we'll review. A plan the family believes in is far better than a perfect plan that won't happen.

 

Why this answer works

The answer starts with empathy rather than correction and uses an open question to understand the real barrier. It explains amblyopia simply, offers practical strategies, and stays within scope by involving seniors before changing treatment.

 

Key points to include

• Listen without judgement and explore the real barriers
• Explain amblyopia and the treatment window simply
• Offer practical strategies to improve tolerance
• Check glasses wear and skin tolerance
• Involve seniors before changing treatment, and document the plan

 

Common mistakes to avoid

• Lecturing or blaming the parent
• Using jargon such as occlusion and visual acuity without explanation
• Changing treatment without following protocol or senior advice
• Forgetting to document the agreed plan and review

 

NHS values and standards

Compassion; Respect and dignity; Working together for patients; HCPC Standards of conduct, performance and ethics

 

Further reading

• BIOS clinical guidance on amblyopia
• NICE guidance on shared decision making
• HCPC Standards of proficiency: Orthoptists

 

 

Question 4: A four-year-old has missed three amblyopia follow-up appointments. What would you do?

Safeguarding question  ·  Safeguarding children

 

What the interview panel is assessing

The panel wants to see that you understand 'was not brought' as a possible safeguarding indicator rather than a simple admin issue. They are looking for a proportionate, curious response that follows local policy and involves the right people.

 

Model answer

I'd start by remembering that a four-year-old can't bring themselves to clinic. The language many trusts now use is 'was not brought' rather than 'did not attend', because it puts the focus back on the child's needs. Missed appointments can have very ordinary explanations, but repeated ones can also be part of a wider picture of neglect, so I wouldn't just discharge.

My first step would be to look at the notes and the patient record. Has the address or GP changed? Are there other services involved, or any safeguarding alerts? Has the child been missing other hospital or community appointments? Then I'd try to contact the family directly by phone, because sometimes it's as simple as letters going to an old address or a parent who's struggling with a new baby.

If I made contact, I'd explain why the follow-up matters, offer a time that works for them and check whether they need help, such as an interpreter or travel support. If I couldn't reach them, I'd follow our trust's was not brought policy. Typically that means informing the GP and, for children, sharing the concern with the health visitor or school nurse, and asking for advice from the safeguarding children team. I'd discuss it with my senior orthoptist too.

If there were other worries, like a previous disclosure, concerns noted by another service or signs the child's health needs weren't being met more generally, I'd raise a safeguarding concern through the proper route rather than waiting. Throughout, I'd document every contact attempt, who I spoke to and what was agreed.

I'd keep in mind that untreated amblyopia can mean permanent reduced vision, so this isn't just about an empty clinic slot. It's about a child's sight and possibly their wider welfare.

 

Why this answer works

The answer reframes missed appointments as a child-centred issue and shows a stepwise, proportionate response. It names the right partners, uses local policy, and links the clinical risk of untreated amblyopia to the safeguarding picture.

 

Key points to include

• Use 'was not brought' thinking and stay child-centred
• Check records and look for wider patterns
• Try to contact the family and remove practical barriers
• Follow the trust's was not brought and safeguarding policy
• Involve GP, health visitor or school nurse and the safeguarding team as appropriate, and document

 

Common mistakes to avoid

• Discharging back to the GP without further thought
• Assuming the parents are neglectful without exploring
• Acting alone without seeking safeguarding advice
• Failing to document contact attempts

 

NHS values and standards

Everyone counts; Commitment to quality of care; Working together for patients; HCPC Standards of conduct, performance and ethics

 

Further reading

• Working Together to Safeguard Children (England; check the equivalent guidance in Scotland, Wales or Northern Ireland)
• Children Act 1989 and 2004
• Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff (intercollegiate document)
• Your trust's was not brought policy

 

 

Question 5: Which presentations would make you seek an urgent same-day medical opinion in an orthoptic clinic?

Clinical Scenario question  ·  Red flags and urgent referral

 

What the interview panel is assessing

This checks that you can recognise sight-threatening and life-threatening presentations and escalate without delay. The panel wants clear red flags, appropriate urgency and an understanding of your scope as an orthoptist.

 

Model answer

For me, the guiding principle is that I'm not there to make the final diagnosis, but I must recognise when something can't wait and get the right doctor involved straight away. I'd always follow our local referral pathway, but there are some presentations I'd treat as red flags.

In children, a new squint, especially with an abnormal or white red reflex, needs urgent ophthalmology review because a rare cause is retinoblastoma. A sudden-onset squint or sixth nerve palsy in a child, particularly with headaches, vomiting, unsteadiness or behaviour change, raises concern about raised intracranial pressure. New-onset nystagmus in an older baby or child is another one I'd escalate.

