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www.optometry.co.uk July 1 2011 vol 51:13 £4.95<br />

optometrytoday<br />

Sight test fee frozen<br />

ID’11 previewed<br />

GP/optom<br />

roundtable<br />

Spectator<br />

Letters<br />

Are we there yet?<br />

UK vision standards for driving – the evidence base


Become our fan on Facebook<br />

CONTENTS<br />

http://twitter.com/<strong>Optometry</strong><strong>Today</strong><br />

July 1 2011 vol 51:13<br />

16 31 37<br />

News<br />

5 Sight test fee frozen<br />

Confirmation that the £20.70 GOS fee will<br />

remain in place until March 2012 at the earliest<br />

– but other payments are up by 5%<br />

6 Vision strategy applauded<br />

Health minister Lord Howe tells the Vision UK<br />

conference that the sector’s vision strategy is<br />

just the sort of scheme the Government wants<br />

7 Uplift-ing message<br />

Birmingham-based business Uplift aims to<br />

become a household name for eye surgery and<br />

wants independents to join in its success<br />

8 Comment<br />

OT’s Editor-in-Chief David Challinor explains<br />

why the first LOCSU professional roundtable<br />

was so valuable<br />

10 Deadline nears for students<br />

Student optometrists and DOs need to renew<br />

their GOC registration soon before the July 15<br />

deadline<br />

12 Letters<br />

OT readers throw down a challenge over frames<br />

fashion and also offer cash help on specific<br />

legal action against PCTs<br />

Cover story<br />

37-40 CET: Vision standards<br />

for driving<br />

Sharifa Hirani looks at the evidence base<br />

for <strong>this</strong> topical <strong>issue</strong>, discussing whether<br />

current legal vision standards are sufficient,<br />

how these could be improved and how<br />

practitioners can advise their patients when<br />

asked about whether their vision is good<br />

enough for driving<br />

Products<br />

16-17 Industry News<br />

New launches from BBGR, Bausch & Lomb,<br />

No7 Contact Lenses, and Johnson & Johnson<br />

Vision Care, plus an Olympic boost for Zoobug<br />

and a prize promotion from Rodenstock<br />

News Extras<br />

21 Boots’ 500 practice milestone<br />

The multiple’s rebranding of Dollond &<br />

Aitchison continues apace<br />

22 GP/Optom roundtable<br />

An LOCSU and GP magazine debate points the<br />

way forward<br />

Events<br />

30-31 Independents Day 2011<br />

Preview of the expanded exhibition<br />

at Monday’s event, which is aimed at<br />

independent practitioners<br />

Features/interviews<br />

20 Q&A<br />

Spotlight on a Newcastle independent<br />

23 Bookshop boost<br />

Historic retailing name joins forces with OT<br />

Regulars<br />

14 Spectator<br />

Why the profession needs to have more<br />

dialogue with GPs<br />

25 Crossword<br />

This month’s prize competition<br />

26 Diary dates<br />

All the latest optical events<br />

27 Student news<br />

AOP student conference booking opens plus<br />

good news for Cardiff University<br />

Clinical<br />

28-29 VRICS: Ocular therapeutics<br />

and disease Part 1<br />

Our latest VRICS looks at the management of<br />

common ocular diseases, with an emphasis on<br />

the increased role of therapeutically-trained<br />

practitioners<br />

32-36 CET: Referral refinement<br />

Part 7 Visual impairment support<br />

Our series continues by describing how<br />

optometrists and dispensing opticians can<br />

ensure that their patients with low vision have<br />

access to help and support from a variety of<br />

disciplines, including rehabilitation workers,<br />

counsellors, social workers, teachers of the<br />

visually impaired and ophthalmologists, by<br />

discussing the referral pathways available<br />

Classified<br />

42-46 Jobs<br />

All the latest vacancies with opportunities in<br />

Australia and New Zealand<br />

47-50 Marketplace<br />

Arrow Auctions has a public tender sale of<br />

optometry equipment<br />

Feature is online<br />

Video is online<br />

www.optometry.co.uk


new collection coMinG Soon<br />

continental eyewear<br />

0151 426 3907


NEWS<br />

Rejected sight test fee<br />

freeze is imposed<br />

EFFORTS to improve the level of<br />

the GOS sight test fee for eye care<br />

professionals have been dashed<br />

by the Government.<br />

Michael Bateman (pictured),<br />

the chairman of the negotiating<br />

committee representing the<br />

profession, said a freeze on the<br />

£20.70 fee was imposed by the<br />

minister – Lord Howe – on the<br />

advice of his officials. This figure<br />

will now stay in place until March<br />

2012.<br />

However, Mr Bateman and his<br />

colleagues from the Optometric<br />

Fees Review Committee were<br />

pleased to announce that the<br />

grant for supervising pre-<br />

registration trainees have both<br />

increased by 5%.<br />

Announcing the news on the<br />

GOS freeze first, Mr Bateman said:<br />

“We made clear in the strongest<br />

possible terms that the proposed<br />

freeze was unacceptable to the<br />

profession, especially at a time of<br />

rising domestic inflation which<br />

is pushing up practice running<br />

costs and international inflation<br />

which is increasing the cost of<br />

spectacles and lenses.<br />

“These are significant pressures<br />

on the profession, and freezing<br />

the sight test fee will have a real<br />

impact on the optical frontline<br />

and on the ability of the<br />

Milestone reached<br />

profession to deliver the sight<br />

testing service.”<br />

Mr Bateman said that over<br />

several years the OFRC has<br />

delivered significant efficiency<br />

savings to the Government.<br />

“Not least,” he said, “in the level<br />

of diagnostic equipment now<br />

common in optometric practices,<br />

increased levels of regulation, and<br />

the documented increase in time<br />

taken to conduct a GOS sight test.<br />

“We have made very clear<br />

to departmental officials<br />

and minsters that we will<br />

not undervalue the services<br />

optometrists and OMPs provide,<br />

and there is absolutely no<br />

flexibility in the £20.70 sight test<br />

fee for any ‘good will’ work.<br />

“We rejected the offer on<br />

fees and it was imposed by the<br />

minster on the advice of his<br />

officials.”<br />

The 5% increase in the CET<br />

payment takes it to £491, and the<br />

supervisors of pre-registration<br />

optometrists grant rose to £3,166.<br />

Optical negotiators expressed the<br />

opinion that the CET payment<br />

remained inadequate which did<br />

not cover the cost of achieving<br />

the necessary credits, and that<br />

the supervisors grant was ‘still<br />

way out of line’ with the levels<br />

of grant for the other contractor<br />

professions.<br />

The increase on gross fees for<br />

GPs and community dentists<br />

was 0.25%. Taken together,<br />

the increase in the two grants<br />

for optometry amounts to a<br />

0.1% increase on gross fees but<br />

without a requirement to achieve<br />

additional efficiency gains which<br />

the Department has negotiated<br />

with the other professions.<br />

A meeting is being arranged<br />

with the minister, and the<br />

negotiators will soon start<br />

discussions about the 2012 fees<br />

negotiation round.<br />

5<br />

01/07/11 NEWS<br />

Marokey Camara (pictured)<br />

is the eight millionth<br />

patient to benefit from<br />

optical charity OneSight<br />

since it was founded in<br />

1988. She received vision<br />

care during OneSight’s<br />

first clinic in The Gambia,<br />

West Africa conducted in<br />

partnership with fellow<br />

charity Sightsavers. “We’ll<br />

never forget the expression<br />

on Marokey’s face when she<br />

received her new glasses,”<br />

said David Berumen,<br />

OneSight clinic manager.<br />

“The fact that we are sharing<br />

<strong>this</strong> significant patient care<br />

milestone with our partners<br />

from Sightsavers makes<br />

it even more special.” The<br />

Gambia Clinic is the first in<br />

a three-year partnership<br />

between Sightsavers and<br />

OneSight, the latter being a<br />

Luxottica foundation.


optometrytoday<br />

JULY 1 2011<br />

VOLUME 51:13<br />

ISSN 0268-5485<br />

ABC CERTIFICATE OF CIRCULATION<br />

January 1 2009 – December 31 2009<br />

Average Net: 20,203<br />

UK: 19,308 Other Countries: 895<br />

Editor-in-Chief: David Challinor<br />

T: 020 7202 8164<br />

E: davidchallinor@optometry.co.uk<br />

Deputy Editor:<br />

Robina Moss<br />

T: 020 7202 8163<br />

E: robinamoss@optometry.co.uk<br />

Web Editor:<br />

Emily McCormick<br />

T: 020 7202 8165<br />

E: emilymccormick@optometry.co.uk<br />

Reporter: Chris Donkin<br />

T: 020 7202 8162<br />

E: chrisdonkin@optometry.co.uk<br />

OT Multimedia Editor: Laurence Derbyshire<br />

T: 020 7401 5310<br />

E: laurencederbyshire@optometry.co.uk<br />

Clinical Editor: Dr Navneet Gupta<br />

E: navneetgupta@optometry.co.uk<br />

OT Manager: Louise Walpole<br />

T: 020 7401 5330<br />

E: louisewalpole@aop.org.uk<br />

Editorial Office:<br />

<strong>Optometry</strong> <strong>Today</strong>, 61 Southwark Street,<br />

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Advertising: Vanya Palczewski<br />

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CET and bookshop enquiries: Charlotte Verity<br />

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Production: Ten Alps Creative<br />

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Membership Dept:<br />

61 Southwark Street, London SE1 0HL<br />

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Editorial Advisory Board<br />

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Hynes, David Ruston, David Shannon, David<br />

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Published fortnightly for the Association of<br />

Optometrists by Ten Alps Creative<br />

Subscriptions<br />

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UK £130, OVERSEAS £175 for 24 <strong>issue</strong>s<br />

