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APRIL 2015
DISPENSING
OPTICS
NE WS , I NFORMATION and
ED UC ATI ON for OP TIC IANS
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Dispensing Optics APRIL 2015
Contents
12.
32.
37.
38.
17.
Features
35.
18.
36.
Pushing the boundaries
Area news
Round-up of the latest regional events
20.
Sunwear in the spotlight
38.
CET Answers
Considering ocular motor balance in dispensing
by Stephen Freeman
32.
ABDO overseas
Shanghai surprise
by Elaine Grisdale
Continuing Education & Training
OCD on OCT
by Andrew Keirl
30.
Mido 2015
The Italian job
Sunglasses & UV protection
22.
ABDO Conference
Regulars
5.
DO Dispatches
6.
Black Arts
by ABDO president, Peter Black
Business
Real life stories to promote your practice
by Antonia Chitty
8.
News
40.
Jottings
Age is just a state of mind
by Brad Parkes
FRONT COVER
Silhouette x Felder Felder:
product code 9907, colour
is 6050
42.
Classifieds
Dispensing Optics APRIL 2015
3
ABDO at Optrafair
18 - 20 April 2015 • Birmingham NEC
ABDO CET LECTURES
Saturday 18 and Sunday 19 April 2015
• Featuring internationally acclaimed speakers
• Including special guest Bernard Maitenaz, the inventor of Varilux lenses
• Each lecture is approved for 1 interactive CET point and free to attend
• Book your place for lectures online via the Optrafair website at optrafair.co.uk
ABDO PAEDIATRIC DISPENSING WORKSHOPS
Monday 20 April 2015 at 9.30am, 11.00am, 12.30pm and 2.00p m
• The workshops are free to attend and approved for 3 interactive CET points
• Admission is strictly limited
• No advanced booking, places will be available on the day on a first-come, first served basis
ABDO CET WILL BE HELD AT THE ABDO THEATRE (T60) AND IS APPROVED FOR
DISPENSING OPTICIANS AND OPTOMETRISTS
ABDO AND FMO NETWORKING PARTY
Sunday 19 April 2015
• A unique opportunity for ABDO and FMO members to get together
• Live music, drinks and canapés
• The party is free for ABDO members to attend
• Admission is strictly by ticket only
• Book your party ticket online at www.abdo.org.uk/events
ABDO AT THE ASSOCIATION LOUNGE
• ABDO board members and ABDO staff will be on hand in The Association Lounge at S50
• An opportunity to discuss ABDO’s strategies and to let us know your views
• Find out more about the 2015 ABDO INSIGHT programme with ITN Productions
ABDO COLLEGE
• Visit the ABDO College team on stand H17
• Find more about the extensive range of ABDO College courses
• Come and discuss the College’s degree programmes run in conjunction with Canterbury
Christ Church University and how they apply to you
• ABDO College Bookshop will be exhibiting a selection of its best-selling publications including the new 2015 edition of Ophthalmic Lenses Availability
For more information about Optrafair and to register online for the show visit optrafair.co.uk
Optrafair 2015
THE MUST-ATTEND EVENT FOR EVERY ABDO MEMBER
Optrafair is the leading UK exhibition and educational conference dedicated to the needs
of the optical profession since 1978. As an official event partner ABDO will have a strong
presence at the show and has organised a number of special and events and activities.
The Association therefore urges its members to attend and thereby benefit from all that
the show has to offer - we look forward to seeing you there!
CET LECTURES & WORKSHOPS ● ABDO / FMO NETWORKING PARTY ● THE UK’s LARGEST OPTICAL EXHIBITION
Association of British Dispensing Opticians
DISPENSING OPTICS
The Professional Journal of the Association
of British Dispensing Opticians
VOLUME 30 NO 4
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
£140
UK
£150, including postage
Overseas
Tom Veti
Apply to
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
DISPENSING OPTICS IS PUBLISHED BY
ABDO, 199 Gloucester Terrace, London W2 6LD
DISPENSING OPTICS IS PRINTED BY
Lavenham Press, Lavenham, Suffolk CO10 9RN
DO Dispatches
BIGGER IN BIRMINGHAM
I am delighted to confirm that ABDO will
have an even bigger presence at Optrafair in
Birmingham later this month, than we have
done in previous years.
In addition to the normal Association and ABDO College stands,
we will be providing innovative and challenging CET for
members in a specially designed lecture theatre inside the main
exhibition hall.
This, coupled with a major networking reception on the Sunday
evening, run jointly with the Federation of Manufacturing
Opticians, will provide our members with a wide range of
opportunities to mix with colleagues whilst attending what is
likely to be a very successful show.
The ABDO president and I look forward to seeing as many
members as possible over the three days.
MAKE A DATE FOR MANCHESTER
While we are looking ahead, I would like to remind everyone to
put the dates for this year’s ABDO Conference – 20 and 21
September – in their diaries. Plans for this year are almost
finalised and the conference team are determined to deliver
the “best conference for years” with a mix of CET, social events
and the exhibition. Read more about what’s in store on the
programme on page 35 of this issue, in the first of a series of
previews we’ll be publishing in the run-up to the event.
We hope you enjoy this issue, featuring some of the latest
product innovations in sunwear, a review of Mido 2015, a look
at how to use case studies to build your practice business by
Antonia Chitty, and a report from ABDO’s Elaine Grisdale about
her recent trip to China to explore future collaborative
possibilities. Our excellent CET article this month is by Andrew
Keirl on the subject of OCT.
Sir Anthony Garrett
ABDO general secretary
© 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
Dispensing Optics APRIL 2015
5
BLACK
ARTS
PETER BLACK
Our monthly column from the ABDO president
The auditors revisited
y column last month, and
especially its section,
‘Beware the auditors are
coming’, created a small
ripple of outrage
amongst some members so I thought it
would be worth clarifying matters further.
All seem to agree that optometrists
need to make it very clear why they are
issuing a GOS3 voucher if the practice is to
avoid accusations of over-prescribing and
improper use of NHS funds. Despite what
certain optometric advisers say, we all know
that even an 0.25 change can make a
significant difference to the vision of some
patients. However, if that improvement in
visual acuity from the old Rx to the new Rx
is not documented then a voucher should
not be issued unless on grounds of fair wear
and tear, which also must be documented
to avoid repayment of funds following a
post payment verification visit.
M
POLICING OPTOMETRY: A DO’S JOB?
What some members were less happy with
is the notion that it is the responsibility
of a dispensing optician contractor to
police the record keeping of the optometrists
in their employment. One wrote: “…I fail
to see that it is my job to police what is or
is not done in a GOS eye test. This is the
responsibility of the optometrist
and why each optometrist has their own
professional indemnity”.
I’m afraid I disagree. A GOS contract is
with the contractor, not the performer and
if any money is to be repaid to the NHS
then it will be the contractor who will have
to repay it. That said, optometrists guilty of
fraudulent prescribing, or poor record
keeping that supports the reclaiming of
fees, can expect to be sued by the
contractor (which may be a DO, another
optometrist owner, or a company) to
reclaim any fees.
Dispensing opticians who are the
contractors themselves (as business owners),
or who work for a company contractor with
6
Dispensing Optics APRIL 2015
optometrist performers, are quite likely to
find themselves on the hook for fitness to
practise proceedings if optometrists’
records are found wanting and/or GOS
vouchers have been issued unnecessarily.
What should a record include? What
should be done in a sight test is prescribed
by law and includes: an external eye
examination; an internal eye examination;
any other tests deemed necessary.
Afterwards, a statement is issued which
should include an Rx if required.
I am aware of PPV visits seeking to
reclaim sight test fees because there was no
evidence of an external exam (pupil
reactions, etc) having been done. It
certainly makes one wonder what lengths
the NHS might go to in order to reclaim
money it believes it has overpaid on what is
essentially a technicality. If a sight test fee
is reclaimed then any voucher issued must
also be repaid too it seems.
Contractors and practice managers can get
further information on contract compliance
from www.qualityinoptometry.co.uk and on
legal compliance from the GOC website by
searching ‘Opticians Act’ or ‘Rules of Council’
as well as ABDO advice and guidelines.
A COMPARISON WITH PHARMACY
It is often said that the relationship
between the dispensing optician and
optometrist is similar to that of the
pharmacist and doctor. Recently a friend of
mine was relieved that a vigilant pharmacist
noticed that a doctor had prescribed an
adult dose of medicine for his then sixmonth old daughter that he was told could
well have been fatal had she reached the
end of the course.
Our work might not be life and death,
but checking each other’s work, and record
keeping in particular, helps us get things
right first time, can save the practice money
and, most importantly, save patients being
put to unnecessary inconvenience and risk.
Yet these days many dispensing opticians
barely get the information they need to do
their jobs properly let alone any means of
checking up on their colleagues’ record
keeping. Overzealous data protection means
DOs often do not have access to the clinical
records they need to make sense of a patient’s
visual needs and expectations, let alone act
as NHS contract police.
ILLEGAL SUPPLY
Law and professional conduct have been on
my mind a lot recently and I’ve been
refreshing my memory of the Opticians Act
as I was asked to attend the GOC’s steering
group on illegal supply, which seeks to address
illegal supply of contact lenses in part through
the development of a voluntary code.
The online retailers are represented on
the group and it is clear that in return for
them cleaning up their act, they will expect
the High Street to clean up its own – in
particular how many practices are still
failing to issue contact lens specifications
when they should?
I must confess that I am rather
disappointed that the GOC is only looking
at illegal supply of contact lenses when
there is so much illegal supply of spectacles.
Every day we come across illegal ‘dispensing’
whether in person or online, including:
• Failure of online retailers to verify their
customers are over 16 and not registered
sight impaired;
• Failure of online and community optical
retailers to check and record spectacle
vertex distance for all Rx over +/-5.00D
where necessary or record that no
compensation is required
• Failure of sight testers to provide BVD
in the first place on Rx over +-5.00D in
the highest meridian including any
reading addition where prescribed
• Failure of companies to ensure adequate
supervision of non-registered staff
dispensing optical appliances to
regulated groups
• Failure of supervisors to ensure adequate
advice to parents of patients at risk of
permanent visual loss due to amblyopia
•
Sale of spectacle mounted low vision aids
by non-registered people or companies
• Sale of multifocal spectacles online
• Sale of multifocal ready readers online,
via mail order and in practices
• Sale of prescription spectacles that do
not conform to British Standards
• Sale of ready readers that do not conform
to British Standards, etc
I would hold that although much of
ophthalmic dispensing has been deregulated
it should still be of concern to the GOC if
companies and individuals regularly break
the Rules of Council or the Opticians Act. It
is not sufficient, nor in the public interest,
to divert complaints towards the Optical
Consumer Complaints Service or Trading
Standards. I hope that the GOC will turn its
attention to these points very soon as part
of its ongoing reviews of profession
standards, business registration, and in
getting an Opticians Act that is fit for
purpose in the future.
Another area where the Opticians Act is
totally failing the industry is in prescribing
precisely what must be done in a sight test.
Optometry is alone in suffering this
ridiculous indignity, and also alone in being
unable to delegate any party of its core
function too. Increasing scope of practice
for optometrists seems to be possible
through the College of Optometrists, or via
a local arrangement with ophthalmology,
which is neither nationally recognised nor
transferrable.
Compare this to other professions such
as medicine and nursing. I attended an
ophthalmic nursing conference in Bath in
March and was surprised to learn what
nurse practitioners get up to in the eye
department with as little as six months
specialist training in order to meet the
needs of patients in a service under
immense pressure.
In a glaucoma clinic, for example, not
only can nurses do pretty much everything
an optometrist can do including fairly
advanced techniques such as Goldmann
applanation tonometry, gonioscopy, and
dilated fundus assessment, but they also
make clinical decisions on the management
of glaucoma patients. Nurses are giving
intra-vitreal injections for the treatment of
AMD, conducting corneal cross-linking
therapy on keratoconics, and fitting
@
Letters
therapeutic bandage contact lenses on
patients with a wide variety of difficult eye
problems. They weren’t doing this five years
ago, and there was no need for a change in
the law to allow them to do so. It rather
brings the refraction debate into perspective
doesn’t it?
So why can’t dispensing opticians and
optometrists get in on the act and deliver
some of the services currently delivered in
the overstretched hospital eye service
(HES)? The truth is they already do. We
heard in last month’s Jottings from CLO,
Max Halford, who is Diabetic Retinal
Screening lead for Devon LOC and I have
met many DOs and CLOs who work in the
HES in specialist low vision and contact
lens fitting roles and increasingly CLOs are
getting involved in MECS (minor eye
conditions services) and other locally
commissioned enhanced services.
For opticians to really make the most of
potential career development opportunities,
and for the public to get the eyecare service
they deserve, there needs to be a radical
rethink of the training that is made available.
A presentation by Moorfields Eye Hospital
at 100% Optical stated that more than 30
per cent of all ophthalmic A&E cases are for
dry eye, blepharitis and other simple eye
conditions that are neither accidents nor
emergencies. The time is ripe for there to be
a nationally commissioned service for
community opticians to deal with such
routine procedures, and free up the HES to
do what it does best. And the time is right
for opticians and optometrists to have their
skills recognised by the HES too.
WHAT’S NEW IN
EYECARE FAQ?
New this month on Eyecare FAQ,
you’ll find an infographic to share
on glaucoma, FAQs on the disease
as well as an optical lingo bingo
card full of glaucoma 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
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-the-public/eyecarefaq/
and promote the role of the registered
dispensing optician.
HAVE YOUR SAY
Email [email protected] or write to
Dispensing Optics, PO Box 233, Crowborough TN27 3AB
Follow us on Twitter
@ABDOCollege and
@MembershipABDO
Dispensing Optics APRIL 2015
7
NEWS
UPDATED ONLINE CONTACT LENS RESOURCE
Barry Duncan
NEW ROLE IN POLICY
AND DEVELOPMENT
Barry Duncan has been appointed to the
newly created role of ABDO head of
policy and development.
A past president of ABDO, Barry has
served the Association as members’ support
manager since October 2011. Since that time,
Barry has played a leading role in assisting
Area members in the regions and developing
the profession at a local level, engaging
with LOCSU and liaising with Optometry
Scotland, Wales and Northern Ireland.
ABDO general secretary, Tony Garrett,
commented: “This new appointment
reflects Barry’s enhanced role following on
from the introduction of the new CET
scheme. In particular, Barry will take the
lead on policy and new projects affecting
members in everyday practice. This is an
exciting and challenging time within optics
and I am sure everyone will want wish
Barry every success in the future.”
LOW INCREASE IN
VOUCHER VALUES
GOS voucher values for 1 April 2015 to
31 March 2016 are increasing by an
overall one per cent in England, Wales
and Scotland.
An Optometric Fees Negotiating
Committee spokesperson said: “We are
disappointed at the low voucher value
increase this year. We made strong
representations to the government about the
importance of a realistic increase in voucher
values because they affect the range and
quality of spectacles optical practices can
make available to patients. But despite our
best efforts, the government has so far
failed to address the bizarre anomaly
whereby if they help patients by holding
down dental and prescription charges, they
conversely penalise NHS spectacle wearers.
“We will continue to press NHS England
and the Department of Health on this issue.’’
The new voucher values can be downloaded
at www.fodo.com
8
Dispensing Optics APRIL 2015
Alcon’s updated Guide to Clinical Contact Lens Management has joined its portfolio of
online resources available on myalcon.com/cclm
The guide, edited by Dr Lyndon Jones, director of the Centre for Contact Lens
Research at the University of Waterloo School of Optometry & Vision Science, Canada,
provides a compact summary of signs, symptoms and management options of a broad
range of anterior segment and contact lens-related conditions. There is also a section
specific to contact lens fitting complications.
“We are pleased to partner with Dr Lyndon Jones and his team to provide a practical
guide that has application for both the novice and experienced eyecare professional,”
said Carla Mack, director of US professional and clinical support for Alcon.
Dr Jones added: “With contact lens knowledge evolving so rapidly, text books are
often out-of-date soon after they are published. This web-based resource is a dynamic
source of information, which will be frequently updated with new images, videos and
treatment suggestions.”
