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www.optometry.co.uk January 28 2011 vol 51:2 £4.95<br />

optometrytoday<br />

Antarctic<br />

adventure<br />

Mystery year<br />

competition<br />

Four CET<br />

credits<br />

Scandinavian style<br />

New frame collections for the Spring

January 28 2011 vol 51:2<br />

optometrytoday<br />

21<br />

14<br />

25<br />

Comment<br />

Eye care in England<br />

AOP chief executive Bob Hughes gives his<br />

views on the opportunities which the<br />

Health and Social Care Bill will bring<br />

News<br />

High Court appeal decision<br />

The AOP wins an appeal over a 2010<br />

News<br />

OT Live to run in April<br />

Bookings to begin in February for the<br />

education programme at Optrafair<br />

Industry<br />

New collections available<br />

Our latest round-up on products<br />

for the practice<br />

8<br />

7<br />

20-21<br />

Pre-reg Focus<br />

Don’t overlook a hospital place<br />

Optometrist Nadeem Rob extols the<br />

benefits of hospital placements for<br />

pre-regs<br />

Feature<br />

Our man in Antarctica<br />

Andrew Gasson reports on eye<br />

care at the bottom of the world<br />

Geoff Shayler’s second article in<br />

fitness to practise case 6 26-27 our Ageing Vision series 37-40<br />

Profile<br />

Garrey Haase<br />

The Yorkshire optometrist takes our<br />

20 Questions Q&A<br />

News Extra<br />

On the road with the LOCSU<br />

We report on the first of LOCSU’s<br />

roadshow seminars about the<br />

future provision of eye care services<br />

24<br />

28<br />

30<br />

VRICS<br />

Anterior Eye & Contact Lens<br />

Assessment<br />

Take our latest picture quiz 34-35<br />

Free CET<br />

Visual features of Parkinson’s<br />

disease<br />

Free CET<br />

Sight saver, life changer<br />

Dr Cameron Hudson writes about<br />

the wider work of the role of an<br />

eye care practitioner 41-45<br />

Visit www.optometry.co.uk today

NEWS<br />

Teamwork aims to steer<br />

Health Bill in optics’ favour<br />

THE TURBULANT debate over the<br />

Government’s Health and Social<br />

Care Bill shows no sign of abating<br />

as it heads towards its second<br />

reading in the House of Commons<br />

on Monday (January 31).<br />

Nevertheless, sources within and<br />

outside optics believe the Bill can<br />

bring the sector improvements,<br />

such as further enhanced service<br />

schemes within England.<br />

The Bill has attracted controversy<br />

with its aims of allowing GPs to<br />

purchase patient care from 2013<br />

after the abolition of Primary<br />

Care Trusts in England, and the<br />

establishment of a national<br />

Commissioning Board. Although<br />

ministers expect to save billions<br />

of pounds later <strong>this</strong> decade, the<br />

Bill’s critics have claimed it to be a<br />

massive gamble at improving the<br />

nation’s health care provision.<br />

However, those closer to<br />

optometry believe that the Bill<br />

will provide optical practitioners<br />

improved chances to get involved<br />

in shared care schemes and<br />

eventually win wider recognition.<br />

Speaking at the first of a dozen<br />

events for the LOCSU, specialist<br />

optometric adviser from Primary<br />

Care Commissioning – the<br />

Department of Health group –<br />

John Hearnshaw commented:<br />

“Now is a good time to be<br />

seeking those new, enhanced<br />

optical services. The new GP<br />

commissioning consortia may<br />

have open minds, but empty<br />

wallets – that’s not necessarily a<br />

bad thing though, if we can show<br />

them some savings.”<br />

Minister visits Moorfields<br />


Howe visited Moorfields Eye<br />

Hospital NHS Foundation<br />

Trust and spoke about the<br />

new Health Bill.<br />

He was at the hospital to<br />

learn more about a new role<br />

which provides practical<br />

support to people with sight<br />

loss, or their carers.<br />

Moorfields’ new eye<br />

clinic liaison officer (ECLO)<br />

Caroline Beebee, pictured<br />

with the minister, said: “My<br />

job is to support patients<br />

and their families in coming<br />

to terms with their new<br />

situation by offering guidance<br />

on specialised equipment,<br />

employment services and<br />

support groups.”<br />

Lord Howe held a<br />

roundtable discussion at the<br />

hospital with senior directors<br />

Speaking on behalf of the<br />

Optical Confederation, Bob<br />

Hughes, AOP chief executive, said:<br />

“The Health Bill brings a number of<br />

opportunities for optometry and<br />

optics. The outcome for Primary<br />

Ophthalmic Services being with<br />

the new National Commissioning<br />

Board is carried through to the Bill,<br />

and the Board has the powers to<br />

set protocols and prices for what<br />

are currently enhanced services.<br />

“Of course, like all opportunities,<br />

there are potential dangers. For<br />

instance, the Board could decide<br />

it won’t involve itself in enhanced<br />

optometric services or we may<br />

fail to persuade the Department<br />

of the public health needs in eye<br />

care.<br />

“What is certain is that it is vital<br />

for the profession that we are<br />

working together nationally and<br />

locally. LOCSU are working with<br />

LOCs and the optical bodies have<br />

formed a Bill team to work on the<br />

detailed aspects of the Bill as it<br />

goes through Parliament.”<br />

from Moorfields and<br />

representatives from optical<br />

charities.<br />

He said: “Our Health<br />

and Social Care Bill is<br />

about improving patient<br />

care and tailoring services<br />

locally so that they meet<br />

individual needs. This is<br />

a great example of how<br />

NHS care is more than just<br />

providing medical treatment<br />

by helping people who need<br />

emotional and practical<br />

support so they can return<br />

to living the lives they<br />

want to lead.”<br />


J&J and others<br />

back at Optrafair<br />

CONTACT LENS companies are<br />

returning to Optrafair within a<br />

dedicated pavilion. It is understood<br />

that attendees at the NEC show in<br />

April will hear news of a major new<br />

lens launch.<br />

Large companies such as<br />

Johnson & Johnson and Bausch &<br />

Lomb are being joined by suppliers<br />

