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FEBRUARY 2015 DISPENSING OPTICS NE W S , I NFORMATION and E D U C ATI ON for OPTICIANS abdo COLLEGE A unique career opportunity in dispensing optics Foundation Degree/BSc (Hons) in Ophthalmic Dispensing Working in partnership, ABDO College and Canterbury Christ Church University are proud to offer a comprehensive blended learning course for prospective dispensing opticians: A two year Foundation Degree course followed by a third year BSc Degree course in Ophthalmic Dispensing – leading to BSc (Hons) and the ABDO Level 6 FBDO qualifications. • The only blended learning degree course in ophthalmic dispensing available in the UK • Leads to a BSc (Hons) degree and the registerable FBDO qualification • A successful partnership committed to the furtherance of dispensing optics • Equips students with the ability to problem-solve within the practice, benefiting both students and their employers • A proven track record of success through consistently high theory and practical examination results • Establishes a platform to build further career advancement Course features • Combines academic and work-based learning • 32 weekly distance learning units in each academic year • Four weeks block release at Godmersham in each academic year • Access to supplementary web-based interactive tutorial presentations • Block release accommodation can be provided • Year 1 courses will commence in September 2015 Entry requirements • Grade C or above GCSE in English, mathematics, science and two other subjects, including evidence of recent learning • Applicants must be working in practice as a trainee dispensing optician for a minimum of 30 hours per week and have the support of their employer For further information and application forms for this and other courses, or to request a copy of the ABDO College Prospectus, please contact the ABDO College Courses Team on 01227 738 828 (Option 1) or email [email protected] ABDO College Operational Services, Godmersham Park, Godmersham, Canterbury, Kent CT4 7DT www.abdocollege.org.uk www.twitter.com/abdocollege Dispensing Optics FEBRUARY 2015 Contents 10. 31. 28. 12. 16. Features 27. 15. 31. Next of kin concerns by Ben Brewer Lenses in the spotlight Continuing Education & Training Silicone hydrogel: the best all-rounder? by Claire Mc Donnell 23. 24. Events New chapter at #BCLA2015 Unique designs and innovations 18. In practice Regulars 4. DO Dispatches Successful contact lens fitting to children by Nick Black 6. Black Arts Business 7. Letters Building your spectacle lens business by Antonia Chitty 12. News 32. Jottings CET Answers by ABDO president, Peter Black Flying the flag for independence by Nicole Banbury FRONT COVER 34. Classifieds Danish-designed Thomsen Eyewear, available in the UK from Academy Eyewear through the National Eyecare Group Dispensing Optics FEBRUARY 2015 3 DISPENSING OPTICS The Professional Journal of the Association of British Dispensing Opticians VOLUME 30 NO 2 EDITORIAL STAFF Editor Assistant Editor Managing Editor Email Design and Production Email Admin. Manager Email Sir Anthony Garrett CBE HonFBDO Jane Burnand Nicky Collinson BA (Hons) [email protected] Rosslyn Argent BA (Hons) [email protected] Deanne Gray [email protected] EDITORIAL/ADVERTISING Telephone 0781 2734717 Email [email protected] Website www.abdo.org.uk SUBSCRIPTIONS UK £140 Overseas £150, including postage Apply to Tom Veti Association of British Dispensing Opticians Godmersham Park, Godmersham, Kent CT4 7DT Telephone Email Website 01227 733922 [email protected] www.abdo.org.uk ABDO CET CET Coordinator Paula Stevens MA ODE BSc(Hons) MCOptom FBDO CL (Hons)AD SMC(Tech) ABDO CET, 5 Kingsford Business Centre, Layer Road, Kingsford, Colchester CO2 0HT Telephone Email or email 01206 734155 [email protected] [email protected] CONTINUING EDUCATION REVIEW PANEL Joanne Abbott BSc (Hons) FBDO SMC(Tech) Keith Cavaye FBDO (Hons) CL FBCLA Andrew Cripps FBDO (Hons) PG Cert HE FHEA Kim Devlin FBDO (Hons) CL Stephen Freeman BSc(Hons) MCOptom FBDO (Hons) Cert Ed Abilene Macdonald Grute FBDO (Hons) SLD (Hons) LVA Dip Dist Ed Cert Ed Richard Harsant FBDO (Hons) CL (Hons) LVA Andrew Keirl BOptom (Hons) MCOptom FBDO Angela McNamee BSc(Hons) MCOptom FBDO (Hons) CL FBCLA Cert Ed Linda Rapley BSc FCOptom JOURNAL ADVISORY COMMITTEE Richard Crook FBDO Kim Devlin FBDO (Hons) CL Kevin Gutsell FBDO (Hons) SLD Ros Kirk FBDO Angela McNamee BSc(Hons) MCOptom FBDO (Hons) CL FBCLA Cert Ed DO Dispatches SHOW SEASON KICKS OFF It is already February and we are now fully into a busy schedule of conferences and exhibitions. This month ABDO will have a significant presence at 100% Optical, from 7 to 9 February at ExCel London. In addition to CET points for paediatric dispensing, we will be presenting a skills workshop throughout the three-day event. All this plus the chance for members and friends to pop in for some rest and refreshment at the ABDO Arms hospitality area. This event provides an excellent opportunity for members, particularly those living in and around London and the South East to gain a significant number of CET points whilst enjoying some very new presentations. Two months later we will be in Birmingham at Optrafair from 18-20 April where we will have our largest ever presence, with high quality CET and unrivalled networking opportunities. These two events, important though they are, are just the prelude for the ABDO Conference, which takes place in Manchester on 20 and 21 September. This year’s conference promises to be the largest we have organised for many years, and it will certainly be both innovating and exciting so I hope the date is already firmly penciled in your diary. Thank you for the very pleasant comments which the production team has had since the launch of our ‘new look’ journal. We aim to provide the very best publication for you – our members – and the best possible advertising vehicle for those in industry to directly address those who are at the sharp end of delivering the best possible service to patients. We welcome comments upon any topics you wish to see covered, or more general suggestions on content. Sir Anthony Garrett ABDO general secretary DISPENSING OPTICS IS PUBLISHED BY ABDO, 199 Gloucester Terrace, London W2 6LD DISPENSING OPTICS IS PRINTED BY Lavenham Press, Lavenham, Suffolk CO10 9RN © ABDO: No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means whatever without the written prior permission of the publishers Dispensing Optics welcomes contributions for possible editorial publication. However, contributors warrant to the publishers that they own all rights to illustrations, artwork or photographs submitted and also to copy which is factually accurate and does not infringe any other party’s rights ISSN 0954 3201 AVERAGE CIRCULATION: 9,025 Jan-Dec 2014 ABDO Board certification 4 Dispensing Optics FEBRUARY 2015 FRAME: Barbour International 015 c1 black Ophthalmic and sunwear frame ranges exclusively from Norville Eyewear The Norville Group, Magdala Road, Gloucester GL1 4DG Tel: 01452 510321 • Fax: 01452 510331 • Email: [email protected] www.norville.co.uk BLACK ARTS PETER BLACK Our monthly column from the ABDO president DOs can make all the difference hen I began thinking about how to put this article together over the Christmas period I was in the process, like the rest of Conlons head office staff and a handful of practice based colleagues, of trying to find myself a new job. The good news is that dispensing opticians are in demand. In December on the Optician website and elsewhere online there were around 500 jobs for dispensing opticians advertised. Senior management roles are a little thinner on the ground to say the least, however, there are more than enough opportunities available up and down the country for people with the right combination of optical and managerial skills. Nonetheless a period of unemployment is a worrying time for anyone, and is fraught with questions. Will I have found a job before the redundancy money runs out? Is it time for a change in career direction out of optics altogether? Should I open my own practice? Opening your own practice is the aspiration of many dispensing opticians and optometrists, yet it is not an option that many are taking at present. This year the Optical Confederation (OC) will be seeking to address this to ensure the independent sector can survive and thrive going forwards, to ensure patient choice on the High Street and in the community. To this end, ABDO vice president, Fiona Anderson, a partner in two independent practices, will be representing ABDO on the OC Independent Practice Committee led by the Association of Optometrists, which aims to promote successful independent practice going forwards. W GENEROSITY AND SUPPORT For me, personally, my questions on unemployment were a little more complicated. If I started my own practice 6 Dispensing Optics FEBRUARY 2015 could I afford to carry on as ABDO president? Would any future employer support me in my role? It is only a couple of months since Kevin Gutsell had to stand down as ABDO vice president in order to be able to accept his position as chief executive of ABDO’s Optical Confederation partner, the Federation of Manufacturing Opticians, and if I were to stand down now it would probably not be ideal. Thankfully most of the companies I have been talking to have been supportive of my ABDO role and I feel I must take this opportunity to say a big thank you to all the companies and individuals who took the time to talk to me and conduct interviews over the festive period, and show their support for my ABDO role. ABDO is greatly indebted to those companies that employ our board members, committee members and examiners and give them the time and support they need to carry out their ABDO duties – thank you. And thank you to all the companies that have agreed to sponsor our Area CET events in 2015; their generosity has made it possible for us to deliver Area CET for free this year and hopefully this, in turn, will attract more members and, for a small fee, their optometrist colleagues, who will spend more time with exhibitors and a virtuous cycle will have begun. EXPRESSLY BUILDING BUSINESS Having worked for the same, albeit large, independent for more than 26 years, it has been fascinating to take a look at a number of optical businesses and see how they compare to the way we did things at Conlons, and wonder how on earth, in the face of such relentless competition, the independent sector, even those without the burden of final salary pension schemes, can survive. The scale of investment in acquisition, expansion, efficiency, equipment and people is staggering. Despite its enormous size, Vision Express clearly possesses an ability to do what is usually seen as the preserve of small-scale businesses – that is to move swiftly. Fleetness of foot was certainly demonstrated when acquiring Conlons in just a few weeks from start to finish. Express by name – express by nature it seems. Here is a company proud of its retail skills, adept at extracting every ounce of efficiency from the supply chain, whose new state-of-the-art lab facility, soon to be partnered by a brand new head office, is quite simply stunning. At around the size of a couple of large sports halls, it is big enough to impress, but what is most impressive is how much more volume of work can now be processed through such a relatively small space through increased use of robotics, digital surfacing and clever stock control. I was particularly impressed by their new checking procedures. It has long been debated why it is necessary to check spectacles in practice when they have already been checked in the lab – yet there are two obvious reasons. Firstly, the job should be checked against the sight test prescription not just the order and, secondly, it is possible for the checker to fiddle the print out by, for example, tilting the glasses to make the axis or power read differently. Vision Express seems to have cracked both these concerns, and more besides. Firstly, the prescription data is only entered once so there is no scope for data entry error between sight test, dispensing consultation and lab. A very sophisticated checking system utilising semi-robotic focimeters (that pick up the order data from microchips embedded in the job trays and compare the actual specifications to the order and British Standards automatically), also ensures that the system can’t be cheated by the operative if the job is outside tolerance in any way at all. MIND-BOGGLING INVESTMENT My visits to Optical Express were equally impressive, especially its palatial new refractive surgery clinic in the heart of Glasgow. The level of investment is again mind-boggling, with £350m invested in refractive surgery alone and a desire to also invest in ophthalmic dispensing and optometry. The most obvious investment is in new networkable prescreening equipment, as well as software, that has culminated in the recent launch of the company’s new service iScan. Although it has required huge investment in state-of-the-art diagnostic equipment, iScan is a simple concept. Whether a patient is being referred for elective refractive surgery or a suspected brain tumour, iScan will be incredibly useful for both medical practitioners receiving referrals from Optical Express and patients weighing up their visual correction options. iScan is simply a means of presenting clinical findings following an eye health examination at the click of a button in a single document, in different formats according to the needs of the recipient whether practitioner or patient. How many other opticians are prepared to give their patients the results of their eye examination? It is certainly food for thought? My visit to Boots Opticians’ headquarters (which apparently occupies an area the size of Monaco and has its own internal park and ride bus service!) came the day after its merger with Walgreens created what is anticipated to be the world’s largest healthcare company with annual sales of the order of £100bn. I am pleased to say my visit was a productive one, and by the time you read this, I should be happily settling in to my new challenge as dispensing services manager for Boots Opticians. Walgreens Boots Alliance revenues are of the order of £3,000 every second – an amount some independent optical practices struggle to take in a week – and even the best independent practices would consider a reasonable day’s takings. DOS ARE KEY FOR INDEPENDENTS So as these giants of UK optics pursue the Jolly Green Giant, still comfortably number one in terms of market share, what does the future hold for the independent sector and remaining regional groups? Can they survive? I firmly believe that the independent sector is an important part of the mix of optics and optometry in the UK, and that every town, community and shopping centre needs a good independent to provide choice to the optical consumer. Instead of growing at each other’s expense, a vibrant independent sector will mean a growing market with all sectors growing within it. So how can the independent sector compete? There is a chicken and egg situation at work here. It is my observation that the majority of successful practices, whether independent or multiple, employ dispensing opticians. So are they successful because they employ DOs? Or do they employ DOs because they are successful? Either way, DOs are a key element of success. If only competitive strategy were as simple as employing good dispensing opticians, but as a DO it does at least differentiate your practice from half the practices in the UK. And for all practices, indeed all companies, differentiation is the key. Studying for my MBA, strategy was my favourite module, and competition the most interesting topic. If you are a practice owner, director or manager, or you want to be one in the future, then I would commend the work of Harvard professor of competitive strategy, Michael Porter, to you. Porter will really open your eyes to the possibility for independent practices, indeed all practices, to compete effectively. It is worth remembering that 25 or 30 years ago, both Specsavers and Optical Express started off as small independents, and equally that many independent practices are very, very successful. I don’t know if the General Optical Council shares the view that the independent sector is important, but one of the ways it could help improve business skills across the whole sector is to take a leaf out of the book of the US Council for Optometric Professional Education and make optical business administration a core competency from 2016. Because by then, the optical business will be different to the one we live in today… @ HAVE YOUR SAY Email [email protected] or write to Dispensing Optics, PO Box 233, Crowborough TN27 3AB Letters NEW LOOK A HIT I just wanted to say that the new look Dispensing Optics magazine is a hit with me. Whilst not radically different in format, it feels fresh and keeps our interest! Mark Gibson FBDO Garstang Preston EXCITING TIME FOR SMART EYEWEAR It was interesting to note the news from Google last