AN OPTOMETRIST accused of<br />

misconduct has been found not<br />

guilty by a fitness to practise<br />

committee of the GOC.<br />

Northamptonshire-based<br />

Jonathan Pointer faced seven<br />

allegations in the hearing which<br />

took place on June 16. They<br />

included that he failed to use<br />

a suitable test for the age of a<br />

three-year-old female patient<br />

who was assessed in 2009, in<br />

that he undertook a Sheridan<br />

Gardiner single letter test. He<br />

was further accused that he<br />

incorrectly concluded that<br />

a visual acuity of 3/9, which<br />

was claimed to be recorded as<br />

‘approximately equivalent to<br />

6/18’, was an acceptable visual<br />

acuity for the patient. It was also<br />

claimed that the optometrist<br />

did not undertake retinoscopy<br />

with a cycloplegic agent in<br />

circumstances where the<br />

examination indicated a visual<br />

acuity of 3/9, stereo acuity was<br />

200 seconds of arc, there was<br />

NEWS<br />

Optom found not guilty<br />

limited cooperation from the<br />

child patient, and the reason for<br />

the examination was she had<br />

been squinting and closing her<br />

eyes when watching television.<br />

However, at the conclusion<br />

of the evidence called, Ian Stern<br />

QC, on behalf of the optometrist<br />

submitted there was no evidence<br />

to support these allegations,<br />

which the committee accepted.<br />

However, in further accusations,<br />

in which the optometrist was<br />

said to have advised the patient’s<br />

mother her daughter was<br />

‘squinting out of habit and there<br />

was no problem with her eyes’,<br />

and that she should attend a<br />

return appointment in 12 months’<br />

time in circumstances where he<br />

had not undertaken a complete<br />

examination, the committee<br />

found <strong>this</strong> matter proven. It<br />

also found that the practitioner<br />

had not referred the patient for<br />

specialist examination by the<br />

hospital eye service, or asked for<br />

her return in the near future to<br />

complete his examination.<br />

In determining whether these<br />

facts amounted to misconduct,<br />

the committee was referred to<br />

the case of Calhaem v the General<br />

Medical Council.<br />

Corinna Kershaw, chair of<br />

the committee, concluded:<br />

“Applying the test in Calhaem,<br />

and in particular what Mr<br />

Justice Jackson said at<br />

paragraph 30(2) that a single<br />

act or omission is less likely<br />

to cross the threshold of<br />

‘misconduct’ than multiple acts<br />

of omissions, the committee<br />

found that the acts and<br />

omissions did not, in <strong>this</strong> case,<br />

amount to misconduct.”<br />

Vision Strategy applauded<br />

COLLABORATIVE WORKING<br />

like that of the UK Vision<br />

Strategy will be key to the<br />

new NHS, delegates at Vision<br />

UK 2011 were told.<br />

Speaking at last month’s<br />

event, Lord Howe (pictured),<br />

Parliamentary under secretary<br />

of state for quality with<br />

responsibility for eye care,<br />

explained the relevance<br />

of prime minster David<br />

Cameron’s ‘Big Society’<br />

idea in eye care services. He<br />

explained how the UK Vision<br />

Strategy was an excellent<br />

example of the Government’s<br />

initiative to get all sectors<br />

working together to get better<br />

value in healthcare.<br />

“The development of the<br />

Vision Strategy and the work<br />

to take its aims forward<br />

provide an outstanding<br />

example of the Big Society in<br />

action,” he said. “We believe<br />

that locally-led, clinically-led,<br />

patient focused collaborative<br />

working is the way forward.<br />

It’s the best way to improve<br />

services to patients and<br />

support people who have lost<br />

their sight.<br />

“Cross sector planning and<br />

collaboration is key. What<br />

are the things we should be<br />

looking for from collaborative<br />

working? Well, professional<br />

collaboration is vital when<br />

looking to design and develop<br />

local care pathways, achieving<br />

more integrated care and<br />

improving service quality<br />

in providing a better patient<br />

experience and achieving a<br />

more efficient use of available<br />

resources.<br />

“Better integration across<br />

primary, secondary and social<br />

care, public health and the<br />

voluntary sector is key in<br />

increasing value.”<br />

Comment on the news via www.optometry.co.uk


Ambitious network<br />

targets 250 practices<br />

UPLIFT, the network of optical<br />

surgeons and optometrists, is<br />

aiming to have 250 independent<br />

practices involved in its business<br />

by 2013.<br />

The Birmingham-based<br />

company, which offers<br />

optometrists involvement in<br />

referrals for cosmetic eyelid<br />

surgery and other types of optical<br />

procedures, is preparing for a<br />

‘significant marketing campaign’<br />

later <strong>this</strong> year in the first stage of<br />

an ambition to make its name<br />

a household brand for optical<br />

surgical treatment, including laser<br />

eye surgery.<br />

Omar Durrani (pictured),<br />

himself a specialist in cosmetic<br />

eye surgery, who helped found<br />

the company, told OT that Uplift<br />

has expansive plans to involve<br />

optometrists from independent<br />

practices in the network.<br />

“We hope to have100 optical<br />

outlets involved by the year-end”,<br />

he said, “and by 2013 we’re aiming<br />

Glaucoma test named<br />

in top UK research list<br />

New computer-based<br />

technology which provides a<br />

simple and effective test for<br />

glaucoma has been selected<br />

as ‘one of the most important<br />

research projects taking place<br />

in the uK’ at the moment.<br />

Developed by experts at<br />

moorfields eye Hospital, the<br />

ucL Institute of ophthalmology<br />

and city university,<br />

the moorfields motion<br />

Displacement test (mmDt) was<br />

named in <strong>this</strong> year’s ‘Big Ideas<br />

for the Future’ report.<br />

to have 250 in the network.<br />

“We’re really going to push<br />

<strong>this</strong> [brand]. One of our main<br />

business plans is to make Uplift a<br />

household name, associated with<br />

quality eye care.”<br />

Mr Durrani said the company<br />

grew from discussions with fellow<br />

optical professionals dissatisfied<br />

with the current model of facial<br />

and eye surgery in the UK.<br />

“The major clinics are only in<br />

the major cities, and there is a lack<br />

of continuity of care,” he claimed.<br />

“We hope to bring a truly local<br />

service to patients, and also find<br />

the annual report, jointly<br />

published by the research<br />

councils uK and universities<br />

uK, looks at research in a variety<br />

of fields including science,<br />

social sciences, engineering and<br />

humanities.<br />

Dr Gay Verdon-roe, senior<br />

the best surgeon for their needs.”<br />

Uplift is involving independent<br />

opticians in the referral process<br />

for those who require eyelid<br />

surgery as well as cataract and<br />

laser eye treatment.<br />

“The optometrist puts the<br />

patient in touch with a surgeon<br />

following a diagnosis guide,” said<br />

Mr Durrani, “and one of the key<br />

things is that there is no selling<br />

surgery at that point, simply<br />

a discussion about seeing a<br />

surgeon for potential treatment.”<br />

He said he expects most of<br />

Uplift’s patients to be generated<br />

by its website which states<br />

that ‘only leading, national or<br />

internationally recognised,<br />

reputable NHS accredited<br />

consultants are invited to join the<br />

company’.<br />

The website will also feature<br />

the optical practices involved,<br />

and will benefit the practitioners,<br />

in part via Uplift’s growing<br />

reputation, said Mr Durrani.<br />

research fellow to the mmDt<br />

project, said: “the mmDt is a<br />

good example of translational<br />

research, where universities<br />

work together to improve the<br />

standard of care to patients.”<br />

the tool, which researchers<br />

began developing in 1999,<br />

tests a patient’s field of vision<br />

and has been designed to<br />

run on a standard computer,<br />

allowing the technology to<br />

offer an affordable and portable<br />

method for detecting glaucoma<br />

in the community.<br />

News updated regularly at www.optometry.co.uk<br />

BRIEFING<br />

New optical leads<br />

arrive at LOCSU<br />

TWO new optical leads have been<br />

appointed by the LOCSU (Local<br />

Optical Committee Support Unit) to<br />

work with senior commissioners.<br />

Experienced clinician and chair<br />

of Barnet, Enfield and Haringey<br />

LOC, Sue Leighter, has been tasked<br />

by LOCSU with raising the profile<br />

of community optometry within<br />

London. Joan Myhill, who is<br />

administrator and liaison officer<br />

for Cambridgeshire LOC, has been<br />

appointed as optical lead for East of<br />

England. She has much ophthalmic<br />

experience, combined with<br />

business experience of the utilities<br />

software sector for three global<br />

companies.<br />

Katrina Venerus, LOCSU’s director<br />

of operations and commissioning,<br />

said: “The appointment of a<br />

further two optical leads, means<br />

that every region in England now<br />

has an optical lead to help LOCs<br />

influence senior current and future<br />

commissioners and maximise<br />

opportunities for our professions.<br />

“From engaging with GPs<br />

through our stand and event at the<br />

recent Commissioning<br />

2011 conference,<br />

we know that many<br />

are keen to involve<br />

representative groups<br />

so that NHS makes the<br />

best use of resources to<br />

put the right care in the<br />

right place at the right time.”<br />

In addition Steve Mayer<br />

(pictured) has been appointed<br />

as a LOCSU board member<br />

following the departure of Rena<br />

Souten. Currently the chair of<br />

West Pennine LOC, he has his own<br />

practice in the north west.<br />

Welcoming his appointment,<br />

chair of LOCSU Alan Tinger said:<br />

“We are delighted that Steve will be<br />

taking up the mantle for LOCs in the<br />

north and ensuring that their voices<br />

are heard at the highest level. His<br />

experience of leading an LOC will<br />

help ensure that LOCSU’s board<br />

strategies become realities for<br />

optical committee members.”<br />

7<br />

01/07/11 NEWS


neWS<br />

comment<br />

8<br />

01/07/11 NEWS<br />

Cataract thresholds<br />

are ‘false economy’<br />

ARBITRARY THRESHOLDS<br />

for cataract treatment<br />

being initiated by some<br />

PCTs are a ‘false economy’,<br />

and will reduce the<br />

quality of life for older<br />

people, an RNIB report has<br />

concluded.<br />

Following a Freedom of<br />

Information Act request<br />

to all English PCTs for<br />

relevant data, the charity<br />

found that 53% of those<br />

who responded had an<br />

acuity threshold in place for treatment, with<br />

some trusts falling short of Department of Health<br />

guidance.<br />

Action on Cataracts, the DoH’s best practice<br />

document on the subject, sets out three criteria<br />

which should be met for an operation to be<br />

performed, without setting an acuity threshold:<br />

‘The cataract must affects the individual’s sight,<br />

the reduction in the patient’s sight has to have a<br />

negative impact on their quality of life and that<br />

the patient understands the risks and agrees to<br />

having surgery.’<br />

The RNIB’s eye health campaigns manager,<br />

Barbara McLaughlan (pictured), told OT: “It is clear<br />

that some PCTs are introducing policies which<br />

force patients in need of cataract operations to<br />

live with unnecessary sight<br />

loss and a reduced quality of<br />

life. Yet, cataract surgery is safe<br />

and has been shown to be<br />

cost and clinically effective.<br />

“Introducing arbitrary<br />

visual acuity thresholds and<br />

delaying cataract operations<br />

is a false economy. A patient<br />

whose sight is restricted by<br />

a cataract will at some stage<br />

absolutely need surgery.<br />

“Delays can stop a patient<br />

from reading, driving or living<br />

an independent life. But <strong>this</strong> short-term saving<br />

could also lead to older people having falls and<br />

expensive hip replacement surgery, potentially<br />

increasing NHS costs in the longer term.”<br />

The new report, released <strong>this</strong> week, also<br />

includes information from a Royal College of<br />

Ophthalmologists’ online survey of members<br />

where 38% said they had encountered situations<br />

where a patient had been disadvantaged<br />

because of restrictions on cataract surgery.<br />

The report emerged as OT is receiving<br />

reports from concerned practitioners who<br />

believe financial cutbacks by some PCTs are<br />

creating a ‘postcode lottery’ in cataract surgery,<br />

and treatment in being provided only when a<br />

patient’s condition becomes severe.<br />

Carrots in warm-up<br />

The sighT of<br />

carrots doing<br />

press-ups<br />

on London’s<br />

Millennium Bridge<br />

to highlight<br />

eye care <strong>issue</strong>s<br />

was greeted<br />

by commuters<br />

and tourists last<br />

month. Organised by optical charity Fight<br />

for sight, the warm-up routine marked<br />

the launch of fundraising for its inaugural<br />

15-mile ‘Carrots Nightwalk’ which will<br />

see volunteers<br />

walking around<br />

some of London’s<br />

famous attractions<br />

dressed in carrotsbranded<br />

T-shirts<br />

on september 23.<br />

Registration for the<br />

main event is £25<br />

with a suggested<br />

minimum sponsorship level of £150.<br />

Visit www.fightforsight.org.uk/carrotsnight-walk-london<br />

for more details and<br />

to register to take part.<br />

From little<br />

acorns grow…<br />

IT WAS good to attend the first LOCSU<br />

professional roundtable last month (see<br />

page 22). The London event, organised<br />

with GP magazine, brought together a<br />

number of General Practitioners and<br />

optometrists for a discussion on how to<br />

improve eye care services.<br />

What was admirable, and inspiring for<br />

both sides, was the levels of agreement<br />

that optometrists are ready to get<br />

involved in a wider level of care, and at<br />

times the GPs candid acknowledgement<br />

that they were simply agreeing to<br />

referrals the optoms passed on.<br />

It wasn’t the biggest roundtable I have<br />

attended, but as a first – the LOCSU<br />

intends to have more of <strong>this</strong> type of<br />

meeting – it was a success, and it is<br />

featured on our website as a broadcast.<br />

Elsewhere I was struck by the passion<br />

and commitment of ophthalmologist<br />

Omar Durrani who I met last week (see<br />

page 7) – who has launched a business<br />

to provide a network of surgeons and<br />

optometrists to deliver a variety of<br />

optical-linked surgery. Birminghambased<br />

Uplift wants to work solely with<br />

independent opticians to help patients<br />

who require cosmetic eyelid and request<br />

laser eye surgery.<br />

The company currently has around<br />

two dozen practices involved, but Mr<br />

Durrani has expansive ambitions, with<br />

the hope that 250 outlets will be part of<br />

the network by 2013.<br />

In an economic environment which<br />

is not conducive to major new plans,<br />

Uplift’s aim to expand the business of<br />

those smaller practices who join the<br />

network – and help their involvement<br />

with patients who require optical surgery<br />

– is as refreshing as it is rare.<br />

David challinor, editor-in-chief ot<br />

comment on the news via www.optometry.co.uk


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THE VISION CARE INSTITUTE is a trademark of Johnson & Johnson Medical Ltd. © Johnson and Johnson Medical Ltd. 2011.


NEWS<br />

10<br />

01/07/11 NEWS<br />

BRIEFING<br />

Fitness to practise<br />

was ‘not impaired’<br />

AN OPTOMETRIST has been found not<br />

guilty of misconduct by a fitness to<br />

practise committee of the GOC.<br />

It heard allegations against<br />

Rotherham-based Robert King that<br />

emerged from a 2009 consultation.<br />

It was claimed that the<br />

practitioner did not adequately<br />

investigate the patient’s history,<br />

or ask the patient about the type<br />

of visual aura experienced after<br />

she complained of a ‘grey area’ in<br />

her vision. It was alleged that the<br />

optometrist failed to perform tests<br />

required to investigate her complaint<br />

adequately, or refer her on to another<br />

appropriate health care professional.<br />

It was also claimed that he did not<br />

conduct an appropriate visual field<br />

test such as the confrontation test,<br />

and that he did not take account of<br />

the patient’s myopia, gender and a<br />

nasal visual field defect.<br />

The committee was concerned<br />

at the quality of the evidence given<br />

by a doctor called as an expert for<br />

the Council who gave six risk factors<br />

which could detect the presence of<br />

retinal detachment, but in the case<br />

of the patient in question conceded<br />

that only one, myopia, was present.<br />

It was also concerned with the<br />

patient’s evidence and that it could<br />

not ‘safely place reliance on her<br />

evidence as to what she had told the<br />

registrant at the consultation’.<br />

Gerda Goldinger, AOP director of<br />

legal services, said: “ The striking<br />

feature about <strong>this</strong> case is that each<br />

of the allegations was considered by<br />

the FTP committee. The committee<br />

members listened to the evidence<br />

put forward on behalf of the GOC<br />

which included expert evidence<br />

and, without having to consider<br />

our member’s response to the<br />

allegations, found that Mr King<br />

was not guilty of misconduct and<br />

that his fitness to practise is not<br />

impaired. Our member’s long and<br />

unblemished career remains intact.<br />

It is difficult to fathom why the GOC<br />

could not have reached <strong>this</strong> decision<br />

much sooner, given that the facts<br />

were first raised with it in 2009.”<br />

Public health roundtable<br />

emphasises strategy need<br />

REPRESENTATIVES FROM<br />

across optics joined with public<br />

health specialists to discuss the<br />

opportunities and challenges of<br />

advancing ophthalmic public<br />

health at a specially convened<br />

roundtable event hosted by<br />

the College of Optometrists last<br />

month. The meeting earmarked<br />

the need for an ophthalmic<br />

public health strategy.<br />

Settiing the scene City<br />

University’s Professor John<br />

Lawrenson (pictured) presented<br />

an evidence-based view of<br />

eye care and public health,<br />

followed by Professor Darren<br />

Shickle (Leeds University) who<br />

gave participants an overview<br />

of public health policy and<br />

questioned whether primary<br />

care optometry is “up for the<br />

challenge” of public health.<br />

Leaders of the optometric<br />

THE DEADLINE for student<br />

optometrists and DOs to<br />

renew their GOC registration<br />

is now just two weeks’ away.<br />

In total 2,034 students on<br />

GOC-regulated courses are<br />

yet to apply to renew their<br />

registration, and they must<br />

do so by July 15 if they wish<br />

to continue their studies<br />

next year. Failure to apply<br />

on time will mean having to<br />

pay an additional £10 late<br />

application fee on top of the<br />

standard £20 fee.<br />

For the first time <strong>this</strong> year,<br />

students can apply to renew<br />

their registration online.<br />

This should take less than 10<br />

minutes, the Council claims,<br />

bodies in the UK’s devolved<br />

administrations, LOCSU for<br />

England, and the RNIB, responded<br />

by outlining the levels of public<br />

health activities taking place.<br />

Dr Cindy Tromans, president<br />

of the College of Optometrists<br />

and chair of the roundtable<br />

said: “Prompted by the current<br />

government health reforms, <strong>this</strong><br />

was the first time that the sector<br />

has come together to debate the<br />

<strong>issue</strong> of ophthalmic public health.<br />

Although not an easy topic to<br />

tackle, all participants agreed<br />

that action was needed now to<br />

resolve the main <strong>issue</strong>s.”<br />

It was agreed that the College<br />

and the Optical Confederation<br />

will discuss how best to draw<br />

up an ophthalmic public health<br />

strategy for consultation.<br />

A spokesperson for the<br />

Optical Confederation said:<br />

“If we succeed in advancing<br />

ophthalmic public health,<br />

our efforts will lead to better<br />

health outcomes, but also to<br />

full utilisation of clinical training<br />

for practitioners and more<br />

investment in the optical sector<br />

which in turn will lead to better<br />

population outcomes – <strong>this</strong> is a<br />

‘win-win’. The challenge is how<br />

we, as a sector offer leadership<br />

and make that happen, as noone<br />

else will. Watch <strong>this</strong> space.”<br />

Deadline approaches soon<br />

for student GOC retention<br />

via the GOC’s website at<br />

www.optical.org<br />

GOC registrar and chief<br />

executive, Samantha Peters<br />

(pictured) said: “I would<br />

encourage everyone to apply<br />

by July 15 to save money<br />

and potential problems with<br />

continuing their studies.<br />

“Maintaining GOC<br />

registration is an important<br />

part of studying optometry or<br />

dispensing optics – students<br />

who allow their registration<br />

to lapse could find<br />

themselves excluded from<br />

exams and clinical training.”<br />

Those students who<br />

apply after the deadline and<br />

between July 16 and August<br />

31 will need to pay the extra<br />

late application charge<br />

Those who also miss the<br />

August 31 deadline will be<br />

removed from the registers<br />

in September, and they will<br />

then have to restore to the<br />

registers at a cost of £40.


Visit us on<br />

Independence Day<br />

4th July,<br />

Birmingham<br />

(stand F13)


LETTERS<br />

Sponsored by<br />

Action is recommended<br />

If it can be done in the small<br />

small claims court the cost of<br />

a repair was needed for under-<br />

they will. Stand up to the bullies<br />

claims court, I would like to<br />

filing is about£30 and a court<br />

16s on GOS4 forms I wrote and<br />

and they will back down. If they<br />

recommend that at least two<br />

date is about £50. Each side is<br />

told them it was not part of GOS<br />

think we will defend ourselves<br />

people who bought field<br />

responsible for their own costs.<br />

requirements, and did they want<br />

they will be less prepared to try<br />

screeners as a result of pressure<br />

I took my LHB to court for the<br />

me to do it. They replied they did<br />

and bully us in the future.<br />

from a PCT take legal action (OT,<br />

return of the difference between<br />

and I complied and sent them<br />

I am prepared to put my<br />

June 17).<br />

the NHS fee and the private fee<br />

a bill for doing so. They initially<br />

money where my mouth is and<br />

One against a PCT and one<br />

that they withheld from me<br />

refused, but when I threatened<br />

offer £100 each towards the<br />

12<br />

against an individual who<br />

signed a letter telling them<br />

after a private patient submitted<br />

an HC1 and got full help. I lost.<br />

them with the small claims court<br />

they paid up because they knew<br />

costs of the first two people to<br />

take a PCT or an individual from<br />

to purchase a field screener<br />

However, when they told us<br />

it was not an idle threat.<br />

a PCT to court.<br />

or lose their contract. In the<br />

we had to fill out reasons why<br />

Let them walk all over you and<br />

Peter Harrop, Caernarfon<br />

01/07/11 LETTERS<br />

Throwing down a frames gauntlet<br />

I work in a small city<br />

centre practice whose<br />

business is fairly<br />

evenly split between<br />

contact lenses and<br />

spectacles. We have been<br />

attempting to re-stock<br />

our spectacle frames<br />

with a good variety of<br />

frame models but to<br />

no avail. Over the past<br />

few years a few larger<br />

frame suppliers (two<br />

firms based in London,<br />

one in Yorkshire) have<br />

unceremoniously closed<br />

our accounts – even<br />

though every monthly<br />

statement was paid<br />

immediately. We can only<br />

assume that we are being<br />

punished for not stocking<br />

“x-dozen” premium<br />

priced frames from their<br />

homogeneous ‘designer’<br />

ranges.<br />

This has reduced the<br />

number of our potential<br />

suppliers, also our frames<br />

variety considerably. It is<br />

fair to say that many contact<br />

lens wearers don’t like<br />

‘heavy’ spectacles. With<br />

the current vogue for thick<br />

rimsy/trims and larger eye<br />

sizes it can be seen that<br />

many contact lens wearers<br />

are drifting even further<br />

away from spectacles wear.<br />

It is these patients who are<br />

being poorly served by the<br />

current (none) variety in<br />

frame choice.<br />

It seems every new<br />

catalogue has the same<br />

style of heavy/rectangular<br />

styles. Every batch of each<br />

collection has no variety<br />

contained therein. We also<br />

find many of these modern<br />

frames are very hard to<br />

adjust correctly due to thick,<br />

wide sides, long trims or<br />

overly stiff materials.<br />

We are definitely seeking<br />

a few finer, lighter styles<br />

along the lines of the (older)<br />

Jeff Banks 453, Ferruci 192,<br />

Luxottica 1501/2/3.T – i.e.<br />

46+50 eyes, sensible colours<br />

e.g light bronze, almond<br />

with shallow oval/barrel<br />

shapes – do any OT readers<br />

know of any suppliers of<br />

such frames? Are there<br />

any brave manufacturers/<br />

suppliers out there who are<br />

wishing to supply frames<br />

that will be dependable<br />

sellers, but fly in the face of<br />

current fashion? We await<br />

the industry response with<br />

interest!<br />

G J White, FBDO,<br />

Sedgebrook,<br />

Lincolnshire.<br />

<br />

Come along to our induction days<br />

The flurry of political activity over the past week following the NHS<br />

‘listening exercise’ means that the commissioning landscape is<br />

changing rapidly. Members of Local Optical Committees have a great<br />

opportunity to use the good relationships many already have developed<br />

with their local GPs to get more enhanced services in their region.<br />

However, we all know that in some areas it is not as easy as that,<br />

particularly when the nuts and bolts of how the reforms will actually<br />

work are yet to emerge. I would urge LOC members, both new and<br />

not so new, to come along to either of LOCSU’s two induction days,<br />

July 13 (London) and July 18 (Leeds), which will provide the latest<br />

information and news on what the commissioning reforms will mean<br />

for them. For any LOC that has struggled with a difficult combination<br />

of local personalities and complex commissioning arrangements, these<br />

events offer members the chance to look afresh at how they can use<br />

the opportunity of the NHS changes to raise the profile of community<br />

optometry in their region.<br />

For more details about the courses, please contact Jacque Hudson,<br />

LOCSU office manager on 020 7202 8156 or jacquehudson@locsu.co.uk<br />

Katrina Venerus<br />

LOCSU director of operations and commissioning<br />

OT Letters, 61 Southwark Street, London SE1 0HL E: davidchallinor@optometry.co.uk The Editor reserves the right to edit letters and points out that the views expressed may not be those of the journal.