specialising in solutions and dry eye<br />

treatments. The specific area has<br />

been warmly welcomed by optical<br />

companies in <strong>this</strong> sector –<br />

Shirley Bovonsombat, senior<br />

product manager for Johnson &<br />

Johnson Vision Care in UK and<br />

Ireland said: “We are delighted to<br />

be returning to Optrafair for the<br />

first time in five years. The new<br />

Contact Lens Pavilion is a welcome<br />

addition for the industry and will<br />

provide us with a fantastic platform<br />

to launch a brand new lens,<br />

showcase our entire Acuvue range<br />

and discuss the latest innovations,<br />

trends and developments with the<br />

entire optical community.”<br />

Eye Logic, one of the first<br />

companies to secure space within<br />

the Contact Lens Pavilion, will<br />

be promoting its liposomal spray<br />

for dry eyes, available only to<br />

independents.<br />

“We are aiming <strong>this</strong> particularly<br />

at contact lens wearers and<br />

computer users,” said David<br />

Gunning, marketing manager for<br />

Eye Logic UK.<br />

Alcon vision care business unit<br />

manager, Chris Miller, who is<br />

also bringing his company to the<br />

contact lens pavilion, said: “We are<br />

delighted to be part of Optrafair<br />

and are looking forward to using<br />

the event as a launch platform to<br />

share information with customers<br />

on exciting new products.”<br />

5<br />

28/01/11 NEWS

optometrytoday<br />

JANUARY 28 2011<br />

VOLUME 51:2<br />

ISSN 0268-5485<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 />

London SE1 0HL<br />

Advertising: Vanya Palczewski<br />

T: 020 7878 2347<br />

E: vanya.palczewski@tenalps.com<br />

Sponsorship: Sunil Singh<br />

T: 020 7878 2327 E: sunil.singh@tenalps.com<br />

Recruitment & Classified: Haley Willmott<br />

T: 020 7878 2313 E: haley.willmott@tenalps.com<br />

CET and bookshop enquiries: Denise Williams<br />

T: 020 7878 2364 E: denise.williams@tenalps.com<br />

Production: Ten Alps Creative<br />

T: 020 7878 2343 E: louise.greenall@tenalps.com<br />

Membership Dept:<br />

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

T: 020 7261 9661<br />

W: www.aop.org.uk<br />

Advertising and Production Office<br />

Ten Alps Creative and Ten Alps Media,<br />

Commonwealth House, One New Oxford Street,<br />

High Holborn, London WC1A 1NU<br />

Editorial Advisory Board<br />

Duncan Counter, Leon Davies, Mark Draper,<br />

Polly Dulley, Dan Ehrlich, Andy Hepworth,<br />

Niall Hynes, David Ruston, Gill Robinson, David<br />

Shannon, David Whitaker, Vincent Yong<br />

W: www.optometry.co.uk<br />

Published fortnightly for the Association of<br />

Optometrists by Ten Alps Creative<br />

Subscriptions<br />

Alliance Media Limited, Bournehall House,<br />

Bournehall Road, Bushey, Herts, WD23 3YG<br />

T: 020 8950 9117<br />

E: stelios.kontos@alliance-media.co.uk<br />

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

THE AOP has won an appeal<br />

in the High Court against the<br />

decision of a GOC fitness to<br />

practise committee which<br />

found an optometrist guilty<br />

of misconduct and deficient<br />

professional performance.<br />

In January last year a fitness<br />

to practise panel found AOP<br />

member Janine Vali’s fitness to<br />

practise to be impaired after<br />

it was alleged that she failed<br />

to take appropriate action on<br />

discovering a patient had raised<br />

intraocular pressures.<br />

The case arose when a<br />

complaint was lodged in 2007<br />

relating to a sight test conducted<br />

in 2005 when Ms Vali was newly<br />

qualified.<br />

When announcing its decision<br />

in 2010, the fitness to practise<br />

committee <strong>issue</strong>d Ms Vali with<br />

a series of conditions to adhere<br />

to whilst practising for a period<br />

of two years, which have now<br />

been overturned. They included:<br />

remaining under the supervision<br />

of a supervisor who would<br />

NEWS<br />

AOP wins High Court<br />

appeal over FTP case<br />

monitor her compliance with the<br />

decision and report back to the<br />

GOC’s registrar every six months;<br />

not performing examinations on<br />

patients over 40-years-old unless<br />

supervised; not undertaking<br />

any locum work without prior<br />

agreement with their supervisor<br />

and the GOC registrar; and<br />

attending a specialist glaucoma<br />

clinic in a hospital eye department<br />

as an observer for 12 sessions.<br />

On Friday (January 14) Appeal<br />

Court Judge Ounsley allowed the<br />

appeal, and quashed the decision<br />

and the conditions stipulated by<br />

the fitness to practise committee,<br />

upholding the lesser charge of<br />

misconduct and awarding costs<br />

against the GOC. The Judge did<br />

not accept that Ms Vali’s fitness<br />

to practise was impaired in 2010,<br />

but that there had been a one off<br />

oversight.<br />

Commenting on the successful<br />

appeal, Bob Hughes, AOP chief<br />

executive, said: “Fighting for our<br />

members is what the AOP is for<br />

and what our staff are engaged<br />

in day to day – protecting our<br />

members. Congratulations to our<br />

legal director, Gerda Goldinger,<br />

and all her team on a significant<br />

victory for the profession.”<br />

Web success for CIBA Vision<br />

TWO HUNDRED eye care<br />

practitioners from the UK and<br />

Ireland participated in CIBA<br />

Vision’s optical business live<br />

web seminar from their own<br />

homes. A further 30 were in the<br />

London-based studios where<br />

the event was beamed live, with<br />

more following on Twitter.<br />

The event supported the<br />

launch of a new book from<br />

the company, ‘Maximise your<br />

practice success with contact<br />

lenses’. Developed by using<br />

insights from global best<br />

practices, the publication shows<br />

practitioners how increasing<br />

contact lens sales leads to<br />

better customer satisfaction<br />

and loyalty.<br />

Business consultant Patrick<br />

Myers and CIBA’s head of<br />

professional affairs, Mark<br />

Draper led discussions with the<br />

audience on three key areas<br />

of the book, key performance<br />

indicators, marketing your<br />

practice and staffing.<br />

Mr Draper said: “These<br />