month that it was ceasing its Explorer programme and moving on its Glass project ‘from concept to reality’. Google always referred to the Explorer programme as ‘the research phase’ and the fact that they are now changing the operating system and working with Intel on future versions, it is not surprising that they are ceasing sales of Google Glass in its current guise. Within the Google organisation, Glass is now ‘graduating’ from being part of Google (X) which looks at all areas of innovation to being within its own team at Google, and I see this as a very exciting development. In their own words they describe this as ‘moving from concept to reality’. Interest in smart glasses has never been greater and at CES in Las Vegas last month there were many new smart glass products on show [see news page 14]. Our Epson Moverio product attracted a huge amount of attention and even Sergey Brin, the head of Google, was photographed checking it out. At last month’s Opti show in Munich too we had phenomenal interest. At 100% Optical [7-9 February] we will have numerous smart glass products on display that visitors can experience, and we’ll be showing the UK industry the world’s first smart glasses specifically for sports. Working with our US partners Rochester Optical we are committed to providing optical solutions for wearers of smart glasses who need vision correction. Bob Forgan Managing director Waterside Laboratories We kindly reserve the right to edit contributions prior to publication. Follow us on Twitter @ABDOCollege and @MembershipABDO ABDO events and booking information can be found at www.abdo.org.uk/events Dispensing Optics FEBRUARY 2015 7 NEWS PATIENTS BACK LOCAL SCREENING SERVICE Zeiss teams up with Stepper STEPPER TO CREATE ZEISS FRAMES Lens giant Zeiss and Stepper Eyewear have signed a license agreement that allows Stepper the exclusive use of the Zeiss trademark for manufacturing and worldwide distribution of optical frames, sunglasses and accessories. “Zeiss enters into partnerships when they strengthen our market position – and this is the case with Stepper,” said Sven Hermann, Carl Zeiss Vision board member with international responsible for marketing. “All Zeiss models share a modern, international design, extremely high-quality materials such as titanium and feature outstanding comfort and fit,” commented Hans Stepper of Stepper Eyewear. With an established presence in the UK, led by managing director Richard Crook, Stepper will distribute premium Zeiss optical frames, sunglasses and accessories to more than 50 countries. The first Zeiss Collection of Titanium and TX5 frames was presented at Opti 2015 in Munich last month, and the UK launch is expected in June/July. Richard Crook told Dispensing Optics: “This is an exciting collaboration between two great brands, and represents a fantastic opportunity to enhance the premium eyewear range offering in the UK. We look forward to an early summer introduction to our UK customers.” Patient feedback about a diabetic retinal screening (DRS) service in Plymouth has revealed a 98 per cent satisfaction rate amongst patients. The Plymouth DRS Programme Board (part of NHS England) commissioned Devon LOC to carry out the patient survey last summer, and 300 patients responded from a pool of eight practices. Another key finding was an 87 per cent preference for screening to be carried out at local optical practices. Plymouth has had a successful optometric-led DRS service in place for many years, delivered by suitably trained, qualified and experienced eyecare professionals, who manage more than 16,000 patients appropriately and safely. The DRS lead for Devon LOC is dispensing optician, Max Halford, who told Dispensing Optics: “The involvement of the dispensing optician in the screening programme is absolutely key, and following suitable City & Guilds training, offers DOs a fantastic career progression opportunity. “It’s been incredibly interesting to be part of the screening programme in my local area and as our recent patient survey shows, locally delivered shared care services led by professionals they know and trust are what patients really want.” Hear more from Max Halford, and his role in optometric-led shared care, in next month’s Jottings. Rodenstock Club award winners TOP AWARD FOR HEREFORD PRACTICE Rodenstock named BBR Optometry as the leading Centre of Excellence at its annual awards ceremony held in London in December. The Hereford opticians, which features in this month’s business article (see pp.2830), came second in 2013 but took home the award for overall best-performing practice for 2014. It also scooped an award for its success in dispensing Rodenstock’s Excellence lenses. Burnett Hodd & Jenkins in Sidcup was named runner-up in the Centre of Excellence category, while Martin Steels in Emsworth came third. More than 250 Rodenstock Club members attended the lunch and awards ceremony on 17 December at the Rosewood London Hotel in High Holborn, where practices from across the UK competed in a number of product specific categories, as well as marketing. All the winners will join Rodenstock in March on a trip to Rome. Speaking at the event, Rodenstock managing director, Neils Jensen told guests that new frames, brands and trends were emerging at considerable pace, along with developments in lenses, adding: “While there are signs that the industry is ‘hitting barriers’ in physics, where reducing aberrations further in progressive lenses would not be possible, if we cannot reduce the aberrations any further, we can move them to areas where they irritate least.” Rodenstock’s Impression FreeSign 3 was, he said, ample proof that the company was again leading this innovative process (see our lenses feature on pp. 16-18). NEW ROLE AT BOOTS Peter Black, ABDO president, has joined Boots Opticians as dispensing services manager. Peter, who spent 26 years with Conlons Opticians, latterly as retail development director, before the company was sold to Vision Express at the end of 2014, said: “I am honoured to be offered the challenge of dispensing services manager at Boots Opticians. I am heartened that Boots sees a wider role for dispensing opticians and look forward to working with my new colleagues and helping the company improve standards of ophthalmic dispensing going forward.” Eddie Watson, Boots Opticians director of professional standards and operations, said: “I am delighted that Peter has agreed to join my team. He has a wealth of experience in the profession as well as a proven track record in leadership roles. Peter will support our ambition to drive the highest standards of patient care and ophthalmic dispensing and I am very pleased that he joins us at such an exciting time for Boots Opticians.” 8 Dispensing Optics FEBRUARY 2015 optometrytoday OPE WE NS TH EKE IS ND ! REGISTER NOW AT: 100percentoptical.com EUROPE’S HOT NEW OPTICAL SHOW Event Partners A Media 10 event NEWS TOMISON APPOINTED TO COUNCIL Bradford students celebrate GRADUATES OF DISTINCTION Something different for independents DANISH DESIGNS EXPAND Thomsen Eyewear, the Danish company whose frames are exclusive to members of the National Eyecare Group (NEG) via Academy Eyewear, has launched a range of stylish acetate frames to complement its metal collection. “The Thomsen Eyewear range offers NEG independent practice members a great opportunity to offer their patients something different from the competition,” said Academy’s Lee Williams. The collection draws on classic trends but with a contemporary twist – and a choice of “noisy colours without noise”. “A good frame design is when shape, colour and the choice of material all work for the better and express a personal style,” said designer, Morten Thomsen. Bradford College graduates in ophthalmic dispensing courses celebrated their achievements at their graduation ceremony held at St Georges Hall, Bradford, on 2 December. Twenty-seven students graduated with a BSc (Hons) Ophthalmic Dispensing with Management, nine of whom received 1st Class Honours. This is a full time course studied over three years. The Foundation Degree in Ophthalmic dispensing is delivered one day a week over three years; 31 students graduated with nine students achieving a distinction. Graduates comments included: “This was a very enjoyable course”; “The tutors are very supportive and very helpful”; “Moodle, the VLE, is a great learning resource”; and “I would recommend this course”. Students who successfully complete the course and the ABDO Final Qualifying Examinations will obtain the fellowship diploma (FBDO). Our photograph shows Laraib Mahmood and Annabelle Mawondo outside St Georges Hall. Dispensing optician, Glenn Tomison, has been appointed as a new member of the General Optical Council (GOC). Already a member of the GOC’s Standards Committee, Glenn joins as a registrant member of Council, replacing James Russell. Additionally, Rosie Glazebrook has been appointed as a lay member replacing Morag Alexander. Glenn, who has stood down from his role as chairman of the Federation of Ophthalmic and Dispensing Opticians to avoid any professional conflict, said: “I look forward to being able to use my experience and insight to help the GOC protect the public and ensure public confidence in the optical professions. It is an exciting time to join the GOC and I am pleased I will be able to contribute to its work, ensuring in particular that the important role that dispensing opticians play in serving the public is fully understood.” Glenn has more than 35 years of experience in the optical sector, continuing to work as a registered self-employed dispensing optician as well as a part-time clinical instructor and lecturer at the University of Manchester. GOC chair, Gareth Hadley, said: “I am delighted to welcome Glenn and Rosie. Both possess considerable experience and expertise and I look forward to working with them. Qualified barrister, Lisa Davis, is the GOC’s new director of Fitness to Practise, replacing outgoing director of regulation Mandie Lavin. CONFERENCE PACK WIN Dispensing optician, Nicola Fox, has won a delegate package to the British Contact Lens Association’s (BCLA) clinical conference and exhibition in May following a prize draw the Association ran at Specsavers’ PAC conference. A DO at Specsavers in Manchester city centre, Nicola has worked in optics for almost 15 years and qualified in 2008. She said: “I was extremely shocked to discover I had won the competition prize as I rarely win anything. I’m really looking forward to the conference, as this will be the first time I have attended. Thanks to the BCLA again for their generous prize.” Though not a CLO, Nicola said she hadn’t ruled it out and was hoping the BCLA conference might inspire her for the future. LONG MANOEUVRE Andy Long has joined Silhouette UK as its UK sales manager. Andy brings to Silhouette a wealth of experience in the optical industry, most recently as a regional manager for Alcon Visioncare. Prior to this Andy was southern regional manager at CIBA Vision. Silhouette UK MD, David Chalmers, said: “Silhouette is delighted to be welcoming Andy to the team. His addition takes the company one step closer to delivering its goal of becoming the benchmark brand and service offering for premium eyewear.” 10 Dispensing Optics FEBRUARY 2015 Is having the right equipment important to you? Glasses are no different... One pair is never enough! Boost your sales with our Xperio multi pair promotion! From 1st January to 30th June 2015 order a pair of Xperio lenses and for an additional £1 per lens, receive a pair of clear lenses. You can upgrade the clear pair at a greatly reduced cost to match the design of the Xperio pair. To benefit from this offer use the promotional code “2PAIR” when placing the order for the 2nd pair. For full terms and conditions please refer to our website www.bbgr.co.uk www.bbgr.co.uk Tel: 0844 880 1349 Always closer NEWS Lord Danny Finkelstein Optrafair to provide ample CET ABDO TO RUN OWN CET AT OPTRAFAIR ABDO is planning a special CET event for Optrafair 2015, which will consist of five one-hour CET lectures on Saturday 18 and Sunday 19 April. The same lectures will be delivered each day, but at different times, and topics will include fatigue and eye movements, ophthalmic lenses, lens materials, plastic photochromics, Google Glass and spectacle frames, presented by key figures from the R&D departments of some of the world’s leading companies. Other topics on the CET agenda for Optrafair, to be held at the NEC Birmingham from 18-20 April, include contact lens practice, managing dry eye and improving patient care and profitability. A Question Time style panel debate will see Dame Mary Perkins, founder of Specsavers, Jonathan Lawson, CEO of Vision Express, and Ben Fletcher, managing director of Boots Opticians, amongst others discussing ‘The future of retail optics’. They will be joined on stage by representatives from the regional chains and the independent sector taking questions from the floor on the future of retail optics. The panel will be chaired by BBC Radio 4’s Peter White. View the full timetable and programme of seminars at www.optrafair.co.uk IN THE BLINK OF AN EYE Fight for Sight and 100% Optical have launched a #blinkwinkthink social media campaign to raise funds for pioneering eye research to prevent sight loss and treat eye disease. Participants are being asked to take a ‘selfie’ style photo with one eye on show and the other disguised, covered or in ‘wink’ mode and then upload it to Instagram, Facebook and/or Twitter whilst nominating a further three people to take on the challenge. On uploading a picture, a £3 text donation can be made by texting BWTC15 £3 to 70070, to donate to Fight for Sight. Fight for Sight is the charity partner for 100% Optical, taking place this weekend (7-9 February) at ExCel London. The campaign culminates with an ‘eye’ wall of those who have participated in the campaign that will be Take the #blinkwinkthink challenge on display at the event. OPTRAFAIR PROFITS PLOUGHED BACK The Federation of Manufacturing Opticians has returned profits from Optrafair 2014 to the optical community with support for Vision Aid Overseas and the Optical Workers’ Benevolent Fund (OWBF). Receiving a cheque on behalf of the OWBF, trustee Frank Norville, said: “This support enables the fund to respond to calls for assistance for optical workers and their dependents whom may have fallen on hard times and are in need of support. Previous assistance has been given for respite care, mobility, and residence costs – not just for exoptical employees but contact lens manufacturing and opticians workshops.” 