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SPECTATOR<br />

We need to have more<br />

dialogue with the GPs<br />

14<br />

01/07/11 SPECTATOR<br />

WE ARE now in the ‘post-pause’ era – and the pace of<br />

proposed changes to the NHS appears to be continuing<br />

largely unabated. Recent weeks have seen an upsurge in<br />

the number of ‘commissioning’ conferences and events as<br />

the convention industry cashes in on an identified market<br />

need – provision of ‘how-to’ learning events for a target<br />

audience of GPs, NHS managers and service providers<br />

to support the roll-out of the Government’s planned<br />

reforms for the NHS. The topic of commissioning has<br />

figured in <strong>this</strong> column previously, largely as a reflection<br />

of the frustration which exists across the profession that<br />

our current and potential contribution is either taken for<br />

granted or simply over-looked. But maybe <strong>this</strong> is about to<br />

change.<br />

In the margins of one such commissioning event<br />

“Commissioning 2011” the LOC Support Unit co-hosted<br />

a roundtable discussion between optometrists and GPs<br />

(pictured) about improving eye care services through<br />

commissioning. Reported in last week’s GP magazine,<br />

among the many positive aspects to emerge from the<br />

discussion was the comment by GP and government<br />

adviser Dr James Kingsland who acknowledged that there<br />

was a ‘huge repository’ of largely untapped knowledge in<br />

optometry.<br />

GPs are probably the key audience our profession<br />

needs to educate during the run-up to full-blown<br />

commissioning, and LOCSU should be congratulated for<br />

creating <strong>this</strong> opportunity for us to be heard. More of the<br />

same please.<br />

Earlier in the month, various research reports highlighting<br />

eye care related <strong>issue</strong>s were released in time to coincide<br />

with National Eye Health Week. A recurring theme among<br />

these were the particular problems encountered by older<br />

people.<br />

Last week saw the publication of the joint College<br />

of Optometrists and British Geriatrics Society review<br />

on the importance of vision in preventing falls and at<br />

the beginning of <strong>this</strong> week, Age UK published its own<br />

study which indicates likely cuts in older people’s social<br />

care of 8.4% <strong>this</strong> year. Many of these cuts will be as a<br />

result of local authorities striving to protect front-line<br />

services – but by making savings in areas such as social<br />

care provision, domiciliary care packages and reducing<br />

the number of placements in care homes. Age UK’s<br />

report estimates that the number of older people in need<br />

of social care, who do not receive any formal support<br />

from either state or private sector agencies will rise from<br />

800,000 to well over one million over the next four years<br />

as a result of these cuts. Optometrists and dispensing<br />

opticians have an important role to play here – and an<br />

important responsibility to meet. Provision of domiciliary<br />

eye care is an area of practice that many practitioners elect<br />

not to become involved in, leaving <strong>this</strong> provision to the<br />

various national domiciliary companies.<br />

However, in England, the Department of Health’s own<br />

data shows that the take-up of domiciliary eye care is<br />

lower than would be expected for the population and <strong>this</strong><br />

means that there is certainly unmet demand.<br />

We must take individual responsibility for ensuring the<br />

needs of <strong>this</strong> particularly vulnerable patient group are met.<br />

Now is the time we should be considering how, rather than<br />

if, we should get involved in delivering <strong>this</strong> service.<br />

Those practitioners with school age children will have<br />

had their week disrupted one way or another by teachers’<br />

industrial action. Meanwhile, another group of public<br />

employees – namely the doctors – who are facing the<br />

same proposed changes to their pension age, have made<br />

it clear that they will not take industrial action. With few<br />

exceptions, optometrists and dispensing opticians are not<br />

public employees and hence have never had the option<br />

of a public sector pension. While there will be a range<br />

of views about the fairness of these proposed changes<br />

(particularly for those who are close to retirement) it is<br />

probably fair to say that on <strong>this</strong> topic the doctors have<br />

judged the public mood better than some other groups of<br />

public employees. We are all having to negotiate our way<br />

through the current tough times and, while we recognise<br />

the need for individual groups to be able to protect their<br />

own positions, please do not make the rest of us suffer<br />

more in the process.<br />

For more comment visit www.optometry.co.uk


CL UpDaTe<br />

INDUSTRYNEWS<br />

16<br />

01/07/11 INDUSTRY NEWS<br />

New launches<br />

Bausch & LomB has launched new packaging<br />

for its full range of gas permeable lenses.<br />

Borrowing technology from its soft lens<br />

packaging, the company is now providing gas<br />

permeable contact lenses pre-soaked in blisters,<br />

(pictured) meaning that practitioners or patients<br />

will no longer need to soak them when they first<br />

receive them.<br />

Each lens, which is made to measure to an<br />

individual’s prescription, is now provided in a<br />

blister containing Boston advance conditioning<br />

solution with the label indicating the lens design<br />

and prescription. also indicated is the 28-day<br />

expiry date for the solution.<br />

“From talking to our customers, we became<br />

aware that some patients may not be soaking<br />

their GP lenses sufficiently before they inserted<br />

them for the first time, resulting in discomfort,”<br />

said technical support manager, steve Williams.<br />

“as we already provide our soft lenses in blisters<br />

and solution, we were able to study the process<br />

and apply it to our GP lenses, allowing patients<br />

to have an even more positive first experience of<br />

their GP lenses.”<br />

Johnson & Johnson Vision care is encouraging<br />

contact lens wearers to be more compliant by<br />

signing up to its improved acuminder service,<br />

after research showed patients are 91%<br />

more likely to change their lenses within the<br />

recommended period when reminded. Reusable<br />

contact lens wearers can sign-up to receive free<br />

reminders via text or email to keep track of all<br />

their contact lens needs, including when they<br />

need to schedule an eye examination, by logging<br />

on to www.acuminder.co.uk.<br />

“although past research in the uK has<br />

shown that wearers of monthly and twoweekly<br />

replacement lenses have equal states<br />

of compliance, it can always be improved,”<br />

said David Ruston, professional affairs director,<br />

western region at Johnson & Johnson Vision<br />

care. “This great service aims to make wearing<br />

reusable contact lenses as simple as possible.<br />

It’s just another way that practitioners can<br />

encourage their patients to take a more<br />

personal role in looking after their own eye<br />

health, for free.”<br />

UK Indian lens first<br />

BBGR has introduced anateo Jeevan, the UK’s first progressive lens designed for<br />

presbyopes from the Indian subcontinent. Jeevan means “life” in hindi.<br />

Using data from a year-long survey conducted among 37,000 patients<br />

in Chennai and Bangalore, BBGR has adapted the award-winning anateo<br />

design to satisfy three key visual requirements of presbyopes from the<br />

Indian subcontinent – eye anatomy, facial anatomy and ergonomics.<br />

The survey concluded that, compared to European and North<br />

american wearers, significant differences were recorded in<br />

average PD, eye length, rotational axis, BVD and wrap angle.<br />

also noted was the higher degree of head movement<br />

exercised by typical Indian presbyopes and a tendency to<br />

hold objects closer when reading.<br />

BBGR’s business development director, Nick Browning<br />

said: “Our survey clearly illustrated that the design<br />

should be optimised for the very different parameters<br />

found in wearers from the Indian subcontinent.<br />

These differences may explain why opticians often<br />

comment that non-tolerance rates in Indian, Pakistani<br />

and Bangladeshi patients are higher than found in other<br />

population groups.”<br />

anateo Jeevan is offered in a full range of materials and<br />

indices, including Transitions, with Neva Max available on<br />

all lens combinations.<br />

& 0844 880 1349


Dreaming<br />

up better<br />

Ortho-K<br />

No7 CoNtaCt Lenses has launched<br />

EyeDream, a re-branding of its popular<br />

ortho-K lenses, which now have over<br />

3,500 wearers across 200 proactive<br />

centres and growing.<br />

No7 felt that it needed to support<br />

practitioners further by offering<br />

marketing materials for the practice to<br />

personalise to drive patient awareness.<br />

Commercial director, Maxine Green,<br />

said: “the materials provide a host<br />

of compelling reasons for patients to<br />

consider EyeDream over other forms<br />

of vision correction.”<br />

the new initiatives can be<br />

personalised with practice details. they<br />

include an interactive patient website,<br />

window displays and patient leaflets.<br />

there is also a patient presentation<br />

which can be displayed on a practice PC<br />

or linked to the practice website.<br />

& 01424 850620<br />

Celebrating<br />

glory days<br />

Norville has released the new Best<br />

Under the sun collection from Polaroid<br />

eyewear which celebrates the history of<br />

Polaroid sunglasses. The heritage range<br />

re-creates some of Polaroid’s most iconic<br />

designs from the 1930s to the 1980s,<br />

but made from the latest lightweight<br />

materials and featuring Polaroid’s<br />

Ultrasight lenses. each design has been<br />

selected to reflect the keynote fashions<br />

of a particular decade.<br />

“This is the first time our retail<br />

partners will have the opportunity to<br />

show the complete history of Polaroid<br />

sunglasses in a single attractive window<br />

display.” said Polaroid eyewear’s UK<br />

and ireland sales manager, rebecca<br />

harwood lincoln.<br />

& 01452 510321<br />

olympic frames boost<br />

ZOOBUG has been<br />

chosen to produce the<br />

Official London 2012<br />

sunglass Collection<br />

for children, which<br />

will be launched in<br />

the UK <strong>this</strong> month<br />

following the signing of a<br />

licence between the children’s<br />

eyewear specialist and the London<br />

Organising Committee of the Olympic and Paralympic<br />

Games (LOCOG). The sunglass collection will be<br />

manufactured under licence by Zoobug in celebration<br />

of the London 2012 Olympic and Paralympic Games<br />

and will be available to UK opticians for delivery before<br />

Christmas.<br />

“Zoobug is honoured to be involved in the Olympics, having been chosen to produce their<br />

official sunglasses for children,” said company founder, Dr Julie Diem Le. “The London 2012<br />

Games is the biggest organised event in the world. This is huge and will make for such an<br />

exciting retail and marketing opportunity for all UK opticians in the run up to, and during,<br />

the Games.”<br />

Each sunglass style will boast a new flexible hinge design and adjustable rubber end<br />

tips for “high-level comfort”, plus 100% UV protective lenses. The frames are designed in<br />

popular shapes using the bright colour palette of London 2012. They are designed to be safe,<br />

comfortable and durable, for children of all ages.<br />

Decorative elements will include the Olympic and Paralympic mascots, Wenlock and<br />

Mandeville, and the London 2012 Union Flag designs. The collection will also incorporate Team<br />

GB designs, using the red, white and blue colour palette in support of the team, which will<br />

compete at the Games. Each product will come with a London 2012 or Team GB sunglasses<br />

pouch.<br />

& 0207 251 8122<br />

Anyone for prizes?<br />

Rodenstock has launched a special prize promotion for all Wimbledon sunglass stockists<br />

to celebrate the 125th anniversary of the Wimbledon championships. Running until the end<br />

of July, practices which promote the Wimbledon sunglass collection of frames can take<br />

part in a special promotion for both the practice and the consumer – ‘125 years, 125 chances<br />

to win’.<br />

the consumer can enter the competition in practice for the chance to win one of 125<br />

prizes ranging from a nintendo Wii with tennis pack, to Links of London Wimbledon lifestyle<br />

accessories and assorted Wimbledon championship items.<br />

Practices can gain by having striking point-of-sale material to entice potential customers<br />

in and can benefit further as every 125th Wimbledon sunglass repeat order that Rodenstock<br />

receives will be free of<br />

charge so practices could<br />

be credited for multiple<br />

orders at the end of the<br />

competition period.<br />

the 2011 Wimbledon<br />

sunglass collection<br />

consists of 18 models for<br />

women and men.<br />

& 01474 325555<br />

17<br />

01/07/11 INDUSTRY NEWS


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PROFILE<br />

20 Questions: John Davidson<br />

John Davidson, optometrist and owner of Querido & Davidson in Heaton, Newcastle, takes our Q&A<br />

20<br />

01/07/11 20 QUESTIONS<br />

How are you?<br />

I am happy, healthy and busy, so life is<br />

great.<br />

And how is business generally<br />

right now?<br />

Business is thriving. We grew 15% last year<br />

and are looking for the same in 2011.<br />

Have you had any promotions in<br />

your outlet that were especially<br />

successful?<br />

We promote the practice primarily by word<br />

of mouth, where satisfaction and attentive<br />

service are often enough to keep new<br />

clients joining the practice. Other than<br />

that, our website is very efficient at driving<br />

new business to the practice.<br />

What do you like about working<br />

in optics?<br />

Optics is a great industry to be in. It’s small<br />

enough to get to know so many people.<br />

I have found people from all parts of the<br />

industry to be friendly and always helpful.<br />

What’s the best thing that’s<br />

happened in the profession<br />

during your time working in it?<br />

I think the most recent national stance<br />

on glaucoma referral refinement has, for<br />

the first time, shown that we can act as a<br />

united profession to show decision makers<br />

what we can do and what we will do.<br />

Who do you admire in optics?<br />

Chris Steele from Sunderland Eye Infirmary<br />

has been inspirational in changing my<br />

perception of just how far optometrists<br />

can go clinically. Nick Rumney inspires me<br />

as an optometrist and practice owner, with<br />

an immense wealth of knowledge.<br />

Favourite places in the world<br />

that optics has taken you?<br />

The city of Prague at the Johnson &<br />

Johnson Vision Care Institute.<br />

Are you superstitious?<br />

Not at all. I don’t think fate, or superstition<br />

play any part in our existence. It’s all<br />

about probability and circumstances.<br />

If you were granted one wish<br />

for the profession, what would<br />

you wish for?<br />

An end to the seemingly untenable NHS<br />

funding <strong>issue</strong>. If our work is only funded<br />

to 40% of its value, then we need to<br />

move away from the system as soon as<br />

possible. I applaud those involved in the<br />

lobbying and political process of trying<br />

to keep the momentum of change.<br />

Do you have a favourite film?<br />

Glengarry Glen Ross which has amazing<br />

performances from Jack Lemmon, Al<br />

Pacino and Kevin Spacey.<br />

Outside of the profession,<br />

what are your hobbies?<br />

I am training for a cycling trip in<br />

September, and run when I can, however,<br />

my two young sons take up most of my<br />

time outside of work.<br />

Sum up your feelings for the<br />

next 12 months in five words.<br />

Optimistic opportunist optometrist<br />

operating optimally.<br />

Where do you go on holiday?<br />

Mostly in the UK, but I am lucky to have a<br />

brother in Denver so we go to the USA.<br />

What are your favourite<br />

products in the optical sector?<br />

Lindberg and Paul Smith spectacle frames,<br />

Maui Jim sunglasses. SO2Clear and<br />

Ortho-K contact lenses.<br />

If you weren’t in the profession<br />

what would you be doing?<br />

Possibly doing stand up comedy. …..or<br />

kids’ entertainment at birthday parties.<br />

Who’s your favourite singer?<br />

Tim Minchin – absolutely hilarious.<br />

What do you put down your<br />

company’s success to?<br />

Find your market, get to know your<br />

market, stick to it and don’t deviate.<br />

Favourite time of year?<br />

Spring. That feeling of anticipation, and<br />

renewed energy is great.<br />

Your perfect day?<br />

Watching rugby at Twickenham with<br />

friends, followed by the resurrection of<br />

Miles Davis for a final intimate concert of<br />

his Kind of Blue album at the Blue Notes<br />

in New York. Finally a nightcap watching<br />

the sunset over Sydney Harbour with<br />

Cameron Dias. Is <strong>this</strong> possible?<br />

Any final thoughts?<br />

A perfect marriage is one where you<br />

can agree on an acceptable number of<br />

cushions!