are tough times for eye care<br />

professionals. Practitioners<br />

told us they wanted more<br />

help in attracting new contact<br />

lens wearers. The volume of<br />

your contact lens business has<br />

a direct impact on practice<br />

profitability and so <strong>this</strong> is a<br />

strategy that is very important<br />

to ensure growth.”<br />

For a complimentary copy<br />

of the book visit http://www.<br />

cibavisionacademy.co.uk/<br />


Book for OT Live at NEC<br />

FOLLOWING the success of the<br />

inaugural OT Live lectures in 2009,<br />

the AOP-organised education<br />

forum will be back at Optrafair<br />

in 2011. Booking for OT Live<br />

will open at the beginning of<br />

February, offering delegates the<br />

chance to experience an exciting<br />

programme of education and<br />

attend the exhibition. Optrafair<br />

takes place April 9-11 at the NEC,<br />

Birmingham.<br />

With two lecture theatres<br />

located in the main exhibition<br />

hall delegates will be spoiled<br />

for choice when it comes to<br />

accessible and relevant CET.<br />

Places at the lectures are free<br />

but must be booked in advance.<br />

Readers can book online at<br />

www.otlive.co.uk or by calling<br />

0845 1801 318. You can also<br />

register for the exhibition at<br />

www.optrafair.co.uk<br />

Larry J Alexander, OD FAAO, one<br />

of the International speakers at OT<br />

Live 2009, said of the event: ”What<br />

an exciting and fun meeting. It was<br />

a great format and tremendous<br />

interaction. A truly remarkable<br />

learning and teaching experience<br />

with wonderful hosts.”<br />

Platinum sponsors for the event<br />

have been confirmed as Johnson<br />

& Johnson and Topcon. Other<br />

sponsors include Zeiss, Optos,<br />

Optegra, Grafton and Transitions.<br />

Education Advisor for the<br />

AOP Karen Sparrow said: “We’re<br />

delighted to have Topcon back<br />

as a sponsor for OT Live as their<br />

‘Lunch & Learn’ session in 2009 was<br />

sold out. In addition Johnson &<br />

Johnson are already well-known<br />

for their high quality CET lectures<br />

so it’s great to have them on<br />

board for 2011.” For more details<br />

readers can email Ms Sparrow at<br />

karensparrow@aop.org.uk.<br />

Westminster reception<br />

promotes eye care’s role<br />

IN BRIEF<br />

Membership offer<br />

R A Valuations, the property<br />

advice company whose expertise<br />

is part of the AOP’s membership<br />

benefit package, has announced<br />

a 10% discount for the provision<br />

of a business valuation to the<br />

Association’s members. The offer<br />

runs until February 28 2011. Read<br />

Mark Ridout’s – who is a director of<br />

R A – account of how the downturn<br />

has affected practice values on<br />

pages 32-33 of <strong>this</strong> week’s <strong>issue</strong>.<br />

Facebook focus<br />

The latest group to use the social<br />

networking craze is the BCLA. From<br />

<strong>this</strong> week viewers of Facebook can<br />

learn more about <strong>this</strong> year’s clinical<br />

conference and exhibition on the<br />

new page ‘BCLA 2011’. “We hope our<br />

new Facebook page will help create<br />

a real buzz around <strong>this</strong> year’s event,”<br />

said BCLA marketing manager,<br />

Caroline Seville. “Over the coming<br />

months we will be posting regular<br />

updates, photos and messages and<br />

we invite all members and others<br />

within the profession and industry,<br />

including BCLA 2011 exhibitors and<br />

sponsors, to join us for a chat and to<br />

share their views on what we have<br />

planned for BCLA 2011.”<br />

7<br />

28/01/11 NEWS<br />


ALLIANCE Parliamentary<br />

reception attracted highpowered<br />

support last week,<br />

with 15 MPs and 18 peers<br />

attending to hear passionate<br />

speeches on the millions<br />

at risk from unnecessary<br />

blindness.<br />

Hosted by John Baron<br />

MP (pictured), co-chair of<br />

the All-Party Parliamentary<br />

Group on Eye Health and<br />

Visual Impairment, the event<br />

included a speech from<br />

Professor Nick Bosanquet<br />

who presented an overview<br />

of his paper Liberating the<br />

NHS: Eye Care.<br />

Mr Baron (pictured)<br />

warned attendees: “We need<br />

to act now to stop more<br />

people needlessly going<br />

blind due to undetected<br />

eye conditions. Eye health<br />

is often overlooked and<br />

we must work together to<br />

change <strong>this</strong>. This important<br />

public health message<br />

must be taken seriously<br />

by national and local<br />

government, commissioners,<br />

and health and social care<br />

professionals.”<br />

Professor Bosanquet<br />

added: “By 2050 the number<br />

of people living with sight<br />

loss is set to increase by<br />

115% to almost four million<br />

people, unless urgent action is<br />

taken now. The NHS urgently<br />

needs to free up capacity in<br />

hospital eye care services. Reengineering<br />

services as I have<br />

proposed in my recent report<br />

is the only way of meeting <strong>this</strong><br />

challenge. This opportunity<br />

has been missed twice in the<br />

last decade. It is vital not to<br />

miss it again.”<br />

The MPs and peers in<br />

attendance included several<br />

members of the House of<br />

Commons Health Committee<br />

and Dr John Pugh, the cochair<br />

of the Liberal Democrat<br />

Parliamentary Policy<br />

Committee on Health and<br />

Social Care.<br />

Murder plot case<br />

starts<br />

The trial of laser eye surgery boss<br />

Dr Michael Mockovak has started in<br />

Seattle, US. Dr Mockovak, who cofounded<br />

the Clearly Lasik business,<br />

is accused of hatching a murderfor-hire<br />

plot against his former<br />

business partner, and the company’s<br />

president, reported the Seattle Times<br />

(January 18).<br />

Lansley visit<br />

In the run-up to presenting his bill to<br />

Parliament, health minister Andrew<br />

Lansley visited Cardiff University’s<br />

optometric postgraduate centre.<br />

The centre was chosen by Welsh<br />

Assembly minister for health Edwina<br />

Hart as an example of how Wales<br />

is ‘leading the way in eye care and<br />

reducing the burden of the NHS’.