12 Dispensing Optics FEBRUARY 2015 TIMES EDITOR ON THE BILL Sight Care conference delegates will have the chance to hear from Lord Danny Finkelstein, associate editor of the Times, at the event’s pre-conference dinner and during a keynote presentation. The group’s annual conference for independents on Monday 2 March, at the Hilton Metropole Hotel in Birmingham, is themed, ‘People, purpose, passion’ and is preceded on Sunday 1 March by an afternoon workshop on stock control and investment in technology. Dispensing opticians who will be speaking include: Grace Haine, discussing her experiences of starting her business from scratch just two years ago and why great customer care is the great differentiator; James Taylor-Short, looking at the patient journey and why independents should constantly review everyday activities; and ABDO board member, Jo Holmes, explaining how she creates great PR within the local community. Amongst other presenters, celebrity speaker Geoff Ramm will explain why service delivery remains a number one priority and how it can be delivered in a fresh and imaginative way. Registration is open to both members and non-members of Sight Care. For the full programme and registration, visit www.sightcare.co.uk PARIS PRIZE DRAW RETURNS Back due to popular demand, the Hoya Paris prize draw is open to all independent practices with a Hoya account and runs until 31 March. Patients who purchase a pair of Hoyalux iD lenses before 31 March are eligible to receive a prize draw entry ticket. Additional tickets and point-of-sale can be ordered on Hoyanet or the VSE shop for free while stocks last. Tickets must be received by Hoya by 24 April and the winner will be drawn and announced on 1 May. COLLEGE CONFERENCE OFFERS DO/CLO CET CET events Peer review and legal roadshows Aberdeen Nov 17 Nov 18 Legal roadshows Peer review roadshows Glasgow Sep 1 Nov 10 Belfast Newcastle Feb 24 Sep 30 Sep 29 Leeds Manchester Mar 10 Chester Mar 25 Sutton Coldfield Nov 24 Peterborough Birmingham Oct 6 Oct 20 Cambridge Oct 20 Cardiff London Feb 11 Southampton Ashford Feb 7-9 Exeter Mar 11 Sep 22 Oct 20 Jun 9 Map of AOP roadshows in 2015 NEW PARTNERSHIP APPROACH TO CET ABDO members are to benefit from new reduced rate CET courses run by the Association of Optometrists (AOP), as well as free access to its regional peer review and legal roadshows. AOP chief executive, Henrietta Alderman, said: “We have agreed a new partnership approach to our CET courses from 2015, with ABDO members able to attend AOP regional peer review and legal roadshows free of charge, plus all other courses at the member rate and vice versa. This joint approach will ensure that dispensing opticians and optometrists who work together get access to the best training and education in the market.” Tony Garrett, ABDO general secretary, said: “I am delighted that the AOP and ABDO are working closely together on the provision of top quality CET for the benefit of our members. It is another step forward in the close relationship between the two bodies.” Barry Duncan, ABDO members support manager, added: “For some time both the AOP and ABDO have discussed how we might share resources when it comes to the delivery of CET. This is most definitely a step in the right direction and will provide AOP and ABDO members with greater learning opportunities and valuable CET points in various locations throughout the UK.” Launching in February, the first AOP peer review sessions will take place in Cardiff and Leeds, and the first legal roadshow in Sutton Coldfield in March. For all AOP CET events, visit www.aop.org.uk/events A model from the Invu kids collection ENVY-INSPIRING POLARISED SUNGLASSES Invu – pronounced ‘in view’ and phonetically spelling out ‘I envy you’ – is a new brand in the polarised sunglass sector now available from Norville. The new range for men, women and children features a mix of materials and colours, ranging from the pop art flashy trend range to more calm blacks and browns within the classic collection. Notable features include the use of new materials such as TR90 as well as temple embellishments and innovative frame treatments. The frame case also incorporates a polarising lens tester to aid sales. Norville also offers the Invu range in a prescription option for more than 80 per cent of the sunwear models. “The ultra-polarised lens technology from Swiss Eyewear Group gives consumers an extraordinary experience of crystal-clear, glare-free vision with improved colour contrast as well as a best in class UV-400 absorber,” said the company. The College of Optometrists’ annual conference, Optometry Tomorrow at the Brighton Centre from 8-9 March, is promising up to 15 interactive CET points for delegates with a two-day ticket and, for the first time, some sessions will offer CET points with dispensing optician and contact lens competencies. The DO competencies covered include professional conduct, optical appliances and low vision. These can be gained at sessions including Professor Dave Elliott’s lecture on the prevention of falls, seminars on rehabilitation strategies in visual impairment and off-axis performance of lenses, and a skills workshop on low vision. For contact lens practitioners, competencies include communication, contact lenses and professional conduct. These can be gained via a lecture on the innovation of contact lens practice, and one on myopia and soft contact lenses. There is also a seminar on inflammation and allergy, and a discussion workshop on orthokeratology. Visit www.optometrytomorrow.org NEW DO COMMITTEE MEMBER Paula Baines, dispensing development manager at Vision Express, has replaced Glenn Tomison as a dispensing optician member of the General Optical Council’s Standards Committee (see news page 10). Mitesh Patel, digital strategy director of Vision Express and founder of the online retailer, Lenstorereplaces, has replaced Brian Carroll as a member of Companies Committee. Paula said: “I am delighted to be joining the Standards Committee. I strongly believe in the importance of professional responsibility and registrants working within an effective set of standards. I look forward to working with the committee during a crucial time as the GOC continues its strategic review of the standards for dispensing opticians and optometrists.” The regulator has also announced eight new Hearings Panel chairs, who will chair fitness to practise and registration appeal hearings. Visit www.optical.org for details. NEWS A prototype of ODG’s AR smart glasses GOOGLE SUSPENDS SALES OF GLASS Google has halted its Explorer programme and ceased sales of its Glass smart eyewear concept in order “to focus on future versions of Glass” under a new division. The Explorer programme, giving software companies the chance to buy Glass for $1,500, was launched in the US in 2013 and in the UK last summer. Bob Forgan, managing director of Waterside Laboratories, which has been concentrating on bringing lenses and frames to market for smart eyewear, told Dispensing Optics: “Glass is now ‘graduating’ from being part of Google (X), which looks at all areas of innovation, to being within its own team at Google and I see this as a very exciting development. In their own words they describe this as ‘moving from concept to reality’.” CONTACT LENS DEBUT AT OPTI MUNICH Italian contact lens firm, Safilens, debuted its new daily lens for presbyopes based on Fusion technology at Opti in Munich last month. The company is heralding its Fusion 1day Presbyo contact lens as a ‘gamechanger’ for the contact lens industry. Fusion technology incorporates a copolymer made from Tamarind-Seed Polysaccharides (TSP) and hyaluronic acid (HA) into the contact lens. “This synergy heightens the well-known Meanwhile, last month’s Consumer Electronics Show (CES) in Las Vegas saw two notable debuts in the smart eyewear category. Already with its own smart glasses, Sony’s SmartEyeglass Attach is a snap-on, one-lens concept that attaches onto existing frames, for sport and fitness use. A tiny prism sits in front of the right eye and acts as what Sony calls an ‘OLED micro-display’. Additionally, Osterhout Design Group (ODG), which makes military smart goggles, showcased an augmented reality (AR) version of its smart glasses system. “Consumers today are very sophisticated and have come to expect a high degree of utility and entertainment from their technology,” said Pete Jameson, ODG COO. “Our intention is to deliver a state-of-the-art system in a consumer friendly form that you can wear to do specific things your laptop, phone or tablet can’t, such as work privately on an airplane or train, watch 3D movies on a large screen in bright sunlight, play interactive 3D games, or obtain heads-up line-of-sight directions or instructions while keeping your hands free and your eyes engaged in your environment.” ODG said its smart glasses allow users to do everything they do with a tablet, with 3D graphics overlaid and in a true, hands-free format. properties of TSP and HA in hydrating, lubricating and protecting the surface of the eye from mechanical stress caused by wearing contact lenses, thus promoting the re-growth of epithelial microvilli,” said the company in a press statement. “This technology improves wearer comfort through normalisation of the tear film and works in harmony with the eye to continuously, and in a controlled manner, release a natural tear film substitute and mineral salts from the lens to the tear film.” The lens is available with a 8.60mm base curve, 14.10mm diameter and powers ranging from +8.00D to -10.00D. PROJECT TO EDUCATE GPS ON SIGHT LOSS Healthcare provider Simplyhealth is supporting a project that aims to raise awareness of the importance of eye health and the impact of sight loss amongst GPs and practice staff. The project is being jointly delivered by the Royal College of General Practitioners (RCGP) through its Clinical Champion, Dr Waqaar Shah, and the UK Vision Strategy, and runs until March 2016. It will deliver a series of training resources, webinars and events for GPs and practice staff. The launch comes after a recent survey revealed many GPs in the UK were not confident when diagnosing major eye diseases. Just one third of respondents were confident in spotting the symptoms of age-related macular degeneration, with only half of GPs confident in recognising diabetic retinopathy or glaucoma. The survey also found that only a quarter of respondents had been offered training on how to support patients who were blind and partially sighted, and the majority of respondents expressed an interest in receiving training or guidance on how to support patients who were blind and partially sighted. Dr Waqaar Shah said: “GPs and practice staff have told us that they need more training opportunities to increase their knowledge and confidence of the issues relating to older people with sight loss. We are delighted that Simplyhealth have kindly given their support to the Clinical Priority for Eye Health Project to make this possible, as it will enable us to deliver significant improvements in preventing avoidable blindness and improving the quality of life for patients with sight loss.” New sunglasses from Celine Dion BUMPER SUN SELECTION Dunelm Optical has launched more than 50 new frames in its annual sun brochure, featuring designers Paul Costelloe and Janet Reger, Celine Dion, Julian Beaumont, Retro, Sunset, Sunset+ and Whiz Kids. The new 80-page brochure spans a wide range of new styles, old favourites and the latest influences in sun spec design, with all styles glazed to prescription from Dunelm’s in-house lens laboratory. Director Peter Beaumont said: “The focus is on good craftsmanship and high quality materials, building on popular styles that sell year after year but also experimenting with contemporary features and colours to give the ranges an update. It’s set to be another busy sun season, so we’re offering opticians a special discounted rate if they place orders before March.” 14 Dispensing Optics FEBRUARY 2015 Unique designs and I N N O VAT I O N S LENSES In this month’s product spotlight, we take a look at some of the most recent developments in spectacle lens technology A “perfect solution” for single vision prescription sunwear New tool for glazing polarised lenses SPORT AND FASHION DESIGN WITH ATTITUDE New for 2015, Shamir has taken its already successful Shamir Attitude lens and developed two unique new lenses – one for sport and the other for fashion. Keeping in line with its long-term goal to create personalised lenses, the design of these two new lenses addresses the visual needs of sport and fashion prescription sunwear in a wide range of frames. The new Attitude III Sport & Fashion lenses have vision zones that are especially suited for any lifestyle or activity, be it extreme sports or an outdoor coffee with friends, and expanded peripheral vision specifically designed for large frames. To complete the solution, the Attitude III SV is said to provide a “perfect solution” for those requiring single vision prescription sunwear. Other benefits include an extended range of base curve and face-form angles, Shamir’s Glacier Sun coating package with Achromatic AR coating for the front surface and anti UV reflection coating for the rear surface, impact resistant and high index materials, as well as a wide range of tints and filters. With unique benefits for sport and fashion, Attitude III Sport & Fashion lenses incorporate Shamir's four most advanced technologies: Eye-Point Technology III, improving the viewing experience regardless of prescription or choice of frame; Natural Posture, minimising discomfort and allowing for a natural near viewing posture; IntelliCorridor, providing an optimal power profile specifically for sports and fashion; and As-Worn Quadro, ensuring complete viewing comfort for any frame shape. NEW DISPENSING GADGET AND TECHNIQUES Norville’s new Polarising Axis Verifier Gauge has been designed to facilitate the correct glazing of polarising lenses. The company said: “The ISO BSI Standard allows +5° as the glazing axis tolerance for polarising lenses, that is, the axis of polarisation rather than the glazed cylinder axis which sometimes can have a much wider allowance depending on its lens power. However, a more serious error can occur when glazing polarising lenses is a complete 90° swing of the polarising axis, easier than you may think with spherical polarising powers. Technicians can neglect to recall there is an axis to a polarising spherical power. This little gadget will catch such errors before they get onto a patient’s face.” Other developments at Norville include the availability of Presto prism control bifocals – a traditional concept repackaged with the demise of the solid 30 prism control bifocal, as the company explains: “We have expanded our use of the Presto technique to develop a FT28 bifocal option, allowing the optician to independently prescribe prism requirements for distance and near. “Bringing these two lenses together, either as a Flat Top 25, 28 or even 35mm segment, provides a separate prism segment to be popped into the carrier distance lens. This allows the practice to prescribe well over 10D prism at near, with no prism in distance, or any combination in most resin materials.” Dispensing Optics FEBRUARY 2015 15 Impression FreeSign 3 – taking wearers into a new dimension A modern, comprehensive dispensing aid An innovative lens material for all frames 16 Dispensing Optics FEBRUARY 2015 PROGRESSIVE LENS IN THREE DESIGN OPTIONS Rodenstock’s Impression FreeSign 3 is the result of five years of research and development, providing unrestricted clear vision, maximum image stability, and minimum distortion. “This innovative lens takes progressive spectacles wearers into a new dimension,” explains Rodenstock’s lens product manager, Debbie Bathgate. “And thanks to Rodenstock’s patented Flexible Design Technology, we’ve made it really easy for opticians to perfectly adapt the Impression FreeSign 3 to the personal requirements of even their most demanding customer. “Swimming effects that are typical of a progressive lens are finally a thing of the past and the peripheral aberrations can be positioned in such a way that the customer will hardly know they are wearing spectacles,” adds Debbie. In addition to the Individual design option, Impression FreeSign 3 comes in three easy-to-dispense design types to suit different lifestyles – Impression FreeSign 3 Active, Impression FreeSign 3 Allround, and Impression FreeSign 3 Expert. The FreeSign 3 Consulting module in Rodenstock Consulting allows the wearer to specify their vision requirements based on images on screen. The Virtual Consulting App simulates the view through an Impression FreeSign 3; while Rodenstock’s new EyeConsulting+ 2.0 app can determine a customer’s refraction values with different tests, paying special attention to far and near refraction. INDIVIDUALISED PROGRESSIVE WITH SUPPORT TOOL Seiko Optical is describing its new Seiko Superior Xcel as a “truly individualised” inner surface progressive lens. The design calculation software considers more than 5.7 billion variables, and respects both lifestyle requirements and frame fitting parameters to create a personalised lens for every wearer. The lens integrates advanced inner surface progression with meridian optimised, internal multi-aspheric design, resulting in incredibly stable imaging even outside the central viewing zones, says the company. A spokesperson said: “This revolutionary concept provides the wearer with a significant increase in field of view, with advanced correction of off-centre astigmatism and power error. Combined with precise calculations for pantoscopic angle, vertex distance and face form angle, Seiko Superior Xcel offers nine corridor lengths, three lifestyle options, monocular inset and optimised working distance, to offer our most comprehensively individualised lens.” To complement the lens, Seiko has introduced its Digital MultiTool, which allows precise measurement of all individualised features of the lens. It also provides a function to measure natural angle of gaze, so corridor length can be optimised to provide natural, comfortable head position for near and intermediate visual tasks. Additionally, the Digital MultiTool features a detailed lens demonstrator and a frame selection mode, to provide a modern, comprehensive dispensing aid. REVOLUTION IN HIGH PRECISION OPTICS ‘The world’s thinnest lens’, the 1.76 index from Tokai Optical, is “the result of dedicated research by experts with an established history in their field,” explains Leigh Smith, managing director of Tokai Optical UK. “This latest advance from Tokai has been tirelessly extended and refined to produce an enviable range of single vision and progressive lenses. “Flexibility is key to this index,” continues Leigh, “with a range of 80 per cent ABS tints and Transitions VII availability. It’s perfect for higher prescriptions where patients are much more sensitive to the thickness and optical performance of their lenses. The 1.76 index perfectly combines these two aspects to ensure the ultimate in aesthetics and lens design.” The 1.76 default standard coating, the Super Power Shield, was created by using Tokai’s latest thin-film technology. “It’s a revolutionary ultraflexible AR, which provides the lens with a superior scratch resistance and minimises the chance of crazing, even at the thinnest point of the lens,” Leigh explains. “It also protects the lens against invisible edging cracks that could occur during the glazing process.” Polarised lenses “with no equivalents” FASHIONABLE