* The Alcon Air Optix Colors team was at the Bullring Shopping Centre in Birmingham
recently for a ‘pop-up’ event to promote the range direct to consumers. Shoppers could
virtually try on the lenses using digital augmented reality screens, or experience the
lenses for real with the help of the eyecare professionals on hand.
Contact lens campaign hits the shops
RIMLESS COLLECTION ENHANCED
Model SI 93650 is the
latest addition to Stepper’s
rimless collection of
classic, elegant frames.
“Our latest rimless
frames are a vivid addition
to the strong selling Stepper
rimless collection,” said
managing director, Richard
New Stepper model SI 93650
Crook. “They make a rich
and striking statement and will create visual interest to any frame display.”
The superlight titanium frame weighs only 3.8g, and it can be adjusted to maximise
fit for the wearer. The six colour options include Electric Orange and Shocking Pink. “This
frame is a great way for those who love colour to express themselves with a most beautiful
pair of spectacles,” added Richard.
SOFTWARE DEMOS OFFERED
Orasis practice management software will launch the latest version of its software at
Optrafair this month.
Linus Mason, director of Orasis, will be conducting demos every day and will be
joined by developer, David Francis, and other members of the Orasis team.
Linus said: “We understand how busy it is in practice and the improvements we have made
to the software will ensure Orasis increases the practice efficiency with fast user input.”
STEPPER titanium frames are half the weight of conventional
metal frames, corrosion resistant and hypo-allergenic
EYEWEAR FASHION THAT FITS
Stepper UK Limited
11 Tannery Road
Tonbridge
Kent
TN9 1RF
01732 375975
NEWS
Alex Gage (centre) with staff
BIG BLUE BEHAVIOUR
A Sheffield Optometrist turned his
practices blue to raise awareness of
World Autism Day on 2 April.
The blue themes at Alex Gage Family
Optometrist included blue balloons
outside the Crosspool and Woodseats
practices, staff wearing blue wigs and
items of clothing and a competition to win
coloured prizes throughout the day.
Alex was inspired to take part in the
initiative after specialising in behavioural
optometry; a branch of optics that studies
how vision can affect human performance.
He said: “Autism can come with a range of
challenges in making sense of the world. In
behavioural optometry, we work to make
the information coming into the eyes good
information, as in they can see clearly, and
then we work to help process that
information and make sense of what they
are seeing.”
FUTURE OF OPTICS
IN SIGHT
ALL SET FOR
OPTRAFAIR EDUCATION
A project designed to look at the impact
of technology on the entire optical
sector has been commissioned by the
Optical Confederation and the College of
Optometrists, with joint funding from
the Central (LOC) Fund.
With an Oversight Group chaired by
Alan Tinger, the Foresight Project has
commissioned the independent Think Tank,
2020Health, to undertake the underpinning
research. Julia Manning, chief executive and
founder of 2020Health, practiced as an
optometrist for 19 years.
The research project is in four stages.
Phase 1 will look at future technology
worldwide, taking into account the changing
demographic make-up of the UK. Phase 2
will look at the effect of Phase 1 on business
models in optics, and the final two phases
will look at the impact on education across
the professions and on regulation.
Alan Tinger said: “This is a very timely
and important piece of work with online
and mobile digital health technologies
developing at an exponential rate. All
innovation has the potential to be disruptive,
so it is vital for us to understand the impact
of developments on the sector, and in
particular what they could mean for all the
professional groups, plan ahead and make
the findings available to the sector so that
people can be as well informed as they can
be about the possible future.
“The sector is indebted to the Central
(LOC) Fund for its generosity in supporting
the proposal and providing funding to get
it off the ground,” Alan added.
Some 121 CET points will be offered at
Optrafair 2015 in Birmingham this
month through seminars, panel led
discussions, hands-on equipment
workshops and peer discussion.
Delegates can earn up to 36 CET
points over the three days from sessions
in the two large education theatres and
four workshop spaces at the heart of
the show – and not forgetting ABDO’s
CET programme on Saturday and
Sunday 18 and 19 April, and paediatric
dispensing workshops on Monday 20 April
(see our preview in the March issue of
Dispensing Optics).
Highlights of the show include the
‘Show and tell’ workshops in which leading
manufacturers present the latest in
optometric instrumentation, and peer
discussions focusing on the theme of
safeguarding children and vulnerable
adults – a major new area for governance
which will require optical professionals to
update their skills. Delegates can also
attend a variety of valuable seminars, and
hear ‘expert opinions’ from renowned
industry figures, including special ABDO
guest, Bernard Maitenaz, the inventor of
Varilux lenses.
Alongside the exhibition, the
General Optical Council will be holding
consultation workshops on the future
standards of practice using feedback from
practitioners. These sessions also carry
three CET points. A ‘Question Time’ style
panel debate on Saturday 18 April at
4.30pm will discuss the future of retail
optics chaired by BBC Radio 4’s
Peter White.
Read all the latest news and book
places at www.optrafair.co.uk
NEW HEAD OF SALES
To support its investment in Europe, mark’ennovy Personalised Care has appointed
Gary Daniels as its new sales director for the UK and Ireland.
Gary, who has experience in the contact lens industry and with large global corporations
such as Procter & Gamble and Mars, said: “I am thrilled at being a part of such a great business
that places customer service, quality and innovation at the forefront of its core principles.”
DIGITAL CONSULTATIONS PROVING POPULAR
An app to help with that
10
Dispensing Optics APRIL 2015
Cutting-edge technology is playing an increasingly important role in helping
opticians consult effectively with patients, says Rodenstock.
“Opticians are recognising that they need to really make themselves stand out in the
optical market against tough opposition from the High Street and internet,” said
Rodenstock lens product manager, Debbie Bathgate. “It’s no longer enough to just supply
the same lenses the consumer has always had – they can do that themselves online.
“To stand out as a specialist you need to talk about the very best solutions available
to each customer, every time,” Debbie continued. “You can do that by making the most of
available consulting tools, either electronic and interactive with the Rodenstock
Impression Consulting for PC or Virtual Consulting app for iPad, or with more traditional
tactile products like the Rodenstock Competence Centre to effectively demonstrate the
benefits of superior products.”
NEWS
Bryony Pawinska
Titan One from Silhouette
NEW ONE-PIECE
RIMLESS SERIES
Silhouette debuted its new one-piece
construction frame – Titan One – at Mido
last month (see our report on pages 36-37).
The latest innovation in the company’s
iconic Titan series, Titan One lenses are
attached at only one point, with no screws
and no hinges, and both the temples and
bridge are made from a single piece of
high-tech titanium around 50cm long.
“The precise manufacturing process
combined with the inherent material
properties deliver a product that is minimal
and functional whilst also flexible, sturdy
and comfortable to wear,” said Roland
Keplinger, Silhouette’s head designer.
Titan One will initially be available in a
Limited Signature Collection of 4,000 pieces,
weighing just 3.24g, in four models and
four colours.
I-DAY TO MARK
A DECADE
Proven Track Record (PTR) will celebrate
the 10th anniversary of its Independents
Day (i-Day) and Night (i-Night) events
on Sunday 5 and Monday 6 July.
The annual business symposium,
networking dinner and exhibition is
dedicated to those who practise in the
independent sector, and will once again be
held at the Hilton Birmingham Metropole.
The theme of this year’s i-Day is
‘Niches for riches: supplementary services
for happy patients and healthy profits’.
PTR director, Nick Atkins, said: “To celebrate
our 10th anniversary meeting, i-Day 2015
will be packed with more high-quality
business content than ever before. This
year the focus will be on additional
products and services that independents
can look to offer their patients, and
showing how carving out these so-called
niches can increase patient satisfaction
and grow practice profits.”
Visit www.independentsday.co.uk for
more details.
12
Dispensing Optics APRIL 2015
COLLEGE CEO TO RETIRE
Bryony Pawinska, chief executive of the
College of Optometrists, has announced
her plan to retire in early 2016 after
serving for more than 12 years.
Dr Cindy Tromans, chair of the
College’s Board of Trustees, said: “Bryony
has achieved a great deal since she joined
the College in 2003 with a clear mandate
for change. We now have modern and
effective governance, stable finances, well
managed operations, and a world class preregistration scheme.”
Bryony added: “It is far too early to say
how sorry I will be to leave the College, but
I will be. I do not intend to stop working –
but it is the right time for me to have a
more balanced lifestyle, and for the College
to have a fresh pair of eyes at the top.”
THEFTS LEAD TO
GOC ACTION
The General Optical Council (GOC) has
suspended Merseyside-based student
dispensing optician, Andrew Uttley, from
its registers for 12 months.
A GOC Fitness to Practise committee
found his fitness to undertake training impaired
by virtue of misconduct in dishonestly
taking monies totalling £1,111 from his
employer. Uttley is now unable to undertake
training in the UK as a dispensing optician.
At a separate hearing, Manchesterbased dispensing optician, Deborah Tripp,
was erased from the GOC register after a
Fitness to Practise committee found her
fitness to practise impaired by virtue of
convictions for theft from her employer and
false accounting.
In making its decision the committee,
chaired by Sir Alistair Graham, noted that:
“The committee had particular regard to
the fact that the offence was one of
dishonesty that took place at work and that
involved an abuse of trust. The committee
had regard to the fact that the offences
were repeated and had taken place over a
prolonged period of time.”
At the time of going to press, both still
had time to appeal their suspension and
erasure. Neither are ABDO members.
Sue Cockayne
SENIOR STAFF
MAKE TRANSITION
Following its US$1.2bn acquisition of
Sauflon, CooperVision has announced
new roles within its European business
for three senior staff.
Former Sauflon director of professional
services, Sue Cockayne, is now CooperVision
Europe professional services director.
Former Sauflon international marketing
manager, Myles Hustler, has become
CooperVision Europe head of marketing,
and former Sauflon national sales manager,
Paul Maxwell, is now CooperVision national
sales manager (UK and Ireland).
Mark Harty, president of CooperVision
Europe, said: “These appointments are key
to our commitment to support our
customers and their patients. Sue, Myles
and Paul bring an incredible amount of
experience to the wider CooperVision group
and they are already making significant
contributions to the business.”
David and Bradley Wells, former joint
managing directors of Sauflon, have left
the organisation.
SOFTWARE COMPANY
EXPANDS
Continued growth in the optical market
has prompted optical software company
Ocuco to expand its team of engineers.
Over the past year Ocuco has invested
heavily in training programmes for its
engineers with around 170 now employed,
and the Worshipful Company of Spectacle
Makers has worked with the company to
create a course that helps its engineers to
design and implement systems that
improve efficiency and profitability.
A recent satisfaction survey amongst
users of the company’s new Focus 2
upgrade showed that 82 per cent of
customers were satisfied with the product,
and that 98 per cent of customers were
satisfied with the customer support.
FRAME: Barbour B021 Black
The Norville Group, Magdala Road, Gloucester GL1 4DG
Tel: 01452 510321 • Fax: 01452 510331 • Email: [email protected]
www.norville.co.uk
NEWS
Eye Define Studio innovation
SUPPORT TOOLS FOR
BEAUTY BRAND LENS
Johnson & Johnson Vision Care has
produced new online training to support
the launch of its eye enhancement
contact lens, 1-Day Acuvue Define.
The resource includes how to
communicate the benefits of natural eye
enhancement and explains why fitting
staff with the lenses can help attract
interest from patients. A video includes top
tips for introducing the lenses to patients
without the need for additional chair time.
The training is available at
www.jnjvisioncare.co.uk/define
The company is also set to showcase
its new Eye Define Studio at roadshows
and professional events, allowing eyecare
professionals (ECPs) to experience the lens
technology firsthand, before taking the
studio out to the public. The studio booth
uses technology called EYE-D Creator,
which identifies and analyses the five
unique attributes of a women’s eye: size,
colour, shape, whiteness and shine. Based
on this analysis, with the help of their ECP,
consumers can discover how to accentuate
their own eye features with the range.
* The company recently announced
that it was discontinuing its line of Acuvue
Advance lenses with the recommendation
to upgrade to Acuvue Oasys.
CCG LOBBY ON
AMD DRUG
Clinical leaders from 120 clinical
commissioning groups (CCGs), almost 60
per cent of all CCGs, are calling on the
General Medical Council, the Department
of Health and NHS England to remove
the current barriers preventing CCGs
from commissioning “safe and effective
14
Dispensing Optics APRIL 2015
Supporting optometrists overseas
SUCCESS FOR ZAMBIA CONFERENCE
Vision Aid Overseas (VAO) hosted Zambia’s first-ever Optometrists Conference last
month, marking a milestone in the country’s evolving eyecare health system.
The event was set up to support graduates of the new three-year Optometry
Technology Diploma, which the charity helped to develop and fund, and drew 22
delegates over three days.
Delegate, Jacqueline Mwachikoka, said: “I cannot wait to start educating my
community about the importance of regular eyecare and that having healthy eyes is
more than being able to see with glasses.”
SEASIDE CROWD AT CONFERENCE
The College of Optometrists welcomed more than 700 delegates to the shores of
Brighton on 8 and 9 March for its annual conference and AGM.
The event offered delegates numerous opportunities to earn interactive CET points,
network with colleagues and visit a large
trade exhibition. New this year was the
chance to earn four additional interactive
CET points by discussing binocular vision
case studies, as well as CET for DOs
and CLOs.
Catherine Bithell, director of member
services and communications for the
College, said: “The feedback from delegates
so far has been fantastic. We work hard to
develop and grow Optometry Tomorrow
every year to make sure we meet the needs
of our members.”
Workshopping in Brighton
eyecare services” using the drug Avastin
‘off-licence’ to treat wet age-related
macular degeneration (wAMD).
David Parkins, president of the College
of Optometrists, commented: “The College
of Optometrists welcomes the…call…for
Avastin to be used off licence to treat
wAMD in place of Lucentis, and for the
£102m in savings that could be made
every year to be re-invested in the
frontline delivery of eye health services in
the interest of the patients.
“The College acknowledges the need
for an open debate around a review of the
use of Avastin to effectively treat wAMD,
but our primary responsibility is to ensure
patients receive the best possible
treatments for their eye conditions, and
for doctors to be able to make the right
choice of treatment for their patients.”
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NEWS
LANDMARK MEETING
OF STAKEHOLDERS
All things smart at Waterside
SMART MOVES FOR BIRMINGHAM SHOW
Waterside Laboratories will launch its new Elysium lens concept at Optrafair this
month, and profile its exclusive range of smart glass frame and lens technologies.
“Elysium progressives take individualised lens design to a whole new level thanks to
Digital Ray-Path Technology,” explained managing director, Bob Forgan. “When dispensed
in conjunction with our all-new innovative iPad app, which can be used by either
consumer or optical professional as part of the lens selection process, progressive
wearers can have lenses designed to match their individual needs and lifestyle.”
Bob will also be delivering in the ABDO CET programme, ‘Smart glasses: the future of
eyewear’, providing an insight into the latest developments in smart glass technology,
focusing on the opportunities this new category offers to opticians and addressing how
to overcome the new optical challenges that smart glasses will present.
Pharmacy, optical and hearing
organisations attended a landmark
meeting in Ealing on 18 February with
the local council, the clinical
commissioning group (CCG) and Health
and Wellbeing board (HWB) to discuss
health and social care in the borough, the
NHS Five Year Forward View and how
local services might be reshaped to meet
the needs of an ageing population –
including supporting more people out-ofhospital and in the community.
LOCSU MD, Katrina Venerus, said: “The
event provided an excellent opportunity to
raise awareness of the wider role
optometrists, opticians, pharmacists and
hearing care providers can play in
supporting the delivery of more services in
primary care. LOCSU and Ealing,
Hammersmith and Hounslow Local Optical
Committee look forward to working more
closely with partners across Ealing to help
deliver local outcomes for patients as part
of the Five Year Forward View.”
INVESTMENT IN ACQUISITIONS
Duncan & Todd, one of Scotland’s largest independent optical chains, has secured a
£3.5m follow-on investment from BGF (Business
Growth Fund) and additional senior debt facilities
from RBS to continue its growth and facilitate
future acquisitions.