NEWS<br />


Parents are warned<br />

over new 3D gadget<br />

8<br />

28/01/11 NEWS<br />

THE AOP’s education advisor Karen Sparrow<br />

(pictured) has spoken out warning parents to<br />

be aware of the potential harm overuse of the<br />

new Nintendo 3DS portable games system<br />

could cause to children’s eyesight.<br />

Both the Daily Telegraph (January 21) and<br />

the Guardian online (January 20) featured<br />

the story last week. In the <strong>issue</strong>d statement,<br />

Ms Sparrow warned: “As with anything else –<br />

children should not use the 3DS to excess. As<br />

3D technology has only recently hit the High<br />

Street there is little scientific research available<br />

yet but Nintendo is right to warn the public of<br />

the potential harm of excessive use.<br />

“This [potential risk] is not unique to the<br />

Nintendo 3DS as watching 3D images through<br />

other means, such as at the cinema or on<br />

a 3D television could give rise to the same<br />

concerns, however there are two additional<br />

factors when using the 3DS. The close<br />

proximity of the device could place more<br />

stress on eyesight than looking at a television<br />

set, meaning that eyes have to focus harder,<br />

and it is more likely to be used by children for<br />

longer periods.<br />

“Children need a clear, sharp image in<br />

each eye in order for their vision to develop<br />

properly. If anything upsets that balance<br />

(natural or artificial) it could affect the visual<br />

development resulting in amblyopia or a<br />

squint.<br />

“This can be a problem when viewing 3D<br />

if you have a weaker eye. If a child spends<br />

excessive time using a device such as the 3DS<br />

it could effectively act as a negative exercise,<br />

as opposed to strengthening the eye, and it<br />

can leave it underdeveloped, causing a ‘lazy<br />

eye’.”<br />

More concern for eyesight and 3D<br />

technology – see page 12.<br />

Has the NICE Glaucoma<br />

Guideline affected you?<br />


London’s South Bank<br />

University is seeking<br />

your views on how<br />

the introduction of<br />

the NICE Glaucoma<br />

Guideline has<br />

impacted optometric<br />

practice.<br />

Peter Campbell is<br />

asking practitioners<br />

across England and Wales to fill in a short<br />

questionnaire on how the glaucoma/ocular<br />

hypertension NICE Guideline has affected<br />

them since its<br />

introduction in 2009.<br />

The survey, which<br />

is anonymous<br />

and takes just a<br />

few minutes to<br />

complete, can be<br />

found at https://<br />

www.surveymonkey.<br />

com/s/JWVWFGP<br />

The survey closes<br />

on February 28, 2011.<br />

For more information contact<br />

glaucomasurvey@yahoo.com<br />


The Health and Social Care Bill will<br />

revolutionise the NHS. Support it or not,<br />

it represents a considerable opportunities<br />

for optometry.<br />

To start with, PCTs are going and<br />

most AOP members will be delighted.<br />

Many PCTs act with a carefully crafted<br />

combination of arrogance, ignorance and<br />

bullying towards the profession. You<br />

have to ask: “Has all their over-zealous<br />

checking and judging been of benefit to<br />

patients?” The answer would be no.<br />

Primary Ophthalmic Services will<br />

become the responsibility of the new<br />

National Commissioning Board in line<br />

with what we had asked, and they<br />

will oversee the recognition of LOCs.<br />

Nationally and locally <strong>this</strong> provides<br />

opportunities for England to learn from<br />

the measurably improved eye health in<br />

Wales and Scotland.<br />

We have put a Bill team in place, led<br />

by our head of public affairs Heather<br />

Marshall. They are charting progress<br />

through Parliament and ensure MPs<br />

are briefed. We are working with the<br />

BMA and other contractors on areas of<br />

common interest; and with the Royal<br />

Colleges of GPs and Ophthalmologists,<br />

the UK Vision Strategy and of course<br />

the College of Optometrists to give<br />

professional substance to our arguments.<br />

This is complemented by LOCSU. Their<br />

current training courses are specifically<br />

aimed at equipping LOC leaders for the<br />

new NHS world, and we are hosting an<br />

informal meeting of experienced LOC<br />

leaders to ensure we take into account<br />

their experience on the ground.<br />

The devil is in the detail. These<br />

changes could transform eye care, or it<br />

could amount to little or nothing. Our<br />

future is largely up to us, and we are<br />

engaged in giving optometry a say in<br />

shaping a better future. There is little that<br />

could be more important, and it is an<br />

opportunity we cannot afford to miss.<br />

Bob Hughes, AOP chief executive<br />


If they’re comfortable here,<br />

1,2<br />

they’re comfortable anywhere.<br />

ACUVUE ® OASYS ® contact lenses give that “no lens feeling” 1 ,<br />

even when using a computer.<br />

When working at a computer we blink five times less 3 , leading to dryer eyes and discomfort.<br />

ACUVUE ® OASYS ® delivers a unique combination of smoothness, breathability,<br />

flexibility and wettability to ensure patients experience a lens so comfortable they’ll<br />

forget they’re wearing them 1 .<br />

Eyes are also shielded by the highest level of UV protection 4,5 of any reusable lens.<br />

