Janet Silver, who has died aged 73 of leukaemia, was a pioneer in the development of care for the visually impaired. She recognised there was a need to combine expertise in clinical optics and understanding of the underlying eye disease together with a knowledge of the psychological impact of visual loss and an understanding of each individual's visual needs.
In a 30-year career at Moorfields Eye hospital, London, she expanded a small department of ophthalmic opticians into a world-renowned visual assessment department. She taught generations of postgraduate students in the UK, and also taught in Africa and the Indian subcontinent. She was a consultant to the World Health Organisation and the EU.
Janet was born in London to Ruby and Lionel Silver - her father was an ophthalmic optician and the son of an optician. Educated at Camden School for Girls and Northampton College, London (now City University), she joined her father's optician business before starting part-time work at King's College hospital, south London. In 1960, she went with her first husband, Hal Fass, to Africa, where she had her first experience of the problems of health care in developing countries.
On her return to the UK in 1964, Janet began part-time work at Moorfields. At that time, ophthalmic opticians were accepted at the hospital reluctantly and were considered to be the poor relations of both high street opticians and other ophthalmic professions.
After taking over as departmental head in 1970, she set up the first hospital low-vision aid clinic. Under her leadership the department thrived, becoming a centre of international repute. By the time she retired in 1995, Janet had seen the profession change its name from ophthalmic optics to optometry; and when she left, her visual assessment department merged with the contact lens department to become the optometry department, with a staff of almost one hundred.
Many professionals in the field owe their careers to Janet; I would never have considered a career in hospital optometry if it were not for her. When I started work at Moorfields in 1984, she was a well-established international figure within hospital optometry and her chosen field of low vision. She was a formidable boss who thrived on robust debate; those who won her respect were warmly received into her home, where she was also a wonderful cook.
Janet had exacting standards for her own work and insisted that all raised their game to her level. Now, to be able to write "trained at Moorfields" on a CV holds the same status in optometry - testing eyesight, detecting disease and prescribing corrective lenses - as it does in ophthalmology - the diagnosis and treatment of eye diseases.
Today, Moorfields optometrists play an increasing role in the clinical team, working in both general and specialist clinics (including paediatric); the optometrists teach ophthalmologists; optometrists and other disciplines work closely with the Institute of Ophthalmology and produce high quality research. One of Janet's own last pieces of work was with research optometrist Michael Crossland, reviewing changes in practice in the low-vision clinic she set up 30 years earlier.
Over the years, Janet worked closely with Professor Alan Bird at the Institute of Ophthalmology, contributing to his research into macular disease and retinitis pigmentosa. Following her early work evaluating low-vision services for children and adults, she investigated the impact of VDU legislation on spectacle prescribing and evaluated product information on ultra-violet transmission of sun spectacles.
With Patricia Sonksen, at the Institute of Child Health, Janet helped develop the Sonksen Silver linear test chart for assessing children's vision. She taught many consultant ophthalmologists the art of refraction, and was proud to be the one of the first optometrists to become an honorary lecturer at the Institute of Ophthalmology.
Janet saw early on that political change was coming to the NHS, and in spite of some criticism that she was compromising her socialist principles she brought commercial spectacle dispensing into the hospital - for the first time, fashion frames stood side by side with old NHS specs. She then made a further financial case and persuaded the hospital to develop the only spectacle surfacing and glazing facility in any UK hospital, improving the service offered to patients.
Her dynamism and enthusiasm made her a difficult colleague to say no to. She relished a challenge and continued to drive forward the projects dear to her heart right to the end. Even in retiremen, she was always perceptive and able to see the broader perspective. She worked tirelessly to bring low-vision services to developing countries and collaborated in international research. She was proud to receive an honorary DSc from City University and the OBE in 1996. Earlier this year she was overjoyed to be offered honorary life membership of the Royal College of Ophthalmologists.
Her interests were not restricted to optometry and ophthalmology, and for many years she was on the Woman of the Year committee. In retirement she worked with Age Concern and was chair of University College London hospital patient and public involvement (PPI) committee forum.
She is survived by her second husband, Martin Albu, his children Michael, Lucy and Tom, and by the children of her first marriage, Dan and Sarah.
· Janet Helen Silver, optometrist, born July 9 1933; died March 25 2007