The business recently purchased 20:20 Opticians, a
six branch retail group, consisting of four sites in
Edinburgh and two in Glasgow. The acquisition will
increase Duncan & Todd’s retail footprint to 30 branches
across Scotland and is expected to provide the business
with a strong platform and brand name to expand
further into the central belt.
Frances Duncan, managing director, said: “We are
very excited about the future. Having a material
presence in the central belt with the strong brand name
of 20:20 provides a great platform for the business to
continue its expansion across Scotland.”
Frances Duncan
TRAINEE CLO OFFER REMINDER
Trainee contact lens opticians (CLOs) in their first or second year of study, who are
members of the British Contact Lens Association (BCLA), are reminded that they are
eligible to apply for one of 50 free places at this year’s BCLA conference, being held
at the ACC Liverpool from 29-31 May.
“BCLA CLO student membership costs just £30 so if you’re not already a member,
join up quickly so you can grab one of those 50 free places,” said BCLA CEO, Cheryl
Donnelly. “As a CLO myself, I would have welcomed the opportunity to attend a BCLA
conference when I was training. Don't forget there’s always heaps of fun and freebies in
the BCLA exhibition for our delegates and visitors.”
To apply for a free place, contact the BCLA on 020 7580 6661 or email [email protected]
16
Dispensing Optics APRIL 2015
CHAMPAGNE INCENTIVE
FOR NEW JOINERS
The Association for Independent
Optometrists and Dispensing Opticians
(AIO) will be making a major membership
recruitment drive at Optrafair in
Birmingham this month, with the added
lure of champagne.
“Over the last two years, AIO
membership numbers have increased
nearly threefold demonstrating the
independent sector’s desire to belong to a
strong body that will not only represent
them with other stakeholders, but also
proactively promote independents to the
public,” said AIO chairman, Peter Warren.
“We’ll be introducing our new Code of
Conduct in 2015, enabling the public to
understand what level of care that they
will receive from independents that sign
up, and further information about the
Code will be available at the show,”
added Peter.
Anyone who joins at Optrafair will
be entered into a draw for a magnum
of champagne.
Colin Lee with his wife, Linda
CELEBRATIONS
ALL ROUND
ABDO past president, Colin Lee, celebrated
his 70th birthday at Colin Lee Opticians’
annual social event, which also marked
185 years of service between 10 members
of staff.
Those rewarded for their long service
included dispensing opticians, Margaret
Norris (20 years), Beth Ryder (10 years),
Sharon Harris (10 years) and Kim Marchant
(20 years). Clive Marchant and Mike Cody,
company directors and dispensing
opticians, presented gifts to all staff and
congratulated them on their achievements.
Also during the evening, Colin Lee
Opticians announced its Great Barr,
Birmingham, practice as 2014 Practice of
the Year. The practice will be enjoying a
special day out as their prize as well as a
trophy to display in practice for the year.
Colin said: “I had the most fantastic
birthday bash when Clive decided our
annual staff do would double as my 70th
birthday party. We were also delighted to
congratulate so many of our colleagues
who had completed such long periods of
service with us, all of whom received a well
deserved gift.”
Sohail Hakim with Salford Red Devils prop, Adrian Morley
NORTHERN EXPOSURE ON THE PITCH
Alan Miller Opticians has teamed up with the Salford Red Devils Rugby League Club
as its official eye partner.
Part of the Hakim Group, Alan Miller operates two practices in Irlam and Salford. They
will provide players and club staff with exclusive eyecare plans in a deal which, in turn,
will see the Alan Miller brand gain exposure to an estimated 250,000 Sky TV viewers and
up to 12,000 ticket holders on home match days with pitch side advertising. They will also
be featured in match day literature, club newsletters and other marketing materials.
Dispensing optician, Dhiren Patel, said: “This is an exciting new venture for us. We
are delighted to be sponsoring the Red Devils and believe the integrity and talent with
which Salford play mirrors and reflects the values held in our own business and within
the community.”
Emma receives her award
NEW MD STEPS UP
AWARD FOR FUNDRAISING MUM
Black & Lizars has appointed Geraldine
Wood as its new managing director.
Geraldine was previously the
company’s chief operating officer and has
been with the business for more than 12
years. Her appointment follows the
departure of Mark Ross, CEO, and Alison
Scammell, supply chain director. Colin
Black remains as senior optometrist.
Emma Salisbury from Kent was crowned 2015 Tesco Mum of the Year recently for her
campaigning work to raise funds for Fight for Sight.
Emma’s son, Tommy, was diagnosed with choroideremia aged five. Since his diagnosis
in 2005, Emma has raised some £400,000 to support research into the rare inherited
condition via the sight loss charity. This helped to enable initial research led by Professor
Miguel Seabra at Imperial College London to be carried out. This, in turn, helped Professor
Robert MacLaren and his team at Oxford University to carry out the world’s first clinical
trial for gene replacement therapy for choroideremia.
Emma is pictured receiving her award from DJs Fearne Cotton and Sara Cox.
Dispensing Optics APRIL 2015
17
AREA
NEWS
A warm welcome from Area 5 chairman, Clive Marchant
AREA 5 (MIDLANDS):
RECORD NUMBERS
IN DERBY
Report by Ian Hardwick
On the bright sunny springtime morning
of 2 March, our Area chairman, Clive
Marchant, welcomed a record 167
delegates to our latest CET day at the
Riverside Centre, Derby. Clive explained
that the day would be slightly different
this time, as the ABDO CET department,
membership services and support office
had undertaken a lot of the organising
and booking. He went on to thank all of
our exhibitors and sponsors, who were
Spectrum Théa, Orasis, Mainline,
Silhouette, Nikon, Orange Eyewear, Hoya,
Bollé, Optical Service, UltraVision, Wolf
Eyewear, Shamir, OWP and Zoobug.
Peter Black addresses Area 5
18
Dispensing Optics APRIL 2015
The morning session consisted of a
‘Playing it safe’ lecture by Emmanuel
Hannebicque of Bollé, worth one CET point,
followed by ‘Always say yes’, a peer
discussion by Josie Barlow of UltraVision
worth three CET points and then
‘Vocational dispensing’, a discussion
workshop by Chris Hirst of Shamir worth
three CET points. Alongside the discussions
we ran two sessions of a skills workshop
upstairs with ABDO president, Peter Black,
each worth three CET points for a
maximum of 18 delegates, which were
booked on the day on a first come, first
served basis.
Between the two discussions we had a
30-minute break, which gave delegates time
to visit the exhibition. At about 1pm we
broke for a nice buffet lunch and
considering numbers were our highest ever,
the catering staff of the Riverside Centre
did a great job making sure all were ready
for the afternoon session to commence.
During the lunch break, I caught up with
Alex France, West Midlands sales manager
of Spectrum Théa, who said: “The ABDO
Area 5 CET event allowed us to inform
delegates about our new products and
educate them about how they are used to
manage chronic eye conditions. Delegates
were very keen to learn more about our dry
eye, lid hygiene and nutritional product
ranges and keen to sample products on
practice members and patients.” She went
on to say that it was a very informative
event with a wide ‘spectrum’ of enthusiastic
delegates – leading her to re-stock samples
ready for the afternoon.
We reconvened after lunch at 2pm with
‘Everyday eye problems’, a discussion
workshop by Peter Black worth three CET
points, and then ‘Lenses for modern
lifestyles’, a lecture by John Heritage of
Hoya worth one CET point and finally, ‘The
synchronicity of the eye lens’ by Professor
Barbara Pierscionek of Fight for Sight worth
one CET point. Due to demand, Peter Black
found himself running an extra skills
workshop during the afternoon, and three
sessions of Barry Duncan’s workshop,
‘Paediatric spectacle fitting skills’, allowing
delegates to fit first hand.
Between the final two lectures we had a
short interval for tea and coffee and to give
the delegates a final chance to visit the
exhibition. From registration and then
throughout the day, we ran a poster quiz
worth two CET points; delegates were
required to be in teams of three or four and
and were able to go about answering the 12
questions at any time to suit them during
the day.
However, there will be further CET
opportunities throughout the year - the
next being on 12 May. For details of this
and future events please visit the events
section of the ABDO website.
AREA 12 (SCOTLAND):
CET WITH THE NES
Report by Fiona Anderson
UltraVision’s Josie Barlow discusses contact lens prescribing
After the day came to a close for
delegates, Clive thanked everyone for coming
and reminded them that our next CET day
would be taking place on Monday 2 November
at the Manor Hotel, Meridan, Solihull.
As the day came to a close, I asked
regular attendee of our CET events, Sarah
Thomas, what she thought of the day. She
replied: “My DO colleagues Heather Lunn,
Maureen Taylor and I have been attending
the Area 5 CET events in both Solihull and
Derby for some years now and find them an
excellent opportunity to not only gain
invaluable CET points but to learn from the
lecturers and discuss topics with our peers.
We particularly enjoyed Professor Barbara
Pierscionek's lecture as it gave an insight
into the research carried out on intraocular
implants of the future. She was such an
enthusiastic lecturer, introduced us to her
work and really made us think. It was also
very interesting to learn that research is
funded by Fight for Sight, which is
supported by our practice.
“Peter Black’s ‘Everyday eye problems’
got us all talking in his discussion workshop
and we thoroughly enjoyed John Heritage’s
excellent unbiased lecture on ‘Lenses for
modern lifestyles’, which explained freeform
designs and surfacing in such detail. What a
shame that our colleague Jenny Martin
missed the event, but someone had to cover
in the practice!” added Sarah.
As the committee packed away, it was
felt that it had all gone very smoothly. At
that point Barry Duncan came in to thank
our committee for their hard work during
the day helping to make it so successful. We
very much appreciated his words. Over the
next 24 hours, I received emails of thanks –
all highly appreciated.
AREA 11 (LONDON):
SHARING SKILLS
AND IDEAS
Report by Ian Anderson
More than 115 members attended the
first London Area meeting of 2015, on 25
February, which provided two workshops
and a VRT giving eight points in total for
the evening. On arrival, members were
able to network and browse around our
small exhibition while having a snack.
The first workshop was, ‘Prescription
analysis’ presented by Barry Duncan, giving
delegates the chance to discuss various
solutions to a prescription. This is
something we do daily in practice, but it is
useful to get alternative ideas from
colleagues. This was a last minute workshop
as the advertised workshop by Charmant
had to be cancelled due to illness.
After a short coffee break, more time for
completing the VRT and networking, there
was the second workshop, ‘Soft multifocal
contact lenses and troubleshooting’
presented by Amanda Bogers from Alcon.
There were various case scenarios that
members discussed in groups, which also
gave us alternative ways to deal with
difficult prescriptions and patients. It is with
the support of our sponsors that we were able
to put on such a great evening and also serve
food for the members. So a big thank you to
Charmant, Hoya, Wolf Eyewear and Alcon.
The evening was enjoyed by all, except
for the 25 members who did not turn up.
Unfortunately, without prior notification
their place could not be offered to others.
The demand is high for CET points and as
Area 11 has the biggest number of members.
Yet another enjoyable day was had by all
at Glasgow Caledonian University on
Sunday 1 March for a day filled with CET
funded by NES Optometry (NHS
Education for Scotland). A total of 12 points were on offer as the
day was filled by four rotating workshops
on, ‘Prescription analysis’, ‘To refer or not to
refer’, ‘New paediatric skills workshop’ and
‘A day in the life of the orthoptist’. The allnew workshops were challenging and
thought provoking, and were well received
by the delegates on the day.
Unfortunately the day was marred by
those who booked a place for the day and did
not turn up – meaning that some of the 50
delegates on the waiting list could not attend
the day and were denied the opportunity to
gain their CET.
My thanks go to all the facilitators who
did such a superb job and to Glasgow
Caledonian University for hosting the day.
Email your Area news and reports to
[email protected]
BOOKING REMINDER
Booked onto an Area CET event but
now can’t attend? Please let us
know...
“In light of the demand for places
at ABDO CET events, it is essential that
members who book to attend an event
but, due to circumstances cannot make
it, inform ABDO at the earliest
opportunity. In the early part of the
year, the number of members failing to
attend is alarmingly high. On occasion,
this has prevented colleagues on
waiting lists from attending. Members’
assistance on this matter would be
greatly appreciated,” Barry Duncan,
ABDO head of policy and development.
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 APRIL 2015
19
DUAL SELLING OPPORTUNITY WITH POLARISED COLLECTION
The INVU polarised sunglass collection, available through Norville, features
bright colours and mirror coatings in an extensive selection of sizes and
colours for one-year-olds through to teens with full UV400 protection. For
active and outdoor pursuits, the 2015 collection offers a choice of 15
attractive wrap models.
Norville also offers the INVU range as a NuPolar prescription option
with more than 80 per cent of the INVU Sunwear models being available to
prescription. “We believe this gives a great dual selling opportunity for
practitioners, encompassing the very best in polarised lens technology,”
said Frank Norville. The new NuPolar Glare Demonstrator helps show the
glare reduction effect to patients in a compact counter-top demonstration
unit for NuPolar polarised lenses. The self-contained, battery powered unit
sits neatly on a counter with glazed polarising lorgnette and an LED image
illumination switch on the top.
INVU sunglasses
from Norville
NuPolar Glare Demonstrator
reveals the lens benefits
Sunglasses & UV protection
UV danger awareness is now greater than ever as consumers appreciate the need to protect their
eyes and vision all-year long. We look at some of the latest sunwear products for your practice
Dunelm’s Sunset+ 386
Benefits of Essilor Xperio lenses
20
Dispensing Optics APRIL 2015
TOP STYLES FROM SUNRISE TO SUNSET
Dunelm Optical’s best-selling Sunset+ range has been expanded with 15
new styles. The new designs offer the latest trends in sunwear including
this unisex sports inspired wrap model (Sunset+ 386). Combining style and
practicality, this matte black frame is made from an extra strength flexible
material with UV prescription lenses to give 100 per cent protection – ideal
for biking and skiing.
Dunelm recently 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.
COVERING ALL SITUATIONS UNDER THE SUN
Essilor offers a wide range of sunwear solutions – from polarised to mirror
lenses – providing wearers protection without compromising on fashion
and style. “As with all Essilor products, the success of our range rests on the
quality of the products and the excellent service that Essilor provides,” said
Andy Hepworth, Essilor professional relations manager.
“With tinted lenses, visual fatigue or headaches can occur. But Essilor’s
Xperio polarised lenses eliminate disabling glare, offering increased visual
comfort and performance. We know that UV rays are very harmful to the
eyes and can cause short but more concerningly longer term ocular damage.
Unfortunately, patients still make the common mistake of protecting their
skin without protecting their eyes. All Xperio polarised sun lenses provide the
best UV protection, E-SPF 50+ when combined with Crizal Sun UV or
Optifog UV. The lenses are available in brown, grey and grey-green and
adapt to every wearer’s sight, covering the widest combination of lens
design and materials on the market in single vision and Varilux progressive
lenses, including the Varilux S series.
“Xperio polarised lenses are particularly efficient for driving, and research
has shown that driver reaction time is improved by one third of a second,
allowing drivers to stop their vehicles seven metres sooner at 80km/h,”
Andy added.
EYE-SUN PROTECTION FACTOR
Recommended for computer and digital device users and for those wanting
optimal UV protection, Nikon Optical’s premium clear lens coatings,
SeeCoat Plus UV and SeeCoat Blue UV, can be combined with tints and
mirrors and are available in all indices, including 1.74 and high base options.
Martin Thompson, Nikon Optical managing director, said: “Providing
ultimate contrast enhancement, SeeCoat Plus UV builds on the success of
SeeCoat to offer the best advantages in coating technologies. By improving
and re-designing the coating layers, it delivers promising enhancement in
both performance and appearance, offering the ideal level of optical clarity
ever imagined across all portions of the lens. Meanwhile, SeeCoat Blue UV
cuts and reflects UV and blue light entering the eyes, thus improving
contrast, reducing eye strain when using digital screens and protecting eyes
from UV,” Martin added.
SUNNY SIDE UP WITH B&S
Dibble Optical will launch four new collections of B&S (Breitfeld &
Schliekert) children’s sunglasses at Optrafair later this month. Exclusive to
Dibble, the German B&S brand represents “exceptional quality at modest
prices”, said managing director, Barry Dibble. The new models add a further
40 frames to an already comprehensive range – including several with
polarised mirror-coated lenses. Colour options include grey, fuchsia, blue,
light green and purple and a fresh-looking display case is available to
showcase the collection in practice.