Talk to your patients today about why ACUVUE ® OASYS ® is the best choice for<br />

computer use.<br />

www.jnjvisioncare.co.uk<br />

1. JJVC Data on File 2006. 84% of patients using the computer more than 25 hours a week agreed strongly/somewhat that ACUVUE ® OASYS ® made them forget they were wearing lenses. N=174. 2. Young G, Riley CM, Chalmers RL, Hunt C. Hydrogel lens comfort in<br />

challenging environments and the effect of refitting with SiH lenses. OVS 2007; 84; 4: 302-308. 3. Patel S, Henderson R, Bradley L et.al. Effect of visual display unit use on blink rate and tear stability. Optom Vis Sci, 1991;68:11 888-92. 4. UV absorbing contact lens are<br />

not substitute for UV-blocking sunglasses as they do not completely cover the eye and the surrounding area. 5. JJVC Data on File, 2010. ACUVUE ® , ACUVUE ® OASYS ® , HYDRACLEAR ® and SEE WHAT COULD BE are trademarks of Johnson & Johnson Medical Ltd.<br />

© Johnson & Johnson Medical Ltd. 2010. Johnson & Johnson Vision Care is part of Johnson & Johnson Medical Ltd.

NEWS<br />

10<br />

28/01/11 NEWS<br />

IN BRIEF<br />

Let them buy<br />

cakes…<br />

Students and staff at the University<br />

of Ulster’s optometry department<br />

raised £965 for last year’s World Sight<br />

Day Challenge – with nearly a third<br />

of that total coming from sales of<br />

buns made by the department. A<br />

total of almost £300 came from the<br />

sale of cakes on campus, with nearly<br />

£300 from a night out organised by<br />

second-year optometry students,<br />

with the rest raised from a raffle.<br />

Brandreth speaks<br />

Gyles Brandreth will be guest speaker<br />

at Oulton Hall, Leeds at the Optix<br />

user group annual meeting in March.<br />

With sponsorship from Nikon, Hoya,<br />

Rodenstock, Essilor and Birmingham<br />

Optical Group, an attendance of<br />

160 delegates is expected for the<br />

meeting, which is scheduled to take<br />

place on March 22-23.<br />

Hobson is choice<br />

International Eyewear has appointed<br />

Mark Hobson as joint managing<br />

director to work alongside Julie Abel.<br />

He has spent several years in the<br />

optical sector, and was latterly at<br />

Silhouette for two years as MD.<br />

ABDO 25th lunch<br />

ABDO will host a luncheon to<br />

celebrate its 25th year at the<br />

Plaisters’ Hall, London, on May 6.<br />

The event will acknowledge some of<br />

those who have played a part in the<br />

Association’s development since its<br />

foundation in 1986.<br />

Eyeplan bucks an uncertain<br />

market and hits million mark<br />

EYEPLAN, THE provider of<br />

monthly payment eye care<br />

schemes, has reported it is<br />

collecting in excess of £1m<br />

in eye care fees per month.<br />

The company works<br />

with independent optical<br />

practices in the UK and<br />

enables opticians to offer<br />

more value to their patients.<br />

In exchange for a small<br />

monthly fee, patients are eligible<br />

for a range of eye care benefits<br />

including free examinations,<br />

lower prices on spectacles and<br />

accidental damage cover.<br />

Eyeplan has seen growth in<br />

2009-2010 via an increase in the<br />

number of practices adopting<br />

the Eyeplan Business Model, and<br />

more patients choosing to join<br />

the scheme and receive greater<br />

value from their eye care.<br />

“Our healthy growth shows<br />

that despite challenging<br />

economic times, many patients<br />

are still placing importance on<br />

EFFORTS TO make the<br />

recording of pupillary distance<br />

(PD) measurements a part<br />

of optical prescriptions have<br />

been responded to by the GOC.<br />

However, the organiser of the<br />

campaign says he will take<br />

the matter to the Office of Fair<br />

Trading as a next stage.<br />

As reported in OT (January<br />

14) Metsuki.com managing<br />

director Ewan McFarlane<br />

handed in an online petition<br />

to the Harley Street-based<br />

organisation earlier <strong>this</strong> month.<br />

The petition contains over<br />

2,500 names. Mr McFarlane,<br />

who has been campaigning on<br />

the matter for several months,<br />

receiving great value from their<br />

eye care provider,” said Chris<br />

Clemence, commercial director.<br />

“We are delighted that our<br />

commitment to care, quality and<br />

value in optics has translated into<br />

strong growth and a successful<br />

year.”<br />

Before Christmas Eyeplan<br />

introduced a Bonus Bonds system<br />

for its Eyeplan Associate Opticians.<br />

The profit-sharing initiative is a<br />

result of several years’ successful<br />

growth for the company and an<br />

increasing number of practices<br />

adopting the Eyeplan Business<br />

OFT is next step for PD man<br />

said he hoped that those who<br />

regulate the optical professions<br />

would take note of the strength<br />

of feeling of some of the<br />

consumers who left comments<br />

on the site.<br />

Registrar of the GOC, Satjit<br />

Singh, has written to Mr<br />

McFarlane reminding him that<br />

optometrists do not have to<br />

provide PD measurements<br />

when providing an eye test.<br />

“It would appear that the<br />

arguments you have raised<br />

about requiring a PD refer to<br />

the retail market,” Mr Singh<br />

wrote. “As I have mentioned,<br />

our primary function is to act<br />

in the interests of public health<br />

Model. Bonus Bonds have<br />

been awarded to those<br />

Eyeplan practices with 100<br />

members or more and<br />

each has been registered<br />

to receive a certain number<br />

of bonds, depending on<br />

practice membership<br />

levels.<br />

At the declaration of<br />

each Bonus Bond Dividend,<br />

a proportion of Eyeplan’s profits<br />

will be distributed amongst its<br />

registered practices. More bonds<br />

can be earned as membership<br />

levels grow and there is no limit<br />

on the frequency or value of the<br />

payment.<br />

“The Bonus Bonds scheme was<br />

created by a desire to share in our<br />

success and enable associates to<br />

benefit financially from Eyeplan’s<br />

continuing growth,” said Mr<br />

Clemence.<br />

The company has also<br />

introduced discretionary Bonus<br />

Bond awards.<br />

and safety, but having said<br />

that, our Council is currently in<br />

the process of reviewing our<br />

strategy and as part of that<br />

process we are looking at the<br />

changing environment in which<br />

we operate. This includes a<br />

range of <strong>issue</strong>s, including sales<br />

over the internet.<br />

“Should our work conclude<br />

that changes in the law are<br />

necessary in the interests of<br />

health and safety, we would<br />

in due course be approaching<br />

the Government who have<br />

the ultimate power to amend<br />

legislation. The timing and<br />

process for <strong>this</strong> review has yet<br />

to be agreed.”