NEWS EXTRA<br />

Boots’ 500 is up in<br />

‘momentous year’<br />

ALLIANCE BOOTS has announced that<br />

its latest wave of rebranding Dollond &<br />

Aitchison practices has resulted in the<br />

500th Boots Opticians being opened.<br />

The new-look outlet in Colchester was<br />

officially re-opened by the town’s mayor,<br />

Councillor Helen Chuah in June.<br />

The roll-out of the rebranded practices<br />

is a result of the merger between the two<br />

companies in 2009, which made it the<br />

second largest optical chain in the UK.<br />

It includes both franchise and core practices, and together with<br />

those that are still currently branded Dollond & Aitchison, there<br />

are almost 700 practices across the entire chain.<br />

Andy Ferguson, managing director, Boots Opticians, said:<br />

“2011 is proving to be a momentous year for Boots Opticians.<br />

Amongst other things, we had an amazing start to the year, being<br />

ranked as the Sunday Times number one Best Big Company<br />

to Work For in the UK 2011; we have also started the process<br />

of moving to one supply chain, which will help make things<br />

more efficient for both our teams and<br />

our customers. These achievements<br />

have been in the planning stages since<br />

the merger, but to see them all come to<br />

fruition is exceptionally rewarding. The<br />

second half of <strong>this</strong> year will prove to be<br />

no less exciting, with lots more initiatives<br />

planned for the coming months.”<br />

One of the latest to be rebranded was<br />

the historic D&A store at 428 The Strand,<br />

London, which was re-opened on June 24.<br />

It was in nearby Vine Street that optical instrument maker Peter<br />

Dollond opened his first optics business in 1750.<br />

Andrew Chandler, retail director, Boots Opticians,<br />

commented: “Since the merger of Boots Opticians with Dollond<br />

& Aitchison, good progress has been made with the integration<br />

of the two businesses. We have combined the best of both former<br />

businesses to offer our customers an enhanced product offering.”<br />

The rebrand roll-out programme by the company will<br />

continue throughout 2011.<br />

21<br />

01/07/11 D&A RE-BRANDING


NEWS EXTRA<br />

GP/Optom roundtable<br />

points the way forward<br />

22 28<br />

08/04/11 01/07/11 GP ROUNDTABLE<br />

OPTOMETRISTS anD<br />

General Practitioners<br />

can work towards<br />

improvements in eye care<br />

services and more costeffective<br />

working.<br />

This was one of<br />

the conclusions of<br />

a roundtable debate<br />

between optical<br />

practitioners and GPs<br />

which took place in<br />

London on June 16, at the<br />

Hilton Olympia hotel.<br />

It was chaired by<br />

Dr James Kirkland,<br />

Merseyside GP and<br />

president of the national<br />

association of Primary<br />

Care, and national PBC Clinical network lead. It was<br />

organised by GP magazine and the Local Optical Committee<br />

Support Unit (LOCSU), and is the first of a series of<br />

roundtable events that LOCSU hopes to host.<br />

One of the optometrists involved, Katrina Venerus, who<br />

is also the Unit’s director of operations and commissioning,<br />

commented: “James Kingsland did an excellent job as chair<br />

and the other GPs who were present, who are involved<br />

The panel discussed... new ways<br />

of working to help take pressure<br />

off hospital eye departments<br />

in commissioning in various parts of England, were very<br />

supportive of the case for getting eye health on a wider<br />

agenda and redesigning eye care pathways to involve<br />

community optical practices via LOCs.”<br />

The panel discussed the ageing population and the need<br />

of new ways of working to help take pressure off hospital<br />

eye departments.<br />

Optical practitioners<br />

said they were ready<br />

to take on extended<br />

responsibilities<br />

with their specialist<br />

knowledge.<br />

at one point in the<br />

discussion the routine<br />

referral process, in<br />

which optometrists<br />

have to refer to a<br />

GP who then refers<br />

to secondary care,<br />

was criticised by<br />

one of the General<br />

Practitioners present<br />

who admitted their<br />

role as being ‘a very<br />

expensive secretarial<br />

service’.<br />

Trevor Warburton,<br />

the Stockport-based<br />

optometrist and chair<br />

of LOCSU’s clinical<br />

advisory group,<br />

agreed his profession<br />

could bring more<br />

expertise into eye<br />

care services, and Specsavers’ director of professional services<br />

Paul Carroll said that the business was intently focussed on<br />

providing what patients want which could improve eye care<br />

services.<br />

Professor nick<br />

Bosanquet’s report into<br />

cooperative eye care,<br />

which was released<br />

at the end of last year,<br />

was mentioned as a<br />

basis for cooperation<br />

and showed how the<br />

skills of optometrists<br />

can be used to provide<br />

improved nHS eye care outcomes.<br />

The GPs involved in the discussion said collaborative<br />

working in various eye care schemes was going well, although<br />

the point was raised that sometimes commercial pressures<br />

had stopped optical outlets from being involved.<br />

• The roundtable consisted of: Dr James Kingsland<br />

(chairman), Katrina Venerus, Paul Carroll, Trevor<br />

Warburton, Dr andrew Parson (GP lead at Bromley Clinical<br />

Commissioning Consortium), Dr Rubin Minhas (Kent GP and<br />

member of the nICE technology appraisal committee), Dr Raj<br />

Thakkar (Buckinghamshire-based GP with a special interest in<br />

cardiology) and Dr Tim Dukes (GP and clinical lead at Seisdon<br />

Peninsula Locality Commissioning Group, Staffordshire).<br />

The roundtable debate is available to watch on<br />

www.optometry.co.uk.


BOOKSHOP<br />

Historic retailing name<br />

joins forces with OT<br />

OT collaborates with Foyles in a new bookshop launched with up to 50%-off some publications<br />

OT IS pleased to<br />

announce that it<br />

has launched its<br />

new bookshop<br />

in partnership<br />

with Foyles. By<br />

visiting www.<br />

optometry.<br />

co.uk/bookshop<br />

you will have<br />

two links to<br />

choose from.<br />

Either select to<br />

view OT titles<br />

sold directly via<br />

the journal, or buy books from other publishers by clicking on<br />

the relevant Foyles OT Bookshop link provided.<br />

By using the link to the Foyles OT Bookshop, you will have<br />

access to special discounts on ALL externally published titles,<br />

with discounts ranging from 10% to more than 50%. Foyles’s<br />

e-commerce manager, Becky Jones said: “Foyles is delighted<br />

to be partnered with the industry leading <strong>Optometry</strong> <strong>Today</strong><br />

to provide books on all subjects at great prices. Whether it is<br />

the latest book on optics or a new fiction bestseller you’ll find<br />

them on our website.”<br />

Use the search facility or browse the dedicated pages in<br />

the ophthalmology or optometry pages. Alternatively, click<br />

on the home button to look at other publications and still<br />

take advantage of the discounts available. You can earn and<br />

spend ‘Foyalty’ points too. All you need to do is sign up to<br />

the scheme on the website which is free and easy to join – you<br />

will need an email address and then you can start to earn<br />

points every time you shop and redeem them whenever you<br />

want. For every £1 you spend you will earn four ‘Foyalty’<br />

points, each point worth 1p.<br />

OT manager, Louise Walpole said: “I’m so pleased we<br />

have <strong>this</strong> opportunity to provide discounted products to<br />

our readership. With OT being the profession’s leading CET<br />

provider, we must align ourselves with an equally prestigious<br />

educational resource provider such as Foyles.”<br />

In addition, you can order any of the OT published books<br />

direct, again, just go to the bookshop website and click on the<br />

relevant tab to view the fantastic offers available, including a<br />

full collection of CET titles from just £10. Offers are subject<br />

to change and are only available for a certain amount of time.<br />

Visit the bookshop at www.optometry.co.uk/bookshop and to<br />

see some of the fantastic offers available.<br />

Book offer<br />

To mark the introduction of the new OT<br />

Bookshop we are offering readers the<br />

opportunity to purchase OT’s Shared Care<br />

Series of nine CET titles for only £10.<br />

The package contains a wide variety of CETrelated<br />

books, including titles: Cataract Referral<br />

& Management; Clinical Decision Making & the<br />

Management of Contact Lens Complications;<br />

Systemic Pathology; Neurology & the Eye; Anterior Segment Eye<br />

Disease; Ageing Eye; Ocular Therapeutics: Case Studies; Ocular<br />

Disorders: A Series of Case Studies; and Silicone Hydrogel Contact<br />

Lenses. The package is subject to a £3.50 postage and packaging<br />

fee.<br />

For more information visit www.optometry.co.uk/bookshop,<br />

or to order directly contact charlotteverity@aop.org.uk/<br />

020 7202 8163.<br />

23<br />

01/07/11 READER OFFER


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COMPETITIONS<br />

July crossword<br />

This <strong>issue</strong> we continue our monthly crossword series. So why<br />

not enter our competition before the closure date, August 1. The<br />

winner will receive £50 in Marks & Spencer vouchers.<br />

Sign up<br />

to Job<br />

Alerts<br />

To hear about the<br />

lastest job<br />

vacancies first<br />

www.optometry.<br />

co.uk<br />

25<br />

Boost your chances<br />

of finding the<br />

ideal candidate<br />

for your vacancy<br />

by advertising on<br />

www.optometry.<br />

co.uk or call<br />

020 7878 2313<br />

01/07/11 CROSSWORD<br />

ACROSS<br />

1. Large snake (6)<br />

5. Fuel (8)<br />

9. Excessive food served to one (8)<br />

10. Twenty-fifth anniversary (6)<br />

11. Chemical used to fight tooth decay (8)<br />

12. Paint colour ‘Burnt ------‘ (6)<br />

13. Not ‘Northern’ (8)<br />

15. Short-legged terrier (4)<br />

17. Jogging gait (4)<br />

19. Watery Goddess (3,5)<br />

20. Rascally servant (6)<br />

21. Moved rapidly to keep warm (8)<br />

22. Famous musical with a slippery feel (6)<br />

23. Ampersand (8)<br />

24. Positive assertion (8)<br />

25. Bank messenger (6)<br />

DOWN<br />

2. Keeps the house secure (4,4)<br />

3. Controlled environment for plants (3,5)<br />

4. Total success (2,7)<br />

5. Parting gift with the Midas touch (6,9)<br />

6. Bound to make a personal view (7)<br />

7. Original thinker devising new ideas (8)<br />

8. Increase one’s wealth (4,1,3)<br />

14. That which us left over (9)<br />

15. Recovered (8)<br />

16. One’s own reflection (8)<br />

17. Intimidate (8)<br />

18. Do it again (4,4)<br />

19. Offspring, related by marriage (4-3)<br />

Name:<br />

Address:<br />

Send entries to OT, July Crossword, 61 Southwark Street, London SE1 0HL to arrive by August 1,<br />

2011. You can now enter the crossword competition online at www.optometry.co.uk.<br />

Display Advertising:<br />

Vanya Palczewski<br />

T: 0207 878 2347<br />

E: vanya.palczewski@<br />

tenalps.com<br />

Classified:<br />

Haley Willmott<br />

T: 0207 878 2313<br />

E: haley.willmott@<br />

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Sponsorship:<br />

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T: 0207 878 2327<br />

E: sunil.singh@<br />

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DIARYDATES<br />

12 Downing College, University of Cambridge,<br />

Cambridge, AMD for optometrists 2011<br />

(www.amdforoptometrists.org)<br />

NEW… 8 No7 Contact Lenses, venue TBC,<br />

London, Beyond the limbus evening SEE<br />

ABOVE<br />

20 UltraVision, Head Office, Leighton<br />

Buzzard, Bedfordshire, KeraSoft IC workshop<br />

(workshop@ultravision.co.uk)<br />

12 NES, Kingsmills Hotel, Culcabock Road,<br />

Inverness, Developing optometric skills<br />

SEE ABOVE<br />

26<br />

01/07/11 DIARY DATES<br />

Culture and CET with AIO<br />

Education, dancing and the opportunity for a fascinating historical<br />

The famous setting of Aintree racecourse plays host to <strong>this</strong> year’s<br />

College trip are of all Optometrists on offer at <strong>this</strong> conference, year’s Association see below for Independent<br />

<strong>Optometry</strong> (AIO) conference <strong>this</strong> Autumn.<br />

Tickets are now available for the October 7-9 event at Kilworth<br />

House Hotel, close to Market Harborough, Leicestershire, which is<br />

near to Bosworth Battlefield and the National Space Centre.<br />

Delegates will be able to earn CET points from the event including<br />

lectures by two ophthalmic surgeons. The Saturday night of the<br />

event will also include a Ceilidh band to entertain late-night revelers.<br />

Contact secretary@afio.co.uk for further details and to book.<br />

JULY<br />

4 Independents Day, National Motorcycle<br />

Museum, Birmingham<br />

(www.independentsday.co.uk)<br />

NEW… 6 Optical Confederation, 199<br />

Gloucester Terrace, London, W2, Optical sector<br />

steering group training and apprenticeship<br />

workshop (karensparrow@aop.org.uk)<br />

NEW… 11 Hospital of St John and St<br />

Elizabeth, 60 Grove End Road, London, All<br />

things retinal lecture (kate.jaffe@hje.org.uk)<br />

NEW… 12 No7 Contact Lenses,<br />

Cambridge, Irregular cornea,<br />

Free CET day, includes lab tour<br />

(www.no7contactlenses.com)<br />

12 NES, The Beardmore Hotel,<br />

Clydebank, Glasgow, Developing optometric<br />

skills (www.nes.replaylearning.com/<br />

clinical-skills)<br />

9 NES, The Marriott Hotel, 500 Argyle<br />

Street, Glasgow, Developing optometric<br />

skills SEE ABOVE<br />

NEW… 25 No7 Contact Lenses, Manchester,<br />

Speciality day SEE ABOVE<br />

AUGUST<br />

NEW… 4 No7 Contact Lenses, venue TBC,<br />

London, Beyond the limbus evening<br />

roadshow SEE ABOVE<br />

17 UltraVision, Head Office, Leighton Buzzard,<br />

Bedfordshire, KeraSoft IC workshop and fitting<br />

techniques SEE ABOVE<br />

22, 23, 24, 25 J&J, The Vision Care Institute,<br />

Pinewood, Wokingham, OSCE preparation<br />

one-day courses (www.thevisioncareinstitute.<br />

co.uk)<br />

NEW… 23 No7 Contact Lenses, Cambridge,<br />

Ortho-K and topography day SEE ABOVE<br />

SEPTEMBER<br />

1 NES, Ettrick Riverside, Dunsdale Road,<br />

Selkirk, Developing optometric skills<br />

SEE ABOVE<br />

NEW… 5 No7 Contact Lenses, Manchester,<br />

Irregular cornea day SEE ABOVE<br />

7 The Scottish Optical Golfing Society,<br />

Ladybank, Fife, final annual outing<br />

(haddington@montgomeryoptometrists.<br />

co.uk)<br />

NEW… 4 No7 Contact Lenses, Cambridge,<br />

Irregular cornea day Free CET day, includes<br />

lab tour SEE ABOVE<br />

14 BCLA, Royal Society of Medicine, London,<br />

presidential address (events@bcla.org.uk)<br />

NEW… 14-15 Aston University,<br />

Birmingham, Bernfest including several<br />

International speakers, limited availability<br />

(www.aston.ac.uk/bernfest)<br />

21 UltraVision, Head Office, Leighton<br />

Buzzard, Bedfordshire, KeraSoft IC workshop<br />

and fitting techniques SEE ABOVE<br />

22-24 International Conference on<br />

Ophthalmic Photography, Venue TBC, Oxford<br />

(www.icopmeeting.org)<br />

25-26 BABO, Oxford University, college TBC,<br />

Oxfordshire, Annual conference and 20th<br />

anniversary celebration (www.babo.co.uk)<br />

29-2 (October) Silmo, Paris Nord Villepinte<br />

exhibition center, Paris, France<br />

(www.silmoparis.com)<br />

OCTOBER<br />

NEW… 7-9 Association for Independent<br />

<strong>Optometry</strong>, Kilworth House Hotel,<br />

Leicestershire (secretary@afio.co.uk)<br />

*Up to £5k<br />

trade-in for<br />

your old<br />

edger<br />

*OFFER ENDS<br />

30TH SEPT.<br />

2011<br />

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OPHTHALMIC INSTRUMENTS<br />

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directory<br />

See more events at www.optometry.co.uk/events


STUDENTNEWS<br />

Sponsored by<br />

Conference booking opens<br />

This year’s<br />

AOP student<br />

conference<br />

will take place<br />

on November<br />

25-27 at<br />

Center Parcs<br />

in Longleat.<br />

The event<br />

is returning<br />

for a second<br />

consecutive<br />

year to the Wiltshire-based holiday resort,<br />

and students are urged to book early to<br />

avoid disappointment after last year’s<br />

conference was a sell-out.<br />

The annual three-day event focuses on<br />

providing students with important career<br />

advice and guidance on the pre-reg period.<br />

Once again travel to and from each<br />

university will be arranged, and after the<br />

conference closes at lunchtime on Sunday<br />

(November 27) students will have the<br />

afternoon free to enjoy Center Parcs’<br />

leisure facilities.<br />

A draft programme, which is currently<br />

subject to<br />

change, is<br />

available<br />

to view on<br />

the new<br />

dedicated<br />

Student AOP<br />

website,<br />

www.<br />

studentaop.<br />

org.uk/events<br />

Popular<br />

sessions expected to return from last year<br />

include ‘Planning for your Pre-reg’ with Dr<br />

Anna Kwartz and Professor Steve Parrish;<br />

‘What you didn’t know you didn’t know about<br />

how to get a Pre-reg’ by AOP education<br />

adviser Karen Sparrow; and ‘Circuit Training’<br />

with a variety of industry representatives.<br />

Tickets cost £85. To book visit, https://<br />

www.eiseverywhere.com/ehome/index.<br />

php?eventid=24716&, or use the QR code<br />

on the events poster which appears in<br />

<strong>this</strong> edition of OT. Watch footage from last<br />

year’s conference at www.optometry.co.uk/<br />

multimedia/ view-video?id=713145297001<br />

Research wins<br />

£120K grant<br />

Researchers at<br />

Cardiff University<br />

have received a<br />

grant exceeding<br />

£120,000 to help<br />

fund its work into<br />

glaucoma.<br />

The funding,<br />

given by Fight for<br />

Sight, was awarded<br />

for a project studying the sclera with Dr Craig<br />

Boote and Professor Keith Meek (pictured).<br />

The study aims to identify changes to the<br />

sclera which may contribute to optic nerve<br />

damage. Data gathered from motion capture<br />

video technology allows the researchers<br />

to accurately record the movement of<br />

the eyeball surface as internal pressure<br />

changes. Combined with data on the sclera’s<br />

microscoptic structure, the information is used<br />

to build computer models of the human eye<br />

that could lead to the development of new<br />

treatments.<br />

The funding coincides with a £2,000<br />

donation to the research project by<br />

Specsavers.<br />

27<br />

01/07/11 STUDENT NEWS<br />

Congratulations to all graduates<br />

The AOP would like to congratulate all new<br />

optometry graduates and Alison McClune,<br />

chair of the AOP Membership Committee,<br />

wishes them all the best as they embark on<br />

their pre-reg period.<br />

Ms McClune writes: “The next step<br />

is going into practice and seeing “real”<br />

patients – I remember the nervousness and<br />

the excitement like it was yesterday. I also<br />

remember how important it was to get on<br />

well with the receptionists! It’s a rewarding job<br />

and one with so many opportunities, both in<br />

and out of practice. Enjoy your pre-registration<br />

year – a year when you’ll be honing your<br />

skills and learning new ones, learning to work<br />

as part of a team, providing the public with<br />

an amazing eye health service, and finding<br />

yourself part of a proud profession. Work hard,<br />

learn as much as you can and look forward to<br />

the day that you are supervisor free…like taking<br />

the L plates off.”<br />

AOP chairman, David Shannon added:<br />

“Congratulations on completing your<br />

undergraduate training. The pre-reg period<br />

is another step on the way to your career as<br />

an optometrist. It may seem daunting at the<br />

moment but it will be over before you know it.<br />

“The profession of optometry is constantly<br />

evolving and rest assured the AOP will be there<br />

to support you in providing high quality eye<br />

care with confidence from the start of your<br />

career. Whether it is help or advice we are only<br />

a phone call away. I hope I get to meet some<br />

of you soon. Good luck.”<br />

<strong>Optometry</strong> students can take advantage of<br />

a range of pre-reg study aids in the new<br />

Learning Zone on the Student AOP website,<br />

www.studentaop.org.uk. Students are reminded<br />

that they can renew their free AOP membership<br />

for their pre-reg year and continue to gain full<br />

advice and access to the discounts and benefits<br />

needed. Call 020 7401 5311.