Sunwear
Optimal UV protection
from Nikon
Eye-Sun Protection Factor
SeeCoat Plus UV SeeCoat Blue UV
Presentation case
for the B&S range
IN CONTROL OF UV PROTECTION
Following the successful introduction of Hoya BlueControl in March 2013,
Hoya now presents UV Control – a unique coating applied to the back
surface of the lenses blocking the reflection of harmful UV into the eyes.
Together with Hoya’s UV resistant lens material, UV Control is said to
offer 100 per cent protection against the harmful effects of UV and UV
related eye diseases. The coating comes as standard in combination with
Hoya’s Hi-Vision LongLife anti-reflection coating – the showpiece of the
company’s coating innovations department. Its long-lasting anti-reflective,
scratch resistant, water, dirt and dust repellent properties have been
designed to provide spectacle lens wearers with extra comfort and relaxed,
clear vision.
FASHION FUSED WITH TECHNOLOGY
Innotec, an Ogi Eyewear brand, has debuted its new three-piece collection of
sunglasses featuring Innotec’s proprietary fusion of materials and cutting
edge technology.
The masculine Denton Sun features a double laminated TR90 front with
Innotec’s signature hand painted demi pattern paired with stainless steel
temples “for lightweight comfort and unsurpassed style with an edge”. The
Fenwick Sun is made with German Wagner 5mm thin stainless steel and an
inlay of Innotec’s signature hand painted TR90 material. Finally, the Willow Sun
pairs Innotec’s signature hand painted demi pattern with flash mirror lenses, the
Innotec logo and silver rivets. All mirror lenses offer 100 per cent UV protection.
PROTECTION AND COMFORT FOR ACTIVE LIFESTYLES
Sunwise prides itself on offering practices a practical and affordable sport
prescription solution for sports and outdoor leisure pursuits.
Its Montreal White Sunglasses have low, medium and strong light
interchangeable lenses providing “superb visibility in strong glare conditions”.
All lenses provide 100 per cent protection against UVA and UVB rays while
the flat arms profile, rubber nose pads and sleeves provide extra comfort
and a secure fit. The use of Air-Flow technology allows the lenses to be
slotted at a lower level to create ventilation, ideal for high speed activities
alongside the shatterproof polycarbonate lenses.
Latest coating
option from Hoya
New three-piece
sunwear collection
from Ogi
Montreal White
sunglasses from Sunwise
Next month’s product spotlight is on contact lenses and related products.
Dispensing Optics APRIL 2015
21
COMPETENCIES COVERED
Dispensing opticians: Ocular Examination, Ocular Abnormalities, Low Vision
Contact lens opticians: Ocular Examination, Contact Lenses
Optometrists: Ocular Examination, Ocular Disease, Contact Lenses
CET
OCD on OCT
by Andrew Keirl BOptom (Hons) MCOptom FBDO
ptical coherence
tomography (OCT) is a
non-invasive imaging
technique producing highresolution images, which
show the structure of parts of the eye in
three dimensions.
OCT can be used to image the macula,
optic disc and the anterior segment (cornea
and anterior chamber angle). With more
and more community practices using OCT
in primary eyecare, dispensing opticians and
support staff may be called upon to take
scans of patients on the instruction of an
optometrist or ophthalmologist. While it is
outside of the scope of practice of the
dispensing optician to interpret OCT scans,
interpretation of an OCT image is often a
case of pattern recognition as common
features present with most diseases.
Most common data plots produced by
the OCT software use a colour coded
indicator to show how far the appearance
of the image captured is from the norm,
which can also aid in the initial screening
for certain anomalies. It is therefore
interesting and useful for the dispensing
optician taking OCT scans to be able to
differentiate the normal from the abnormal
and, in most cases, it becomes relatively
straightforward to recognise the common
abnormal ocular conditions that can be
visualised using an OCT. It is, however,
important to be familiar with the normal
anatomical structure of the eye.
OCT was first demonstrated in 19911
and has been commercially available since
O
around 1996. It has rapidly evolved as the
only non-invasive diagnostic technique able
to provide increasingly detailed and accurate
images of the retinal microstructure in vivo.
OPTICAL PRINCIPLES
All OCT machines work on the principle of
interferometry between incident and
reflected light. A beam of near infrared
light, generated from a superluminescent
diode, is directed through the tissue being
examined. The wavelength of the incident
light dictates the penetration of the beam
into the eye. Shorter wavelength infrared
will give better resolution images of more
anterior structures while a longer
wavelength will penetrate further and is
more suited for retinal viewing, as is the
case with most OCT instruments found in
optometric practice. Structures posterior to
the retina are not adequately imaged by
this technique.
The different layers and structures
within the tissue will backscatter and
reflect this light to various reproducible
degrees. The electronics and computer
software will then capture and interpret this
reflected signal and reconstruct a two- or
three-dimensional image based on the
signal received. Any obstacle in the optical
pathway (such as corneal scarring, cataract,
posterior capsular opacification, an
accumulation of inflammatory material due
to uveitis or asteroid hyalosis) has the
potential to block or reduce the strength of
the generated image thus affecting the
quality of the image captured2.
THE CLINICAL USE OF OCT
OCT has several applications in clinical
practice, the most common being the
assessment of the retina around the macula
or assessment of the optic disc. A crosssectional retinal image is produced as the
light source passing through the retina
scans across the retina, stacking and
aligning consecutive axial-scans (A-scans)
side by side to produce a two-dimensional
transverse-scan (B-scan)3.
An OCT scan covering the whole of
the macular region and captured in a few
seconds typically consists of over 30,000
A-scans giving enough high resolution to
view all the retinal layers. Consecutive
B-scans can then be aligned to produce a
3D cross-section of the retina. The image
produced resembles that of a histological
section, with contrast produced by differences
in the refractive index and scattering
properties of the different retinal layers.
Using an OCT is a bit like performing a
vertical biopsy of the retina using laser light
rather than a knife! The first OCT
instruments introduced in 1996 used a time
domain analysis system, whereby the
reflected radiation was analysed in terms of
any time delay between the reflected light
from tissue structures and that from a
moveable calibration mirror. A major
advance came in 2003 with the
introduction of Spectral or Fourier Domain
analysis, a complicated analysis process
which complements time delay with
interpretation of differences in the
oscillations within the interference
This article has been approved for 1 CET point by the GOC. It is open to all FBDO members, and associate
member optometrists. The multiple-choice questions (MCQs) for this month’s CET are available online only,
to comply with the GOC’s Good Practice Guidance for this type of CET. Insert your answers to the six MCQs
online at www.abdo.org.uk. After log-in, go to ‘CET Online’. Questions will be presented in random order.
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 August 2015 issue of Dispensing Optics. The closing date is 10 July 2015.
22
Dispensing Optics APRIL 2015
C-39649
spectrum of the tissue and reference
reflections. This latter method allows
significantly faster analysis and offers much
greater resolution in any image captured,
even allowing the visualisation of individual
photoreceptors in some systems.
In community optometry, a macular
OCT scan is invaluable in the differentiation
between wet and dry age-related macular
degeneration (AMD), therefore avoiding
unnecessary referrals and prioritising those
that do. Other clinical benefits of a macular
OCT scan include the identification of
previously undiagnosed conditions such as
vitreomacular traction and epiretinal
membranes, which may explain a slight
reduction in vision. In addition, OCT is
useful in the diagnosis of conditions such as
central serous retinopathy (CSR); early
detection of diabetic maculopathy and
screening for macular oedema following
cataract surgery.
RETINAL ANATOMY
As the images generated by an OCT
represent live in vivo histology4 a sound
working knowledge of the structures being
imaged is important. However, before we
consider abnormal retinal pathology, it is
necessary to review the structure of the
normal retina, which can be confusing.
However, this can be considerably simplified
by considering the retinal as a two-layer
structure (the neuro-retina and the retinal
pigment epithelium (RPE)).
The two layers join relatively late in
gestation and represent a weakness in
structure. Partition of the two is described
as a retinal detachment, which is not, as
many mistakenly think, the whole retina
breaking from the choroid. The neuro-retina
includes the nerve fibre layer (NFL), ganglion
cells, bipolar cells, and photoreceptors (rods
and cones). The photoreceptors convert
light into electrical impulses, which are
then transmitted to the brain and are the
most energy dependent tissue in body. A
cross-section through the retina is shown in
Figure 1.
The RPE, which is in contact with the
choroid, recycles material from the
photoreceptors (necessary to maintain
efficient function), contains pigment (melanin)
to stop internal reflections thereby preventing
‘glare’ inside the eye and pumps water out
of the neuro-retina and potential sub-retinal
space to keep it ‘dry’. The choroid supplies
oxygen and glucose to the photoreceptors
and the RPE, and has the highest blood flow
per unit area of any tissue in the body. Recall
what happens when you faint. The retina is
always working very hard.
Figure 1. The layers of the retina. Modified from Ocular Anatomy
And Histology (with permission)
The outer retina (supplied with oxygen
by the choroid) consists of the RPE and the
photoreceptors whereas the inner retina
(supplied by the central retinal artery)
comprises the nerve fibre layer, ganglion
cells and bipolar cells. It is important to
note that RPE and photoreceptors must not
part company. They act as a single unit and
any disruption to this RPE-photoreceptor
partnership can result in significant and
rapid visual loss.
A healthy macular greyscale OCT Bscan is shown in Figure 2, with the different
retinal layers identified. Differentiation of
the retinal layers is possible due to their
varying scattering properties and
differences in refractive indices. A false
colour image of the same eye is shown on
Figure 3. With a false colour image,
reflections of a higher intensity are
depicted by warm colours (yellow to red),
while less intense reflections are depicted
by cooler colours (blue to green). Images in
greyscale use brighter shading to represent
strong reflections from dense structures.
Most OCTs allow the user to switch from
greyscale to a false colour image, which can
help in identifying certain features. As the
vitreous is not very dense, it appears black.
Similarly, if fluid is present within the retina
this will also appear black.
There are two well-known areas of high
reflection (brighter in a greyscale image and
red in a colour image). These are the nerve
fibre layer (NFL) and the retinal pigment
epithelium (RPE). The NFL is an organised
collection of nerve fibres and cytoplasm,
which runs laterally along the inner surface
Figure 2. A healthy macular greyscale OCT B-scan
Dispensing Optics APRIL 2015
23
Continuing Education and Training
analysis (compared to a normative
database) along with disc, cup and
neuroretinal rim measurements, which are
useful in the detection and monitoring of
glaucoma. Pachymetry and anterior
chamber visualisation is also a feature of
most instruments.
Figure 3. A false colour image of Figure 2
of the retina towards the disc and,
combined with the internal limiting
membrane and posterior hyaloid, gives off a
high reflection on OCT and most machines
use this reflection as part of their means of
measuring NFL thickness.
The RPE is an organised monolayer of
cells at the outer retina and, together with
their apical cellular pigmentation and
Bruch’s membrane at the basal surface,
produce a high level of reflection, which is
useful in detecting the outer retinal
boundary. With age, there is a build-up of
deposits of the waste products of
photoreception on top of Bruch’s
membrane which, by the age of 60 years,
are usually large enough to cause
depigmentation of the overlying RPE
revealing them as small, discrete white
lesions or drusen. The OCT is easily able to
locate these at the outer retina. Exudates,
lipid leakage common in diabetic eye
disease, may appear similar using
ophthalmoscopy but the OCT highlights
their position towards the middle layers of
the neuroretina, clearly anterior to drusen.
The retinal layers visible on OCT are not
simply reflective bands but are cells
consisting of nuclei, cell bodies and
processes. Cell nuclei generally have a low
level of reflectance and this is seen in the
retina at the level of the ganglion cell
nuclei, the inner nuclear layer and the conerich outer nuclear layer around the fovea.
An interesting normal anatomical feature
can be observed in the foveal region, as the
outer segments of photoreceptors appear
to become oedematous (darker). This is a
normal feature of the fovea and represents
the elongation of cone photoreceptors to
enable closer packing and hence provide
high visual acuity and is indicated using the
red arrow in Figure 2 and the white arrow
in Figure 3.
The photoreceptor integrity line is the
junction between inner and outer segments
24
Dispensing Optics APRIL 2015
(IS and OS) of the photoreceptors. It is
barely visible in histological sections but
due to the difference in the refractive
indices of the inner and outer segments of
the photoreceptors, it is highly prominent
with OCT and a well demarcated IS/OS
junction suggest good photoreceptor
function.
Retinal thickness varies over the
macular region with the thinnest area being
at the very bottom of the central foveolar
pit (the umbo). There is a wide range of
retinal thicknesses in the normal population
and retinal thickness is reported to vary
according to several factors including age,
axial length, ethnicity and gender5,6,7. The
average thickness of a normal macular is
around 200 microns. A retinal thickness of
more than 250 microns is often described
as a ‘thick’ retina and is usually due to
leakage whereas a retinal thickness of less
than 150 microns is usually due to atrophy
and can be described as ‘thin’. However, it
can be difficult to assess retinal function on
thickness alone. While OCT is good at
showing swelling due to leakage, a fundus
fluorescein angiogram (FFA) is still needed
for showing blockage of blood vessels.
Retinal pathology (as seen using OCT)
can be identified in and associated with
specific layers. For example, diabetic
retinopathy and retinal vein occlusion are
associated with the inner retina (retinal
circulation), whereas AMD and central
serous retinopathy (CSR) are associated
with the outer retina (choroidal circulation).
Retinal surface pathology (mechanical
problems) includes vitreomacular traction
and epiretinal membrane. However, retinal
pathology can involve more than one layer.
For example a full thickness macular hole
involves all layers and a lamellar macular
hole usually involves the surface and inner
retina.
Most OCTs will permit a scan of the
optic disc and will provide a nerve fibre
DISEASES
It is not the intention of this article to
provide a detailed clinical discussion and
description of eye diseases but to provide a
brief overview of common abnormal ocular
conditions, which may be encountered in
practice where the use of the OCT is of
particular value.
AGE-RELATED MACULAR DEGENERATION
AMD is a major cause of ocular morbidity
and irreversible vision loss in high income
countries, accounting for over half of blind
and partial sight certifications in the UK8. If
a patient presents with suspected AMD, a
fundal examination (using a binocular
indirect ophthalmoscopy technique, for
example, a slit-lamp and fundus viewing
lens) and OCT will provide a great deal of
information towards deducing the nature of
the AMD as both the wet and dry types are
easily distinguished using macular OCT scans.
The most common type of AMD is the
dry or atrophic type, which accounts for up
to 90 percent of all cases of AMD9. Dry AMD
is characterised in its early stages by drusen
within the macular region (Figure 4). When
examined using an OCT macular scan,
drusen appear as focal, hyper-reflective
elevations of the RPE, disrupting the usually
straight and smooth appearance of the RPE
with no obvious fluid (Figure 5). The disease
usually develops slowly and patches of
retina thin and atrophy, possibly becoming
flecked with pigment. The retinal thinning is
clearly detectable by OCT. Figures 4 and 5
are images of the same eye.
Figure 4. Drusen in the macular region as
seen using digital retinal imaging. This is
characteristic of dry AMD
Figure 6. Wet AMD as seen using digital
retinal imaging. Note the haemorrhages
and grey appearance of the macular area
Figure 5. Drusen as seen using a macular OCT scan.
Note the lumpy-bumpy hyper-reflective appearance of the RPE
Wet (exudative or neovascular) AMD
(Figures 6 and 7) is associated with the
development of choroidal
neovascularisation (CNV) and is found in
approximately 10 per cent of all AMD cases.
CNV is considered to be a key clinical sign
in wet AMD and describes new (weak and
leaky) vessels growing into the sub-RPE
space caused by serous fluid leaking
through Bruch’s membrane from the
choroid. RPE elevation is indicative of wet
AMD and a cross-section of the retina using
OCT shows this ‘bulging’, often in the
absence of any significant change seen with
traditional ophthalmoscopy.