education through inspiration<br />

Vision For Life<br />

Educational Roadshow<br />

Coming to you soon<br />

The Vision Care Institute is about to hit the road again, with <strong>this</strong><br />

year’s series of educational roadshows. Always extremely popular, they offer<br />

a unique opportunity to gain knowledge and experience in all aspects<br />

of contact lens wearing and fitting, and are hosted by a wide range of leading<br />

professional figures. This year, the theme of the event is Vision For Life, exploring<br />

vision correction for the whole of your patient’s life, and how <strong>this</strong> can help expand<br />

your patient base and profitability.<br />

Dates and Venues 2011<br />

Sunday<br />

6th February<br />

Monday<br />

7th February<br />

Thursday<br />

10th February<br />

Birmingham<br />

Austin Court<br />

Leeds<br />

Royal Armouries<br />

London<br />

Royal College of Physicians<br />

The lectures are:<br />

• Prescribing for Children in Optometric Practice<br />

• Myopia Control: Can We Really Make a Difference?<br />

• The Psychology of the Presbyope<br />

• Keeping Mums and Dads in Contact Lenses<br />

• The Ageing Eye<br />

• Keeping Eyes Young<br />

Last year’s educational roadshows were extremely successful, and because we predict<br />

<strong>this</strong> year’s to be the same, call now and reserve your free place, before it’s too late.<br />