In adults, a third nerve palsy with a dilated pupil or with pain is a big one, because it can be caused by an aneurysm and needs emergency assessment. Any acute diplopia with headache, other neurological signs or swollen discs worries me. In an older adult with new double vision, I'd ask about jaw pain on chewing, scalp tenderness, weight loss and visual loss, because giant cell arteritis can cause sight loss quickly. Fatigable ptosis or diplopia makes me think of myasthenia, and I'd specifically ask about swallowing, speech and breathing, because that can become an emergency. Sudden painful proptosis or restricted movement would also need same-day review.

In practice I'd keep the patient in the department, speak directly to the on-call ophthalmologist or the consultant in clinic rather than just sending a letter, and clearly explain what I've found. If the patient was unwell, for example with signs of a stroke, I'd get emergency medical help immediately. Then I'd document my findings, the advice given, who I spoke to and the time. If I'm ever unsure, I'd rather ask and be told it's fine than wait.

 

Why this answer works

The candidate gives a well-organised list of genuine paediatric and adult red flags and explains why each matters. The answer stays within scope, emphasises direct verbal escalation and documentation, and shows a sensible low threshold for asking.

 

Key points to include

• Recognise paediatric red flags such as abnormal red reflex and acute sixth nerve palsy
• Recognise adult red flags such as pupil-involving third nerve palsy, GCA symptoms and myasthenia
• Escalate verbally and directly, not just by letter
• Keep the patient in the department while escalating
• Follow local pathways and document clearly

 

Common mistakes to avoid

• Booking a routine follow-up for a red flag presentation
• Trying to make a definitive diagnosis beyond scope
• Escalating only in writing
• Forgetting systemic symptoms such as GCA or bulbar involvement in myasthenia

 

NHS values and standards

Commitment to quality of care; Working together for patients; HCPC Standards of proficiency: Orthoptists

 

Further reading

• BIOS clinical guidance on neuro-ophthalmic presentations
• Royal College of Ophthalmologists guidance on urgent referral
• NICE guidance on suspected cancer: recognition and referral
• Your trust's urgent ophthalmology referral pathway

 

 

Question 6: Talk us through how you would assess a three-year-old referred with a suspected squint.

Clinical Scenario question  ·  Paediatric assessment

 

What the interview panel is assessing

The panel is assessing both technical knowledge and your ability to get reliable results from a young child. They want a structured but flexible assessment, engagement with the parent and clear next steps.

 

Model answer

With a three-year-old, I'd plan the order of the assessment around the child, not the textbook. I'd get the most important information first, while they're still fresh and willing.

Before I even start testing, I'd take a history from the parent: when they noticed the eye turning, whether it's constant or comes and goes, whether it's worse when tired, any family history of squint or glasses, birth history and general development. I'd also watch the child while we talk, how they move, how they look at toys, whether there's a head posture.

Then I'd move to vision, using an age-appropriate test, often a matching picture or letter test, making it a game with the parent's help. If they won't cooperate with a single-eye test, I'd still record what I can and note how reliable it was. Next would be the cover test for near and distance using a small, interesting target, followed by ocular movements, convergence and a stereo test if they'll manage it. I'd check the corneal reflections and look at the head posture throughout.

The child would then normally need a cycloplegic refraction with the optometrist or ophthalmologist, because uncorrected long sight is a common cause of squint in this age group, and a fundus examination by the appropriate clinician. I'd make sure the drops are given safely in line with our protocol.

Throughout, I'd explain to the parent what I'm doing and what I'm seeing, in plain language. If I found anything unusual, like a reduced or abnormal red reflex, a sudden-onset squint, restricted eye movements or signs of neurological illness, I'd escalate urgently rather than booking routine follow-up. Finally, I'd document everything clearly, including how cooperative the child was, so the next clinician can compare like with like.

 

Why this answer works

The answer shows a child-led order of testing, a thorough history and the core orthoptic tests, while recognising the role of refraction and fundus examination. It includes red flag awareness and the importance of recording reliability.

 

Key points to include

• Plan the order around the child's attention span
• Take a full history from the parent and observe the child
• Use age-appropriate vision tests, cover test, movements and stereo
• Recognise the need for cycloplegic refraction and fundus examination
• Escalate red flags and document reliability

 

Common mistakes to avoid

• Following a rigid adult order that loses the child's cooperation
• Forgetting the history and family history
• Not recording how reliable the results were
• Ignoring red flags such as an abnormal red reflex

 

NHS values and standards

Commitment to quality of care; Compassion; HCPC Standards of proficiency: Orthoptists

 

Further reading

• BIOS clinical guidance on childhood strabismus and amblyopia
• Royal College of Ophthalmologists guidance on childhood squint
• HCPC Standards of proficiency: Orthoptists

 

 

Question 7: A 68-year-old attends with double vision that started three days ago. How would you assess and manage them?

Clinical Scenario question  ·  Adult diplopia

 

What the interview panel is assessing

This tests your approach to acute adult diplopia: a careful history, a systematic orthoptic examination and safe escalation of possible serious causes. The panel also wants to hear about practical support for the patient.