VRICS<br />

VISUAL RECOGNITION<br />

AND IDENTIFICATION<br />

OF CLINICAL SIGNS<br />

Sponsored by<br />

This FREE VRICS test should be completed online by clicking on the “VRICS Test” button at http://www.otcet.co.uk/<br />

and answering the Multiple Choice Questions (MCQs) using the associated images. Please note that there is only<br />

one correct answer for each MCQ. The associated reading list provides useful help for completing the MCQS.<br />

Successful completion will result in two CET points. VRICS regularly appears in <strong>Optometry</strong> <strong>Today</strong>.<br />

28<br />

OCULAR THERAPEUTICS & DISEASE PART 1<br />

COURSE CODE: C-16565 O/AS/SP<br />

Dr Mhairi Day, BSc (Hons), MCOptom, PhD,<br />

Dr Douglas Lyall, MBChB MRCOphth<br />

A<br />

About the author<br />

Dr Mhairi Day is an optometrist and lecturer at Glasgow Caledonian University. She is responsible<br />

for the Introduction to Ocular Disease and Clinical Ophthalmology undergraduate modules and<br />

co-ordinates training of UK optometrists in the postgraduate Ocular Therapeutics course.<br />

Dr Douglas Lyall is a Specialty Registrar in the West of Scotland Deanery and is an Honorary Clinical<br />

Research Fellow at NHS Ayrshire and Arran. The authors wish to thank Gartnavel General Hospital<br />

Ophthalmology Department for providing images for <strong>this</strong> VRICS.<br />

B<br />

01/07/11 VRICS<br />

1. A patient with the clinical information shown in Image A has<br />

the anterior eye appearance shown in Image A. Which one of the<br />

following does <strong>this</strong> patient have?<br />

a) Pseudoexfoliation syndrome<br />

b) Pigment dispersion syndrome<br />

c) Iris cysts<br />

d) Previous trabeculectomy<br />

2. Which of the following is the MOST suitable course of action<br />

for the patient in Image A?<br />

a) Follow-up in 6 months time<br />

b) Follow-up routinely in 2 years<br />

c) Refer to the GP for glaucoma medications<br />

d) Refer to an ophthalmologist for glaucoma medications<br />

3. What is the MOST suitable first line treatment for the patient in<br />

Image A, if they are diagnosed with early glaucoma?<br />

a) Topical prostaglandin analogue<br />

b) Topical beta-blocker<br />

c) Topical carbonic anhydrase inhibitor<br />

d) Laser trabeculoplasty<br />

4. A 30-year-old male patient presents with bilateral painful and<br />

itchy eyes. The clinical finding is shown in Image B. Which one of the<br />

following is NOT associated with <strong>this</strong> condition?<br />

a) Acne rosacea<br />

b) Eczema<br />

c) Hayfever<br />

d) Keratoconus<br />

5. The patient in Question 4 reports that he is taking systemic<br />

medication for the condition shown in Image B, and he is<br />

experiencing drowsiness. Which of the following medications is the<br />

patient MOST likely to be taking?<br />

a) Acrivastine<br />

b) Cetirizine<br />

c) Chlorphenamine<br />

d) Loratadine<br />

6. Regarding the appearance seen in front of the corneal surface of<br />

Image B, as indicated by the arrows, which of the following ocular<br />

therapeutic agents is MOST suitable for treatment of the condition<br />

shown in Image B?<br />

a) Antazoline sulphate<br />

b) Chloramphenicol<br />

c) Aciclovir<br />

d) Acetylcysteine


Sponsored by<br />

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IMPORTANT INFORMATION: Under the new Vantage rules, all OT CET points awarded will be uploaded to its website by us.<br />

All participants must confirm these results on www.cetoptics.com so that they can move their points from the “Pending Points record” into<br />

their “Final CET points record”. Full instructions on how to do <strong>this</strong> are available on their website. The closing date for <strong>this</strong> examination is<br />

September 2 2011. CET points for <strong>this</strong> exam will be uploaded to Vantage on September 12 2011.<br />

2 FREE CET POINTS<br />

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Approved for Optometrists Approved for AS Approved for SP<br />

<br />

<br />

Associated reading:<br />

1. Kanski JJ (2011) Clinical Ophthalmology: A Systematic Approach: Expert Consult,<br />

7th Edition Elsevier<br />

2. Ehlers JP et al. (2008). The Wills Eye Manual: Office and Emergency Room Diagnosis and<br />

Treatment of Eye Disease. 5th Edition Lippincott Williams & Wilkins<br />

3. The College of Optometrists Clinical Management Guidelines (http://www.college-optometrists.<br />

org/en/professional-standards/clinical_management_guidelines/index.cfm)<br />

4. British National Formulary (BNF) (http://bnf.org/bnf/index.htm)<br />

C<br />

D<br />

29<br />

01/07/11 VRICS<br />

7. A patient presents with irritated eyes, the appearance of which<br />

is shown in Image C. Which of the following is NOT evident in Image<br />

C?<br />

a) Chalazion<br />

b) Crusting of the lid margins<br />

c) Lid margin swelling<br />

d) Lid margin hyperaemia<br />

8. Which of the following is NOT a first line treatment of the<br />

condition shown in Image C?<br />

a) Warm compresses<br />

b) Lid hygiene with baby shampoo twice daily<br />

c) Advice on the avoidance of ocular cosmetics<br />

d) No treatment is required as <strong>this</strong> should resolve fully in 2 days<br />

9. If the condition in Image C persists after suitable first line<br />

treatment, which of the following is NOT suitable as a second line<br />

treatment?<br />

a) Topical artificial tears<br />

b) Topical antibiotics<br />

c) Systemic tetracycline<br />

d) Systemic steroids<br />

10. A 25-year-old female patient presents with a watery eye and<br />

with the appearance shown in Image D. Which of the following<br />

statements about the finding in Image D is TRUE?<br />

a) The appearance is of follicles since there is a central vascular tuft on each<br />

raised bump<br />

b) The appearance is of follicles since there is pallor<br />

c) The appearance is that of papillae since each raised bump is discrete<br />

d) The appearance is that of papillae which are due to hyperplasia of<br />

lymphoid t<strong>issue</strong><br />

11. Which of the following would NOT be a helpful test to facilitate<br />

differential diagnosis of the condition shown in Image D?<br />

a) Assessment of corneal sensitivity<br />

b) Sodium fluorescein staining<br />

c) Rose bengal staining<br />

d) Intraocular pressure measurement<br />

12. If no other abnormalities are found for the patient in Question<br />

10 and with the condition in Image D, which one of the following<br />

pharmacological treatments is MOST suitable?<br />

a) No pharmacological treatment is required<br />

b) Topical anti-viral agent<br />

c) Topical anti-bacterial agent<br />

d) Topical non-steroidal anti-inflammatory agent


eVeNTS<br />

Independents Day 2011<br />

We preview next Monday’s event which is aimed at independent practitioners, and its exhibitors<br />

designed to reduce spherical aberration, which can result in<br />

halos and glare. This exceptionally thin, monthly lens offers<br />

crisp, clear vision, even in low-light situations.<br />

30 28<br />

08/04/11 01/07/11 COVER ID ‘11 guIDE STORY<br />

InDEpEnDEnTS Day has built up a reputation as one<br />

of the key events in the optical calendar for independent<br />

practitioners. as well as the symposium there is a large<br />

exhibition with over 40 companies attending. Here we review<br />

what’s on offer:<br />

AEL Partners<br />

aEL partners has provided specialist VaT and tax solutions<br />

to independent practices in the UK since 1988. partner Marc<br />

Bennett and VaT services manager andy Kontakkis will be<br />

available to provide you with jargon free advice on <strong>issue</strong>s<br />

such as “What’s the best VaT method for my practice?”; “am<br />

I paying too much tax?”; “Should I incorporate?” and “How<br />

much is my practice worth?” you will also be able to pick up<br />

a free copy of the updated aEL report on ‘practice valuation<br />

and tax planning’.<br />

Bausch & Lomb<br />

The contact lens giant will be showcasing recent innovations<br />

including Biotrue multi-purpose solution, which provides<br />

‘exceptional’ disinfection, three bio-inspired innovations (pH<br />

balanced to match healthy tears, utilising hyaluronan and<br />

keeps certain beneficial tear proteins active) and helps keep<br />

lenses moist for up to 20 hours; and pureVision2 with High<br />

Definition Optics, a comfortable and healthy lens option,<br />

Carl Zeiss<br />

Carl Zeiss has been established as a world-leading company<br />

in optometric equipment, from the gold standard Humphrey<br />

Visual Field instruments, to the best selling Cirrus OCT.<br />

adding to the range, Carl Zeiss now has the worlds first<br />

objective, repeatable macular pigment density measurement<br />

with the new Visucam 200. This technology can help educate<br />

patients to the dangers of a low macular pigment density<br />

and show them that by taking supplements they can protect<br />

themselves against developing aMD. Visitors to the stand will<br />

have the opportunity to check their macular pigment density.<br />

CIBA Vision<br />

Contact lens company CIBa Vision is committed to<br />

supporting independent practitioners by providing<br />

innovative business initiatives that help grow your practices,<br />

it says. This includes the highly acclaimed Management and<br />

Business academy (MBa), a series of intensive residential<br />

business training programmes where practitioners learn<br />

from leading business experts and network with like-minded<br />

practitioners. Latest initiatives to support independent<br />

practitioners include a series of web seminars focusing on<br />

business growth.<br />

Essilor<br />

Lens manufacturer Essilor is proud to be title sponsors of<br />

Independents Day for the fourth consecutive year meaning<br />

that Varilux consultant opticians continue to get a discount<br />

on their conference fees. The company’s CET workshop will<br />

highlight techniques that can be used in practice to increase<br />

the penetration of aR coated lenses to patients. Essilor will be<br />

showcasing the latest range of lenses and coatings (including<br />

the award winning Crizal lenses), as well as bringing the<br />

‘ideal’ patient journey to life with Visioffice demonstrations.<br />

Eyeplan<br />

Eyeplan has been providing professional eye care plans for<br />

independent professionals for 12 years. at its core are the<br />

fundamental beliefs that independent practitioners should be<br />

rewarded for the clinical excellence and care that they offer.<br />

Eyeplan provides a fully managed direct debit and credit<br />

card collection service, marketing, training and in practice<br />

support. additionally with Eyeplan Connect, practices can<br />

access the company’s marketing and design skills to create<br />

a tailor made, targeted mailing service to help recruit new<br />

patients and communicate with existing ones, including its<br />

Eyeplan membership.


Hoya<br />

Hoya, winner of the Optician Awards Optical Supplier<br />

of the Year 2011, will be demonstrating its precision<br />

measurement system with a difference, visuReal. Delegates<br />

can experience the benefits for themselves by visiting the<br />

Hoya stand for a free demonstration, including information<br />

about all the marketing support tools available. The team<br />

will be on hand to discuss its range of other products and<br />

services which helped to secure their winning award.<br />

Independent Practice Growth UK<br />

Specialist optical growth company Independent Practice<br />

Growth UK is offering every visitor to Independents Day<br />

a free copy of a new paperback book on marketing and<br />

growing your independent practice. It’s Time to Fight Back<br />

has been written by the man behind the company, Richard<br />

Pakey, and looks at how to beat the bad economy, the<br />

multiples, and online glasses websites.<br />

Johnson & Johnson<br />

Johnson & Johnson is very proud to be supporting<br />

<strong>this</strong> year’s Independents Day. As part of its continual<br />

commitment to independent eye care practitioners, the<br />

company will have an exhibition stand enabling delegates<br />

to learn all about Acuvue Oasys with Hydraclear Plus,<br />

which has been shown to provide better overall and<br />

end-of-day comfort, leaving patients feeling like they are<br />

wearing no lens at all.<br />

fundraising initiative that specifically targets the prevention<br />

of blindness and impaired vision due to uncorrected<br />

refractive error – simply the need for an eye exam and a<br />

pair of glasses. Having disbursed $US4m to date, <strong>this</strong> has<br />

translated to the funding of programs in 16 countries and the<br />

screening of over 3.8 million people.<br />

Seiko<br />

This year Seiko celebrates its 130 th anniversary, and the 90 th<br />

anniversary of its optical business. Being accredited as a<br />

‘Seiko lens specialist’ makes a statement about a practice,<br />

the company believes. Consumers associate the brand<br />

with innovation, technology and style, precisely the types<br />

of associations that many independent opticians wish to<br />

nurture. This month the company will launch its latest<br />

catalogue. Visitors to its stand will also get the chance to win<br />

Seiko watches and clocks.<br />

Shamir<br />

For nearly three decades Shamir has been investing in<br />

R&D and has developed, designed and patented innovative<br />

Freeform lens design technologies. With lenses such as<br />

Shamir Autograph FreeFrame, its latest introduction Shamir<br />

Autograph Plus, Shamir Autograph and Shamir Autograph<br />

Attitude, the business can support premium lens solution<br />

requirements. Shamir also has advanced FreeForm Digressive<br />

and Single Vision lenses, as well as the latest in broadband<br />

coatings.<br />

31<br />

01/07/11 ID ‘11 guide<br />

Kodak<br />

Kodak Lens Vision Centre representatives will be present<br />

at Independents Day to explain the Kodak model to all<br />

practice and prospective practice owners. The company<br />

says it offers operational support, national marketing and<br />

bespoke local marketing, as well as a range of products<br />

under “one of the world’s best known brands”. Its growth<br />

programme is available to all Kodak Lens Vision Centres,<br />

together with its training centre in Gloucester.<br />

<strong>Optometry</strong> Giving Sight<br />

Optical charity <strong>Optometry</strong> Giving Sight is grateful to<br />

Independents Day organisers, PTR for once again providing<br />

a stand space at the event’s exhibition. First launched in<br />

the UK in 2003, <strong>Optometry</strong> Giving Sight is the only global<br />

Topcon<br />

Instrument company Topcon has launched more than 10 new<br />

products <strong>this</strong> year and many of these will be showcased at<br />

Independents Day. Some of the new items include Topcon’s<br />

first practice management system, i-Clarity, which is billed to<br />

revolutionise the optometric IT sector with its intuitive user<br />

interface; and the latest 3D OCT-2000 scanner, capable of<br />

capturing 50K scans per second. Approved by the ENSPDR,<br />

<strong>this</strong> next generation fundus camera has more functions<br />

designed for all levels of ophthalmic professionals.<br />

• Independents Day will take place on Monday July 4 at<br />

the National Motorcycle Museum, Birmingham. For more<br />

information visit www.independentsday.co.uk


CET CONTINUING<br />

EDUCATION<br />

& TRAINING<br />

1 FREE CET POINT<br />

Approved for: Optometrists 4 Dispensing Opticians 4<br />

OT CET content supports <strong>Optometry</strong> Giving Sight<br />

Having trouble signing in to take an exam?<br />

View CET FAQ Go to www.optometry.co.uk<br />

32<br />

01/07/11 CET<br />

Visual impairment<br />

support<br />

REFERRal REFINEmENT PaRT 7 COuRsE COdE: C-16469 O/d<br />

dr michael Crossland Phd mCOptom FaaO<br />

People with visual impairment may need help from many health and social care<br />

disciplines, including optometrists, dispensing opticians, rehabilitation workers,<br />