11 CET POINTS<br />

(including distance learning)<br />

The Booking Hotline – 0845 310 5347<br />

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

Tuesday<br />

15th February<br />

Thursday<br />

17th February<br />

Bristol<br />

Watershed<br />

Manchester<br />

The Lowry Theatre

NEWS<br />

12<br />

28/01/11 NEWS<br />

IN BRIEF<br />

IP success for duo<br />

Dr Scott Mackie – professional<br />

services director at Optical<br />

Express – and his wife Dr<br />

Roisin Mackie are pictured<br />

after collecting their Diploma<br />

in Therapeutics, Independent<br />

Prescribing (IP) award(s) at the<br />

College of Optometrist ceremony<br />

in Westminster. Their aim was to<br />

become the first couple in the UK to<br />

be awarded <strong>this</strong> higher qualification.<br />

Mr Mackie stated that the Glasgow<br />

Caledonian University IP course<br />

was demanding and rewarding,<br />

but would assist him in developing<br />

optometrists. Ms Mackie said that<br />

she would use it as part of a new<br />

Acute Referral scheme in her local<br />

Health Board. They thanked Dr Sanjay<br />

Mantry, Stobhill Hospital, who acted<br />

as mentor to both Drs Mackie.<br />

Debate over 3D technology<br />

grows with optics’ insight<br />

WITH THE debate growing over<br />

what 3D technology could mean<br />

for eyesight, professional bodies<br />

within UK optics have outlined<br />

their positions.<br />

With current concern regarding<br />

the release of the Nintendo 3DS,<br />

the AOP’s Karen Sparrow outlined<br />

her views to the national press<br />

<strong>this</strong> week (see page 8).<br />

As 3D films and TV are<br />

becoming more common place,<br />

the College of Optometrists has<br />

moved to reassure the UK public<br />

that there is no evidence of any<br />

long term harm being caused by<br />

using 3D displays and they may<br />

be helpful in uncovering some<br />

‘subtle eye disorders’.<br />

In a statement, the College<br />

has said: “These eye disorders<br />

may also cause difficulty when<br />

doing tasks such as reading so we<br />

would recommend that people<br />

who have difficulties watching<br />

3D have a full eye examination to<br />

identify and correct any cause.’”<br />

Loughborough University’s Dr<br />

Peter Howarth is about to publish<br />

a review of the potential hazards<br />

of viewing 3D in the College’s<br />

research journal Ophthalmic<br />

and Physiological Optics. He<br />

said: “Although people have<br />

reported experiencing symptoms<br />

when watching 3D content,<br />

specifically headaches and<br />

eyestrain, there have been no<br />

studies whatsoever which have<br />

detected any permanent damage.<br />

Furthermore, stationary examples<br />

of these types of pictures have<br />

been around since Victorian times<br />

(Wheatstone stereoscopes), and<br />

films have been around since the<br />

craze for them in the 1950s. The<br />

normal eye is adaptable enough<br />

to accept small 3D stereoscopic<br />

content without stress. It is only if<br />

there are large, prolonged effects<br />

that people experience symptoms<br />

of eyestrain.”<br />

And ABDO has added its voice to<br />

the debate. Its spokesman said: “It<br />

is essential to advise any member<br />

of the public who is seeking to<br />

benefit from 3D technology, that,<br />

prior to purchase, they should have<br />

an eye examination to discover<br />

if they will be able to enjoy the<br />

benefits it offers. The association<br />

also asks all manufacturers and<br />

suppliers of such equipment to<br />

clearly draw attention to the fact<br />

that there are those who will be<br />

unable to obtain a 3D view.”<br />

Appeal for Week<br />

Organisers of National Eye Health<br />

Week are calling on organisations to<br />

back a national campaign to educate<br />

the public on the importance of eye<br />

health and the need for regular sight<br />

tests. It will take place during June<br />

13-19 with sponsorship packages<br />

available to purchase immediately<br />

on a first-come, first-served basis.<br />

Further details can be found at www.<br />

visionmatters.org.uk<br />

Retailing in focus<br />

Key figures from Boots and Asda will<br />

give tips and advice at Retail Week’s<br />

2011 conference which will take<br />

place on March 16-17 at the Hilton<br />

London Metropole. The event, which<br />

will hear how the British consumer<br />

is changing, and that UK retailing is<br />

at a crossroads, is offering admission<br />

savings if attendees register before<br />

February 4.<br />

New GOC registrar is named<br />

THE GENERAL Optical<br />

Council has announced the<br />

appointment of a new chief<br />

executive and registrar.<br />

Samantha Peters (pictured),<br />

who has worked in the<br />

health sector for 11 years,<br />

leading the British Society of<br />

Rheumatology, is expected<br />

to take up the position from<br />

March 28, and will replace Satjit<br />

Singh, who has held the post in<br />

an interim capacity since 2010.<br />

Ms Peters has an MBA from<br />

Cass Business School and<br />

has been at the forefront of<br />

Britain’s health professionals<br />

in rheumatology. In these<br />

roles, and as chief executive<br />

of the British Youth Council,<br />

she has worked closely<br />

with an extended network<br />

of professionals and wider<br />

stakeholders, and has<br />

strong policy, advisory and<br />

communications functions.<br />

In addition to her full-time<br />

employed roles, Ms Peters<br />

has held a number of public<br />

interest posts focusing on<br />

delivering services and<br />

support for patients and the<br />

wider general public, including<br />

as a trustee of Arthritis Care<br />

and of the Arthritis and<br />

Musculoskeletal Alliance.<br />

Anna Bradley, chair of<br />

the GOC, said: “I am really<br />

looking forward to Samantha’s<br />

arrival. We have a challenging<br />

organisational agenda and<br />

live in interesting times in<br />

the health sector. Samantha<br />

will give us the clear and<br />

personable leadership we<br />

need to take the GOC forward.”<br />

Ms Peters said: “I am<br />

delighted to be joining the<br />

GOC, and look forward to<br />

helping it deliver its invaluable<br />

role in promoting high<br />

standards of optical care. I<br />

welcome the chance to work<br />

with the GOC’s Council, staff<br />

and registrants to build on<br />

its strong reputation for<br />

protecting the public, and<br />

delivering excellent service.”