GRADIENT TINTS WITH POLARISATION Younger Optics has launched NuPolar Gradient lenses allowing practitioners to offer the most fashionable gradient tints with 99 per cent polarisation efficiency, without need of the “unreliable lens tinting process”. According to Julian Wiles, Younger Optics Europe’s UK representative, “This revolutionary new lens has no equivalents in today’s ophthalmic lens market.” NuPolar Gradient is made available in polycarbonate semi-finished lens blanks for all Younger Optics lab clients. NuPolar Gradient lenses are available in two colours: Dark Grey 85 per cent light absorption – Bottom: Light Grey 70 per cent light absorption; and Dark Brown 80 per cent light absorption – Bottom: Light Grey 70 per cent light absorption. The gradient effect is achieved through the special treatment of the polarising film, which is fully encapsulated inside the lens and therefore protected from potential colour fading. GRAPHITE GREEN JOINS LENS COLOUR FAMILY Transitions Optical has unveiled a new colour to add to its Signature lens offering, Graphite Green. The new colour is described as “a refreshingly modern and stylish addition to Transitions Optical’s family of coloured lenses, which simultaneously offers superior light management technology, optimising vision. A green sunglasses colour was originally developed in the 1950s because research showed that eyes did not respond equally to all colours in the visual spectrum. Based on this insight, Transitions Optical and Essilor International jointly developed the new grey-green colour using a unique patented colour science technology to provide an enhanced colour and contrast experience. Transitions says its lenses offer spectacle wearers a unique vision experience every day that goes beyond simple acuity. Clear indoors, they adjust their tint to the level of light outdoors, becoming as dark as sunglasses in bright sunlight, constantly optimising the amount of light the eyes receive, to reduce glare and eventually eye fatigue. INDIVIDUALISED DESIGN TECHNOLOGY Waterside Optical has launched a new generation progressive lens, which it says take individualised lens design to a whole new level thanks to Digital Ray-Path Technology. When dispensed in conjunction with the company’s new iPad app, which can be used by either the consumer or optical professional as part of the lens selection process, progressive wearers can have lenses designed to match their individual needs and lifestyle. “This clever new interactive on screen consultation app generates confidence and transforms the buying experience for progressive wearers,” explained Waterside managing director, Bob Forgan. “Essentially it identifies the best lens for the individual through a series of steps, engineered to evaluate the wearers’ expectations, needs, previous experience and reading habits”. The OptikamPad from Waterside is an ultra-portable measuring system and dispensing aid, which incorporates the iPad Air. “One photograph providing 10 measurements, coupled with interactive sales and dispensing aid functions, OptikamPad enhances the dispensing experience for the eyecare professional and patient alike,” said Forgan. Traditions’ signature Graphite Green in Lafont Leo frames Enhancing the dispensing experience Next month’s product spotlight is on sports eyewear. Dispensing Optics FEBRUARY 2015 17 CET COMPETENCIES COVERED Dispensing opticians: Contact Lenses, Ocular Abnormalities Contact lens opticians: Contact Lenses Optometrists: Contact Lenses Silicone hydrogel: the best all-rounder? By Claire Mc Donnell FAOI he first soft contact lenses (made from a hydrogel material) became available in 1957. At the time, less was known about the eye’s oxygen requirements but as early as 1967, researchers began to recognise that hydrogel contact lenses could cause contact lens induced hypoxia (which had already been recognised in PMMA wearers)1. Overnight wear of contact lenses became popular in the 1970s and by 1981, the US Food and Drug Administration (FDA) approved the first non-therapeutic, soft contact lens for wear across 30 consecutive days and nights. In the years that followed, researchers learned more about the cornea’s oxygen requirements and the increased infection risk that came with the overnight wear of lenses. Manufacturers thought that by increasing oxygen transmission through a soft contact lens, they could improve corneal health and reduce the infection risk. The ability of silicone to transmit oxygen was already well known but silicone is intrinsically hydrophobic and, therefore, difficult to combine with hydrogel. It was not until 1999 that the first silicone hydrogel (SiHy) lenses became commercially available in the UK. Their popularity for fits and refits has steadily increased since that time and in the latest available Euromcontact market statistics report (2013)2, SiHy material now T accounts for 86 per cent of fortnightly and monthly disposable lenses sold in Britain and 55 per cent of all soft lenses. SiHy lenses are now available in toric prescriptions, multifocal designs and planned replacement modalities. FIRST GENERATION LENSES The first generation lenses were PureVision by Bausch + Lomb and Focus Night & Day (now known as Air Optix Night & Day) by CIBA Vision (now Alcon). They were marketed as 30-day continuous wear lenses and were also indicated for therapeutic use, eg. as a bandage contact lens following corneal refractive surgery. These lenses had a special surface treatment to make them hydrophilic and to reduce the protein and lipid deposits commonly found with silicone. The treatment used on PureVision transforms silicone to silicate using charged gas molecules to form islands of hydrophilic silicate between the hydrophobic silicone. The distance between the islands is small enough to make an overall hydrophilic surface3. It is also electrically neutral, which helps to prevent protein deposition3. The Night & Day lens undergoes a plasma surface treatment which makes it hydrophillic4. In both lenses, the treatment actually becomes part of the lens matrix and, therefore, cannot be rubbed off. First generation lenses have high Dks, low water contents and a high modulus. SECOND GENERATION LENSES In 2004, Johnson & Johnson Vision Care released its Acuvue Advance fortnightly SiHy lens for daily wear only, followed 15 months later by Acuvue Oasys, which could be worn up to seven days and six nights consecutively (extended wear) and which were also indicated for therapeutic use. These are known as second generation SiHy lenses. These lenses do not have a surface treatment to make them hydrophilic, instead the material itself has PVP (polyvinyl pyrrolidone) incorporated into it. The PVP binds moisture, making the material more flexible, and it provides a buffer between the hydrophobic silicone and the tears3. These lenses have lower Dks than the first generation, higher water contents and a lower modulus. THIRD GENERATION LENSES In 2007, a new generation of SiHy lenses was introduced to the market. These include Biofinity from CooperVision and PremiO from Menicon, both of which are indicated for extended wear. The silicone in the Biofinity lens is in the form of macromers and, therefore, this lens is hydrophilic without the need for surface treatments or wetting agents. PremiO combines siloxane and hydrophilic monomers using a patented polymerisation system, called MeniSilk, and it has a surface treatment. This article has been approved for 1 CET point by the GOC. It is open to all FBDO members, including associate member optometrists. The multiple-choice questions (MCQs) for this month’s CET are available on page 22 and online. An answer sheet for posted or faxed entries is available for download on ABDO’s Dispensing Optics log-in page. Online entry: log in to www.abdo.org.uk, and follow the centre section link to ‘CET Online’.Please ensure that your email address and GOC number are up-to-date. The pass mark is 60 per cent. The answers will appear in the June 2015 issue of Dispensing Optics. The closing date is 15 May 2015. 18 Dispensing Optics FEBRUARY 2015 C-38611 Lens Generation Dk/t Water content Modulus (MPa) Purevision First 110 36% 1.1 Air Optix Night & Day First 175 24% 1.5 Advance Second 86 47% 0.43 Oasys Second 147 38% 0.72 Biofinity Third 160 48% 0.8 Premio Third 161 40% 0.9 Table1 This latest generation of lenses can provide high Dk values and higher water contents without necessarily having the high modulus values seen with the first generation lenses5. OXYGEN TRANSMISSION SiHy lens materials were originally developed in order to supply the demand for overnight wear of contact lenses. The first generation lenses were approved for up to 30 days (and nights) consecutive wear, which is known as continuous wear. However, in spite of the fact that the subsequent second and third generation lenses also had excellent oxygen transmission, they were only marketed (and approved) for up to seven days (and nights) consecutive wear which is known as extended wear. This is because an increase in oxygen transmission did not solve all the problems inherent with overnight lens wear. Several researchers have now concluded that a Dk/t of 125 is required to provide the cornea with a normal supply of oxygen even in the closed eye state6,7,8. Dk is a measure of the oxygen permeability of a material, whereas Dk/t measures the oxygen transmission through a particular lens with the “t” representing thickness. Table 1 shows the manufacturers’ stated Dk/t for various SiHy lenses. It can be seen from the table that most of the lenses meet the Dk/t requirement of 125. However, manufacturers normally state the DK/t for a -3.00D lens and, as the lens thickness increases, the Dk/t drops and therefore most lens materials do not meet the 125 requirement in the higher prescriptions (particularly with plus prescriptions). For daily wear, Harvitt and Bonano have proposed that a Dk/t of 35 would be sufficient to avoid hypoxia across the whole cornea8. While the increase in oxygen transmission to the eye through SiHy materials solved some problems, eg. limbal neovascularisation, it did not reduce the risk of infection with overnight wear and this is probably why there has not been a significant increase in the rate of continuous wear prescribing in the last 10 years9. MODULUS AND WATER CONTENT Silicone is inherently stiff. It is the water content that gives a lens much of its flexibility. The modulus of a material gives an idea of the rigidity of the material (or how well that material resists deformation). However, modulus relates to the material and the actual stiffness of a lens will also depend on the lens thickness and shape. The first generation lenses had a low water content and a high modulus. The second generation lenses had internal wetting agents that increased water content and decreased modulus, but it is in the third generation of lenses that manufacturers have managed to combine higher water contents (thus reducing the modulus) without necessarily compromising on oxygen transmission. See Table 1 for the water content and modulus of SiHy lenses. FITTING TECHNIQUE The fitting technique for SiHy lenses is the same as for soft hydrogel lenses. If lenses are to be worn overnight then the movement of the lens post-blink should be optimal at 0.4-0.5 mm when the eye is in the primary position, and twice that again on upgaze. This is to ensure that overnight debris has the best possible chance of being washed from under the lens with tear exchange. This aside, many contact lens experts feel that even with lenses designed specifically for overnight wear, patients should be encouraged to remove their lenses on waking and to carry out a rub and rinse step with a suitable cleaner before immediately reinserting the lenses. AFTERCARE If a patient is to wear lenses overnight they would normally be fitted with the lenses on a daily wear basis first, particularly if they are a new wearer. Once the patient commences overnight wear, it is usual to recommend that they have an aftercare appointment the morning after the first time they sleep in their lenses10. Overnight wearers are also normally checked more frequently than daily wearers. At aftercare appointments, the practitioner needs to check carefully for specific signs that are more commonly encountered with SiHy lens wearers and overnight wear. SIGNS OF MECHANICAL PROBLEMS Because of the higher modulus of SiHy lenses (compared with hydrogel lenses) SiHy wearers have an increased risk of contact lens papillary conjunctivitis (CLPC) (Figure 1), superior epithelial arcuate lesions (SEALs), mucin balls and epithelial flaps. If a patient is exhibiting signs of any of the above, they should be changed to a lens with a lower modulus. DEPOSITS Silicone is notoriously lipophillic and SiHy lenses can deposit lipids very quickly Fig 1. Grade 1 contact lens papillary conjunctivitis Dispensing Optics FEBRUARY 2015 19 Continuing Education and Training a patient’s lenses appear cloudy they should be changed to a more frequent replacement lens, as denatured protein is very difficult to remove from a lens. Bausch + Lomb’s Biotrue multipurpose solution contains protein stabilisation agents which have been shown to minimise denaturation14. Fig 2. Lipid deposits on a silicone hydrogel lens (Figure 2). Deposited lipids will soon smear a patient’s vision and lead to discomfort. Patients exhibiting signs of lipid deposition can have their lenses changed to a different replacement schedule, ie. daily disposable lenses can be worn instead of fortnightly or monthly replacement. Protein deposits are generally less problematic. Natural protein from the tears is colourless, easily rinsed from lenses and may offer some protection from microbes. When protein becomes denatured it can make a lens cloudy and may cause inflammatory reactions such as CLPC. Several studies from the University of Waterloo, Canada, have shown that SiHy lenses deposit far less protein than hydrogel lenses but that the protein deposited is more likely to become denatured11,12,13. This denaturing effect varies with different SiHy lenses as it is interaction with the specific material which causes the denaturation. In general, protein deposition is not a significant problem with SiHy lenses but if MICROBIAL KERATITIS Of all contact lens-related complications microbial keratitis (MK) is the most feared as, if left untreated, some cases of MK can result in corneal scarring and a subsequent permanent loss of one or more lines of best corrected visual acuity. Several studies have shown that the risk of MK is higher in patients who smoke15 and that overnight wear of contact lenses (regardless of type) increases the risk of MK by a factor of four16. This is why patients on continuous or extended wear need to be monitored more closely than daily lens wearers, and be specifically warned of the increased risk. The symptoms of MK are pain, often photosensitivity and (if the central cornea is affected) possibly blurred vision. The signs are conjunctival hyperaemia, anterior chamber reaction, infiltrates, and significant corneal ulcer-like staining. Patients may not exhibit all of the signs and symptoms but if a patient complains of ocular pain and exhibits significant corneal staining, they should be asked to remove their lens immediately (if they have not already done so) and the patient should be referred to an eye hospital as an emergency. Patients should bring their lenses and case with Figure 3. Central sterile infiltrate 20 Dispensing Optics FEBRUARY 2015 them to the hospital as both can be swabbed to try to identify the pathogen. INFILTRATIVE EVENTS Infiltrates are focal aggregates of white blood cells, which appear in the corneal subepithelium as part of an immunemediated response. Sterile infiltrates appear when there is no active infection but they are an indication that there is a build-up of bacterial exotoxins adhering to the cornea. They are usually small, round and white in appearance (Figure 3). Sterile infiltrates are more likely to be peripheral and single and less likely to stain with fluorescein, when compared with those of an infectious nature. The patient should be instructed to cease contact lens wear until the infiltrates have resolved. Any blepharitis or meibomian gland dysfunction should be treated as both conditions result in an increase in exotoxins in the eye. As infiltrates are more common with overnight wear, patients may have to be changed to daily wear. Sterile infiltrates do not progress to MK but patients should be warned to return to the practice immediately if their signs and symptoms worsen and they develop pain, as infective infiltrates can very easily be misdiagnosed as sterile in the early stages. SOLUTION INDUCED CORNEAL STAINING Solution induced corneal staining (SICS) was first reported in 2002. It is similar in appearance to a diffuse superficial punctate keratitis (Figure 4). It appears to occur in certain patients with specific lens-solution combinations. It has been seen with both hydrogel and SiHy lenses. Depending on how it is measured, it can appear to be more