Moving the RPE away from the choroid
results in ischaemia (reduced blood supply
from the choroid), and this is the trigger for
new vessels to grow as a response. At this
stage, vision is distorted and is often
described by the patient as ‘waviness’ or
‘shimmering’. When the new vessels leak
and burst, blood enters the sub-RPE space
and causes a dramatic drop in vision. Dark
spaces within the scan represent fluid
leaking from the choroid. The fluid appears
dark because it has a low reflectance. When
fluid or blood is found above the
photoreceptors due to breaks in the
neuroretina it is classified as intra-retinal.
Figures 6 and 7 are images of the same eye.
VITREOMACULAR TRACTION
Vitreomacular traction (Figure 8) has a very
characteristic appearance with macular OCT
scans and may be seen in asymptomatic
patients. However, it can cause a reduction
in visual acuity and produce distortion on
an Amsler grid. Vitreomacular traction results
from changes in the consistency of the
vitreous (causing it to shrink away from the
retina except at points of vitreoretinal
attachment) and is seen as a thin, moderately
reflective band that pulls on the retina in an
incomplete v-shaped posterior vitreous
detachment (PVD). Traction on the retina
may lead to the formation of cysts,
distortion of the retina and macular holes.
Figure 7. Wet AMD as seen using a macular OCT scan.
Note the increase in macular thickness, disruption to the
RPE/photoreceptors and pockets of fluid
If the patient is relatively asymptomatic
and vitreomacular traction is an incidental
finding, referral to secondary care is not
required and patients should be advised to
self-monitor with an Amsler grid. However,
if vitreomacular traction has resulted in
reduced vision and the patient has
symptoms of concern, referral should be
made for possible treatment by vitrectomy
or Ocriplasmin injection. Hospitals may
recommend immediate or urgent referral in
these cases.
EPIRETINAL MEMBRANE
Epiretinal membranes (Figure 9) are often
seen during examination of the fundus but
OCT is particularly useful in confirming
diagnosis and for purposes of
documentation. An epiretinal membrane
occurs when a fibrous layer forms along the
internal limiting membrane (ILM). This
membrane often shrinks and the retina
under the membrane begins to wrinkle or
‘pucker’. It is sometimes described as
cellophane maculopathy.
On macular OCT, an epiretinal
membrane appears as a hyper-reflective
Figure 8. Vitreomacular traction as seen using an OCT scan
Dispensing Optics APRIL 2015
25
Continuing Education and Training
Figure 9. An epiretinal membrane as seen using an OCT scan. Note
the pockets of fluid that have formed beneath the retinal surface
layer at the very inner aspect of the retina
(the bright white line on the innermost
surface of the retina in Figure 9). In the
early stages, they usually cause only a mild
reduction in visual acuity. However, as the
condition progresses, membrane formation
may lead to metamorphopsia and more
severe visual impairment. Most epiretinal
membranes have an associated PVD. As
with vitreomacular traction, if an epiretinal
membrane is an incidental OCT finding and
the patient asymptomatic referral is not
required. Treatment, if required, might
include vitrectomy and a membrane peel.
CENTRAL SEROUS RETINOPATHY
Central serous retinopathy (CSR) typically
affects men in the 20 to 50 year old age
group and has been tentatively linked to
stress and individuals with a ‘Type A’
personality10. Such individuals are often
ambitious, high achievers, rigidly organised,
sensitive, impatient, take on more than
they can handle, anxious and proactive.
Presentation is usually unilateral and the
Figure 10. Central serous retinopathy as seen on an OCT scan
exact aetiology of CSR is unknown.
In CSR, fluid accumulates between the
neural retina and the RPE (Figure 10). The
OCT is very good at detecting this type of
fluid due to its low level of reflectivity.
Symptoms include blurred vision and
distortion and a hypermetropic shift is
often detected during a refraction, which is
caused by the change in shape of the
retina. CSR may or may not be visible on
fundus examination and often resolves
without intervention. Generally, the visual
prognosis is good and patients suffer no
significant permanent visual loss.
The patient represented in Figure 10
presented with a sudden loss of vision in
the left eye. The visual acuity on presentation
was 6/60. Figure 11 shows the same patient
one month later. The scan is now normal
and VA had returned to 6/6. The patient was
not referred to the hospital eye service.
DIABETIC RETINOPATHY
Diabetic retinopathy, a major cause of
blindness among the working population in
the UK11, is characterised by damage to
Figure 11. The patient represented in Figure 10 one month later. The scan is now normal
26
Dispensing Optics APRIL 2015
blood vessels in the retina with stages
ranging from mild non-proliferative
retinopathy through to severe nonproliferative and ultimately proliferative
retinopathy. A routine eye examination will
often reveal the early signs of diabetic
retinopathy, which may include retinal
pathology (haemorrhages, exudates and
swelling) and changes in refractive error
due to lenticular shape change.
The OCT is useful in assisting diagnosis
as a macular scan may reveal subtle oedema
leading to retinal thickening, which may have
been difficult to detect by fundus
examination. A macular scan may also show
hyper-reflective hard exudates located within
the inner aspect of the retina, which appear
as highly reflective intraretinal spots. Drusen,
associated with dry AMD occur in the outer
retina. A macular OCT scan of a diabetic
patient is shown in Figures 12a and 12b.
Note the pockets of fluid (dark areas) and
hard exudates in the inner retina.
MACULAR HOLE
Typically, macular holes are idiopathic and
affect elderly, late to middle-aged females
and result from vitreous traction on the
macular area. They are not usually
associated with retinal detachment but can
form after blunt trauma. The mean age of
onset is 65 years but onset in patients as
young as the third decade has been
reported. They cause a painless impairment
of central vision (a central scotoma) which
is often noticed when the fellow eye is
closed. Treatment is by vitrectomy, which is
often followed by strict postoperative facedown posturing for several weeks.
A full thickness macular hole is shown
in Figure 13. Note the subretinal fluid
surrounding the hole and the loss of
RPE/photoreceptors. The patient
represented in Figure 13 had gross
Figures 12a and 12b. A macular OCT scans of a diabetic patient (the same patient)
anisometropia, was an early presbyope (age
48) and a hydrogel contact lens wearer. A
compromise prescription had been given in
the right eye to assist near vision. The
patient had a history of right retinal
detachment surgery and mixed lens
opacities were noted in the right eye at the
last eye examination 11 months previously.
The patient attended for a contact lens
check complaining of blurred vision in the
right eye. The patient’s visual acuity was
6/30 (previously 6/7.6) and an overrefraction achieved a VA of 6/19. The
patient was dilated and a full thickness
macular hole was found using a macular
OCT scan. Interestingly she did not fit
the usual profile of a potential macular
hole patient.
Figure 14 shows the same patient one
month after treatment. Sometimes what
appears to be a full thickness macular hole
with ophthalmoscopy, though perhaps with
less impact on vision, is shown by OCT to
be less deep, or more like a depression. This
helps distinguish lesions such as lamellar
holes (Figure 15) or pseudoholes from the
full thickness hole. Management of these
lesions may be different.
Figure 13. A full thickness macular hole
GLAUCOMA
Glaucoma, a progressive optic neuropathy,
is an area where OCT could be of great
benefit within an optometric practice.
Around two per cent of white Europeans
older than 40 years have chronic open
angle glaucoma (COAG), rising to almost
10 per cent in people older than 75 years.
The prevalence may be higher in people of
black African or black Caribbean descent,
or those who have a family history of
glaucoma12. It is usually associated with
increased intraocular pressure (IOP) and
subsequent damage to the retinal nerve
fibres with a corresponding loss of
visual field.
Traditionally the diagnosis of glaucoma
includes an optic nerve head examination,
measurement of IOP, pachymetry
(measurement of corneal thickness and
correlated with IOP), gonioscopy
(assessment of the structures that form the
anterior chamber angle) and visual field
assessment. As an adjunct to these
investigations, OCT can be used to detect
and measure NFL thickness accurately
around the disc (Figure 16). The scan can
also measure the size of the disc and cup,
cup volume and thickness of the
neuroretinal rim. The data collected is
compared with an age-matched normative
database.
The thickness is measured around a ring
or annulus just outside the disc and should
be thickest inferiorly, then superiorly,
nasally and thinnest temporally (the ISNT
rule). If this ‘thickness ring’ is rolled out as a
flat graph, it has a characteristic ‘twin
peaks’ appearance (as shown in Figure 16)
and variations in this shape are significant.
NFL analysis has high specificity, which
means it should be reliable in confirming
that a patient is normal (negative).
However, a high specificity can generate a
number of false negatives and this is
important if other clinical parameters such
as raised IOP, normal central corneal
thickness (CCT) or a repeatable visual field
defect have indicated possible glaucoma.
It may be that the greatest value of
OCT in optometric practice will be as an aid
to the early detection of glaucoma and
screening of family members with routine
regular follow-up13. Many modern OCTs can
measure the thickness of the ganglion cell
layer, thinning of which is thought to be an
Figure 14. The patient represented in Figure 13
one month after treatment
Dispensing Optics APRIL 2015
27
Continuing Education and Training
Figure 15. A lamellar hole
early sign of glaucoma way ahead of the
appearance of visual field loss.
THE ANTERIOR EYE
Most OCTs have the ability to scan and
assess the cornea, anterior chamber and
angle. With a good quality scan, one can
distinguish the five corneal layers.
Measurement of the corneal thickness
(pachymetry) is straightforward and the
OCT will take numerous scans around the
central corneal region and assess overall
corneal thickness. Again this can be
compared to a normative database. The
non-contact pachymetry possible with OCT
compares well with the established contact
ultrasound technique, and is likely to be
preferred by patients.
Pachymetry is useful if a patient’s IOPs
are outside (higher than) the normal range
as a thicker than normal cornea can result
in a higher IOP measurement. The normal
CCT is around 550 microns. Figure 17
shows OCT pachymetry resulting in a
thicker than normal cornea while Figure 18
shows a keratoconic cornea with an area of
marked inferior corneal thinning indicative
of keratoconus. The 46-year-old male patient
Figure 16. A nerve fibre and optic head analysis using an OCT scan
represented in Figure 17 had been referred
to the hospital eye service (HES) on several
occasions by different practitioners for raised
IOP. His IOPs were evidently always in the
mid-20s but there were never any other
indications of glaucoma. The patient was
discharged from the HES on each occasion.
His IOPs on this occasion were 24mmHg in
both eyes. The OCT scan (Figure 17)
revealed thick corneas (CCT of 634 microns
in the right eye and 636 in the left), which
were probably the cause of the raised IOPs.
Once more, there were no other indications
of glaucoma. The patient was not referred
to the HES on this occasion.
Gonioscopy is the traditional method of
viewing the structures that form the
anterior chamber angle. However, the
technique is invasive and is not easy to
master. An OCT scan of the anterior
chamber angle is a useful alternative if the
van Herrick technique* indicates a narrow
anterior chamber angle. Figure 19 shows an
eye with a shallow anterior chamber angle.
Note the narrow gap between the back
surface of the cornea and the front surface
of the iris (iridocorneal angle). The patient
was referred to the HES for prophylactic
Figure 17. Pachymetry using an OCT scan. The normal
central corneal thickness (CCT) is around 550 microns
28
Dispensing Optics APRIL 2015
YAG laser iridotomy. Sometimes a patient
presents with what is believed to be a very
narrow angle when assessed by van Herrick,
but revealed by OCT to have a nice patent
and open angle. Unnecessary referrals can
therefore be avoided.
SUMMARY
OCT has provided eyecare practitioners
with a new awareness in the visualisation
and understanding of retinal diseases,
glaucoma detection and corneal
assessment. It is a non-invasive method of
capture of accurate and reproducible
information and should allow the
practitioner to provide eyecare with an
increased degree of confidence in his/her
diagnostic abilities. Thanks to OCT, it is now
possible to see what lies beneath the retinal
surface. However, OCT is a tool of which
there are many available and it must of
course be used in conjunction with these
other tools along with a thorough history
and symptoms.
This article is not intended to give an
in-depth clinical description of eye diseases
but the author hopes that it has been of
some interest to the reader.
Figure 18. Pachymetry in keratoconus. Note the
thin inferior corneal thickness (blue region)
11. Broadbent D M, Scott J A, Vora J P et al.
Prevalence of diabetic eye disease in an
inner city population: the Liverpool
diabetic eye study. Eye 1999 13: 160-5
12. NICE Guidelines CG85 Glaucoma:
Diagnosis and management of chronic
open angle glaucoma and ocular
hypertension 2009
13. Mahon G and McCrudden J. Optical
coherence tomography (OCT) - is it
simply pattern recognition? Optometry
in Practice 2011 12: 63-75
Figure 19. A shallow anterior chamber angle as imaged using an OCT
* The Van Herrick technique performed
using a slit-lamp bio-microscope during a
routine eye examination, is used to grade
the depth or ‘openness’ of the anterior
chamber angle.
REFERENCES
1. Huang D, Swanson E A, Lin C P, et al.
Optical coherence tomography. Science
1991 254: 1178-1181.
2. Drexler W and Fujimoto J G. State-ofthe-art retinal optical coherence
tomography. Prog. Retin. Eye Res. 2008
27: 45-88.
3. Costa R A, Skaf M, Melo L A et al. Retinal
assessment using optical coherence
tomography. Prog. Retin. Eye Res. 2006
25: 325-353.
4. Swanson E A, Izatt J A, Hee M R, et al.
In vivo retinal imaging by optical
coherence tomography. Opt. Lett. 1993
18: 1864-1866.
5. Song W K, Lee S C, Lee E S, et al.
Macular thickness variations with sex,
GOC LAUNCHES
CONSULTATION ON
NEW STANDARDS
The General Optical Council (GOC) has
launched a consultation on new standards
of practice for dispensing opticians and
optometrists, designed to promote higher
standards across the optical professions
by making it easier for registrants to
understand the regulator’s expectations.
GOC CEO and registrar, Samantha Peters,
said: “The new standards of practice bring
together in one place, and in an easy-todigest format, all the information registrants
age, and axial length in healthy subjects:
a spectral domain-optical coherence
tomography study. Invest. Ophthalmol.
Vis. Sci. 2010 51: 3913-3918.
6. Lam DS, Leung KS, Mohamed S, et al.
Regional variations in the relationship
between macular thickness
measurements and myopia. Invest.
Ophthalmol. Vis. Sci. 2007 48: 376-382.
7. Kelty PJ, Payne JF, Trivedi R H, et al.
Macular thickness assessment in
healthy eyes based on ethnicity using
Stratus OCT. Invest. Ophthalmol. Vis.Sci.
2008 49: 2668-2672.
8. Bunce C, Xing W, Wormald R. Causes of
blind and partial sight certifications in
England and Wales: April 2007–March
2008. Eye 2010 24: 1692–9.
9. Klein R, Klein B E, Linton KL. Prevalence
of age-related maculopathy. The Beaver
Dam Eye Study. Ophthalmology 1992;
99: 933-943.
10. Bennett G. Central serous retinopathy.
Br. J. Ophthalmol. 1955 39: 605-18.
need to understand what we expect of them.
They will also make it much easier for
patients to understand the standards they
should expect from their optician.
“Registrants will need to use their
professional judgement to decide how to
apply the standards in any given situation,
and may want to refer to guidance produced
by professional bodies and other organisations
in doing so, but the GOC’s standards should
always be their first port of call. I encourage
all registrants to get involved in this
consultation and provide feedback to us.
“As well as the consultation we’ll be
running an online survey of registrants and
focus groups with registrants, students and
RECOMMENDED READING
Bruce J, Chew c and Bron A. Lecture Notes:
Ophthalmology 10th ed. Blackwell 2007
Hiscox R. Discover what lies beneath.
Optometry Today April 2013.
Hiscox R. What you need to know about
OCT - Parts 1, 2 & 3. Optician November
2014, December 2014 and January 2015.
Pipe D and Rapley L. Ocular Anatomy and
Histology 3rd ed. ABDO 2008.
Jackson T. Moorfields Manual of
Ophthalmology. Elsevier 2008
ACKNOWLEDGEMENTS
David Pipe and Linda Rapley for Figure 1
and their permission to modify it for the
purpose of this article and also for their
comments on parts of the text. Bill Harvey
for his helpful comments on an earlier
version of this article.
