This article considers a unique, nurse practitioner (NP)-led accident and emergency service within a large ophthalmic hospital in the United Kingdom. The development of this service from a traditional, ophthalmologist-led department is traced, along with the original intent of the NP role and how it has evolved. Positive and negative aspects of the NP role and the results of the service's first audit are discussed. The service has proved very successful, and the NP role has been and will continue to be dynamic, with NPs totally committed to delivering the best possible care for their patients.