prevalent with biguanide preserved solutions or polyquad preserved solutions. Studies into SICS and its impact on ocular health have come up with conflicting conclusions. In 2012 Professor Nathan Efron Fig 4. Solution-induced corneal staining produced a paper where he gave SICS a new definition and title17. He called it ‘preservative-associated transient hyperfluorescence’ (PATH), which he described as a temporary hyperfluorescence of fluorescein which is bound to the corneal epithelium. Therefore, it is not a true pathological condition in which fluorescein stains the actual epithelial cells themselves or pools within disturbances in the epithelium. There is evidence to support this theory in that the staining is asymptomatic18 and another paper from 2012 found that ocular surface shedding with contact lens wear was similar in all eyes regardless of levels of SICS observed19. On the opposing side of the argument yet another paper from 2012 found that eyes with SICS were more likely to show higher levels of upper and lower palpebral hyperaemia and tarsal roughness20. Both of which would suggest that there is some pathological basis to SICS. It seems that researchers have yet to reach a consensus regarding SICS and, therefore, for practitioners it is probably better to err on the side of caution and change patients with obvious signs of SICS into one of the hydrogen peroxide based solutions, which generally produce little or no SICS in combination with either SiHy or hydrogel materials21. CIRCUMLIMBAL STAINING Circumlimbal staining is circular staining caused by the lens edge (Figure 5). It can be seen in hydrogel lens wearers but is more common in SiHy lens wearers. According to a 2012 study, circumlimbal staining is related to lens edge design and material rigidity22. A rounded edge design (PureVision) was found least likely to stain but more likely to be associated with discomfort. A knife edge design (Acuvue) was found to be most likely to stain but least likely to be associated with discomfort. While circumlimbal staining does not appear to affect wearer comfort, its long-term impact is unknown and, therefore, patients with this sign should be monitored. SUMMARY SiHy lenses might be the first choice of lens to fit patients because of their exceptional oxygen transmission and because many of the high modulus-related problems seen with the first generation lenses appear to have been alleviated with the latest third generation lenses. Practitioners should still be very cautious about fitting patients with lenses for overnight wear as the largest single stumbling block (increased risk of infection compared with daily wear) remains unsolved. Practitioners should check carefully at each aftercare for any contact lens-related adverse signs, but in particular those more commonly associated with SiHy wear. REFERENCES 1. Hill RM. Effects of hydrophilic plastic lenses on corneal respiration. J. Am. Optom. Assoc. 1967; 38 (3):181-4 2. The Euromcontact 2013 market data report for contact lens and lens care Figure 5. Circumlimbal staining from a silicone hydrogel lens edge products. Euromcontact. Available from http://www.euromcontact.org/statsreports. Accessed 12.08.2014 3. Snyder C. A primer on contact lens materials. Contact Lens Spectrum. 2004 Feb: 34-39. 4. Gromacki SJ. Caring for silicone hydogel contact lenses – part two. Contact Lens Spectrum 2005. 5. Carnt, N. Editorial – 3rd generation silicone hydrogel lenses. Siliconehydrogels.org. May 2008. 6. Fonn D, Bruce AS. A review of the Holden-Mertz criteria for critical oxygen transmission. Eye & Contact Lens 2005 Nov; 31 (6): 247-51 7. Papas E. On the relationship between soft contact lens oxygen transmissibility and induced limbal hyperaemia. Exp. Eye Res. 1998 Aug; 67 (2): 125-31 8. Harvitt DM, Bonanno JA. Re-evaluation of the oxygen diffusion model for predicting minimum contact lens Dk/t values needed to avoid corneal anoxia. Optom. Vis Sci. 1999 Oct; 76 (10): 712-9 9. Nicholls JJ. Annual report. Contact Lenses 2013. Contact Lens Spectrum 2014. Available at http://www.clspectrum.com/ articleviewer.aspx?articleID=109320 (accessed 01.09.2014) 10. Purevision lenses brief summary. Available from http://www.bausch.com/ourproducts/contact-lenses/lenses-fornearsighted-farsighted/purevisioncontact-lenses#.U-yyaqOPOSo Accessed 12.08.2014 11. Jones L, Senchyna M, Glasier MA et al. Lysozyme and lipid deposition on silicone hydrogel contact lens materials. Eye & Contact Lens 2003; 29 (1 suppl): S75-S9 12. Senchyna M, Jones L, Louie D, et al. Quantitative and conformational characterization of lysozyme deposited on balafilcon and etafilcon contact lens materials. Curr. Eye Res. 2004; 28 (1): 25-36 13. Suwala M, Glasier MA, Subbaraman L, Jones L. Quantity and conformation of lysozyme deposited on conventional and silicone hydrogel contact lens materials using an in vitro model. Eye & Contact Lens 2007 May; 33 (3): 138-43 14. Wright EA, Payne KA, Jowitt TA, Howard M, Morgan PB, Maldonado-Codina C, Dobson CB. (2012) Preservation of human tear protein structure and function by a novel contact lens multipurpose solution containing protein-stabilizing agents. Eye & Contact Lens Jan; 38 (1): 36-42 15. Stapleton F, Edwards K, Keay L, Naduvilath T, Dart JK, Brian G, Holden B. Dispensing Optics FEBRUARY 2015 21 Risk factors for moderate and severe microbial keratitis in daily wear contact lens users. Ophthalmology 2012 Aug; 119 (8): 1516-21 16. Dart JK, Radford CF, Minassian D et al. Risk factors for microbial keratitis with contemporary contact lenses: A case control study. Ophthalmology 2008; 115 (1): 1647-54 17. Efron N. Putting vital stains in context. Clin. Exp. Optom. 2013 Jul; 96 (4): 400-21 18. Lebow KA, Schachet JL. (2003) Evaluation of corneal staining and patient preference with the use of three multi-purpose solutions and two brands of soft lenses. Eye & Contact Lens Oct; 29 (4): 213-20. 19. Luensmann D, Moezzi A, Peterson RC, Woods C, Fonn D. (2012) Corneal staining and cell shedding during the development of solution-induced corneal staining. Optom. Vis. Sci. Jun; 89 (6): 868-74 20. Young G, Canavan K, Jones S, Hunt C. (2012) Predisposing factors for solutioninduced corneal staining. Optom. Vis. Sci. Nov; 89 (11): 1582-9 21. Carnt NA, Evans VE, Naduvilath TJ, Willcox MD, Papas EB, Frick KD, Holden BA. (2009) Contact lens-related adverse events and the silicone hydrogel lenses and daily wear care system used. Arch. Ophthalmol. Dec; 127 (12): 1616-23 22. Maissa C, Guillon M, Garofalo RJ. Contact lens-induced circumlimbal staining in silicone hydrogel contact lenses worn on a daily wear basis. Eye & Contact Lens 2012 Jan; 38(1): 16-26 CLAIRE MC DONNELL FAOI is a lecturer in the Department of Optometry at the Dublin Institute of Technology where she teaches advanced clinical techniques to optometry undergraduates and qualified practitioners. She has worked in private practice, refractive surgery and education in Ireland, the UK and New Zealand. Multiple choice questions: MCQs 1. What is the usual cause of corneal neovascularisation in contact lens wear? a. Lack of oxygen transmission to the cornea b. Damage from the contact lens edge c. As a consequence of lipid build-up d. Wearing a contact lens with a low water content 4. Complete the sentence correctly. A high modulus and increased oxygen transmission through silicone hydrogel materials have contributed to… a. a reduction in the occurrence of overnight infection b. the steady increase in continuous wear fittings c. a reduction in limbal neovascularisation d. less risk of contact lens papillary conjunctivitis 2. Which statement is CORRECT? a. Lipid and protein deposits are rare with silicone-based material b. Second generation silicone hydrogel lenses have their surfaces treated so that they become hydrophilic c. Third generation lenses can provide high Dk values and high water content without having high modulus values d. Polyvinyl pyrrolidone dispels moisture and tends to stiffen the material 5. Complete the sentence correctly. If a patient wearing silicone hydrogel lenses presents with symptoms which may suggest microbial keratitis they should be told to… a. see an optometrist b. go to an eye hospital as an ocular emergency c. limit their wearing time to daily wear temporarily d. bring their next scheduled appointment for a check-up forward by 1 month 3. For a myope of 2.00D, which lens would NOT provide the cornea with a normal supply of oxygen in all circumstances? a. Advance b. Biofinity c. Premio d. Oasys 6. Complete the sentence correctly. The term modulus refers to… a. the accumulation of denatured protein b. the link between lens thickness and water content c. oxygen transmissibility d. the coefficient of elasticity of a material www.abdo.org.uk Silicone hydrogel: the best all-rounder? By Claire Mc Donnell FAOI THE DEADLINE FOR POSTED OR FAXED RESPONSE IS 15 MAY 2015. The module code is C-38611. Online completion - www.abdo.org.uk - after member log-in go to ‘CET online’ After the closing date, the answers can be viewed on the 'CET Online' page of www.abdo.org.uk. To download, print or save your results letter, go to 'View your CET record after the closing date’. If you would prefer to receive a posted results letter, contact the CET Office 01206 734155 or email [email protected] Occasionally, printing errors are spotted after the journal has gone to print. Notifications can be viewed at www.abdo.org.uk on the CET Online page 22 Dispensing Optics FEBRUARY 2015 MCAs Multiple choice answers: Six of the following questions were presented online to entrants to comply with the GOC’s best practice specifications for this type of CET Which statement is correct? a. The procedure for fitting children with contact lenses is more time-consuming than fitting adults b. Orthokeratology is the ideal solution for all cases of myopic progression c. Eight years of age is the earliest age at which fitting soft lenses should be attempted d. The parents and children must be given support materials to refer to at home d is the correct answer. The author cites written materials, an emergency phone number, video clips and internet resources for parents and children to refer to away from the practice. Which option is correct? Consideration should be given to using a UV absorbing contact lens for children because… a. the ocular absorption of UV is cumulative b. it is estimated 20% of UV exposure occurs before the age of 18 c. retention of correct colour balance is important d. peripheral chromatic aberration will be eliminated a is the correct answer. Melanocyte cells absorb more UV when the eye is young and this builds up over time. Which statement is false? a. Astigmatism over 0.75DC should be corrected with a toric contact lens b. Daily-wear lenses are available in a range of cylinder corrections of up to 2.25DC fitted at any prescribed axis c. Risks of infection are likely to increase after changes in patterns of behaviour d. Consideration of eye dominance is an important factor b is the correct answer. Not all axis directions are available in daily-wear contact lenses. Oblique cylinders may require a two-weekly or monthly lens. Which statement is incorrect relating to an initial “on the eye” experience? a. The child can appreciate the comfort factor of wearing a contact lens b. The quality of vision can be assessed by the child c. The practitioner can evaluate the fit d. Parents should not be involved at this stage d is the correct answer. It is of paramount importance that parents/guardians are involved at every stage. Which option is correct? Daily lenses generally have a range of spherical lens fittings available from: a. -6.00D to +2.00D b. -10.00D to +4.00D c. -8.00D to +8.00D d. -15.00D to +6.00D b is the correct answer. Which option would NOT be considered a valid indication for fitting contact lenses to a child? a. To control myopia b. To comply with parents’ wishes c. To increase self-confidence d. To wear for sport b is the correct answer. The wishes of both the parents and the child must be taken into consideration when assessing a child for contact lens wear. If the child is not motivated, s/he will not be a successful wearer. In case 2 from the author’s practice, what was the main underlying cause of the patient’s visual discomfort with the spherical trial lenses? a. The poor visual acuity with the spherical contact lenses b. A disruption of eye dominance due to unequal VAs c. The spectacle magnification change from spectacles to contact lenses d. The modality of wear b is the correct answer. Although the visual acuity improved R&L with a toric R lens, the problem was solved by restoring the dominance balance that the child was comfortable with. To download, print or save your CET result letter, go to www.abdo.org.uk. Log-in and go to 'View your CET record'. Successful contact lens fitting to children by Nick Black FOR THE MOST UP-TO-DATE ABDO EVENT DETAILS keep an eye out for the eNews landing in your in box, and the events section of the website, visit www.abdo.org.uk/events Dispensing Optics FEBRUARY 2015 23 BUSINESS Antonia Chitty explores how to crack the code to successful spectacle lens sales Building your spectacle lens business o the average spectacle wearer, a lens is just a lens, and it’s not quite clear why they cost so much. As a practitioner, one of your jobs is to explain the benefits to the patient, so they understand the true value of what they are wearing, and how the right product can help them live their life. Being a great dispensing optician requires an in depth knowledge of the technical aspects of lens design, but at the same time you need to be an excellent communicator who can cut through the jargon, and an amateur psychologist who can unpack the patient’s needs and motivations. That may seem like a tall order, so read on to find some tips to help you. T BE A TRUE DETECTIVE The first thing to do is to understand your own strong points and weaknesses. Did you go into optics because you love the science behind a good pair of specs, or because you enjoy a day full of interaction with a wide range of people? If you are strong on the technical side, remember that most customers know almost nothing about spectacle lenses, and check that you’re not speaking in jargon. A simple question like, “Is that clear, or shall I explain it another way?”, can help make sure you are making sense. On the other hand, if you are a good communicator and love working with people, think about whether you need to brush up your technical knowledge. What could you do to stay on top of the latest lens developments? It is vital to do this so you can meet your patients’ needs. The next thing to do is look and listen. Patients share information about their needs right from the moment they enter the practice. They may mention to the receptionist that they are booking a test because of a particular problem, so make sure that is noted down. From their appearance and the way they move, you may be able to glean clues about their lifestyle or hobbies. And, of course, the optometrist will ask questions about how they use their vision at work and at home as part of the eye examination. Glean clues from your patients’ appearance (image by Rodenstock) 24 Dispensing Optics FEBRUARY 2015 As the dispensing optician, you need to be a detective, piecing together these bits of information and getting ‘clues’ from the team, as well as listening to the patient and asking them questions to fill in the gaps in your knowledge of them and their life. A patient who feels they have been listened to is much more likely to be a happy patient, and you will know that you have dispensed the best lens for them. WORK AS A TEAM Better communication is a team effort, and needs to involve everyone in the practice – the receptionist, optical assistants, and the optometrist as well as the dispensing optician. Optometrist Nick Rumney of BBR Optometry explains: “Make sure the optometrist explains the benefits of their recommended lenses in the consulting room before the patient sees the DO.” Jim Green of Eyesite, Brighton, adds: “The seed should be sewn by the optometrist and when the optometrist hands over to the dispensing optician, they then reconfirm the requirements and present a final optical solution to the patient.” Eyesite has been trialling ‘in room handovers’ where the DO comes in to the consulting room on completion of the examination, and the optometrist can explain about the patient’s needs in private. Jim says: “Patients appreciate this transfer of trust, and it means that we can straight away start to talk about the lenses that best meet their clinical need. We like to talk about lenses first, so people don’t compromise on lens choice because they have seen a frame they like. We talk in simple terms and help people pick the lens that will give them the best vision. They then know the cost of the lens, and if they have fallen in love with a particular designer frame are more likely to stretch their budget to get the frame too than the other way around.” While not everyone may be able to afford a £750 pair of glasses, it can be useful to break