ANDREW KEIRL is an optometrist and
dispensing optician in private practice,
associate lecturer in Optometry at
Plymouth University, ABDO principal
examiner for Professional Conduct in
Ophthalmic Dispensing and external
examiner for ABDO College.
patients. I’d encourage everyone with an
interest in our standards to let us know
what they think,” concluded Samantha.
Once finalised, the new standards of
practice will replace the GOC’s Code of
Conduct for individuals. As well as developing
new standards for fully qualified optometrists
and dispensing opticians, the GOC is also
consulting on new standards specifically for
students to recognise that their skills and
knowledge will develop during the course of
their education and training and that they
work under supervision.
Reply to the consultation by 7 June at
https://www.optical.org/en/get-involved/
consultations/index.cfm
Dispensing Optics APRIL 2015
29
Considering ocular motor balance in dispensing
by Stephen Freeman BSc (Hons), MCOptom, FBDO(Hons), Cert Ed
Question 1 was voided, as the printed version contained
an error. The online version was corrected. The marking
was adjusted so that no disadvantage ensued.
2. Which statement best describes the term
‘orthophoria’?
a. It is where only one eye deviates when occluded
b. It is said to exist when all negative fusional reserves have
been used up
c. The active and passive positions of the visual axes coincide
d. A term synonymous with decompensation in heterophoria
c is the correct answer. The coincidence of the right and
left visual axes for all distances and directions of gaze is the
true orthophoric state. This may exist, rather like
emmetropia, depending on the accuracy of assessment.
3. Which statement is UNTRUE?
a. For myopic presbyopes with anisometropia, base down
prism can successfully be removed from the more
negative lens to avoid vertical diplopia
b. Where an eye deviates nasally it indicates esophoria may
be present
c. It is possible for slightly different retinal images to be
fused if they still fall within Panum’s fusional areas
d. If a patient experiences no problems with vertical
differential prism of 2Δ their vertical fusional reserves
may be below average
d is the correct answer. In this case, the vertical
fusional reserves would be above average as about 1Δ is
generally agreed as the tolerance.
4. Complete the sentence with the correct option. The
term ‘positive fusional reserves’ in binocular single
vision refers to…
a. the maximum amount the eyes can converge measured
with base out prism
b. distance vision only
c. hypermetropes who are able to converge to read without
difficulty
d. how much the eyes can diverge before the image doubles
a is the correct answer. These are listed in Table 3.
Negative fusional reserves relate to divergence and are
measured using base in prism.
5. A first-time bifocal wearer has the prescription:
R: +1.25/-1.00 x 180, L: +0.75/-2.75 x 180 Addition
+2.75DS. Visual acuities are 6/6 R and L and N5 just
managed. Which of the following would provide the best
dispensing option to control vertical anisometropia?
a. R R25 and L R40 segments
b. R and L R28 segments as acuities are the same
c. R R40 and L R25 segments
d. R S45 and L S28 segments
c is the correct answer. There is vertical anisometropia
giving rise to 2.25Δ of vertical differential prism. The formula
gives a difference in segment diameters of 16.4mm to
eliminate this and avoid diplopia. Round segments create
base down prism at the NVP, counter-acting the base up
prism due to the distance Rx. The larger segment goes in the
most hypermetropic eye (R) as this requires the most base
down prism. The optical centres of flat top segments are
either on or just below the segment line irrespective of the
segment diameter (unless prism has been specially worked).
6. Which statement is UNTRUE?
a. Digital surfacing techniques now enable relatively small
amounts of prism to be worked on a spectacle lens
b. IFusional reserves may be increased by orthoptic exercises
even where presbyopia exists
c. 8 prism dioptres of esophoria may be present for near but
unlikely to cause symptoms
d. Deviation of an eye from fixating when occluded may be
made worse by extrinsic muscle weakness
c is the correct answer. 8Δ of esophoria would be likely
to cause convergence difficulties.
CARDS TO PUT ‘FUN’
INTO FUNDRAISING
Fundraising
birthday cards –
with four amusing
optical themes –
have been created
by Specs of
Kensington to
support Vision
Care for Homeless
People (VCHP).
30
Dispensing Optics APRIL 2015
Practice owner, Daska Barnett, said: “It is always good to
have a few cards in the drawer and these are a great way to
support a charity which is close to our hearts. A £6 donation,
for the pack of four cards, will help pay for a homeless
person to have an eye examination and spectacles.”
Visit http://uk.virginmoneygiving.com/charities/
visioncareforhomelesspeople and after passing the Gift Aid
section, tick the box that gives VCHP permission to make
contact and send the cards.
To download, print or save your CET result letter, go to
www.abdo.org.uk. Log-in and go to 'View your CET record'.
Multiple choice answers:
MCAs
abdo
COLLEGE
2015 SUMMER
PRE-EXAMINATION REVISION COURSES
ABDO College is now taking applications for its popular dispensing and contact lens
revision courses, to be held at the College in Godmersham. The following courses are available:
Tuesday 26 May
Thursday 28 May
Year 3: FQE Practical Section B
9am to 12noon
Year 1: PQE OL Theory
9am to 12noon
Year 3: FQE Practical Section C/F
1pm to 4pm
Year 1: PQE Optics Theory
1pm to 4pm
Contact Lenses: CL Anatomy Theory
2pm to 5pm
Year 3: Refractive Management Theory
9am to 12noon
Year 3: Low Vision Theory
1pm to 4pm
Year 3: Contact Lens Dispensing Theory
4pm to 6pm
Wednesday 27 May
Year 2: Advanced OL & Dispensing Theory
9am to 12noon
Year 2: Professional Conduct Theory
1pm to 4pm
Friday 29 May
Year 2: Communications Theory
4pm to 6pm
Year 1: PQE Practical
Year 3: FQE Practical Section A
9am to 12noon
Year 3: FQE Practical Section D/E
1pm to 4pm
Monday 1 June
Contact Lenses: CL Visual Optics Theory
9am to 12noon
Contact Lenses: Practical
Contact Lenses: Practice Theory
1pm to 4pm
9am to 4pm
10am to 5pm
Application deadline:
Tuesday 19 May 2015
On-site accommodation available
For course fees and an application pack
if required please contact Joan Griffin by telephone
on 01277 733 911, or email [email protected]
for further details
for these and other courses, or to request a copy of the
ABDO College Prospectus, please contact the Courses Team
on 01227 733 921 or email [email protected]
Lunch
ABDO College Operational Services, Godmersham Park
Godmersham, Canterbury, Kent CT4 7DT
is provided with full day courses and when two half day
courses are taken on the same day
www.abdocollege.org.uk
www.twitter.com/abdocollege
KEEPING EXCELLENCE IN YOUR SIGHTS
BUSINESS
Use everyday case studies to
generate fresh footfall, suggests
Antonia Chitty
Real life stories to
promote your practice
o you see other optical
practitioners appearing in
the media and want to raise
your practice profile too? Or
do you have some interesting
patients with fascinating stories that
you’d like to share? Case studies can help
promote your practice and bring in new
patients as well as showcasing the
specialist skills of you and your staff. In
this article you can learn more about how
and when to use case studies.
D
POWERFUL CALLS TO ACTION
A case study is a story, and people love to
read stories about other people’s real life
experiences. If you look at newspapers,
magazines and websites, they are full of
true life stories. The reader may feel
empathy – ‘That’s just like what happened
to me’ – and that their own experience is
validated by reading the story. Alternatively,
they may feel shock and horror – ‘How
awful, I’m glad that didn’t happen to me’ –
and although those sound like negative
feelings, they can in fact reinforce a sense
of well-being and, ‘I’m all right’.
As a practitioner, people’s true stories
and experiences are a powerful way to get
others to take action. While it is easy to say
‘an eye examination can save your sight’, it
is far more powerful to read a headline in a
newspaper about a specific event happening
to a real person, such as: ‘Eye exam saved
Jane’s sight’.
People reading any newspaper,
magazine or website tend to have a degree
of trust in the publication. Readers usually
regard journalists as independent, which is
another reason why this type of story can
have added weight. And again, there is an –
‘It could happen to me’ – factor. A story
about a young woman who has a brain
tumour detected during an eye examination
makes compelling reading for other young
women, for example.
Reading about others’ experiences can inspire patients to take action
32
Dispensing Optics APRIL 2015
Beyond the media, real life stories can
be valuable additions to your practice
literature and websites. Whether it is a
short quote as a testimonial, or a full-page
story, true stories can help you
communicate important messages. The fact
that the person in the story is independent
of your practice adds weight to their words
in a way that it wouldn’t if you told the story
yourself as the practice owner or manager.
Using case studies isn’t always
straightforward, however, which is probably
why as practitioners we don’t take action
even when someone has a life-changing
experience in the practice. Read on to find
out some more of the issues and how to
address them.
TIMING AND SENSITIVITY
One of the first issues about using
someone’s real experience is that you need
to ask their permission. This can seem
awkward at the time: if the optometrist has
detected signs that might indicate a brain
tumour, the last thing the patient needs is
for you to appear with a consent form and
ask them if they would mind appearing in
the local paper. At this point, just note what
has happened.
Often patients return after a hospital
visit and are keen to update practice staff
on what has happened to them; they have
returned because in some way they want to
tell you their story. This is a better time to
discuss whether they might be interested in
being a case study. Alternatively, after time,
you could phone up to find out how they
are getting on. Some patients won’t be
interested in being a case study at all,
which must be respected.
For many, though, talking about their
own experience can be a positive thing. They
may be motivated by the thought of seeing
their story in the newspaper, or perhaps they
may want to help other people who could
be going through the same experience.
A consent form doesn’t give you carte blanche to share the person’s details
Someone who has had their life or sight
saved by an eye exam may feel that telling
their story and helping others gives them a
reason for having gone through trauma.
Understanding more about what
motivates people to tell their stories can
help you to ask for their consent in a
sensitive way. It can help if you prepare
consent forms in advance. You need to have
space to write the person’s details, and how
their story might be used. Would you use it
only on a practice publication, on the
website, in advertising, on social media? A
written consent form with a list of possible
outlets can help the person think about
where they might be happy to see their
story, and what might make them feel
uncomfortable. Allow them time to read the
form and discuss how they feel. You could
also discuss and list on the form whether
the person is happy to speak to a journalist,
whether they would appear on TV or have
their photo taken.
You need to keep the consent forms and
any details of the person’s story,
remembering your data protection
responsibilities. A consent form doesn’t give
you carte blanche to share the person’s
details. If, for example, they have had a
story in the local newspaper and then the
local TV news show wants to cover it too,
call them and check they are still happy to
speak. A consent form is also necessary if
you want to use shorter quotes, perhaps
alongside an image, as testimonials on your
website or leaflet.
EVERY PICTURE TELLS A STORY
Images are a key element to any story. A
picture of the person is a great start. It can
also be good to have a picture that shows
how their issue was detected, such as the
practitioner and patient at the slit lamp or
tonometer. People always like to see action
shots, and it can be good to show the
person doing their favourite activity,
something they might have struggled with
if the eye problem hadn’t been detected
and treated.
If you are using the story for your
practice website or magazine, you may need
to interview the person yourself. Here are a
few tips.
1. Think about recording your discussion.
Ask the person if they mind it being
recorded so that you can check facts and
quotes. Explain that you won’t share the
recording with anyone else.
2. Set up a quiet room where the person feels
comfortable: ask if they would prefer to
speak to you in practice or in their home.
3. Provide a drink and tissues: retelling a
story can sometimes be traumatic.
4. Have a notebook and pen with you to jot
down key parts of the story.
5. Remember that people don’t always tell
a story in a logical order so you may need
to piece the story together afterwards.
6. When writing up the story, check back
Case study
ERIC (Education and Resources for Improving Childhood Continence)
Natasha Collins-Daniel, education and media manager, ERIC
(5,&LVWKH8.·VRQO\
charity providing
information and support
to children and families
suffering from childhood
continence problems.
Problems such as bedwetting,
daytime wetting, constipation
and soiling affect one in 12
children and young people
LQWKH8.(5,&SURYLGHV
DFRQÀGHQWLDOKHOSOLQH
website and online shop
selling products designed
to overcome or manage
childhood continence
problems.
As part of ERIC’s media work,
case studies are essential
to highlight the real life
experiences of children
suffering with continence
problems, and that of their
parents. ERIC’s core media
– parenting press, women’s
magazines and national press –
often require case studies with
photographs before a story is
considered.
Within ERIC, the entire team
is responsible for providing
potential case study leads to
the media manager. This might
be a marathon runner who
met our community fundraiser
or a parent commenting on
ERIC’s online message board.
A feedback questionnaire
goes to all customers of ERIC’s
online shop which includes a
tick box asking if the customer
would like to provide a case
study to help raise awareness
of ERIC’s work. Contact details
of the potential case study are
passed to the media manager.
8SRQÀUVWFRQWDFWWKHPHGLD
manager will explain why ERIC
needs case studies, how past
case studies have been used
and how the process might
work if a journalist wishes to
speak directly to the case
study. At this stage, we ask if
the case study is willing to be
photographed, and named or
if they would prefer to remain
anonymous. We explain in a
tactful way that photos are
needed for most magazines
and that they would be
helping raise awareness
and reducing the stigma by
speaking out about these
issues. We also ask what type of
media they are willing to work
with – i.e. papers/magazines,
radio and TV.
Due to the sensitive nature
of childhood continence
problems and the risk of
EXOO\LQJZHVWUXJJOHWRÀQG
parents willing to provide
photos and many wish to
remain anonymous. We never
pressure people into providing
images, or taking part in
an interview they are not
comfortable with.
ERIC’s role is to raise awareness
of childhood continence
problems and the help
available, not put children and
families at further risk. On past
occasions, we have decided
not to feature particular case
studies due to a potential
risk of misunderstanding or
persecution towards families.
Case studies are used for
a maximum of one year if
the child has overcome the
problem. After this time, it
FDQEHGLIÀFXOWIRUWKHSDUHQW
to remain as passionate
about the consequences
of childhood continence
problems as they have passed
this stage. If the problems are
ongoing, we continue to use
the case study as appropriate.
Best Practice GuideWR3RUWUD\LQJ%HQHÀFLDULHVDQG6HUYLFH8VHUV
9
A useful resource is available
from Charity Comms
using the notes and your recording to
make sure it is accurate.
7. After that, it can be good to read the
story back to the person to check that it
sounds correct to them before you use it.
If you are hoping to get some media
coverage for the story you will need a
different type of write-up. Journalists will
want to see a few short facts about the
story: what happened, and why is it
compelling and unique? Real life magazines
are often looking for stories that focus on
‘triumph over tragedy’ so emphasise the
strongest points of the story, the real highs
and lows for the person.
Remember that it may help make a
compelling case for the story if you tie your
case study into an event like National Eye
Health Week, or a relevant disease focused
day/week. Draft an email to the journalist,
and then check back and make sure that
you have covered the ‘who, when, what,
why and how’ of the story too. Remember
that you always need the person’s
permission before passing the story on. If
the journalist feels that the person’s story is
a good fit for their programme or
publication, they are likely to want to
interview the person concerned as well as
the practitioner who made the discovery.
They may want to take photos or film in
practice and/or in the person’s home.
Once you have generated some
coverage for your practice using a case
study, remember to follow up. You may
want to thank the person, either in person
or by sending a small gift. You should also
make sure that patients and the wider
public know about the coverage; you could
mention that you have been part of the
person’s story in the local media on your
practice blog and in the newsletter, with a
link to the article. Finally, always stay on
the lookout for compelling stories taking
place in the practice as they are a great way
to communicate about issues that might not
get raised otherwise, and to reach new media.
RESOURCES
• To find out more about the ethics of
journalism you can read the IPSO Code
of practice https://www.ipso.co.uk/IPSO/
cop.html
• Charity Comms has created a great report
which discusses this in more detail: ‘Show
and tell: a Best Practice Guide to portraying
beneficiaries and service users’, which you
can find at http://www.bfunded.org.uk/
uploads/files/charitycomms.pdf
ANTONIA CHITTY is starting a research
project examining how people tell stories
based on life experiences. Read more at
howtotellyourstory.wordpress.com
Dispensing Optics APRIL 2015
33
EVERYTHING A CONFERENCE SHOULD BE
T
he 2015 ABDO Conference and Exhibition
will be held at Manchester Central - an
award winning venue located in the heart of
city centre Manchester. The ABDO Conference
and Exhibition is the premiere event for
dispensing opticians and is also hailed as one
of the most convivial and rewarding networking
events in the UK optical calendar.
