This month marks 15 years since I joined the staff specialist team at the Royal Victorian Eye and Ear Hospital in Melbourne. The RVEEH is Australia's only dedicated specialist eye and ear hospital and one of the most important ophthalmic institutions in the Asia-Pacific region. Reflecting on 15 years of contribution to this institution feels like an appropriate moment to explain what a public hospital appointment means for a surgeon in private practice, and why I have continued to maintain it alongside my private work at Northern Eye Consultants.
What is the Royal Victorian Eye and Ear Hospital?
The Royal Victorian Eye and Ear Hospital is a Victorian government-funded specialist hospital located in East Melbourne. It is the only hospital in Australia dedicated exclusively to the treatment of eye and ear conditions. The RVEEH manages the most complex ophthalmic and otolaryngological cases in Victoria and serves as the primary teaching hospital for ophthalmology training in Victoria, affiliated with the University of Melbourne.
The RVEEH operates one of the busiest ophthalmic emergency departments in Australia, a comprehensive outpatient service, and a full surgical programme covering the complete range of ophthalmic subspecialties including cornea and anterior segment, vitreoretinal surgery, glaucoma, oculoplastics, paediatric ophthalmology, and neuro-ophthalmology. It is the primary centre for corneal transplantation in Victoria and one of the highest-volume corneal transplant centres in the Asia-Pacific region.
What does a staff specialist appointment involve?
A staff specialist appointment at a public teaching hospital is a salaried or sessional clinical role that carries responsibilities beyond those of a private practice consultant. Staff specialists are responsible for the direct management of complex patients who present through the public system, many of whom have conditions that would not be seen in routine private practice. They supervise and teach ophthalmology registrars and fellows in training, contribute to quality and safety programmes, and participate in the institutional governance of clinical care.
At the RVEEH I work in the cornea and anterior segment service, managing complex corneal disease, performing corneal transplantation including DMEK corneal transplant surgery, ultrathin DSAEK, DALK, and penetrating keratoplasty, and supervising trainees in both medical and surgical management of anterior segment conditions. The complexity of cases at the RVEEH, including patients with advanced keratoconus, Fuchs endothelial dystrophy, corneal scarring from infection and trauma, and failed previous transplants, provides a clinical environment that private practice alone cannot replicate.
In addition to corneal surgery, I have taught cataract surgery technique to ophthalmology registrars and fellows throughout my time at the RVEEH, and continue to do so. Teaching phacoemulsification to surgeons in training requires a level of technical understanding and consistency that reinforces the discipline required in my own surgical practice.
Why maintain a public appointment alongside private practice?
The honest answer is that the RVEEH makes me a better surgeon. The volume and complexity of cases seen in the public system, combined with the peer scrutiny that comes with working in a teaching environment, creates a standard of practice that private practice in isolation does not consistently produce.
There is also a training dimension that matters to me. Ophthalmology registrars and fellows in training need experienced surgeons who are willing to supervise, teach, and be observed. This is how surgical skills are transmitted across generations of ophthalmologists. My RANZCO RACE Examiner role since 2019 and my position as Examiner in Chief for the Melbourne Clinical Examination reflects the same commitment to the training pipeline. The decisions made about who qualifies as a specialist ophthalmologist in Australia are consequential, and I take seriously the responsibility of being part of that process.
What 15 years at the RVEEH has meant in practice
Over 15 years at the RVEEH I have managed thousands of complex corneal and anterior segment cases, supervised the training of numerous ophthalmology registrars and fellows, and contributed to the institutional development of the cornea and anterior segment service. The published research that has come out of my time at the RVEEH, including the 2014 paper in Cornea comparing long-term outcomes of DALK versus PKP in Australian keratoconus patients which has accumulated over 90 citations, reflects the kind of outcomes research that a major public institution enables.
The clinical experience gained at the RVEEH directly informs my private practice at Northern Eye Consultants. The complex corneal transplant cases, the keratoconus management, the combined cataract and corneal transplant procedures, and the post-operative complications that require careful management are all conditions I encounter and manage in my private rooms. The skills are not separable.
What this means for patients considering subspecialist care
For patients choosing a surgeon for complex anterior segment conditions including keratoconus, Fuchs dystrophy, corneal scarring, or combined cataract and corneal procedures, a surgeon's public hospital appointment is a meaningful signal. It indicates that the surgeon's work is subject to peer review in a teaching environment, that they manage complex cases beyond the range typically seen in private practice, and that their skills are current and regularly tested against a high standard.
For patients considering cataract surgery in Melbourne, a surgeon who also performs complex cataract surgery and corneal transplantation at a major public hospital brings a level of anterior segment expertise that extends well beyond routine phacoemulsification. The skills required for DMEK, DALK, and combined triple procedures directly inform the technical precision applied to every cataract case.
I consult at Northern Eye Consultants in Bundoora and at Bass Coast Eye Centre in Wonthaggi. For referral information for optometrists, detailed procedure guides are available at corneaeyedoctor.com. A referral from your GP or optometrist is required.