counsellors, social workers, teachers of those who are visually impaired, and<br />

ophthalmologists. Optometrists and dispensing opticians are ideally placed<br />

to ensure that their patients with low vision have been made aware of each<br />

of these services, and to refer patients to different agencies as needed. This<br />

article discusses the role of the different professions who work with people<br />

with visual impairment, and the referral pathways available to practitioners.<br />

low vision aids<br />

Many optical low vision aids can be<br />

effectively prescribed and managed by<br />

community optometrists and dispensing<br />

opticians. Most practices will have a<br />

selection of simple hand and stand<br />

magnifiers available for sale, and all<br />

optometrists should be comfortable<br />

with prescribing high near additions for<br />

people with reduced near visual acuity<br />

(VA). However, for more complex or<br />

expensive devices, referral to a specialist<br />

low vision clinic may be appropriate. In<br />

most hospital low vision clinics, optical<br />

Figure 1<br />

Monomouse CCTV plugged into a standard<br />

television (left) and Optelec ClearView+ (right)<br />

aids are supplied on a permanent loan<br />

system without cost to the patient. For<br />

expensive devices such as monocular<br />

telescopes (which cost around £150)<br />

referral may be warranted so that patients<br />

do not have to pay for these systems<br />

themselves. Many hospital clinics now<br />

employ Eye Clinic Liaison Officers<br />

(ECLOs) to signpost and refer people<br />

with visual impairment to other services.<br />

In some parts of the country there are<br />

primary care low vision services. Most<br />

impressively, the Wales Low Vision<br />

Scheme has accredited more than 170<br />

optometrists and provides low vision<br />

services in 183 practices in and around<br />

Wales. Low vision aids are paid for by<br />

the Primary Health Care division of the<br />

Welsh Assembly and <strong>issue</strong>d on loan<br />

at no charge to the patient. Another<br />

model is the South Essex scheme,<br />

where the hospital eye service pays<br />

local optometrists to perform low vision<br />

assessments and supply low vision aids.<br />

For more complex low vision aids<br />

such as spectacle mounted telescopes<br />

or prismatic field expanders, referral<br />

For the latest CET visit www.optometry.co.uk/cet<br />

to a specialist low vision clinic may<br />

be useful. These clinics may be offered<br />

through the hospital eye service, a local<br />

university optometry department, or<br />

a local community practitioner with<br />

a specialist interest in low vision.<br />

CCTVs and electronic low vision aids<br />

It is not practical for most optometric<br />

practices to have a large selection of<br />

electronic low vision aids to demonstrate<br />

to patients. Specialist low vision centres<br />

will often only have one desktop CCTV,<br />

one portable electronic magnifier, and<br />

one television based magnifier (eg, the<br />

Monomouse, on the left of Figure 1)<br />

for demonstration. In order for people<br />

with low vision to choose the most<br />

suitable electronic magnifier for them,<br />

practitioners should have details of the<br />

local resource centre for demonstration<br />

of many different electronic magnifiers.<br />

Action for Blind People and Royal<br />

National Institute of Blind People (RNIB)<br />

resource centres exist in several large<br />

English cities and offer a variety of<br />

electronic magnifiers and advice on other<br />

assistive technology solutions such as<br />

computer text enlargement software and<br />

electronic readers. Similarly, there are<br />

RNIB resource centres in Scotland and<br />

Northern Ireland. Local charities, such<br />

as the Cardiff Institute for the Blind and<br />

Surrey Association for Visual Impairment,<br />

also have resource centres that can<br />

demonstrate low vision aids. Some device<br />

manufacturers will also demonstrate<br />

aids to people with visual impairment.<br />

A further resource for people with<br />

visual impairment is Sight Village. This<br />

is a trade show that takes place in several<br />

British cities where manufacturers<br />

demonstrate the latest electronic low<br />

vision aids. It is worth warning people that<br />

these exhibitions can be extremely busy.<br />

The Macular Disease Society<br />

website and publications frequently<br />

include details of second-hand


CCTVs for sale. Such devices can<br />

also occasionally be found available<br />

on eBay and other internet sites.<br />

Non-optical aids<br />

A huge variety of non-optical aids are<br />

available for people with sight difficulties.<br />

These can help with many activities of<br />

33<br />

daily living and include talking watches,<br />

large print diaries, speaking kitchen<br />

scales, high contrast chopping boards,<br />

large button telephones, and large print<br />

Figure 2<br />

The Low Vision Leaflet<br />

Scrabble sets. Many local resource<br />

centres will offer these devices for sale,<br />

or they can be ordered through the RNIB<br />

by telephone, mail or online. Local<br />

social services also offer non-optical<br />

aids to people who are referred to them.<br />

Talking and large print books and<br />

newspapers are available through local<br />

libraries and bookshops, through the<br />

Calibre audio library, and through<br />

the RNIB library. People who are<br />

registered as severely sight impaired<br />

are able to obtain free postage on<br />

large print books through the Royal<br />

Mail Articles for the Blind scheme.<br />

social support<br />

Each local authority is obliged to offer<br />

a support service for people with<br />

disabilities, including those with visual<br />

impairment. Depending on the borough<br />

or county, these services may be provided<br />

through the council social services<br />

team or through a specialist sensory<br />

whereas others will only discuss the use<br />

of lighting and will not supply lamps.<br />

If needed, people referred to local<br />

sensory teams should receive a home<br />

visit to enable discussion of lighting,<br />

demonstration of non-optical aids,<br />

mobility training, advice on benefits<br />

and welfare rights, advice on computer<br />

training, and emotional support.<br />

Although some people may require<br />

all of these services, at the time of<br />

referral people with visual impairment<br />

may not require any additional help.<br />

Most local authorities will allow referral<br />

to social services by many different routes,<br />

including GP referral, self-referral, and<br />

referral from friends or family members.<br />

A method of ensuring that these services<br />

are offered to people with visual problems<br />

is the low vision leaflet (Figure 2). It is<br />

recommended that practitioners obtain<br />

details of the local sensory impairment<br />

teams in the areas where they work.<br />

Contact details can be obtained from<br />

and mobility training is the sensory<br />

impairment team at the local council.<br />

Guide dogs can be suitable for<br />

people with severe visual impairment<br />

that makes travelling dangerous or<br />

impossible. There is no minimum or<br />

maximum age requirement for using a<br />

guide dog and it is not necessary to be<br />

registered as sight impaired or severely<br />

sight impaired. People interested in<br />

discussing whether a guide dog would<br />

be suitable for them should contact the<br />

Guide Dogs for the Blind Association.<br />

People registered as sight impaired are<br />

entitled to assistance with travel costs<br />

such as the disabled person’s railcard<br />

(which allows 1/3 off rail fares for the<br />

holder and an accompanying person),<br />

a local bus pass or Freedom Pass. Local<br />

taxi costs or dial-a-ride schemes may<br />

also be available. In Scotland the scheme<br />

is more generous, with free train travel<br />

offered to people who are registered.<br />

01/07/11 CET<br />

impairment team or visual impairment<br />

the local council or the RNIB helpline.<br />

leisure activities<br />

team. Professionals who provide these<br />

Audio-described theatre performances<br />

assessments include specialist social<br />

Orientation and mobility<br />

are available in most large cities.<br />

workers, rehabilitation workers, and<br />

Visual impairment is strongly associated<br />

The VocalEyes organisation provides<br />

occupational therapists. Some areas<br />

with a higher risk of falling. To overcome<br />

details of performances that it audio-<br />

have contracted these services to other<br />

<strong>this</strong>, orientation and mobility training<br />

describes<br />

(www.vocaleyes.co.uk).<br />

agencies such as charities. In the author’s<br />

can be provided with and without aids<br />

This organisation also performs<br />

experience these services vary widely<br />

such as a symbol cane, long cane or<br />

audio description of museum<br />

between different areas in terms of quality,<br />

guide dog. Mobility training can also<br />

exhibitions and other artistic events.<br />

efficiency and scope of services offered. As<br />

help with memorising routes, public<br />

Films with audio description are<br />

an example, some boroughs will provide<br />

transport, and safe indoor navigation.<br />

common and are listed on the website<br />

task lighting for people with poor vision<br />

A first point of contact for orientation<br />

www.yourlocalcinema.com. In addition<br />

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the Cinema Exhibitors Association offers<br />

a card that entitles people with visual<br />

impairment to take an accompanying<br />

person free of charge, to act as a guide and<br />

to audio describe scenes if needed. Many<br />

theatres, concert venues and festivals may<br />

allow a sighted guide to attend events free<br />

of charge with a visually impaired person.<br />

Many Premier League football<br />

grounds and other sporting venues<br />

provide seats specifically for visually<br />

impaired supporters. These may<br />

include headsets for audio commentary,<br />

space for accompanying people, and<br />

unobstructed views of the pitch.<br />

Emotional support<br />

Depression is more common amongst<br />

people with visual impairment than in<br />

the general population and optometrists<br />

and dispensing opticians working in low<br />

vision may find their patients request<br />

advice over counselling services or other<br />

support for depression. People may be<br />

reluctant to volunteer that they are feeling<br />

depressed, so provision of some leaflets<br />

on counselling services where they<br />

can be accessed by patients is advised.<br />

Counselling services and emotional<br />

support may be provided through the<br />

local social services department, through<br />

local charities for the visually impaired<br />

and through national agencies. Both the<br />

RNIB and Macular Disease Society offer<br />

telephone counselling services to people<br />

with visual impairment and people close<br />

to them (see resources section below).<br />

Local groups for people with visual<br />

impairment may provide peer support<br />

and emotional help. The website www.<br />

visionary.org.uk identifies local groups.<br />

Web forums such as those hosted by<br />

the RNIB can also be a useful source of<br />

support, especially for teenagers and<br />

people of working age. Of course, if the<br />

practitioner is seriously concerned that<br />

any of their patients has severe mental<br />

health needs then GP referral is indicated.<br />

Educational support<br />

Practitioners must not forget that<br />

children and students could also suffer<br />

from visual impairment and will require<br />

educational support too. It is beyond<br />

the scope of <strong>this</strong> article to discuss at<br />

length the management of such patients,<br />

but many professionals are involved<br />

in supporting the education of people<br />

of school age with visual impairment.<br />

This includes Qualified Teachers of<br />

the Visually Impaired, Peripatetic<br />

Teachers, Learning Support Assistants<br />

and Special Educational Needs Coordinators.<br />

A comprehensive resource<br />

for children with visual impairment<br />

and their carers is the National<br />

Blind Children’s Society website.<br />

Many local and national charities<br />

provide training for people with<br />

visual impairment in computer<br />

use and other tasks. In addition<br />

the RNIB Loughborough College<br />

provides further education and adult<br />

education on a whole range of subjects.<br />

Employment support<br />

The government's “Access to Work”<br />

scheme provides support for people with<br />

sight impaired<br />

Local travel benefits (eg. local bus pass,<br />

London Freedom Pass, taxi cards)<br />

Protection under the Disability<br />

Discrimination Act<br />

Disabled persons railcard<br />

Help with telephone line rental costs<br />

Cinema exhibitors association Ecard<br />

Help for the digital TV switchover<br />

Free BT directory enquiries<br />

a disability who are in employment,<br />

self-employed or about to start work and<br />

who have difficulty in part of their job.<br />

Depending on the size of the employer<br />

and the length of time the employee has<br />

been there, Access to Work may fund all<br />

or part of the cost of adaptive technology<br />

(such as screen reader software or larger<br />

monitors), fares to and from work,<br />

awareness training for work colleagues,<br />

and support workers at work. The first<br />

port of call for anyone requiring Access<br />

to Work help is the local Jobcentre Plus.<br />

Under the Equality Act 2010, the<br />

employers of people who are (or could be)<br />

registered as sight impaired or severely<br />

sight impaired must make ‘reasonable<br />

adjustments’ to help their employees.<br />

These adjustments may include allowing<br />

time off to attend hospital appointments,<br />

re-allocating some duties to a colleague,<br />

or providing a larger screen monitor. If<br />

people feel that their employer does not<br />

make reasonable adjustments, or that<br />

they are being discriminated against at<br />

work because of their visual impairment,<br />

they can contact the Equality and<br />

Human Rights Commission, the RNIB,<br />

or a Citizens Advice Bureau. The RNIB<br />

has a specialist employment helpline.<br />

severely sight impaired<br />

as sight impaired plus:<br />

Blind person’s personal tax allowance<br />

Blue badge for car parking<br />

Half-price TV licence<br />

Half-price TV licence<br />

Table 1<br />

Some benefits of registration as sight impaired and severely sight impaired<br />