SOCIALISE
PARTY
ABDO
FUN
NETWORKING
GALA DINNER
DANCING
GOLF DAY
OLD
FRIENDS
GOOD COMPANY
GOOD
FOOD
CATCH UP
NET WORKING • CONFERENCE • EXHIBITION
NEW CONTACTS RELAX
ALL WELCOME
• A unique event in the 2015
optical calendar
• Opportunities to network
with convivial company
• Meet friends old and new
• Make new contacts
• All optical professionals
and students are welcome
to attend
• To reserve a place at the
pre-conference golf
tournament email
[email protected]
ONLINE BOOKING AVAILABLE SOON via www.abdo.org.uk/events
Association of British Dispensing Opticians
CITY BREAK
ABDO CONFERENCE
AND EXHIBITION
Sunday 20 and Monday 21
September 2015
Manchester Central
PRE-CONFERENCE GOLF
TOURNAMENT
Saturday 19 September 2015
PRE-CONFERENCE
WELCOME PARTY
Saturday 19 September 2015
Wolfson Reading Room,
Manchester Central Library
ABDO GALA DINNER
Sunday 20 September 2015
The Midland Hotel, Manchester
Preview
Spring is in the air so it’s time to start
counting down to this year’s ABDO
Conference in Manchester…
Pushing the boundaries
here is something for everyone
in Manchester and it’s one of
the easiest cities to get to, with
excellent transport links and
top class hotels. What better
destination then for this year’s ABDO
Conference taking place on Sunday 20
and Monday 21 September at the
Manchester Central Convention Centre.
“There are only six months to go before
our conference and it’s as exciting a
prospect as it could ever be,” said Elaine
Grisdale, ABDO head of professional
services and international development.
“This year, we’ll be truly ‘pushing the
boundaries’, offering all the CET
competencies in a comprehensive and
entertaining CET programme. Delegates will
be able to attain 27 points over the two
days through a mix of lectures and
interactive discussions and workshops.
“The combination of the venue and the
programme reflects the fact that ABDO has
stepped up a gear and continues to
innovate and surprise. Even if you are one
of the lucky ones and already have your
quota of points, it’s an event not to be
missed because of the quality of the speakers
and breadth of knowledge that is being
shared,” Elaine added.
T
PROGRAMME HIGHLIGHTS
So, what can delegates expect? This year,
delegates can make an early start with
breakfast peer discussion. Keynote lectures
will feature two internationally acclaimed
Dr Margaret Woodhouse OBE
speakers tackling subjects they are passionate
about. “We are delighted to welcome as one
of our keynote speakers Dr Margaret
Woodhouse OBE, who’ll be talking about
understanding patients with Down’s
syndrome,” said Elaine. “Maggie was awarded
the OBE for her work in this field, and recently
appeared in a film shot in collaboration
with ABDO and ITN Productions as part of
the EYE TV News programme.”
New technologies are in vogue this
year, with Optician clinical editor Bill
Harvey encouraging DOs to get involved
with the technical revolution, and Bob
Forgan discussing the fast-moving world of
smart glasses. Antonia Chitty will look at
futuristic ways of working social media into
practice, while Paul Surridge of the Sight
Care Group will run a four CET point session
on ‘Understanding patient psychology’ on
day one, followed up with ideas on how the
independent sector can be revitalised on
day two.
There are a number of coaching topics
on the programme including ‘Building your
powers of persuasion’ and a coaching and
mentoring skills workshop. “We are
delighted to welcome Jennie Jones, a lawyer
and conflict management expert from the
OCCS to talk help delegates manage
conflict in practice,” Elaine explained.
Workshops and ‘silent’ lectures will feature
in the exhibition area, and Rob Barrow, a
DO from Spec-Care Services, will run four
repair workshops.
There will once again be a full low
vision two-day track with experts looking at
the holistic approach to low vision and
intra-professional working. “We will hear
from patients who have had life changing
encounters with low vision practitioners,
sharing their experiences of how we can
improve the experiences they have with us,”
explained Elaine. The Guide Dogs for the Blind
Association will be there, inviting delegates
to experience its special sensory tunnel.
Paediatrics remains high on the list of
priorities for DOs and so the conference will
provide a number of paediatric related
workshops and lectures. The ABDO paediatric
heads will enable delegates to refine their
All roads lead to Manchester this September
dispensing skills. Delegates can also discuss
binocular vision issues and the importance
of spectacles in orthoptic management.
Another initiative to push the
boundaries is the new student and
supervisor track, as Elaine explained: “This
parallel event will allow students to practice
for their final qualifying examinations under
the guiding hand of Alicia Thompson,
ABDO’s director of professional
examinations and her team. There will be
opportunities for current and prospective
supervisors to get to grips with their role
and to meet other professionals taking on
this important task.
“This is just a snapshot of what’s in
store in Manchester this year for our
members, but I hope it’s whetted the
appetite for the fantastic event ahead,”
Elaine concluded.
Next month we’ll take a look at other
programme highlights. In the meantime,
please look out for the definitive
programme being published online in the
coming weeks.
Dispensing Optics APRIL 2015
35
Mido
With a significant makeover and record
visitors, Mido 2015 meant business,
reports Nicky Collinson
The Italian job
eld at the Feramilano RhoPero Pavilions in Milan
from 28 February to 2
March, the 45th Mido
optical fair offered its
international visitors a newly ‘tailored’
experience with a 10 per cent increase in
floor space, a more structured layout and
150 new exhibitors amongst the 1,000
plus ‘regulars’.
“We designed and set up the new
format to make it easier to display and give
visibility to the products on show,” said
Giovanni Vitaloni, vice president of Mido
and Anfao, the Italian optical trade
association. “We wanted to find new things
that would appeal and new ways to make
the three-day event, which is always a very
busy one, something more relaxing,
practical, effective and efficient for business
dealings, which are always critical in
increasing production and trade, as well as
functional to the pivotal role of ‘working
well’, which is what we wish to all our
Italian and international exhibitors.”
It seems the changes were well accepted,
with a record 49,000 visitors attending over
the three days – up 8.7 per cent over 2014 –
56 per cent of whom came from outside the
host country. “Over the past few months
we have perceived a growing interest in our
exhibition and in its fast evolution that
picked up even more speed this year,”
commented Cirillo Marcolin, Mido president.
“The new communication campaign, the
new logo, the pavilions located closer to the
subway, the revamped and more
streamlined layout made for a considerably
larger exhibition space and more exhibitors
who had fully booked the exhibition space
in just a few months.
“The online pre-registration had us very
optimistic on the eve of the opening day,
because the outcome was very
encouraging,” added vice president
Giovanni Vitaloni. “Attendees took
advantage of the more visitor-friendly
layout to visit all the theme areas including
the Fashion District, FAiR East Pavilion and
H
36
Dispensing Optics APRIL 2015
Bestand Award winners, Blackfin, with Mido president, Cirillo Marcolin
to be the must-attend exhibition for the
eyewear industry.”
Design Lab and the new Lab Academy, which
was particularly successful. The Otticlub info
meetings also attracted a keen, interested
audience – another sign of the dynamic
atmosphere pervading the industry.”
A new ‘Two trains for Mido’ service
helped to increase the number of Italian
trade people visiting, with Mr Vitaloni adding:
“However, a prevailing widespread desire for
the domestic market, which has been sluggish
for some time now, to get back on track
certainly did its share. The final result is
extraordinary in itself, especially considering
the economic uncertainty that still affects
some countries.”
Summing up the event, Cirillo Marcolin
said: “The record attendance figures confirm
Mido’s undisputed international leadership,
are a reason to be proud and encourage
us to do even better in order to continue
EYEWEAR DEBUTS
Swiss designer Marc Stone showcased his
premium eyewear collection for the first
time at Mido. The collection received
outstanding reviews when it was shown on
the runway at the 2015 Tranoi Fashion
Show in Paris and was officially unveiled by
the Swiss Eyewear Group. Highlights of the
18-model collection include wood finishes
on acetate frames and contemporary
stainless steel frames with discrete, modern
side shields as well as retro inspired heavier
frames. Distinct elements from the Marc
Stone apparel designs have been included
in the eyewear collection and all
sunglasses are handcrafted using the highest
quality materials.
Milan debut for Marc Stone eyewear
Pure Decadence by Anna Karin Karlsson
Fellow Swede and high fashion frame designer known for her unique
and extravagant eyewear, Anna-Karin Karlsson, presented her new
Decadence collection bringing to the wearer “stories of wanton, luxury and
opulence”. The collection is characterised by “excess and indulgence in
pleasure”, with frames bejewelled with handset crystals and 24-carat gold,
each model considered as a piece of art.
Making its global debut hot off the heels of 100% Optical in London,
the entire Aspire Eyewear collection is designed using 3D technology prior
to prototype creation, significantly reducing sample development from 20
weeks to 20 minutes. Created with SDN-4, a specially designed nylon
material proprietary to the brand, the designs offer shape memory, heat
resistance and won’t fade in UV exposure. Using customised SDN-4 sheet
material, Aspire frames are not injected, but created with CNC machinery
to produce unique shapes and endless colour possibilities. The collection is
distributed exclusively through US-based ClearVision Optical.
Entrepreneur and style icon will.i.am unveiled his new collection of ill.i
Optics frames, an innovative series of unisex optical styles. Though
designed in the US, the frames are hand finished in Italy and born out of
will.i.am’s life-long passion for experimental style. The spring/summer 2015
collection pays homage to the evolution of modern optical fashion, drawing
inspiration from rare vintage shapes to create a line that is fresh, dynamic
and timeless. This, the brand’s second collection, looks set to cement ill.i
Optics as a player in the eyewear category.
Fashion’s current love affair with all things denim was captured
perfectly in a new men’s model in the X-IDE collection from Italian firm,
Immagine 98. The metal Cocco frame features blue denim on the front and
temples in an out-of-the-ordinary combination of materials that is both
eye-catching and tactile.
Another notable piece was the Type 8 Convertible model from Hally &
Son, a brand with strong links with the 1960s and 70s distributed by Italian
optical giant, Allison. The Type 8 Convertible model, with its traditional
panthos shape inspired by the early 60s, marries old concepts with a new
combination of materials. The frame can be folded in five easy steps with
the temples and front made in medical steel, and rims in acetate with a
keyhole bridge.
Mountains, trees, greenery and nature provide the open-air ‘laboratory’
inspiring WooDone’s latest invention showcased at Mido: frames covered
with the underside of leaves of the Wych Elm (ulmus glabra). Ulmus is the
name given to the special edition finish, which can be applied to any model
in the collection. It took the company 12 months to identify a tree with
suitable leaves, and to come up with a way to apply the leaf to the frame
without interrupting the pattern traced by the veins using a natural glue
and lacquer finish to prevent the leaf from drying and changing colour.
The famous Italian fashion brand, Silvian Heach, confirmed its
partnership with the internationally renowned designer, Paolo Seminara,
with its new spring/summer 2015 collection signed Silvian Heach Eyewear.
The Made in Italy collection includes eight frames and two sunglasses in
bright colours and fluorescent tones combined with acetate in both
transparent and printed variants.
The striking, post-industrial black metal look of Blackfin’s stand, named
Black Shard, proved a hit with visitors to the show, who ultimately crowned
it winner of the 2015 Bestand Award for the most eye-catching and
communicative stand. “We worked on this project for over a year and we’re
delighted with the result – the perfect representation of Blackfin eyewear
and its philosophy,” said Nicola Del Din, CEO of Blackfin’s Italian
manufacturer, Pramaor. “We’d like to thank all those people who voted for
the new stand, supporting our new communications campaign and the new
Blackfin eyewear collections which have proved the winning formula at this
year’s Mido, ending it on an extremely positive note for us.”
Mido 2016 will take place from 27-29 February at the Fieramilano
Rho-Pero Pavilions, Milan. www.mido.it
3D designed
Aspire Eyewear
Style icon will.i.am unveiled
his second collection
Denim delights with the new
Cocco frame from X-IDE
60s inspired Type 8 Convertible
model from Hally & Son
WooDone’s latest invention:
leaf-adorned eyewear
Italian fashion heavyweight, Silvian Heach
Blackfin’s
industrial stand,
the Black Shard
Dispensing Optics APRIL 2015
37
ABDO
OverseAs
Elaine Grisdale reports on a recent
visit to China to discuss ‘delivering
world class eyecare’
Shanghai surprise
ast month I had the great
privilege of being invited to
address a captive audience of
eyecare practitioners at the
first optometry congress in
Shanghai. This was a unique opportunity
to fly the flag for UK opticians and
promote the skills that we have, and to
explain how ABDO could help support
and develop China’s fledgling dispensing
profession.
The wheels for my sojourn to Shanghai
had been set in motion eight months
previously when Frederic Lefranc, director
of sales for EMEA Pacific at PPG Optical
Materials and Coatings, had contacted me
to ask if I would consider helping the
Chinese to upgrade and standardise their
dispensing profession. They had come to
him looking for a world-class partner – and
Frederic had immediately thought of ABDO.
I subsequently had the chance to speak to
colleagues in China over the phone via an
interpreter and exchange a number of
L
A city that’s going places
emails, but we decided to wait until we
could meet face to face in Europe before
embarking on any sort of cooperation.
With Michael Lu, Director of Sales, China, PPG Optical Materials
38
Dispensing Optics APRIL 2015
And so it was that during a visit to the
Opti show in Munich in January, ABDO
general secretary, Tony Garrett, and I met
with a Chinese delegation from their
professional association, the China
Optometric and Optical Association
(COOA). Our meeting was very interesting
and we enjoyed a fruitful discussion. So
much so that Mr Cui, the chairman of the
COOA, invited me to speak at its first
Global Optometry Conference, which was
being held in conjunction with the big
optical fair in Shanghai.
A COUNTRY ON THE MOVE
There are two huge fairs every year in China –
one just after Chinese New Year in Shanghai
and the other in September in Beijing. The
Shanghai International Optics Fair is
amazing – with four huge halls and more
than 800 exhibitors including all the big
names, some of whom do not exhibit in
Europe anymore. There were thousands of
people waiting to get into the hall on the
first day, a bustling mixture of visitors and
exhibitors, with some 60,000 visitors
expected over the following three days.
Luckily, being in the company of the event
Elaine with COOA chairman, Mr Cui
organisers and the president, Mr Cui, we
sailed past and were let in first.
I had visited Shanghai twice before,
once 15 years ago and again in 2011. I had
even co-written a book with the late, great
Professor Irvin M. Borish, which had been
written for the Chinese market and
translated into Mandarin. I was stunned at
the progress that had been made in the
past four years since my last visit. There
have, for one thing, been massive changes
in the landscape. There are more building
sites and skyscrapers going up than you
could ever imagine. Each site will have
between four and 12 cranes and there are
many developments in progress all the way
from the airport into the city. This is a
country on the move; the quality of cars on
the road has vastly improved and there are
many new and expensive machines on the
road. More people speak English here than
four years ago, although to get anywhere
you need to have your destination written
down in Chinese for the taxi driver.
As part of my programme, I visited a
number of optical outlets, many of which
have their own glazing facilities. There
seems to be a lot of price sensitivity and
the lens types dispensed are not as
sophisticated as in the UK due to the lack
I was very
proud to be
flying the
flag for UK
opticians
and promoting
the skills that
we have
of in-depth training and differing skill levels
on the market.
As a VIP guest, I was introduced to the
Minister of Industry, Mr Qian Gujing, from
the China National Light Industry Council,
who was also the vice chairman at the All
China Federation of Handicraft Industrial
Cooperatives. Mr Gujing was the Guest of
Honour and opened the show in an
elaborate ceremony, which included many
speeches and a prize giving ceremony
honouring top opticians, students and
industry partners.