down the cost of any pair of spectacles over the two years that they will be worn for, or longer for some people. Use real examples that are relevant to each patient: “Well, Mrs Smith, this pair has lasted you three years, so if you spend £150 today, that’s less than a pound a week over the time you will be wearing them for.” BBR Optometry directors Nick Rumney (R) and Nick Black People take several exposures to new information before they take it on board so make sure all the team is briefed about your lens range, to showcase new products and respond to questions. Back this up by highlighting just what different spectacle lenses and coatings can do, in practice display materials, email newsletters, reminder letters and on your social media channels. Offering patients a guided choice can leave them feeling empowered and in control of their purchase. SEEING IS BELIEVING As a further idea Kevin Gutsell, chief executive of the Federation of Manufacturing Opticians, adds: “Staff should be wearing and promoting the products you offer. They can then better talk about the look and feel of their specs together with having the best vision they’ve ever experienced.” What’s more, using the products that you sell can really give you an insight into how they perform. Shauna Reeves of Specsavers Newry, Northern Ireland, says: “Believe in the product you’re selling. There is no point selling something if you don’t believe it is better.” Ensuring that information about the latest developments in lenses is all around you will make your job easier when it comes to the dispense. A pair of spectacles is a big investment for most people, and when they read messages from online sellers such as, ‘It’s just two pieces of glass. It shouldn’t have to be expensive”, they can feel outraged at the price. As a dispensing optician, you can alter this perception by explaining, throughout the dispensing process, just what is involved in creating a pair of spectacles. The more people understand about how lenses are made, why this is important, and how it can benefit them, the more they will appreciate what is on offer. Peter Black, ABDO president, puts it like this: “My Zeiss Progressive Individual tailormade digitally surfaced freeform varifocals are calculated using 2,000 points per surface and made using a machine that costs more than £500,000. The material the lenses are made from is not glass it is a super lightweight, super impact resistant, 100 per cent UV protective light reacting plastic with a nine-layer anti-scratch, antireflective, dirt repellent, oil repellent and water repellent surface. With a top of the range ultralight, ultrastrong, nickel free hypoallergenic titanium rimless, I’d expect to pay as much as £750, which over the typical three years lifespan is under £5 per week – less than 70p per day which is cheaper than the froth on the top of your daily cappuccino. Ninety-nine per cent of glasses are cheaper than this and these are still great value.” FOCUS ON THE BENEFITS Penny Heath is a locum DO in Oxfordshire. She says: “Always recommend what you believe to be best for the customer and tell them why; they can then make an informed choice.” Nick Rumney expands on this: “Always present the benefits, never the features. For example, you could say, ‘You will see better through lighter, thinner, optically superior and harder wearing lens than you have ever seen before.’” If you aren’t quite clear on the difference, a feature might be something technical, while the benefit is all about what it will do for the patient. Offering patients a guided choice can leave them feeling empowered and in control of their purchase. Choices may include explaining that one lens will take a little longer as it is tailormade, for example. Give patients the full picture and they will appreciate it. Explaining benefits can be hard, but it is possible to come up with explanations that customers will relate to. Laura Hing of Stephen Hing Opticians, Shefford, says: “It's not about ‘selling’ the best, it’s how to communicate with the patient why this lens is the best for them. We know what the different lenses do, but how does the patient know without us telling them? “Generally I compare varifocals to cars,” Laura continues. “It’s cheesy I know, but patients understand the reliable mid-range Ford Mondeo compared to the top-of-therange Ferrari. When it comes to coatings, I have a lens with a coated letter ‘K’ on it – as I assume it came from Kodak at some point. This is a great way to show reflections and how clear it looks through the coated part of the lens. I work in a small family business and people trust our opinion, so overselling is not an option.” Locum dispensing optician Suzy Stonehouse also uses a car analogy. She says: “I also talk about cars when I’m dispensing varifocals to explain why some are much cheaper than others. All cars have an accelerator, brake and clutch and they all get you from a to b – but some cars are only good for short journeys as they aren’t as comfortable and don’t have as good suspension as a more expensive car that will give you Dispensing Optics FEBRUARY 2015 25 leather seats, electric windows and amazing suspension. You wouldn’t want to drive to Scotland on a daily basis in a Smart car but you wouldn’t mind it in a Jag.” Suzy, who works in Kent and Essex, has a different way to explain how custom lenses can help: “I talk about suits or wedding dresses when it comes to the ‘tailormade’ lenses on the market. You can go to M&S for a suit and it will fit fine, but if you need a little taken off the length or width you should go to a specialist fitter.” KEEP IT SIMPLE When it comes to it, the important thing is to leave the patient feeling that they are in control of their choices, and have had the help they need to find the best product for them, that will meet their visual needs. Keeping explanations simple is also important. Oliver Kirkpatrick of R. Woodfall Opticians, Worcester Park, says: “I don't believe in dumbing down but as an independent optician, we are trying to simplify choices for patients. We now dispense ‘guaranteed clean and clear’ lenses, all of which is true without explaining destructive interference, hydrophobic etcetera. Patients seem to really respect having things explained in simple terms.” So, when it comes to building your spectacle lens business, is it all about sales skills and techniques? Probably not. Garry Kousoulou of Good Looking Optics in Enfield sums things up: “Selling spectacle lenses can be over complicated. Really all you need is enthusiasm for the product, knowledge about the item, and to understand the customer’s needs. Crack those three elements, and it’s sold.” OPTICAL ASSISTANTS COURSE RETURNS The British Contact Lens Association (BCLA) is once again teaming up with optometrist and staff development consultant, Sarah Morgan, to launch a new series of one-day courses for optical assistants. Kicking off on Thursday 19 March at the Ambassadors Bloomsbury Hotel in London, ‘Contact lenses – the ins and outs’, is designed for staff wanting to increase their confidence with contact lenses. Key approaches and tips for teaching the new wearer, and promoting patient retention will also be central to the day. Sarah said: “This course is for you if you’re helping, or thinking about helping, to teach new wearers how to wear and care for their contact lenses, and feel like you need to know a bit more about things such as lens types, solutions, compliance, lens application and removal, aftercare and customer service. The aim is to get you supporting your optometrist or contact lens optician with confidence and professionalism. “It will be a friendly and fun day – and I promise you’ll return to your practice enthusiastic and invigorated about contact lenses and patient care,” added Sarah. The course costs £160 for staff of BCLA members, and £180 for staff of non-members, with lunch and refreshments Sarah Morgan included. A special rate for hotel accommodation is also available. Places are limited to 24, so early booking is advised by emailing [email protected] or by downloading the booking form from the Events section of the BCLA website, www.bcla.org.uk GOC PUBLISHES ANNUAL REPORT The General Optical Council (GOC) has published its 2013-14 Annual Report and Financial Statement, detailing its work and achievements from April 2013 to March 2014. The report details the GOC’s accounts as well as its Fitness to Practise statistics, the consultation into its approach to tackling illegal practice and its strategic plan, proposing to play a more proactive role in promoting public health and safety through the standards it sets for optometrists and dispensing opticians. Also included is a review of the early stages of the GOC’s enhanced CET scheme. The report was laid before Parliament on 9 December 2014, and can be downloaded from the GOC’s website, www.optical.org NEW VENUE AND FORMAT FOR VISION UK 2015 The seventh annual Vision UK conference will be held on Thursday 18 June at Central Hall Westminster in London. Titled ‘Working together to deliver the UK Vision Strategy’, Vision UK will feature a new format with delegates able to choose from one of five workshop streams, focused on delivering aspects of the UK Vision Strategy. Katherine Raven, UK Vision Strategy senior manager, said: “We are really pleased to confirm Central Hall Westminster as the new location for Vision UK 2015. Central Hall will allow us to effectively deliver the exciting new stream format, which will provide attendees with a conference experience that is tailored to their professional interests. “This year’s event will provide everyone working within the eye health, sight loss and related sectors with a tailored conference experience, with a full day of relevant and engaging content,” Katherine added. Early bird rates are available for those who register and pay before 17 April. Learn more at www.visionuk.org.uk * Following the launch of the UK Vision Strategy’s Commissioning for Effectiveness and Efficiency (CEE) guidance in November 2014, eye health stakeholders are being invited to offer their feedback via a short online survey. The results will inform the evaluation of the CEE project outputs and inform future work to support effective planning and provision of local eyecare services in England. All survey respondents will have the opportunity to enter a prize draw to win a free place at Vision UK 2015. Visit https://www.surveymonkey.com/s/CEEGuidance 26 Dispensing Optics FEBRUARY 2015 IN pRACTICE Next of kin concerns can raise the stakes at spectacles collection time, writes Ben Brewer Next of kin concerns ne short sentence that can take the wind out of any dispensing optician’s sails, and ‘sales’ (pun entirely intended without regret), when a patient is collecting their new spectacles is: “They don't seem any better”. I don’t think we can work effectively with our thoughts set to assume that new spectacles will disappoint our patients, so by the nature of the situation, problems at collection always come with a slight element of concerned surprise. We all have experience of how this situation, in the majority of cases, goes on to end well; after a few seconds, maybe the patient has another look out of the window and decides that they actually can see more clearly. Or maybe the dispensing optician directs the hand holding some reading material closer to within a stronger reading prescription’s focal distance and all is right with the world. However large or small a hurdle at collection turns out to be – as we work along a problem-solving path somewhat similar to ‘encourage, double-check O A frame will feel more comfortable when it’s not such a new sensation for first-time wearers dispensing, refer for recheck’ – there’s one additional factor that has the potential to raise the stakes of that problem solving: the next of kin sitting beside the patient. Nothing will prick up the ears of a family member, friend or carer like the words, “Everything seems blurry”. When we’re dealing with a patient’s next of kin, this generally (but not always) means that we’re dealing with a patient who falls into one of three categories – elderly, disabled or under 16. While there are similarities in ideas for working with the next of kin across these groups, there are some more specific possible situations. COLLECTIONS FOR CHILDREN Children are perhaps the least likely to be an issue at collection for a few different reasons. Firstly, a change in prescription that will require a period of adaptation may result in a few funny squints accompanied by laughter or a “Wow, that’s weird” from a child, but (in my experience at least) very few definite, “I can’t see”s. Laughing along with the child, and an open admission that things may look a bit funny at first before they eventually get used to them, helps to reinforce the idea to both child and parent that they’re right to notice it’s strange – rather than this being a problem – and that given a little time, their vision will return to normal. If this sounds like common sense that doesn’t warrant mentioning, it’s all too easy to imagine an alternative happening in practice: a member of staff (qualified or not) giving a concerned “Hmmm…”, a “Looks a bit strange, does it?”, and starting to look through the child’s record for answers to what the patient’s parents are now at risk of seeing as a problem, rather than something to be anticipated and all part of the plan. However we present a new prescription to a child, there’s always another factor that can work in our favour to encourage collections to run a little more smoothly – the Adult Power Team. While I still feel weird and old when a parent tells their child to behave in practice, or else ‘the man’ will tell them off (I’m only just 30, for heaven’s sake), this subconscious teaming-up with other adults to look after children is a pretty familiar sight. At a stumbling collection, it often shows itself as a parent encouraging Work as a team with parents Dispensing Optics FEBRUARY 2015 27 their child to take any advice given (such as being patient with a new prescription, or perhaps that a frame will feel more comfortable when it’s not such a new sensation for first-time wearers), rather than immediately starting to question the dispensing optician about why they’re having problems. Without straying too far off topic, I have a little girl in practice who insists that every new, correctly-fitting frame she collects is too tight for her. Every time, this is solved by a couple of brief treatments of benchrest. Her parents are absolutely in on it. I’ve previously written in Dispensing Optics about talking to parents who are dubious about their child’s actual need for spectacles and I won’t repeat that all here, but it’s maybe worth mentioning that this too can sometimes be a slight issue that may need attention. While young myopes would generally have few, “It’s no different” issues at collection, children given a first pair of glasses for prescriptions around the +0.75D, +1.00D mark for concentrated work may need more encouragement in the face of apparently little immediate change to their vision. Perhaps they had presented complaining of headaches after extended computer work, or the parents had noticed that they were losing concentration after a short period of reading? Now would be the time to gently remind everyone of this sort of thing. We should bear in mind, of course, that one of the reasons that qualified opticians are called on to deal with under-16s is that they rely on us for a greater standard of care. I definitely don’t want to preach an attitude of ‘the kid’s just complaining, they’ll be fine’, but in cases where our professional knowledge and judgement are telling us that everything is right with the dispense, sometimes that duty of care includes reassuring both the child and their parents that they can have faith in their professional care, even in the face of initial doubts. With the right attitude and the common support (rather than concern) from a child’s next of kin, issues at collection for children still tend to be fairly easy to resolve. This dynamic can sometimes change significantly, though, when the next of kin is the child, carer or even just a close friend of an elderly or disabled adult. ELDERLY AND DISABLED ADULTS If an adult patient who is vulnerable in some way comes into the practice with their next of kin accompanying them by design, then this normally means that their 28 Dispensing Optics FEBRUARY 2015 companion is there with the specific aim of looking out for the patient. This could range from more severely disabled patients, who need continuous care, to patients who are simply ‘slowing down a bit’ in their seniority, with grown-up children who are on hand to make sure everything is being understood clearly. Personally, in practice at the point of collection, hearing that a patient is not sure about their new spectacles always gives me a split-second pause where the rest of the conversation path seems to hang in a fine balance. Will the next of kin take the route of encouragement or concern? Obviously this