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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
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Dispensing Optics FEBRUARY 2015
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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
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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
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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
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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
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