Other VIPs in my party included the
vice president of the American Optometric
Association, Dr Steve Loomis, a delegation
from Salus University (Pennsylvania College
of Optometry) led by Dr Michael
Mittelman, the president of Salus
University, Professor Lu Fan, the vice
president of Wenzhou Medical College, an
esteemed ophthalmologist who trains
ophthalmologists in optometry, Professor
Brien Holden from the Brien Holden Vision
Institute (BHVI) in Australia, Professor Kovin
Naidoo, the global programmes director for
the BHVI, and Dr Tan Kah Ooi who is the
CEO of the research arm of the BHVI in
China. And finally, Dr Brendan Jang, a
professor at Gangdong University and Mr
Polo Qi, chairman of the COOA Committee
of Optometry (my hosts).
We all know what a small world optics
is, but I was very surprised to hear that Mr
Qi had worked on the translation of my book
nearly 20 years earlier to help the translator
I had been collaborating with in France.
I was the only optician speaking at
this first congress in optometry and I was
very proud to be flying the flag for UK
opticians and promoting the skills that we
have. I had been asked to speak about
‘Delivering world class eyecare’ using my
experiences in the UK and further afield
to explain what the foundations should be
to ensure professional excellence and the
best outcomes for the public. I spoke to
more than 300 professionals and have
been asked to write an article for their
professional journal.
I had a number of interesting and
constructive discussions with professionals
and opinion leaders from the region during
the rest of my stay. There are a number
of initiatives that are under discussion and
a number of professional relationships
have been forged for the future. Watch
this space…
Elaine Grisdale FBDO, FAAO, is ABDO head
of professional services and international
development.
Dispensing Optics APRIL 2015
39
As time passes by our perceptions
of things change and improve,
writes Brad Parkes
Jottings
Age is just a state of mind
P
olicemen, and women, are getting younger
aren’t they? Doctors and dentists too. Teachers
have started to look like they are only fresh out
of school themselves. What other signs are
there that we are ‘getting old?
Well, as optical professionals, ‘short arm syndrome’ is an
obvious addition to the list. Have you ever sat in a
restaurant or theatre, or even on a park bench, and seen
someone reading a menu, a programme or newspaper with
arms outstretched, or searching for that little bit of extra
light to help them out? Have you ever felt like walking up
to them to present a business card?
Readers who know me, will know me to be in excess of
six foot in height with subsequent longer than average
arms. So much so, I have been able to resist nature’s call
longer than average too. With my computer monitor pushed
to the edge of the far side of my desk, I relented and took
the plunge to have my eyes examined, knowing what the
outcome would be. Twenty-seven years of advising patients
and customers about the pitfalls of progressive power
lenses meant I was not looking forward to this day.
I’ve known and dispensed first generation lenses that
were identical in both eyes, just rotated a few degrees to
allow for convergence, through to horizontal symmetry
with specific designs for right or left eye lenses, through to
today’s complex design tailor-made lenses. Whatever will
be next? What will our successors be dispensing in, what 50
years’ time? Or even in 100 years’ time? It’s hard to say,
imagine isn’t it?
For years I have told patients to be aware of adaptation,
to be careful up and down stairs, to wear their new glasses
first thing in the morning to help their eyes get used to
them, use them only seated initially and only progress to
walking around once they felt competent, and certainly not
to drive in them for some time. Follow your nose, point
your nose where you want to look, nod your head to find
the sweet spot of prescription for the distance you are
looking at. Beware of the peripheral distortions, the
waviness it creates, and the swimming effect if you move
your head too quickly; that might make you feel sick. Oh
boy, I was not looking forward to today – not one bit. But
the milestone had been reached, I could resist no more, I
took the plunge…
To my great and pleasant surprise, the transition has
been much smoother than I had ever imagined. The lenses
arrived in practice, and were glazed and presented to me in
my office. They were popped onto my face with no
adjustments made, no checks of the marking against my pupil
centres, the lens markings were even left on. Yes! I just
wanted to try them out and get a little insight as to what was
in store for me for the next month or so as I adapted to them.
Three hours later, and I’m still wearing them with the
markings on, no adjustments made, and I have not worn the
single vision pair I had made ‘just in case’ either. I wonder if
40
Dispensing Optics APRIL 2015
it is personal tolerance, modern technology, or have I just
been overly wary of dispensing them for all this time? Have
I over-estimated just what the brain can tolerate. Who
knows? What I do know is that time passes us by, things
change and improve, and our perceptions of many things
change over time too.
PRESERVING OUR CRAFT
Qualifying in the early 1990s and having our graduation
ceremony held at Apothecaries’ Hall, the home of optical
mastery for nearly 400 years, surrounded by the grandeur
of its ambience, its paintings and its artefacts, I remember
something that struck me sitting in that hall. With all the
history, the tradition, the ceremonial and political significance,
the one thing that pricked up my ears that day was: “One
day I’s going to drive my sheep over London Bridge!”
The Worshipful Company of Spectacle Makers has for
four centuries been setting and maintaining standards in
our craft, seeking to combat visual impairment with its
charitable work and supporting the ancient and honourable
City of London.
I recall the days of taking up Freedom of the Company,
Freedom of the City of London, and being ‘clothed as of the
Livery’, the three levels of membership if you like, and
feeling a little intimidated by ye olde worlde English of the
installations, which have remained unchanged. The feeling
of awe at the traditions and customs steeped in history, and
a sense of belonging to something quite special. Having
heard the organisation described as full of ‘the great and
the good’, made me feel nervous to say the least. The
luncheon that followed, however, dispelled all of those
nerves. The warmth and hospitality I received made me
realise I was amongst friends, colleagues, fellow human
beings who accepted me as one of them – someone
interested in the preservation of our craft, the City and
supporting charity.
Now, as an Assistant to the Court, I am ever mindful of
how intimidated and nervous I felt, and look to welcome
newly-clothed Liverymen with the same warmth and
hospitality I received. I am honoured to be able to be one of
the first to welcome them, and that gives a huge degree of
pride. I have been amazed at the number of Liverymen I
have welcomed in my short time as an Assistant already,
and I am also amazed at the number who are younger than
me too. At our recent Court, we again had the pleasure to
install a number of new Liverymen, from many
backgrounds, and not all optical.
Attending the Company’s examination graduation
ceremony last autumn was inspiring too. To witness the
future of optics beaming with the pride that rightly comes
with qualification, having examined some of them and their
successors for a number of years, to see Freemen installed,
gives a great sense of assurance of continuance for the next
four centuries.
It seems to me too, that Liverymen are getting younger
too. There have been debates whether it is the ‘Downton
Abbey’ factor, of the popularity of the television series that
has been sparking an increase in interest of some of our
long held customs and traditions. Our forthcoming annual
Livery Dinner, which is a grand white tie affair, for instance
sold out in a matter of days. There is even a Young InterLivery Group providing a programme of events aimed
specifically at younger Liverymen open to Liverymen and
Freeman of any Livery and their guests.
IN GREAT COMPANY
My conclusion as one of life’s ‘belongers’ is the Worshipful
Company of Spectacle Makers is far from an organisation of
the past. On the contrary, it is very much an organisation
for the future, for the youth of the industry as well as ‘the
great and the good’, with a proven track record of standing
the test of time. With the birth of clinical commissioning
groups, and new examination formats, and CET in their
infancy, change is inevitable, yet the WCSM remains just as
relevant and important today as ever.
Old? Age is only a state of mind! My only wish I’d have
‘got involved’ earlier, and would encourage others to follow
the trend to join the WCSM sooner rather than later.
Whether you are presbyopic already too, on the cusp
with your computer monitor edging closer to the far edge
of your desk, or presbyopia is a long way off; whether you
are newly qualified, or have been qualified a while; whether
you work for a multiple, an independent, or for yourself;
whether you work inside or outside sight care provision;
whether it be in practice, hospital, manufacturing, or
business supply, the one thing you can be assured of is a
warm and hospitable welcome. For more details visit
www.spectaclemakers.com
BRAD PARKES FBDO CL has operated Specsavers in
Solihull and nearby Shirley, West Midlands, since 1993.
He has lectured at Anglia Ruskin University, tutored for
ABDO and examined for the WCSM. He became
Assistant to the WCSM Court in 2013.
Frequently asked questions
answered by Kim Devlin FBDO (Hons) CL
DUPLICATING A PAIR OF SPECTACLES
There has been some discussion as to when a dispensing
optician may duplicate a pair of spectacles; and indeed,
should a DO duplicate spectacles?
There are certain things a registered, qualified DO may
do that an unregistered seller may not under the Opticians
Act; one of them is duplicating a pair of spectacles without
a prescription. So there is no doubt as to the legality of the
action: you may do so but the professional conduct
question is, should you? There has been no Case Law, no
Fitness to Practise hearing to guide us; we must simply
decide each case on its merits.
A scenario might be that a patient, not known to you,
comes into the practice with a broken pair of specs. They
are well beyond repair but you have a workshop on the
premises, you can neutralise the lenses, copy them and cut
them into a suitable frame. That surely is good patient care?
Precisely so, except with a small proviso: you would naturally
record your actions with the prescription details that you had
found (including the optical centres I would suggest), the
frame style and measurements but also the advice given.
You would have asked the patient when they last had
an eye examination, was there any family history of ocular
disease, indeed, did the patient themselves suffer any eye
disease, and record their replies. If you consider that they
ought to be re-examined quickly, you would also note that
advice and the reasoning behind it. It would be sensible to
replace broken glasses as quickly as possible on the
understanding that an eye examination would be booked
(with yourself or their own practitioner) at a reasonable
time. It should also have been pointed out that the
replacement specs might well then have to be upgraded at
further cost. All good professional care, with the patient
making an informed choice.
There are numerous similar situations we have all come
across when the actions of the qualified practitioner would
be equally professional, but are there any circumstances
where a DO should not duplicate spectacles?
Suppose a patient had an old but much loved and used
pair of specs and having broken them, asked you to replace
them, despite them being not the same prescription as the
latest eye examination. Would that be professional action?
It would be my opinion that if the patient was advised
clearly and unequivocally that the replacement spectacles
were not of the same power as the latest prescription and,
as such, would not perform to the same standard – with all
the ramifications of that statement if the legal standard for
driving might be compromised – it may be done
professionally and legally.
We are not policemen; it is not for us to tell patients
what they may or may not wear in the form of spectacles.
Providing the patient has sufficient facts to make an
informed choice, you may supply duplicate spectacles and
record very carefully on the patient’s record that they have
been told the limits of such spectacles, even going to the
lengths of getting them to sign to that effect.
Life will have taught you that such a patient, who feel
they know best, is rarely satisfied with whatever you do;
despite your best efforts they will claim the duplicate
spectacles are ‘not right’ or not as ‘good’ as the broken
ones. You can only do your best, record your actions and be
polite in the face of provocation.
My opinion is based on the patient being an adult with
sufficient mental powers to understand your advice. The
situation is entirely different if the patient is a child and
they, or their parents, wish to have a ‘different’ prescription
dispensed. That, as they say, is a different ball game altogether.
Kim Devlin
is chair of
ABDO’s
Advice and
Guidelines
Working
Group
Past FAQs are available for reference on the ABDO website at http://www.abdo.org.uk/frequently-asked-questions
Dispensing Optics APRIL 2015
41
Jobs & notices
Frost Borneo
Optician Index - January 2015 summary
• Total practice turnover increased by 12 per cent on last
month to 166 Index points but this is two per cent lower
than last January
• Total eye examinations improve by 21 per cent on
December 2014 now at 102 Index points, which is one per
cent lower than last January
• Average dispensing rate increases by two percentage points
from last month to 65 per cent, which is the same as January
last year
• Re-glazes decrease by one percentage point to 13 per cent
of spectacles dispensed from last month and this is two
percentage points lower than January 2014
• Anti-reflective coatings increased by three percentage points
from last month to 45 per cent and this is two percentage
points higher than January last year
The full January 2015 report was published in the
27 February issue of Optician
Optometrists
JOIN US!
OUTSTANDING
DISPENSING OPTICIAN
Challenging and exciting full-time
opportunity in beautiful Henley-on-Thames
We are very excited about a great opportunity at
Frost Borneo for a dispensing optician to join our
team working five days a week including Saturdays
There is potential for career progression
into a management role
Find out more at
www.frostborneo.com/joinus
and if you think this job is for you, then book a phone
call with Catalina or Neil on 01491 574091
NEWLY QUALIFIED DO
FAMILY INDEPENDENT PRACTICE LOOKING FOR
A NEWLY QUALIFIED DISPENSING OPTICIAN
Duties will include dispensing, glazing and general
reception work. Experience desired but not essential
Please send CVs to [email protected]
To place an advert, telephone 0781 273 4717 or email [email protected]
Booking deadline for the May issue is Friday 10 April. Special rate for ABDO members
NEW ‘THROUGH THE
PIN-HOLE’ SERIES
PARTICIPANTS WANTED
DOES YOUR PRACTICE OFFER SPECIALIST SERVICES IN,
FOR EXAMPLE, DRY EYE, PAEDIATRICS, SPORTS VISION,
LOW VISION AND/OR OTHER NICHE AREAS?
We’re looking for member practices to feature
in a new ‘Through the pin-hole’ series
showcasing the fantastic work that ABDO
members are involved with above and beyond ‘the
everyday job’ of dispensing
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]
WE NEED YOUR STORIES
Email [email protected]
to register your interest in taking part
DO YOU HAVE SOME GREAT TECHNICAL TOOL TIPS?
A STORY OF HOW YOU FIXED SOMEONE’S SPECS OR
CREATED A CUSTOMISED FRAME?
Email [email protected] by 15 April
42
Dispensing Optics APRIL 2015
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Introducing the most breathable
colour contact lens available1*
THIS IS WHY
AIR OPTIX® COLORS
sets a new standard in
colour contact lenses.
UNIQUE PLASMA SURFACE + 3-IN-1 COLOR TECHNOLOGY
PLASMA SURFACE
TECHNOLOGY
Offers superior
wettability2**
and provides
deposit resistance
for consistent
comfort from
day 1 to day 303†
+
OUTER RING
defines the iris
PRIMARY COLOUR
transforms the eye colour
INNER RING
brightens and adds depth
PLUS POWERS AVAILABLE FROM 1ST APRIL
Full parameter range available
+6.00D to -6.00D including Plano (0.25D steps)
-6.00D to -8.00D (-0.50 steps)
NEW
PERFORMANCE DRIVEN BY SCIENCE™
9 colours available with or without vision correction.
*Dk/t = 138 @ -3.00dpt. Other factors may impact eye health.
**Compared to ACUVUE^ ADVANCE,^ ACUVUE^ OASYS,^ PureVision,^ Biofinity^ and Avaira^ contact lenses. ^Trademarks are the property of their respective owners.
†
lotrafilcon B contact lenses tested include AIR OPTIX® AQUA, AIR OPTIX® AQUA Multifocal and AIR OPTIX® for Astigmatism contact lenses.
Important information for AIR OPTIX® COLORS (lotrafilcon B) contact lenses: For daily wear only for near/farsightedness. Contact lenses, even if worn for cosmetic reasons, are
medical devices that must only be worn under the direction and supervision of an eye care professional. Serious eye health problems may occur as a result of sharing contact lenses.
Although rare, serious eye problems can develop while wearing contact lenses. Side effects like discomfort, mild burning or stinging may occur. To help avoid these problems,
consumers must follow the wear and replacement schedule and the lens care instructions provided by their eye care professional.
References: 1. Based on ratio of lens oxygen transmissibilities; Alcon data on file, 2009. 2. Based on in vitro measurement of contact angles of unworn lenses; significance
demonstrated at 0.05 level; Alcon data on file, 2009. 3. Eiden SB, Davis R, Bergenske P. Prospective study of lotrafilcon B lenses comparing 2 versus 4 weeks of wear for objective
and subjective measures of health, comfort, and vision. Eye & Contact Lens. 2013;39(4):290-294.
See instructions for use for complete wear, care and safety information.
10911 © 2015 Novartis AG. AIR OPTIX, the AIR OPTIX COLORS logo, FreshLook logo, Alcon and the Alcon logo are trademarks of Novartis AG.