depends on many different factors, including not only the individual patient, but also their relationship with their next of kin and perhaps even both of their previous experiences with the practice. How the next of kin reacts (bearing in mind that silence is a reaction, too) will decide whether they will become an aide to encouraging an otherwise faltering collection, or a person who the dispensing optician may also need to reassure. At the risk of sounding slightly manipulative, or overly-practised: in practice, I find that a reassuring smile to the next of kin as soon as a patient begins to show uncertainty can go a long way. If I can portray, “I might need some assistance with talking to your mum here”, without giving an impression of anything like, “She doesn't know what she’s talking about” (remember, there is still the chance that there is something genuinely amiss), then this will lay good groundwork for a productive conversation. I think the key is at least aiming to keep the option open in the next of kin’s mind that the patient might just need patience or encouragement. I’ve seen some cases in practice before where this is much harder Reassurance can go a long way than others. Times where, despite a next of kin’s presence itself signifying that they understand a physically-able patient to need assistance more in the form of mental support, they will hear them say that a tested 6/18 to 6/9 improvement, “Doesn’t look any different” and start asking accusing questions of the member of staff doing the collection. GETTING BACK ON TRACK Identifying why a person is having problems with a new pair of glasses is something with which all dispensing opticians are familiar and the possible reasons are myriad. At the point of collection, these reasons normally fall into two broad groups – prescription adaptation and using a new lens type properly. When addressing both of these with a doubtful next of kin present, it helps to patiently remember the following few factors. If the next of kin wasn’t present at the time of test or dispense, clear references to the conversations had with the patient at the time may help to get things back on track. Reminding a patient that new readers were dispensed to use with their magnifier, for example, or that a move from progressives into a single-vision distance pair was deemed their best option, may be useful if phrased to remind the patient that these are conversations that have already been had, rather than presented as fresh information. For example, “We’ve put a tint into your lenses”, only needs, “You were complaining about glare with your cataracts, so...”, as a prefix to make it clearer to a patient’s next of kin that the dispensing optician has handled the dispense properly. Where there are questions over how clear visual acuity with the new prescription seems, a combination of an obviouslycareful (almost theatrical) rechecking of the spectacles with, again, a sprinkling of subtle reminders normally helps here too. Occasionally, expressing a little concerned surprise on the part of the dispensing optician, with some variant of, “I’m not sure why it doesn’t seem clear now, as this prescription improved your vision considerably when you were tested last week. Do you want to have another look?”, is more useful here than simply stating that the glasses are clearer. To note a possible contradiction with my earlier opinion on dealing with children’s collection concerns: vision that ‘seems odd’ to an adult with a new prescription may benefit from the same, “It will seem strange until you adapt to the new lenses”, approach as can help with children; the case of new lenses giving visual acuity ‘no better’ or indeed ‘worse’ than a previous pair seems more common in adults and it is here that a little more directed and justified concern appears to work better. As with most of these things, these suggestions are intended as broad strokes that work best in conjunction with actually paying attention to the individual patient’s needs. Communication is always key. I would consider these conversations with adult patients and their next of kins almost as having to have two separate conversations running together, with the dispensing optician’s words having to serve both at the same time equally – one conversation of concern, patience, and assured encouragement with the patient; simultaneously another of firm professional reiteration and confidence in one’s own skills with the next of kin. QUESTIONS ABOUT COST When a patient appears unconvinced of the value of their new glasses, or a particular lens feature or lens type on collection, this can sometimes give rise to another, possibly more unpleasant conversation with their next of kin (particularly, I seem to have noticed anecdotally, where it’s a friend rather than family member who has accompanied them in) – that of cost. Specifically, the question, in some form, of “Why have they had to pay more for their glasses than I have?”, in a range of wordings from quiet concern all the way up to along the lines of, “They’ve ripped you off”. Working in a small independent practice, when this question does arise, it’s inevitably from a friend who goes to one of the cheaper multiples. When I formerly worked in one of those multiples, it was from people who’d gone for our budget range of options themselves, or one of those ‘savvy’ types who wears £2 ready readers from the market. Wherever you practise, these people find you eventually. There is no one-size-fits-all answer to justifying a patient’s purchase to another person. It’s straightforward to see that there are too many variables – from the patient’s needs to what individual people place value on – to give a meaningful answer of that kind. However, no answer at all, or laughing off the question, potentially leaves the patient’s friend with ideas that are then going to follow your patient out of the practice. I find that it’s more a general attitude that helps in these cases. Overly specific reasons are not the best way to tackle concerns about cost. Mentioning that a particular frame brand is more expensive, for example, runs the risk of only cementing the idea of, “Yes, these are expensive glasses”, in the mind of someone who wasn’t there through the original dispense discussion. Another alternative (that isn’t much better) is attempting to launch into a lengthier description of exactly why the new spectacles cost what they did. This not only starts to sound like a sales spiel to a concerned friend (which absolutely does not help), but also begins to stray towards being something that’s even less helpful – defensive. Coming across as too defensive (of cost in particular, but also with regards to other collection concerns) can have the unfortunate effect of confirming to a next of kin that there is in fact something (a fault) to defend. Overly specific reasons are not the best way to tackle concerns about cost Bear in mind that if a patient is already having concerns at collection, then a friend’s response to these justifications of cost may be along the lines of, “Yes, but these expensive, ‘better’, glasses aren’t working”. While there is no perfect answer to addressing this type of situation, there is a general approach that I try to stick to and that seems to work fairly well: to make sure the patient understands that you are not concerned about taking their money. Of course, this is sound advice for every interaction with patients and again may sound like common sense, but there are ways that can be considered to further demonstrate this to the patient. As an example, I’ve found that a general comment to the patient alluding to the need or original desire for the quality of what you’ve provided (“Yes, we needed to give you a slightly more complicated lens this Dispensing Optics FEBRUARY 2015 29 time round, didn't we?”, “Yes, you said you wanted something really lightweight, didn’t you?”) may encourage patients to answer the next of kin’s cost queries themselves. This approach has also often helped to get the patient to ‘notice the positives’ of their new spectacles – “Oh yes, they are nice and light” – and reinforce the idea that you’re more concerned with providing something good, not something costly. PRE-COLLECTION CONCERNS While issues at collection (where a next of kin has been absent from the patient’s examination and dispense) tend to make up the majority of such situations, occasionally we come across conversations with a next of kin before or during a patient’s visit (or our visit to them, in the case of domiciliary patients). The conversations of note here generally centre around the pre-examination idea that the patient doesn’t need or want new spectacles. So what do we do in these cases when they could benefit from a new dispense? I’ve come across this with patients whose reasons for potential dispensing have ranged from having a myopic shift of two or three dioptres, to having a smaller change from an old pair of specs that are being held on by a combination of one surviving half of a frame side and willpower. In the face of such cases, the reasons for a desire to avoid new spectacles on the part of the next of kin are varied and sometimes difficult to understand or deal with effectively. I’ve been in situations ranging from the (at least understandable) “I don’t think my mum needs to spend more money”, through the misguided, “She doesn’t need new glasses”, all the way up to one utterly unpleasant case of, “I think Dad’s on the way out and I’m going to get whatever’s left”. Whether it’s an issue of cost or perceived lack of need, it’s generally a matter of putting both the patient and next of kin in as informed a position as possible to make a decision about a dispense. While it’s more straightforward to actually demonstrate a difference in vision to the patient themselves, talking to someone else about it may provide additional challenges. Without wanting to sound negative (because in the end, a next of kin probably has the patient’s best interests at heart), a significant challenge is when they don’t expect to be challenged about what they’ve requested. Next of kins are often used to making decisions for their wards and deciding what’s best for them. When I first started coming into contact with situations like this, personally I was afraid to challenge what they’d said they and the patient wanted; now I see that it’s my responsibility to make sure everyone understands what’s going on. More than once, it's been suggested that a poorly-corrected myope doesn’t need an update because they never go out – here a next of kin needs to understand that a ‘distance’ prescription includes television watching, perhaps enjoying seeing birds and wildlife in a garden, or maybe just moving around at home safely. As dementia and the presence of a next of kin tend to go hand in hand, it’s worth noting that the Alzheimer’s Society have an excellent piece on their website (www.alzheimers.org.uk) that mentions how much clearer vision is of benefit to patients suffering with the condition (a quick online search easily reveals more similar articles). In the spirit of aiding understanding of a patient’s visual needs, I’ve tended to stop referring to near prescriptions as ‘reading spectacles’. As far as my conversations with next of kins are concerned, they’re ‘near spectacles’ or the slightly more wordy ‘glasses for things closer to’. As well as reading books or magazines, it’s seeing meals clearly, or enjoying crosswords, or appreciating greetings cards that all require a near prescription. I think this comes down to encouraging people to actually put themselves in the patient’s shoes a little more. As a more specific measure, I find it useful in practice to point out when a patient is ‘reading comfortably’ with their old prescription under our fantastic bright practice lights. Where possible, I like to repeat this process in a duller corner of the practice, to better emulate the likely darker conditions that the patient will experience when at home. SUMMARY Overall, the presence of a patient’s next of kin can be (and normally is) entirely appropriate, useful and pleasant for all involved. When there are issues of whatever sort when fitting new spectacles, though, it’s worthwhile for the dispensing optician to always be alert to whatever dynamic exists between all of those present. A patient’s willingness to ‘retrace the steps’ of the dispense for the benefit of both patient and next of kin is a good starting point to identify the source of any perceived issues. Maintaining a reserved confidence in the professional abilities of oneself (or the original dispenser) and, more importantly, leaving everyone else involved with that same impression, are good anchors around which to shift a potentially difficult situation where the patient’s best interests are believed to be seen more clearly by someone else. Playing the part of the ‘knowledgeable adult’ can be especially valuable when addressing issues that children may have with new spectacles. In the end, a lot of how these situations will be resolved depends on the seeds that have been sown at the original examination and dispense. It pays, though, for the dispensing optician to not ‘switch off’ when it comes to collections – particularly the more difficult ones. Ben Brewer BSc (Hons), FBDO is assistant manager at Shore Sight Opticians, in Braunton, Devon, having worked in optics for the last 10 years. GRANDVISION PLANS FLOAT GrandVision, the Dutch parent company of Vision Express, is to launch an Initial Public Offering (IPO) and the listing of its ordinary shares on Euronext in Amsterdam. The IPO would consist of a secondary offering of 20-25 per cent of the shares by GrandVision’s founding shareholder, HAL Optical Investments, an indirect subsidiary of HAL Holding. With a portfolio of 33 leading optical retail banners in 43 countries, with more than 5,600 stores, GrandVision achieved revenue of €2.6bn in 2013 and continued growth in the first nine months of 2014 with revenue of €2.1bn. The company said it expected this market to continue to expand due to a growing and ageing global population, under-penetration, and the emerging middle class. Theo Kiesselbach, CEO of GrandVision, said: “Starting in 1996, GrandVision has, at an incredible pace, grown to become the global leader in optical retail. We believe that this IPO now marks a milestone in the history of GrandVision. With this we feel the responsibility to work even harder to bring high quality and affordable eyecare to more and more people around the world.” 