1. How has serving as president of the UKISCRS broadened your view of cataract and refractive surgery?
The UKISCRS sponsors two scientific meetings per year—a half-day satellite meeting in the spring, annexed to the Royal College of Ophthalmologists congress, and a 2- day meeting in the autumn. My close involvement with organizing these meetings over the past few years has changed my understanding of the educational and training needs of both cataract and refractive surgeons of the society and the delegate targets for the meetings. Contrary to my expectations, these needs are polarized and, interestingly, are based on the surgeon's place of clinical practice. Most (80%) of the cataract surgery performed in the United Kingdom is done in government hospitals, whereas nearly all of the refractive procedures (90% to 95%) are done in private or independent hospitals. The society has addressed this challenge in the past 2 years by running parallel streams of programs in separate lecture theaters. My expectation is that there will be increasing convergence of the interests of cataract and refractive surgeons in the United Kingdom in the future.

2. What is most challenging about overseeing an ophthalmic society?
In my experience, there are three major challenges, each of which are equally demanding, associated with leading an ophthalmic society. The first is maintaining membership and growing the society. The second is meeting the needs of the members and serving their interests. The third is enhancing the profile of the society within the ophthalmic community and increasing delegate numbers at meetings.

3. What differences have you encountered between the United Kingdom and Ireland and other European countries with regard to approaches to presbyopia-correcting IOLs and other presbyopia solutions?
The surgical management of presbyopia through both corneal and IOL techniques is a relatively new lifestyle concept in the United Kingdom and Ireland and is attributable to the baby boomer effect. The penetration of these procedures in these markets is still limited compared with other Western European countries. The surgical procedures for correcting presbyopia are performed predominantly in the United Kingdom's private or independent sector. In contrast, pseudophakic monovision with monofocal IOLs is available in government hospitals. Currently, there is no government scheme (eg, voucher or partial patient-pay option) to provide or promote presbyopia solutions.

The number of presbyopia-correcting lens procedures performed in the independent sector in the United Kingdom has doubled in the past 5 years, and this aspect of clinical practice appears to be growing even in the current economic climate. It is estimated that the number of these procedures performed in the United Kingdom will double again in the next 3 to 4 years, making the United Kingdom one of the fastest growing markets (not necessarily the biggest) compared with other European countries. I believe UK optometrists, ophthalmologists, and patient/client populations have now accepted the concept of surgical correction of presbyopia.

4. What is unique about the iSight Clinics?
The iSight Clinic (previously known as Drayton House Clinic) in Southport, United Kingdom, was established in 1994. It is the United Kingdom's first independent specialist eye day hospital. It is also that country's first ophthalmologist- owned eye hospital to provide a comprehensive range of eye care, including surgical procedures, treatments with five different types of lasers, diagnostic equipment, and consultation services. There are iSight Clinics located in Liverpool and Windermere, both of which have diagnostic and consultation facilities that feed patients to the hospital in Southport. This business model is based on the hub and spoke system—a system of air transportation in which local airports offer transportation to a central airport where long-distance flights are available.

5. How do you like to spend your time when you are not working?
I have managed to bring my golf handicap down from 24 to 18 this year and still find time to play tennis, cycle, and snow ski. I play the saxophone, but I am no longer in a band. I started learning Spanish last year because our three children are now independent.