 

Model answer

Acute diplopia in an older adult always makes me think about safety first, because although many causes are microvascular and recover, some are urgent.

I'd start with the history. Is the double vision present with one eye closed? If it disappears when either eye is covered, it's binocular; if it persists with one eye covered, that points to an eye problem such as cataract, and the pathway is different. Is it horizontal, vertical or tilted, and worse in any direction or at near or distance? I'd ask about headache, pain around the eye, drooping eyelid, weakness, numbness, speech or swallowing problems, and whether it gets worse as the day goes on. Because of their age, I'd specifically ask about jaw pain on chewing, scalp tenderness and visual loss for giant cell arteritis. I'd also ask about diabetes, high blood pressure and any thyroid problems.

Then I'd examine: vision, pupils and lids, cover test in the primary position and other gazes, ocular movements, saccades, convergence, and measurements with prisms. I'd use a Hess or Lees screen and a field of binocular single vision to document the pattern and give a baseline to compare against.

If anything pointed to a serious cause, such as a pupil-involving third nerve palsy, multiple nerves involved, GCA symptoms, fatigability or other neurological signs, I'd seek same-day medical review straight away. If it looked like an isolated microvascular palsy, I'd still make sure the medical team had reviewed the patient in line with our pathway, as that's a medical decision, not mine alone.

For symptom relief, I'd discuss options like Fresnel prisms or temporary occlusion, and I'd advise them not to drive while they have double vision and that they may need to tell the DVLA, checking the current guidance. I'd book a review to monitor recovery and document everything clearly.

 

Why this answer works

The answer moves logically from history to examination to escalation and symptom management. It distinguishes monocular from binocular diplopia, names relevant serious causes and includes practical driving advice, all within the orthoptist's scope.

 

Key points to include

• Distinguish monocular from binocular diplopia
• Take a red flag history including GCA, myasthenia and neurological symptoms
• Systematic examination with objective baseline measurements
• Escalate serious causes urgently and follow the medical pathway
• Offer symptom relief and give driving advice

 

Common mistakes to avoid

• Assuming it's microvascular without excluding red flags
• Forgetting to ask about GCA in an older adult
• Omitting driving advice
• Not recording baseline measurements for monitoring

 

NHS values and standards

Commitment to quality of care; Compassion; Working together for patients; HCPC Standards of proficiency: Orthoptists

 

Further reading

• BIOS clinical guidance on acquired ocular motor palsies
• Royal College of Ophthalmologists guidance
• DVLA Assessing fitness to drive: guide for medical professionals

 

 

Question 8: How do the HCPC standards and BIOS shape your practice as an orthoptist?

Professional Development question  ·  Professional Development

 

What the interview panel is assessing

The panel wants to see that you understand the difference between your regulator and your professional body, and that the standards are part of everyday practice rather than something you only think about at renewal.

 

Model answer

The HCPC is our regulator, so its role is to protect the public. To use the title orthoptist I have to be registered, meet the Standards of proficiency for orthoptists, and follow the Standards of conduct, performance and ethics. I also have to meet the CPD standards, keep a record of my learning, and be ready to submit a profile if I'm selected for audit when I renew.

BIOS, the British and Irish Orthoptic Society, is our professional body. It's not a regulator, but it supports us with clinical guidance, competency frameworks for extended roles, CPD opportunities and a professional voice for orthoptists.

Day to day, the HCPC standards come up more than people think. Working within my scope of practice means that if I'm asked to do something I'm not trained or signed off for, such as an extended role task, I say so and ask for supervision. Communicating effectively, getting valid consent and keeping clear records are all standards I use in every clinic. The duty to be open and honest when something goes wrong and to raise concerns about safety is also part of the standards.

I use BIOS guidance for the clinical side. For example, when I was unsure about a management decision in a child with intermittent exotropia, I looked at professional guidance and then talked it through with my supervisor. I also attend BIOS learning events and use reflective writing on cases to build my CPD.

As a newly qualified Band 5, I see the standards as protecting me as well as my patients. They give me a clear framework for what good practice looks like.

 

Why this answer works

This answer clearly explains the regulator and professional body and how they differ. It then shows how the standards apply in practice with specific examples, which is what panels want to hear.

 

Key points to include

• HCPC is the regulator, BIOS is the professional body
• Standards of proficiency, conduct and ethics, and CPD
• Working within scope and asking for supervision
• Consent, records, openness and raising concerns
• Using professional guidance and CPD in practice

 

Common mistakes to avoid

• Confusing the HCPC with BIOS
• Describing the standards only in abstract terms
• Forgetting the CPD audit requirement
• Suggesting standards only matter at renewal

 

NHS values and standards

Commitment to quality of care; HCPC Standards of conduct, performance and ethics; HCPC Standards of continuing professional development

 

Further reading

• HCPC Standards of proficiency: Orthoptists
• HCPC Standards of conduct, performance and ethics
• HCPC Standards of continuing professional development
• BIOS professional and clinical guidance

 

 

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