30 Dispensing Optics FEBRUARY 2015 There will be a two-year gap after this year’s BCLA conference, so practitioners are being urged not to miss this year’s event in Liverpool EvEnts New chapter at #BCLA2015 he 39th British Contact Lens Association (BCLA) clinical conference and exhibition, to be held at the ACC Liverpool, from 29-31 May, is expected to signify a new chapter for the Association and its members. With booking channels now open via the Association’s newly refreshed website, BCLA members are being invited to make the most of the Association’s Member Loyalty Scheme to obtain the best discounts on delegate packages by the early bird deadline of 31 March. ABDO members are also being invited to save via a special offer to claim a £50 discount on the price of a delegate package by simply downloading the BCLA’s new mobile app from the Google Play Store (for Android) or Apple Store (for IOS devices) and creating a profile (just search on ‘BCLA’ to find the app). A member of the BCLA team will then get in contact to provide a discount code to use when making a booking. T NEW THREE-DAY PROGRAMME Commenting on this year’s event, BCLA president, Susan Bowers, said: “Kicking off with a dedicated myopia management day on Friday 29 May, #BCLA2015 in the heart of cosmopolitan Liverpool will mark the start of our new biennial clinical conference schedule. As such, we are working closely with our industry partners and academic and business consultants to ensure that our new three-day programme appeals to as wide an audience as possible. “A fantastic, Beatles-inspired social programme – the highlight of which will be the BCLA dinner and Industry Awards in the magnificent Liverpool Anglican Cathedral – CET workshops will be free this time free CET workshops and a roll call of the most eminent speakers from the global contact lens community, will ensure #BCLA2015 marks the beginning of a new chapter in the Association’s history. “And don’t forget – there will be no BCLA clinical conference and exhibition in 2016 so don’t miss out on this world-renowned event dedicated to the world of contact lenses and the anterior eye,” Susan added. Highlights of #BCLA2015 include: • Convenient, accessible location in vibrant Liverpool city centre • Fantastic NEW venue for the BCLA at the ACC Liverpool • Dedicated Myopia Management Day on 29 May • Free CET workshops • Networking opportunities • Three-day, three-tracked streamlined event • Dedicated business session • World-renowned free industry exhibition • Beatles-themed dinner in Liverpool Anglican Cathedral • 2015 BCLA Industry Awards • Eminent keynote speakers: Professor James Wolffsohn (UK) and Dr Loretta Szczotka-Flynn (USA) • Award winners: Professor Fiona Stapleton (BCLA Medallist, Australia), Dr Michael Read (Irving Fatt Memorial Lecturer, UK), Dr Nicole Carnt (Dallos Award, Australia) Delegates will be able to build their own attendance prior to the three-day event using the brand new BCLA mobile app, which will also contain key information about the exhibition and exhibitors, the 2015 BCLA Medallist, venue, the social Professor Fiona Stapleton programme with links to social media channels. A programme of workshops can be downloaded from the Discover what’s new in the free exhibition BCLA website, www.bcla.org.uk, and a complete online programme was due to be launched by the end of January. Those who are not BCLA members are able to join the Association prior to booking on 31 March to save almost 25 per cent on the delegate rate. Group booking discounts of up to 20 per cent for 10 or more delegates are also available when booking online at www.bcla.org.uk JOIN THE FELLOWSHIP If you are a CLO and a BCLA member then why not consider applying for BCLA Fellowship. Since the scheme was launched in 2006, some 180 members of the global contact lens community have become BCLA Fellows following viva voce assessment at the BCLA clinical conference and exhibition. The Fellowship scheme is open to full BCLA members of all disciplines – including those working within industry – and allows successful candidates to use the affix FBCLA. The BCLA president presents successful candidates with their certificates during the Association’s gala dinner, if they are attending. Professor James Wolffsohn, BCLA Fellowship consultant, said: “The BCLA Fellowship scheme allows members of the contact lens community at home and abroad the chance to demonstrate high esteem in the field of contact lenses and the anterior eye. It demonstrates to both patients and peers that they have taken their commitment to the field one step further. We look forward to welcoming a new cohort of BCLA Fellows in Liverpool this May.” To apply for BCLA Fellowship, visit the ‘About us’ section of the BCLA website at www.bcla.org.uk Dispensing Optics FEBRUARY 2015 31 JoTTINgS NICOLE BANBURY recounts how taking part in a small business scheme led to a visit to Downing Street Flying the flag for independence itting at my desk on a hot summer’s day, I’d never have imagined that in December I’d be standing on the steps of 10 Downing Street. This just goes to show that, sometimes, extraordinary things do happen. Juggling the usual myriad of orders, collections, dispenses, adjustments and a whole variety of patient queries, I also try to ensure our social media is regularly updated. It was during one of these updates that I became aware of Small Business Saturday and entered the practice into Small Biz 100. Although at first glance social media doesn’t seem to translate directly to sales and profit, it does help to raise the profile of your practice, reminds people that you are there and is a great way of connecting with existing and potential future patients. Best of all it’s free and takes just a few moments to create an instant live update. For those who haven’t heard of Small Business Saturday before, it is a campaign which aims to champion small businesses across all sectors. It began in the USA in 2010 and continues annually on the first Saturday in December. The focus is on highlighting small business success and encouraging consumers to ‘shop local’. The first Small Business Saturday launched in the UK in 2013, but the campaign aims to have a lasting impact for the future. S WESTMINSTER BOUND As an independent practice, we are very aware of industry reports concerning the shrinkage of our sector. Determined not to be a statistic, we looked at ways we could differentiate the business successfully. Working as a team, every staff member is vitally important when presenting a practice that shines, and helps create a strong business for the future. Being independent should mean that you offer services and products not readily available elsewhere, and patient loyalty is key. Our application for Small Business Saturday’s Small Biz 100 encompassed our practice philosophy and we were delighted when we were selected. The campaign featured our business, location, practice photos, videos, website, Facebook page and Twitter account, together with details of our plans for Small Business Saturday on 6 December 2014. Mid-November I received an email on behalf of George Osbourne inviting me to attend a reception at Downing Street on Friday 5 December. A few days later, I received further good news. I had responded to local MP Rebecca Harris’s Facebook comment supporting Small Business Saturday, letting her know we were one of 2014 Small Biz 100. Within minutes I received a telephone call from Castle 32 Dispensing Optics FEBRUARY 2015 Point Deputy Mayor Andrew Sheldon to congratulate the practice and invite me to visit the House of Commons for a behind-the-scenes tour prior to the Downing Street reception. Parliament was fascinating and I can’t accurately put into words how it feels to be a part of the experience. Hearing the division bell calling MPs to vote on various issues, it’s impossible not to get caught up in the buzz. Votes can only be given in person, so when the bell rings the MPs run. Eight minutes later the huge doors slam shut and no more votes are allowed. I was especially tickled to discover the local pub had a division bell, which tourists often mistake for a fire alarm, leading to more than one abandoned pint. There is a real sense of history inside the Houses of Parliament. From the statue that Emmeline Pankhurst handcuffed herself to after hiding in a broom cupboard, to the centuries old wooden beams in Westminster Hall. A brief stroll on the House of Commons terrace allowed me to admire the awe-inspiring view of London’s iconic monuments. I even had time to sit with Andrew and Rebecca in the House of Commons bar, where we discussed the importance of regular eye examinations for drivers and I explained the role of the dispensing optician. A brief but brisk trot later, I managed to dash across the London traffic. After brandishing my passport and invitation, I passed through security and walked into Downing Street. The street had been transformed by the Small Business Saturday team into a Christmas Market, complete with wooden stalls and children’s choir. It was great meeting the other Small Biz 100 guests and finding out about their businesses. I even got a chance to meet businesswoman and Apprentice aide Karren Brady. After a handy tip-off from a fellow Small Biz guest, I was able to sneak my way inside Number 10, as they were letting Nicole outside Number 10 Downing Street people use the bathroom (I was very disappointed to find that there wasn’t a marble sink or a gold tap in sight!) COMMUNITY ENGAGEMENT The following day we celebrated Small Business Saturday back at the practice. Castle Point Mayor Jacqueline Govier and MP Rebecca Harris demonstrated their support by attending. We had also been featured prominently in the local press. In collaboration with Great Tarpots Library, a low vision display showcased products and services available to those living with sight impairment. An Information Station featured leaflets on eye conditions and available support. Other local groups and charities also joined forces with us, including the Art Ministry – a local charity that runs craft clubs for children and adults with sight impairment and disabilities. A fashion and styling hub demonstrated tips on choosing frames, together with predicted trends for 2015 and a vintage frame display. Throughout the day, the practice offered free OCT sessions, refreshments and goody bags containing items kindly donated by ABDO, Essilor, Johnson & Johnson Vision Care and Zeiss. Staff also joined in the fun by donning fancy dress. For us, advertising simply doesn’t work. Public perception of us as a business and patient word of mouth does. It isn’t necessarily about selling a product – it’s about selling ourselves to our patients and building a genuine connection. Patient loyalty is priceless and, for us, being a part of Small Business Saturday has been a rewarding experience. Nicole Banbury FBDO is a dispensing optician at Williams Optometrists, an independent practice in Benfleet, Essex. Frequently asked questions answered by Kim Devlin FBDO (Hons) CL PITFALLS OF ‘HELPING OUT’ A FRIEND The subject for this month’s FAQ came from a member who had been embarrassed by helping a friend out and then got into trouble with the boss. We have all encountered the situation: a ‘friend’ asks if you can get them a frame, “cheap, like” or just have a quick look at their eye, “It’s a bit pink”. The warning bell in your head should be clanging now. There is no such thing as a ‘quick look’ or a ‘cheap’ frame. It’s flattering isn’t it? Someone asks you a favour, we’re obliging types us DOs (who’d be a DO otherwise?) and you want to help. Don’t, is the best advice I can give you. For those members who are newly qualified or, indeed, members who haven’t come across the problem, let me explain further. When we exercise our professional skill or knowledge for a patient, be it dispensing spectacles or fitting contact lenses, we are obliged to use our very best efforts. This means doing everything right; you must take measurements, advise on lens design and frame choice, keep full, accurate and contemporaneous records. In short, do everything your training has taught you to do – on every occasion. The problem arises when you might be chatting to an acquaintance about your work, the conversation moves on but the acquaintance asks you, in front of everyone, could you help them out with a frame. It’s the usual scenario; cash a bit tight, broken frame held together with Elastoplast, needed for work, etc. You feel pressure to oblige, to keep face in front of everyone, so even though you feel a bit uncomfortable, you agree to find them a frame. Back at work it becomes more complicated; you try to order a frame for yourself, to get the ‘friend’ a discount but everyone seems interested and you find yourself lying to cover your discomfiture. Not professional is it? Similarly, a colleague who wants to try contact lenses again asks you to check their eyes in the lunch break; “They feel a bit sore” but that leads to them asking you to order them some diagnostic lenses just to try, unofficially, with no record, just to see how they get on. But then they want another power or design and the number of lenses grows and you’ve never even seen the prescription because you didn’t like to ask. Not what you were trained to do, is it? Set out like this in black and white it’s easy to see the problem coming but, at the time, without the benefit of experience you can easily find yourself in trouble – quite serious trouble. It’s little short of theft from an employer, which the law, and the General Optical Council (GOC), takes a very dim view of. What to do? Many of you reading this will say to yourselves, “She’s making a fuss, I’ve helped friends out and it’s never been a problem”. Maybe you just haven’t got caught? It might have been a very inconsequential thing, nothing to bother about. If that’s the case you wouldn’t have minded telling the boss: “I’ve ordered a frame for my mate Billy, said we’d do it cheap”. How would that have been received? Exactly… Whether it’s your time or goods, as an employee it’s not yours to give – unless you have permission of course. Even then, the waters are murky, suppose your boss is quite happy for you to fit a colleague with contact lenses, in the lunch break. For speed you just do what you’re asked, order the diagnostics, no real check on the slit lamp…well they’ve worn them before, they know what’s what, don’t they? Then disaster happens, your colleague lands up in A&E with something horrible, they lose their sight in that eye, which happens to be their only good eye and then they can’t work. Who will they sue do you think? You? For sure. The boss? Maybe. But whatever happens, you will be up before the Fitness to Practise panel at the GOC, charged with unprofessional conduct – and rightly so. You didn’t act in a professional way because it was a colleague and you were doing them a favour. This is the worst case scenario, but it happens. Take a moment to think how you might react to such a request from a friend. You can refuse, of course, blame the boss, “Oh he’s very strict about things like that”, or just explain how there’s a right way of doing it and that’s for a very good reason. This protects the patient and practitioner if the unthinkable happens. Kim Devlin is chair of ABDO’s Advice and Guidelines Working Group Dispensing Optics FEBRUARY 2015 33 Classified advertisements ABDO CET Administrator Administrator required for ABDO CET department Based in the Colchester office, the position would be for Tuesday to Friday mornings (hours by arrangement) The applicant must be competent with Microsoft Office software and Adobe Acrobat, and must be familiar with working with databases ABDO President’s Consultation Day 20 May 2015 To be held at the offices of the Association of Optometrists 2 Woodbridge Street London EC1R 0DG To book your place, email Jane Burnand at [email protected] DO YOU SPEAK THE LINGO? Please send a CV with covering letter by post to Paula Stevens, ABDO CET 5 Kingsford Business Centre, Layer Road Kingsford, Colchester CO2 0HT For further details telephone 01206 734155 CLASSIfIEdS Overview Optician Index - Report November 2014 • All of our Key Performance Indicators showed an improvement over last month and were higher than the Index values posted in November 2013 • Total eye examinations improved by seven per cent on last month to 107 Index points and this is five per cent higher than November 2013 • Total turnover is four per cent higher than last month at 172 Index points, which is the highest figure we have seen since May 2014 • The sales volume of single vision and bi/tri focal lenses were both around 13 per cent higher than last month • The sample average dispensing rate has increased by two percentage points from last month to 64 per cent and this is three percentage points higher than November 2013 • The value of solutions sold has increased dramatically from November 2013 by 20 per cent to 95 Index points The December 2014 report, which tracks changes throughout 2014, was published in the 30 January 2015 issue of Optician. 34 Dispensing Optics FEBRUARY 2015 New this month on Eyecare FAQ, you’ll find an infographic to share on low vision as well as an optical lingo bingo card full of eye disease related words. How many are you using every day? And do patients know what you mean? You can use any of the FAQ answers and images on your own blog or website. Follow, like and share these useful resources on your practice and personal social media channels, to help the public learn about eyecare and to promote the role of the registered dispensing optician. Get involved with EyecareFAQ, ABDO’s campaign to help consumers learn more about looking after their eyes, and the role of the registered dispensing optician. You can find eyecare FAQ at: • www.facebook.com/eyecarefaq • www.twitter.com/eyecarefaq • plus.google.com/+eyecarefaq • Or visit the website, www.abdo.org.uk/information-for-thepublic/eyecarefaq/ Download the free BCLA App today and create a profile to receive an exclusive £50 off your delegate fee for next year’s Clinical Conference & Exhibition* 2015 39th BCLA Clinical Conference 29 - 31 May ACC, Liverpool & Exhibition Join over 1,000 colleagues at the largest Clinical Conference and Exhibition dedicated to contact lenses and the anterior eye. The conference will offer delegates: • C entrally located venue with excellent transport links • A day dedicated to myopia management • M ore hands on workshops - offered FREE for the first time n exciting mix of networking, social events • A including the welcome drinks reception and the Gala Dinner held at the spectacular Liverpool Anglican Cathedral Available to download from the App Store or Google Play Keynote Speakers Professor Fiona Stapleton • BCLA Medallist • New improved event app • More compact three-day programme • A n average of 40 CET points in a host of core competencies. To find out more and book your place go to www.bcla.org.uk, email [email protected] or call the BCLA team on 020 7580 6661. • Dr Michael Read Irving Fatt Lecturer • Dr Nicole Carnt - 2015 Dallos Award • Professor Loretta Szczotka-Flynn • Professor James Wolffsohn *T&C’s apply www.bcla.org.uk www.bcla.org.uk choose your ATTITUDE shamir atTitudeiii ® sport Fashion Two new prescription sunwear lenses, one for sports and another for fashion. Designed to fit a wide range of frames, flat or wraparound, they are suitable for every type of sport and an active modern lifestyle. Available for Progressive and Single Vision. Choose Your Attitude on Stand L210 at 100% Optical Sat 7th to Mon 9th Feb 2015, Excel London www.shamirlens.co.uk