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Financial support<br />

People who are registered as severely<br />

sight impaired may be entitled to<br />

various state benefits including<br />

disability living allowance, attendance<br />

allowance, carers allowance, tax credits,<br />

pension credit, housing benefit and<br />

council tax allowance. As entitlement<br />

to benefits is complex (and applying for<br />

one benefit may reduce the eligibility<br />

for another benefit), specialist advice<br />

is wise. Citizens Advice Bureau,<br />

the RNIB, and local charities for<br />

people with sight impairment are<br />

suitable sources of information.<br />

Some charities will also award grants<br />

for equipment such as CCTVs or other<br />

assistive devices that are not otherwise<br />

paid for. Local charities such as Lions<br />

and Rotary Clubs will occasionally<br />

give funding to people with visual<br />

impairment to buy equipment. On<br />

occasion, optometrists may be asked to<br />

write letters of support for these grants<br />

and to give details about the nature of the<br />

visual impairment. Of course, written<br />

consent must be obtained from patients<br />

before providing <strong>this</strong> information.<br />

For people who were in the armed<br />

forces, the St Dunstan’s charity<br />

offers considerable help and will<br />

frequently fund the cost of electronic<br />

aids and other devices. They will also<br />

provide low vision assessments and<br />

rehabilitation work for eligible people.<br />

medical support<br />

The person with low vision may well<br />

need further referral to ophthalmology<br />

for registration as sight impaired,<br />

assessment for new treatment, and/<br />

or because of disease progression.<br />

Optometrists may also realise that their<br />

patient may require the input of other<br />

medical services such as audiology,<br />

paediatrics, care of the elderly, or<br />

falls teams. Apart from in emergency<br />

cases, a letter to the GP to suggest<br />

Task Resource Provider and referral mechanism<br />

Optical low<br />

vision aids<br />

Electronic low<br />

vision aids<br />

Non-optical<br />

aids<br />

Home<br />

assessment<br />

mobility<br />

support<br />

Hospital low vision clinic<br />

Local specialist optometrist /primary<br />

care low vision scheme<br />

University low vision clinic<br />

Action for Blind / RNIB resource centre<br />

Other charity resource centre<br />

Manufacturers<br />

Sight village exhibition<br />

Local resource centre<br />

RNIB<br />

Local social services<br />

Local and national charities<br />

Local social services<br />

Mobility training<br />

Guide dogs<br />

GP referral<br />

Varies<br />

Varies<br />

Self-referral<br />

Varies<br />

Self-referral<br />

Self-referral<br />

Self-referral<br />

Phone<br />

Catalogue<br />

Online<br />

Table 2<br />

Resources and referral mechanisms for people with visual impairment<br />

Low vision leaflet<br />

CVI/RVI<br />

Self-referral<br />

Self-referral<br />

Low vision leaflet<br />

CVI/RVI<br />

Self-referral<br />

Local social services (Low vision leaflet;<br />

CVI/RVI; Self-referral)<br />

Guide Dogs for the Blind Association<br />

social support Reduced price cinema tickets Cinema Exhibitors Association<br />

Emotional<br />

support<br />

Educational<br />

support<br />

Employment<br />

support<br />

Financial<br />

support<br />

medical support<br />

Telephone counselling services<br />

Peer support<br />

Formal counselling services<br />

Educational advice<br />

Courses for people with visual<br />

impairment<br />

Access to Work scheme<br />

Equality act protection<br />

Benefits advice<br />

Charitable grants<br />

Ophthalmology, Care of the elderly<br />

Paediatrics, Falls teams, Mental health<br />

services<br />

Macular disease society, RNIB<br />

Local charities<br />

Mental health services (GP referral)<br />

National blind children’s society<br />

RNIB College<br />

Royal National College for the Blind,<br />

Hereford<br />

Jobcentre plus<br />

Equality and human rights commission<br />

Citizens Advice Bureaux, RNIB, Action for<br />

Blind People<br />

Local or national charities<br />

GP referral<br />

35<br />

01/07/11 CET<br />

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36<br />

01/07/11 CET<br />

referral to such teams is often sufficient.<br />

At present, registration as sight<br />

impaired (formerly known as<br />

partially sighted) or severely sight<br />

impaired (previously called blind)<br />

can only be performed by a consultant<br />

ophthalmologist. Contrary to popular<br />

belief amongst our profession, consultants<br />

on the new consultant contract do not<br />

receive any additional payment for <strong>this</strong><br />

work. Registration is performed using a<br />

Certificate of Visual Impairment (CVI).<br />

Benefits of registration are summarised<br />

in Table 1. It should be noted that<br />

registration isn’t a requirement for<br />

social services assessment, which can<br />

be arranged through self-referral or the<br />

low vision leaflet (Figure 2). The biggest<br />

financial benefit of being registered<br />

severely sight impaired is the blind<br />

person’s personal tax allowance, which<br />

is worth £1,890 and can be transferred to<br />

a partner if the registered person does not<br />

have sufficient income to benefit from<br />

<strong>this</strong> allowance. Other important benefits<br />

of registration are protection under the<br />

equalities act, local travel benefits (such<br />

as taxi cards and the Freedom Pass in<br />

London), and a blue badge for parking<br />

when driven in someone else’s car.<br />

The low vision leaflet<br />

For access to social services,<br />

optometrists and dispensing opticians<br />

can give people a low vision leaflet and<br />

ask them to return <strong>this</strong> to their local<br />

council (Figure 2). This leaflet can be<br />

obtained from the local council offices<br />

or downloaded from the Department of<br />

Health website (http://www.dh.gov.uk/<br />

en/Healthcare/Primarycare/Optical/<br />

DH_4074843). An alternative referral<br />

method for practitioners working<br />

in hospital clinics is the Referral of<br />

Vision Impairment form (RVI). This<br />

is designed for people who require<br />

intervention from social services but<br />

who are not eligible for CVI registration,<br />

or who choose not to be registered;<br />

indeed, it should be remembered that<br />

not all patients who have a visual<br />

impairment need to register, with<br />

<strong>this</strong> being a completely free choice.<br />

Conclusions<br />

People with visual impairment<br />

may need referral to many different<br />

professions and agencies. Table 2<br />

summarises the various resources and<br />

referral routes available to practitioners.<br />

All optometrists and dispensing<br />

opticians should have information<br />

about their local sensory teams, details<br />

of their local voluntary organisations for<br />

the visually impaired and information<br />

for national charities for people<br />

with visual impairment such as the<br />

Macular Disease Society and the RNIB.<br />

about the author<br />

Dr Michael Crossland is a specialist<br />

optometrist at Moorfields Eye<br />

Hospital NHS Foundation Trust and a<br />

Research Fellow at the UCL Institute<br />

of Ophthalmology. He qualified as an<br />

optometrist in 1999 and was awarded a<br />

PhD for work on the Preferred Retinal<br />

Locus in Macular Disease in 2004. He<br />

has published over 25 peer-reviewed<br />

papers in the area of low vision and<br />

vision rehabilitation. His current<br />

research is funded by the National<br />

Institute for Health Research. He thanks<br />

his colleagues Caroline Beebee, Jay<br />

Varia and Katy Barnard for advice and<br />

helpful discussion regarding <strong>this</strong> paper.<br />

Resources and references<br />

See http://www.optometry.co.uk<br />

clinical/index. Click on the article title<br />

and then download "references".<br />

module questions<br />

Course code: C-16469 O/d<br />

1. In hospital clinics, EClO stands for:<br />

(a) Enhanced clinical liaison officer<br />

(b) Eye clinic liaison officer<br />

(c) Eye certification and licensing officer<br />

(d) Eye council liaison officer<br />

PlEasE NOTE There is only one correct answer. all CET is now FREE. Enter online. Please complete online by<br />

midnight on July 29 2011 - You will be unable to submit exams after <strong>this</strong> date – answers to the module will be<br />

published on www.optometry.co.uk. CET points for these exams will be uploaded to Vantage on august 8 2011.<br />

4. Counselling for people with visual impairment is offered by:<br />

(a) Local social services<br />

(b) The RNIB<br />

(c) The Macular Disease Society<br />

(d) All of the above<br />

2. attendance allowance may be claimed by people with visual<br />

impairment:<br />

(a) Regardless of their registration status<br />

(b) If registered as severely sight impaired but not if registered as sight<br />

impaired<br />

(c) Only if registered as either severely sight impaired or sight impaired<br />

(d) Only if they are registered as disabled<br />

3. Which of the following statements about the monomouse is<br />

TRuE?<br />

(a) It is a computerised text enlargement system<br />

(b) It is a portable text enlargement system<br />

(c) It is a text enlargement system which plugs into a television<br />

(d) It is an electronic text-to-speech reading device<br />

5. Which of the following statements about the access to Work scheme is<br />

FalsE?<br />

(a) In some circumstances it will fund travel to and from work<br />

(b) It is not available to people who are self-employed<br />

(c) The local Jobcentre Plus is a point of contact for information<br />

(d) It may pay towards the cost of a larger computer monitor<br />

6. Which of the following statements about the low Vision leaflet is TRuE?<br />

(a) It can only be completed for people registered as sight impaired or severely<br />

sight impaired<br />

(b) It is produced and distributed by the RNIB<br />

(c) It can only be completed by a hospital optometrist<br />

(d) It is sent to the local social services department<br />

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Vision standards for driving<br />

– the evidence base<br />

COuRsE COdE C-16307 O/d<br />

sharifa Hirani Bsc (Hons), Msc, MCOptom, RMN<br />

The UK government stipulates that “before you start to learn to drive,<br />

make sure you are aware of the eyesight requirements. If you need glasses<br />

or corrective lenses to meet the requirements, it is a legal requirement<br />

that you wear them every time you drive.” 1 Optometrists and dispensing<br />

opticians are frequently asked by patients whether they need to wear<br />

spectacles when driving. This article reviews the relevant research in <strong>this</strong><br />

area and aims to help eye care practitioners to answer these questions.<br />

Current vision standards for<br />

driving<br />

Driving is recognised to be a visually<br />

intensive task, which is set with<br />

a minimum legal visual standard<br />

requirement for all motorists. 2 Since<br />

January 1983, the European Commission<br />

has laid down the definitive visual<br />

standards for driving licence holders<br />

and <strong>this</strong> has been incorporated into<br />

UK law. 3 The law states that for Group<br />

1 drivers (car and other light vehicles),<br />

the driver should be able to read in good<br />

light (with the aid of glasses or contact<br />

lenses if worn) a registration mark<br />

fixed to a motor vehicle and containing<br />

letters and figures 79mm wide at a<br />

distance of 20.5m, or at a distance of<br />

20m where the characters are 50mm<br />

wide. If a licence holder or applicant<br />

is suffering with a prescribed disability<br />

and is unable to meet the eyesight<br />

requirements, they must not drive. 3<br />

The law also stipulates a minimum<br />

standard for a second group of licences<br />

incorporating large good vehicles (LGV)<br />

and passenger carrying vehicles (PCV)<br />

(including public service vehicles -<br />

PSV). These Group 2 drivers are subject<br />

to more stringent and specific monocular<br />

visual acuity (VA) standards. 2 Since<br />

1997, Group 2 drivers are required<br />

to have an uncorrected VA of at least<br />

3/60 in each eye and, with refractive<br />

correction worn, at least 6/9 in their<br />

better eye and 6/12 in their worse eye. 4<br />

From January 2011, new legislation<br />

was introduced in the European Union<br />

(EU), which will come into full force<br />

in all EU countries by 2013, requiring<br />

driving licences to carry details of<br />

drivers’ sight correction requirements. 5<br />

Under <strong>this</strong> directive, drivers will<br />

be categorised into two groups:<br />

• Private licence holders with corrected<br />

VA of at least 6/12 (0.5 decimal)<br />

or 6/10 (0.6 decimal) if only one<br />

eye is functioning, and horizontal<br />

visual fields of a minimum 120°.<br />

• Professional drivers with corrected<br />

VA of at least 6/7 (0.86 decimal) with<br />

binocular vision, and VA in the worst<br />

eye of at least 6/12 (0.5). A restriction<br />

will also apply if the refractive<br />

correction exceeds -8.00DS (-8.75DS<br />

spectacle refraction if contact lenses<br />

are worn), and the uncorrected vision<br />

must be at least 6/20 (0.3 decimal). 5<br />

It is clear from <strong>this</strong> directive that<br />

there will be an increased reliance on<br />

VA as a measure of one’s visual ability<br />

to drive, but do current optometric<br />

practices make VA testing amenable<br />

to visual standards for driving?<br />

Evidence base for driving<br />

vision standards<br />

VA is perhaps the most commonly<br />

tested visual function in relation to<br />

driving. 6 Literature has shown that there<br />

is a longstanding disparity between<br />

VA measured in optometric practice<br />

and the vision standard stipulated by<br />

law, even though it is recognised that<br />

the “number plate test” is absolute in<br />

law and not open to interpretation. 4<br />

It has been suggested that vision<br />

comprises 90-95% of the sensory input<br />

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to driving, without any direct evidence. 7<br />

As driving is now an integral part of<br />

daily activities and a key factor in<br />

maintaining independence it is essential<br />

that vision standards for driving be<br />

justified to strong empirical evidence. 6<br />

38<br />

01/07/11 CET<br />

Visual acuity<br />

There is no precise critical Snellen<br />

chart VA equivalent to the numberplate<br />

standard. A popularly referenced<br />

comparison of the British number plate<br />

and Snellen vision/VA tests for car<br />

drivers was conducted by Drasdo and<br />

Haggerty. 8 Calculations based on a sample<br />

of candidates who had failed the number<br />

plate test suggest that a driving test<br />

candidate with a Snellen decimal VA of<br />

0.55, or approximately 6/12+2 in clinical<br />

notation, has a 50% chance of passing<br />

the number plate test. However, the level<br />

of VA that would fail the same number<br />

of candidates as the number plate test is<br />

deduced from an approximate population<br />

model to be 0.6 decimal or 6/9-2 Snellen.<br />

Currie et al. 9 considered 50 people<br />

with a Snellen binocular VA of 6/9 and<br />

50 people with a Snellen binocular<br />

VA of 6/12, all of whom could read a<br />

number plate at 20.5 metres. All people<br />

were recruited prospectively from<br />

ophthalmology clinics as having some<br />

form of eye disease and had a mean<br />

age of 78 years, which is not unlike an<br />

average patient seen in an everyday<br />

optometric practice. Thirteen out of<br />

the 50 participants with binocular VA<br />

of 6/9 could not read the number plate<br />

but 17 out of the 50 participants in the<br />

group with VA of 6/12 could read the<br />

number plate. Based on these results,<br />

the authors felt that people with vision/<br />

best-corrected VA of 6/9 or less should<br />

be warned that they may fail to meet<br />

the visual standard for driving but those<br />

with vision/best-corrected VA of 6/12<br />

should not be assumed to be below<br />

the standard. They also recommended<br />

that for people with binocular Snellen<br />

VA of 6/9 or less inquiring about their<br />

eligibility to drive, the only correct<br />

response is “I don’t know” unless the<br />

health professional tests their ability<br />

to read an actual number plate outside.<br />

Character composition<br />

Kiel et al. 10 considered whether the<br />

character composition of a number<br />

plate and the background colour would<br />

affect the ease with which they are read.<br />

They found that there is a significant<br />

difference based on variations in the<br />

letter and numeral composition. In their<br />

study of 210 subjects who achieved a<br />

binocular Snellen VA of between 6/9<br />

and 6/12, 92.3% could read all of the<br />

number plates assessed in the study, at<br />

the legal distance. Of the three number<br />

plates that they assessed, 96.7 % could<br />

read at least one number plate at the legal<br />

distance whilst 3.3% of the test subjects<br />

could not read any of the three number<br />

plates, at the standard distance of 20.5<br />

metres. The authors propose that a<br />

possible explanation for the discrepancy<br />

between Snellen VA and the calculated<br />

theoretical level of acuity required may<br />

relate to the fact that subjects reading a<br />

number plate have a possible choice of<br />

26 letters and 10 numbers (1-in-36 or<br />

2.8%) chance of a correct guess, whereas<br />

those reading a Snellen chart only have a<br />

presumed choice of 26 letters (1-in-26 or<br />

3.8%) chance ie, there is a greater chance<br />

of correct guessing when measuring<br />

Snellen acuity, which could actually<br />

lead to an over-estimation of true VA.<br />

Environmental factors<br />

It has also been thought that VA<br />

measurements in a consulting room<br />

may not correspond to the ability of an<br />

individual to read the standard vehicle<br />

number plate at the roadside, due to<br />

differing conditions of light, glare and<br />

contrast, and may therefore be very<br />

misleading. 8 The unreliability of Snellen<br />

VA measurement in predicting the<br />

outcome of the “number plate test” has<br />

also been recognised and supported by<br />

the Royal College of Ophthalmologists. 3<br />

This is perhaps because Snellen VA<br />

is measured with high contrast static<br />

optotypes, very unlike natural conditions<br />

of the “number plate test”, making Snellen<br />

VA a poor predictor of a person’s ability<br />

to meet the legal driving standard. 9 VA is<br />

evaluated under high contrast and high<br />

luminance conditions, whereas driving<br />

encompasses wide ranging contrast and<br />

luminance levels, 11 including overcast<br />

cloudy days and night driving, as well<br />

as the actual cleanliness of the car/plate.<br />

Contrast sensitivity<br />

McGwin et al. 12 showed that there is a<br />

pattern of difficulty in high-risk driving<br />

situations among those with decreased<br />

VA and contrast sensitivity, even after<br />

adjustments for age, gender, weekly<br />

mileage, and cognitive impairment.<br />

Although contrast sensitivity is not<br />

assessed in determination of driving<br />

For the latest CET visit www.optometry.co.uk/cet


safely, it does bear strong relevance.<br />

Studies of patients with cataracts have<br />

shown that contrast sensitivity may be<br />

significantly reduced with only a modest<br />

accompanying reduction in VA and yet<br />

no attempt has been made to measure the<br />

contrast sensitivity function within the<br />

current DVLA standards. 13,14 Freeman 15<br />

suggests that research is needed to devise<br />

criteria to establish guidelines correlated<br />

to visual-related driving risk assessment.<br />

Visual field<br />

The UK’s Royal College of<br />

Ophthalmologists 3 has recommended<br />

that: “The minimum visual field for<br />

safe driving is a field of vision of at<br />

least 120° on the horizontal meridian<br />

measured by Goldmann perimetry<br />

using the III4e setting (or equivalent<br />

perimetry). In addition there should<br />

be no significant field defect in the<br />

binocular field which encroaches<br />

within 20° of fixation either above or<br />

below the horizontal meridian. By these<br />

means, homonymous or bi-temporal<br />

defects that came close to fixation,<br />

whether hemianopic or quadrantonopic,<br />

are not accepted as safe for driving.<br />

Isolated scotomata in the binocular<br />

field near to the central fixation may<br />

also be inconsistent with safe driving”.<br />

The first large-scale population-based<br />

assessment of visual field impairment<br />

and driver safety was conducted by<br />

Johnson and Keltner. 16 They reported<br />

that drivers with severe binocular field<br />

loss had significantly higher motor<br />

vehicle collision and violation rates<br />

compared to those without any field<br />

loss. Drivers with monocular visual field<br />

loss had similar rates of accidents and<br />

driving convictions as compared to those<br />

with full visual fields. In comparison,<br />

those drivers with bilateral visual field<br />

a study by Owsley et al. 17 which found<br />

that the risk of having an injurious motor<br />

vehicle collision was more than double<br />

for drivers with visual field impairment.<br />

In the UK, the visual field requirements<br />

for driving are often assessed with the<br />

Esterman program. The test generates<br />

an overall score that is weighted<br />

towards visual ability in the central and<br />

inferior field. 2 As the test is binocular,<br />

fixation cannot be monitored; in<br />

recognition of <strong>this</strong>, the Royal College of<br />

Ophthalmologists state that “a perimetrist<br />

should be present with the patient at<br />

all times during the test”. 3 Kotecha<br />

et al. 2 noted well that in practice <strong>this</strong><br />

simply serves to emphasise the inherent<br />

differences between the Esterman test<br />

and the monocular visual field tests upon<br />

which the evidence for impaired driving<br />

ability is based. Case selection is also<br />

raised as an <strong>issue</strong> since the Esterman test<br />

is most often carried out at the request of<br />

the DVLA following a driver declaration<br />

of a pathology that may affect the visual<br />

field, as opposed to a routine assessment<br />

in the larger general population.<br />

Steel et al. 18 suggested that when the<br />

adequacy of a patient’s visual field is<br />

being assessed, the standard does not<br />

specify if spectacles should be worn<br />

or not, and they felt that <strong>this</strong> was an<br />

unrealistic situation because spectacles<br />

are required to meet the VA requirement<br />

and yet can restrict the peripheral field<br />

of vision, based on frame style and<br />

magnification effects. Indeed, spectacle<br />

The future<br />

The current visual standard for driving<br />

is retained mainly because of the<br />

practicality for roadside testing by the<br />

driver him/herself or by the police. 1<br />

Having said <strong>this</strong>, the majority of drivers<br />

continue to have a poor appreciation<br />

of the UK driving vision standard. 19 In<br />

addition, healthcare professionals find<br />

the criteria confusing. The level of VA<br />

at which optometrists, opticians, and<br />

ophthalmologists advise people against<br />

driving ranges from 6/9-2 to less than<br />

6/18. 9 In the short-term, the low cost,<br />

widespread acceptance, and availability<br />

of static VA and perimetric measures<br />

justifies their use but other tests should<br />

be developed to aid correct determination<br />

of one’s visual ability to drive, so that<br />

appropriate allocation of who can<br />

retain their licences can be performed. 20<br />

The importance of considering<br />

contrast sensitivity as part of the<br />

vision assessment for driving has been<br />

mentioned earlier in <strong>this</strong> article. Indeed,<br />

Owsley 11 reported that several studies<br />

have established that older adults have<br />

impaired contrast sensitivity under<br />

photopic conditions at intermediate<br />

and high spatial frequencies, with the<br />

magnititude of deficit increasing with<br />

increasing spatial frequency. Therefore,<br />

could it be reasonable to expect differing<br />

driving standards to be introduced<br />

for differing stages of life (ie, varying<br />

by age)? Renewal of driving licences<br />

is currently conducted using a self<br />

reporting scheme at the age of 70 years<br />

and though research has shown that<br />

aging affects vision, driving standards<br />

are not adapted in accordance with <strong>this</strong>.<br />

VA tests were originally designed for the<br />

clinical diagnosis and monitoring of eye<br />

disease and do not by themselves reflect<br />

the complexity of the driving task. 11<br />

39<br />

01/07/11 CET<br />

loss had twice the rate of accidents and<br />

convictions compared to those with no<br />

frames can, and frequently do, cause<br />

visual field defects that may artificially<br />

Conclusion<br />

field loss. This finding was re-affirmed in<br />

affect a driver’s fitness to drive. 18<br />

The literature reviewed in <strong>this</strong> article<br />

Find out when CET points will be uploaded to Vantage at www.optometry.co.uk/cet/vantage-dates


