optics
Transcription
optics
APRIL 2015 DISPENSING OPTICS NE WS , I NFORMATION and ED UC ATI ON for OP TIC IANS SHAMIR ™ GLACIER BLUE UV Enlightened eye protection SHAMIR GLACIER™ BLUE UV • • • OUR EYES THE ENLIGHTENED PR OTECTION GIVE YYOUR PROTECTION TM VE, WITH SHAMIR GLA CIER BL UE UV THEY DESER DESERVE, GLACIER BLUE 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) ncollinson@abdo.uk.com Rosslyn Argent BA (Hons) rargent@abdo.uk.com Deanne Gray dgray@abdo.uk.com EDITORIAL/ADVERTISING Telephone 0781 2734717 Email ncollinson@abdo.uk.com 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 tomv@abdo.org.uk 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 cet@abdocet.infoman.org.uk pstevens@abdo.org.uk 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 ncollinson@abdo.uk.com 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: sales@norville.co.uk 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.” Is ha ving the right right equipment equipment having import ant to to yyou? ou? important Glasses ar aree no different... different... One pair is never enough! Boost your sales with our Xperio multi pair promotion! From 1st January to 30th June 2015 order a pair of Xperio lenses and for an additional £1 per lens, receive a pair of clear lenses. You can upgrade the clear pair at a greatly reduced cost to match the design of the Xperio pair. To benefit from this offer use the ppromotional code “2PAIR” when placing p g the order for the 2nd pair. p FFor or full terms and conditions please refer to our website website www.bbgr.co.uk www.bbgr.co.uk www www.bbgr.co.uk .bbgr.co.uk TTel: el: 0844 880 1349 Always closer 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 conf@bcla.org.uk 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 ncollinson@abdo.uk.com 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 jgriffin@abdocollege.org.uk 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 info@abdocollege.org.uk 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 bduncan@abdo.org.uk 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 insightopticians@live.com To place an advert, telephone 0781 273 4717 or email ncollinson@abdo.uk.com 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 jburnand@abdolondon.org.uk WE NEED YOUR STORIES Email ncollinson@abdo.uk.com 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 mail@antoniachitty.co.uk by 15 April 42 Dispensing Optics APRIL 2015 GREAT MINDS,, GREAT MINDS BIG IDEAS IDEAS,, NEW INSIGHT INSIGHT.. 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