CET CONTINUING<br />

EDUCATION<br />

& TRAINING<br />

1 FREE CET POINT<br />

Approved for: Optometrists 4 Dispensing opticians 4<br />

OT CET content supports <strong>Optometry</strong> Giving Sight<br />

For the latest CET visit www.optometry.co.uk/cet<br />

Having trouble signing in to take an exam?<br />

View CET FAQ Go to www.optometry.co.uk<br />

40<br />

suggests that VA standards for driving<br />

are inconclusive, and therefore<br />

optometrists ought to advise patients<br />

that they are obliged to follow the<br />

guidelines of the DVLA. 4 Future<br />

EU directives will make vision<br />

standards clearer and collaboration<br />

between the Department of Transport<br />

and the College of Optometrists<br />

for a larger scale quantitative study<br />

that leads to thorough evidencebased<br />

guidelines for optometrists<br />

to use in practice will be welcome.<br />

About the author<br />

Sharifa Hirani is an optometrist at<br />

Brown and Wenman Ltd, in Dunstable<br />

and a clinic supervisor at Anglia Ruskin<br />

University. She is also a registered<br />

nurse with a MSc in Neuroscience<br />

and currently is in her second year<br />

of the Doctorate of <strong>Optometry</strong>.<br />

References<br />

See http://www.optometry.co.uk<br />

clinical/index. Click on the article title<br />

and then download “references”.<br />

Module questions<br />

Course code: C-16307 O/d<br />

01/07/11 CET<br />

1. Which of the following statements about the legal visual<br />

standards for driving licence holders is TRuE?<br />

(a) UK law stipulated the definitive maximum standards in January 1983<br />

(b) The European Commission stipulated definitive minimum standards in<br />

January 1983<br />

(c) The DVLA stipulated definitive minimum standards in January 1983<br />

(d) UK law stipulated definitive minimum standards in January 1997<br />

2. For Group 1 licence holders, drivers should be able to read (with<br />

glasses or contact lenses if worn):<br />

(a) Characters 79mm wide at a distance of 20.5m or 50mm wide at a<br />

distance of 20m<br />

(b) Characters 79mm wide at a distance of 20m or 50mm wide at a distance<br />

of 20.5m<br />

(c) Characters 25mm wide at a distance of 20m<br />

(d) Characters 7.9mm wide at a distance of 20.5 m or 5.0mm wide at a<br />

distance of 20m<br />

3. Which of the following is the CORRECT VA standard for Group 2<br />

licence holders?<br />

(a) Uncorrected vision at least 3/60 in each eye, corrected VA at least 6/9 in<br />

the better eye and 6/18 in the worse eye<br />

(b) Uncorrected vision at least 6/60 in each eye, corrected VA at least 6/9 in<br />

the better eye and 6/12 in the worse eye<br />

(c) Uncorrected vision at least 3/60 in each eye, corrected VA at least 6/9 in<br />

the better eye and 6/12 in the worse eye<br />

(d) Uncorrected vision at least 1/60 in each eye, corrected VA at least 6/9 in<br />

the better eye and 6/18 in the worse eye<br />

4. drasdo and Haggerty suggested that a driver with snellen VA of<br />

approximately 6/12+2 has:<br />

(a) 50% chance of passing the number plate test<br />

(b) 60% chance of failing the number plate test<br />

(c) 60% chance of passing the number plate test<br />

(d) 58% chance of failing the number plate test<br />

5. Currie et al. found that of 50 patients with 6/9 vision:<br />

(a) 26% failed the number plate test<br />

(b) 34% failed the number plate test<br />

(c) 26% passed the number plate test<br />

(d) 34% passed the number plate test<br />

6. Compared to drivers with monocular visual field loss, drivers with<br />

severe binocular visual field loss were reported to have:<br />

(a) Significantly higher motor vehicle collision and violation rates<br />

(b) Significantly lower motor vehicle collision and violation rates<br />

(c) Only slightly higher motor vehicle collision and violation rates<br />

(d) The same number of motor vehicle collision and violation rates<br />

PLEAsE NOTE There is only one correct answer. All CET is now FREE. Enter online.<br />

Please complete online by midnight on July 29 2011 - You will be unable to<br />

submit exams after <strong>this</strong> date – answers to the module will be published on www.<br />

optometry.co.uk. CET points for these exams will be uploaded to Vantage on<br />

August 8 2011.<br />

For the latest CET visit www.optometry.co.uk/cet


JOBS<br />

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or email haley.willmott@tenalps.com<br />

For more details contact Jim<br />

on 01793 648607 or visit<br />

www.outsideclinic.com<br />

TECHNICAL<br />

ADVISOR/SUPPORT<br />

DISPENSING OPTICIAN<br />

Head Office, Wiltshire<br />

OPTICAL ASSISTANTS &<br />

DISPENSING OPTICIANS<br />

Nationwide including<br />

Manchester, Sheffield and Leeds<br />

42 50<br />

Optometrist Project Manager<br />

17/09/10 01/07/11 RECRUITMENT<br />

JOBS<br />

KTP Associate with BBR <strong>Optometry</strong> Limited<br />

£25,000 to £31,000 (dependent on experience) plus<br />

£6,000 individual training budget and opportunity<br />

to study for a PhD<br />

3 year fixed term contract<br />

BBR <strong>Optometry</strong> is an independent privately owned primary care optometry<br />

practice. They have partnered with Aston University on <strong>this</strong> project to develop<br />

a business model based on patient pathways and outcomes for enhanced<br />

primary ophthalmic care provision and revenue streams in commercial<br />

optical practices.<br />

This project is an exciting opportunity for you to develop and hone clinical<br />

competences that might take the average optometrist many years to develop.<br />

You should have a minimum 2:1 BSc (Hons) degree in <strong>Optometry</strong> and be a<br />

General Optical Council registered UK Optometrist, ideally with clinical<br />

experience post registration.<br />

You should be confident, persuasive and a good communicator at all levels.<br />

You will be employed by Aston University but will be based at BBR <strong>Optometry</strong><br />

in Hereford. Please note the successful applicant will be required to undertake<br />

a CRB (Criminal Records Bureau) disclosure.<br />

Please visit our website http://www.aston.ac.uk/jobs for further<br />

information and to apply online. If you do not have access to the<br />

internet telephone 0121-359-0870 quoting reference number:<br />

R110227<br />

Closing date: Midnight GMT 17th July 2011.<br />

Interview date: 18th August 2011.<br />

‘Quality and Equality’<br />

www.aston.ac.uk<br />

Optometrist<br />

Full Time<br />

Suit Newly Qualified<br />

London E5<br />

rob@roseopticians.com<br />

07900552511<br />

Specsavers Opticians<br />

Portadown Northern Ireland • Permanent<br />

position for Optometrist • 3-4 days per<br />

week• Salary dependent on experience<br />

Contact Michael or John on 028 3835 0400<br />

Optometrist - Cardiff<br />

(1 permanent post; also some<br />

locum cover required)<br />

DO/Trainee DO; Optical Assistants<br />

Required for new independent practice in<br />

Cardiff. This will be the new branch of an<br />

existing, established practice that sets high<br />

standards for clinical excellence, great product<br />

range and excellent customer service.<br />

Flexible working hours can be considered.<br />

Please apply in confidence by email to<br />

cardiffoptician@hotmail.co.uk


JOBS<br />

To place an advertisement call 020 7878 2313<br />

or email haley.willmott@tenalps.com<br />

How D.O. You Measure Up??<br />

Are you passionate about your job?<br />

Do you work well in a team environment?<br />

Do you care about the patients behind the sales figures?<br />

Are you nevertheless commercially aware?<br />

Do you want a satisfying job where your voice matters?<br />

Do you want a job that can develop as you do?<br />

Do you like to learn new skills and help with staff training?<br />

If so, why not see how we measure up?<br />

We are looking for an enthusiastic experienced DO with<br />

management experience to join our independent group of<br />

practices in Hampshire<br />

Andrew Matheson DipTp(SP & IP) DipOC FCOptom FAAO<br />

amatheson@matheson-optometrists.com<br />

MATHESON OPTOMETRISTS<br />

3 West Street, Alresford, HANTS. SO24 0JN<br />

01962 736693(weekdays) 01962 771301 (eves) 01962 736877 (fax)<br />

www.matheson-optometrists.com<br />

We often have places for pre-reg optometrists/DOs available


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or email haley.willmott@tenalps.com<br />

42 50<br />

17/09/10 01/07/11 RECRUITMENT<br />

JOBS<br />

PRE-REGISTRATION OPTOMETRIST AMAR-KAASH GANDECHA DIAGNOSED<br />

A MACULAR HOLE AND ALSO HELPED TO IMPROVE THE EDUCATION OF AN<br />

EIGHT YEAR OLD, BUT FOR HIM IT’S ALL IN A DAY’S WORK AT OPTICAL EXPRESS<br />

INSPIRED by his optometrist aunt,<br />

Amar-Kaash knew from a young<br />

age that he wanted to become an<br />

optometrist. His favourite subjects<br />

at school were Maths and Science,<br />

and after gaining three A’s at<br />

A-Level, Amar-Kaash went on to<br />

gain a BSc (Hons) <strong>Optometry</strong> from<br />

Aston University. Now Amar-Kaash<br />

(22) is a pre-registration optometrist<br />

with Optical Express in Leicester.<br />

Here he describes his current<br />

working life:<br />

What does your day involve?<br />

The great thing about my role is that<br />

I never know what challenges I can<br />

expect for the coming day. Every<br />

morning before we open the store,<br />

opticalexpress.com<br />

we have a team meeting in which<br />

we all discuss how the previous day<br />

went and how we can improve to<br />

make today an even better one.<br />

As a pre-registration optometrist,<br />

I carry out sight tests, contact lens<br />

fittings, contact lens aftercare and<br />

glasses dispensing. Every day my<br />

duties are varied, which I find<br />

exciting. Patient appointments are<br />

based around my clinic diary, which<br />

has been specifically designed to<br />

allow me a reasonable amount of<br />

time to carry out tasks based on<br />

my modest level of experience.<br />

The extra time in the diary has<br />

helped to build my clinical<br />

knowledge and skills.<br />

What’s your favourite part of<br />

your role?<br />

Meeting new, interesting people<br />

daily keeps my role varied and<br />

exciting. Everyone needs an eye<br />

test. I’ve carried out eye<br />

examinations for actors, teachers<br />

and plumbers to name a few.<br />

My confidence has grown through<br />

interacting with and advising<br />

different people.<br />

What do you think differentiates<br />

Optical Express from other<br />

optical providers?<br />

The amount of support I have<br />

received from the staff members at<br />

my store, and also colleagues in<br />

senior roles within the company


JOBS<br />

have been amazing. The company is<br />

large, yet through training courses,<br />

discussing complex cases and<br />

receiving new marketing materials<br />

for the store I feel I know many<br />

people who work throughout the<br />

UK for Optical Express. The training<br />

I have been given has helped me to<br />

do well in all my assessments, and<br />

the support of an excellent<br />

Optical Express supervisor stands<br />

me in good stead to become an<br />

excellent optometrist.<br />

As Optical Express is the UK’s<br />

largest provider of laser eye<br />

surgery I have the option of further<br />

training, once I’ve qualified, to<br />

become involved with laser eye<br />

surgery and enhance my<br />

knowledge in the largest growing<br />

area of the optical sector.<br />

To place an advertisement call 020 7878 2313<br />

or email haley.willmott@tenalps.com<br />

explained to me how her daughter’s<br />

school work had shown a significant<br />

improvement since she had started<br />

wearing glasses. To know I have<br />

positively contributed to a child’s<br />

education makes me feel proud.<br />

What advice would you give to<br />

someone considering a career<br />

in optometry?<br />

Get some experience within the<br />

field, it’s the best way to see if it’s<br />

something you’ll enjoy doing<br />

every day.<br />

Advertisement Feature<br />

I was lucky to have my optometrist<br />

aunt who advised me on career<br />

options. It was great being able to<br />

speak with a professional about my<br />

ambitions and hopes for the future.<br />

Make sure you find a good<br />

employer, someone who will<br />

support you every step of the way<br />

and help to keep things exciting<br />

and varied, with the option of<br />

progression up the career ladder.<br />

I have found all of these qualities at<br />

Optical Express.<br />

53<br />

What motivates you on a<br />

daily basis?<br />

Providing optometric services to the<br />

public is a great responsibility and<br />

makes a positive difference in an<br />

individual’s life. From detecting<br />

pathology to providing patients<br />

with glasses and contact lenses,<br />

our team has the capability to make<br />

someone’s life more enjoyable on<br />

a daily basis.<br />

What qualities should you<br />

possess to do your role?<br />

The pre-registration period can<br />

be a difficult time for any recently<br />

graduated student, each individual<br />

must be motivated to self prepare<br />

for quarterly College of Optometrist<br />

assessments and the final OSCE<br />

examinations. It also helps to be<br />

adaptable, as how you advise each<br />

patient varies from one to another.<br />

What do you find most<br />

challenging about your day<br />

to day role?<br />

I am currently in a transition phase,<br />

I find it challenging to implement my<br />

knowledge of theory related<br />

concepts to my practical sight tests.<br />

After each sight test I perform, I<br />

discuss the advice and management<br />

of the patient with my supervisor<br />

and he helps me to see where I can<br />

improve my service to the patient.<br />

Describe one career highlight<br />

to date<br />

After providing glasses to an eight<br />

year old child, her mother came in<br />

to thank me for my help, and<br />

At Optical Express, our unique<br />

approach to optical and refractive<br />

solutions offers a challenging and<br />

structured career pathway for our<br />

optometrists.<br />

Through continuous training and<br />

development, Optical Express<br />

optometrists are given the<br />

opportunity to advance their<br />

clinical skill level and broaden<br />

their knowledge.<br />

If you are committed to clinical<br />

excellence, training and education<br />

and/or commercial optometry,<br />

we offer an opportunity, which<br />

will satisfy all of your career<br />

requirements.<br />

As the only provider of the<br />

complete range of optical solutions;<br />

glasses, contact lenses, laser<br />

eye surgery and intraocular lenses,<br />

NAME<br />

AGE 22<br />

TITLE<br />

LOCATION<br />

DEGREE<br />

FAVOURITE<br />

EYE MYTH<br />

AMAR-KAASH GANDECHA<br />

PRE-REGISTRATION<br />

OPTOMETRIST<br />

LEICESTER<br />

BSC (HONS) OPTOMETRY,<br />

ASTON UNIVERSITY<br />

EATING CARROTS MAKES YOU<br />

SEE IN THE DARK<br />

BEST DIAGNOSIS MACULAR HOLE,<br />

TO DATE FEMALE (48)<br />

Optical Express optometrists are<br />

uniquely positioned to meet the<br />

needs of each and every patient.<br />

We are looking to recruit newly<br />

qualified and experienced Optical<br />

and Refractive Optometrists in the<br />

following areas: Southampton,<br />

Bournemouth, Harlow and Plymouth.<br />

Optical Express is a global<br />

organisation and unique in our<br />

approach, offering very competitive<br />

salaries and great benefits based on<br />

location and experience.<br />

For the first step on your new<br />

journey, and a full list of our<br />

vacancies please visit our website<br />

at opticalexpress.com/careers<br />

or contact<br />

Edward Sweeting on<br />

07917 350293 or email<br />

edwardsweeting@opticalexpress.com<br />

17/06/11 JOBS


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or email haley.willmott@tenalps.com<br />

46<br />

A different approach to<br />

Optical recruitment<br />

Why are we different?<br />

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and reach 25,794 optical<br />

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reach an average of 14,506<br />

unique visitors per month.*<br />

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For more details contact<br />

Haley Willmott on<br />

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01/07/11 JOBS<br />

Visit www.jonesoptical.co.uk<br />

and click the tab<br />

“Bespoke Recruitment”<br />

Or call us on<br />

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optometrytoday<br />

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Glaucoma Optometrist<br />

Opportunities<br />

Hillingdon, Kingston, Midlands, North-West<br />

& Nationwide<br />

Newmedica is a dynamic, innovative UK healthcare company<br />

delivering a network of high quality, optometrist-led glaucoma<br />

monitoring units across the UK. We partner with the NHS to safely<br />

and effectively deliver specialist clinical eye care services to our<br />

patients, both in fixed and mobile settings.<br />

We currently require optometrists to work in our clinics in<br />

Hillingdon, Kingston, the Midlands and the North-West. However,<br />

we are also interested in hearing frm Optometrists nationwide and<br />

from those with experience in other sub-specialties.<br />

If you enjoy leading a small team to deliver high quality patient<br />

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