NEWS<br />

14<br />

28/01/11 NEWS<br />


Optos reveals<br />

double-digit<br />

growth globally<br />

Global retinal imaging company<br />

Optos has reported over a 10% rise<br />

in total revenue for the first quarter<br />

of the financial year to September<br />

30, 2011.<br />

Total revenue for the threemonth<br />

period ending December 31,<br />

2010, stood at $25.7m compared<br />

to $23.3m, a year-on-year rise of<br />

10.3%.<br />

Revenues from the ‘outright sales<br />

of devices’ also saw a steep rise in<br />

growth from $0.3m to $3.7m.<br />

The company’s customer base<br />

increased from 3,912 to 3,954, up<br />

42, with 107 new installations and<br />

65 sites de-installed.<br />

In December last year the<br />

acquisition of Opto Global Pty<br />

Holdings, an ophthalmic device<br />

company based in Australia, was<br />

completed and plans to integrate<br />

the two businesses are now<br />

underway, Optos confirmed.<br />

CEO, Roy Davies said: “We are<br />

pleased to report double digit<br />

revenue growth and continued<br />

strong cash generation in the first<br />

quarter. Further growth is expected<br />

from the launch of our 200Tx<br />

ophthalmology device next month<br />

and as we begin to exploit the Opto<br />

Global opportunity.”<br />

US counts cost<br />

of fireworks<br />

Bottle rockets – part of a ban on<br />

dangerous fireworks in <strong>this</strong> country<br />

several years ago – can cause<br />

significant eye injuries in children,<br />

often leading to permanent loss of<br />

vision, according to a report that<br />

will appear in the May print <strong>issue</strong><br />

of Archives of Ophthalmology. Of<br />

the estimated 9,200 emergency<br />

department admissions resulting<br />

from firework-related injuries<br />

each year in the US, about 1,400<br />

cases involve the eyes with a<br />

disproportionate number of these<br />

injuries caused by bottle rockets<br />

which are about half the size of a<br />

normal firework.<br />

Sports vision clinic opened<br />

with athletic stars’ approval<br />


launched a ‘flagship’ Sports<br />

Vision clinic in Glasgow city<br />

centre. The clinic, which<br />

opened in the company’s<br />

outlet in Renfield Street on<br />

January 20, aims to give<br />

the public the chance to<br />

improve their sporting skills<br />

and increase awareness of<br />

sports specific eye care.<br />

It offers informed advice and<br />

‘appropriate eye care correction<br />

options’ based on an individual’s<br />

requirements, and, the Scottishbased<br />

company claims it is the<br />

most comprehensive sports<br />

vision service available in the UK.<br />

The clinic, run by specially<br />

trained sports vision optometrists,<br />

will have a sports vision trainer<br />

(SVT) and Bassin Anticipation<br />

Timer (BAT) machines that users<br />

can measure and improve their<br />

coordination and awareness.<br />

“Sports vision has been an<br />

important aspect in the training<br />

THE DANGERS of ‘vodka<br />

eyeballing’ have been<br />

highlighted by the College of<br />

Optometrists following a BBC3<br />

documentary on the dangers of<br />

drinking games.<br />

Ready, Steady, Drink!,<br />

broadcast last Monday (January<br />

17), showed comedy actress<br />

Emily Atack investigating binge<br />

drinking amongst young people<br />

and included a segment on the<br />

practice of vodka eyeballing<br />

– taking in vodka through the<br />

eyeball.<br />

President of the College Cindy<br />

and development of top athletic<br />

and sporting professionals for a<br />

number of years,” said an Optical<br />

Express spokesman, “and has<br />

been designed to maximise their<br />

performance, enhance their<br />

comfort and ensure their sporting<br />

activity is both safe and enjoyable.<br />

“Separate to elite athletes,<br />

over 5.2 million UK adults have<br />

membership of a private gym and<br />

it is for them, sporting teams and<br />

clubs, that Optical Express has<br />

opened the Sports Vision Clinic.”<br />

Colin Moulson, a qualified<br />

sports vision optometrist at<br />

Optical Express, commented:<br />

“Many people don’t realise<br />

there is a separate eye<br />

examination available that<br />

is specific to sports, nor<br />

that following a simple<br />

eye training programme<br />

can help improve their<br />

coordination and visual<br />

awareness. Sport is serious<br />

business these days, not<br />

only for seasoned professionals<br />

aiming to reach the top of their<br />

game, but for the growing<br />

population that are choosing to<br />

improve their health and wellbeing<br />

through a more active<br />

lifestyle. Sport is a leading cause<br />

of eye injury, so it is essential<br />

to keep our eyes protected.”<br />

Pictured is Scottish rugby star<br />

Graeme Morrison who has been<br />

training with Optical Express, and<br />

the clinic has won the approval<br />

of other sports stars, including<br />

twice US Open winning golfer<br />

Retief Goosen, and Olympic gold<br />

medallist Daley Thompson.<br />

Dangers of drinking game<br />

linked to eyes is broadcast<br />

Tromans said: “By putting<br />

vodka, or in fact any alcohol, in<br />

your eye actually means that<br />

you are stripping away the<br />

very delicate layer of skin on<br />

the surface of the eye which is<br />

there to protect it. Repeated<br />

direct exposure to alcohol<br />

could cause permanent corneal<br />

scarring and potential loss of<br />

vision.”<br />

Pictured is Dr Tromans<br />

with Emily Atack and Felipe<br />

Dhawahir-Scala, a consultant<br />

ophthalmologist at Manchester<br />

Royal Eye Hospital.

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NEWS<br />

16<br />

28/01/11 NEWS<br />

IN BRIEF<br />

New Leightons boss<br />

Ryan Leighton has been appointed to<br />

the position of chief executive officer<br />

for Leightons Holdings, which runs<br />

the Leightons Opticians group. In his<br />

new role of CEO, he will provide<br />

strategic direction for Leightons<br />

Opticians, its franchises and<br />

HearingCare business. Mr Leighton<br />

will work closely with Sue Cockayne<br />

in her position of managing<br />

director of Leightons Opticians and<br />

Leightons Franchises. She will also<br />

take on responsibility for Leightons<br />

HearingCare to enable Mr Leighton<br />

to devote more time to his new role.<br />

Found on Facebook<br />

The victim of a robbery and mugging<br />

from a man wearing ‘Elvis Costellostyle<br />

glasses’ turned detective and<br />

recognised his attacker from a<br />

Facebook picture of the man wearing<br />

the distinctive spectacles. Daniel<br />

Bolton found the mugger Christopher<br />

Bleasdale on the social networking<br />

site, he was sentenced to 28 months<br />

in jail for robbery at Burnley Crown<br />

Court, reported the Daily Mail<br />

(January 24).<br />

Glasses impounded<br />

A total of 150,000 pairs of prescription<br />

glasses have been impounded in<br />

Italy, optical news gathering agency<br />

eyesway.com has reported. ‘Non-EU<br />

nationals’ have been charged with<br />

possession of large quantities of<br />

counterfeit goods by Italian Tax Police<br />

at Bari. The 10 non-EU nationals<br />

were arrested at the end of a health<br />

protection operation according to the<br />

source, Ansa.it, and the seized models<br />

were off-the-shelf reading glasses<br />

with a dioptre of +4.00.<br />

Milton Rogovin<br />

One of the world’s most respected<br />

photojournalists, who trained and<br />

worked as an optometrist and<br />

contributed to eye care in the Second<br />

World War, has died. Milton Rogovin,<br />

won fame from his photography<br />

of America’s poor, worked as a<br />

practitioner for the US Army and from<br />

1942-45 ran an optometry business<br />

until he was nearly 70, according to<br />

the Press Association. He died <strong>this</strong><br />

month, aged 101.<br />

J&J roadshows return<br />

next month<br />

JOHNSON & JOHNSON Vision<br />

Care’s educational roadshows<br />

return next month to explore<br />

vision correction for patients<br />

of all ages.<br />

The ‘Vision For Life’ themed<br />

free-to-attend events will run<br />

from February 6-17, making five<br />

stops across the country.<br />

Booking is now open and<br />

there are up to 11 CET points<br />

available to those who attend.<br />

Beginning the nationwide<br />

tour at Birmingham’s Austin<br />

Court on February 6, the<br />

roadshow will then visit the<br />

Royal Armouries in Leeds<br />

(February 7), London’s Royal<br />

College of Physicians (February<br />

10), the Watershed in Bristol<br />

(February 15) and The Lowry in<br />

Manchester (February 17).<br />

Key topics which will be explored<br />

include: ‘Prescribing for children<br />

in optometric practice’; ‘Myopia<br />

control: can we really make a<br />

difference?’; ‘Keeping mums and<br />

dads in contact lenses’; ‘The ageing<br />

eye’; and ‘Keeping eyes young’.<br />

David Ruston, director of<br />

professional affairs for J&J in<br />

Western Europe, said: “Building<br />

on the popularity of a heavily<br />

over-subscribed event in 2010, the<br />

‘Vision For Life’ roadshows from<br />

The Vision Care Institute should<br />

be immensely popular and aim<br />

to help eye care professionals<br />

keep up-to-date with the latest<br />

vision correction techniques for<br />

their patients, both young and<br />

old. We aim to help strengthen<br />

patient satisfaction and loyalty<br />

from all members of the family<br />

and to show practitioners how <strong>this</strong><br />

can help them to develop their<br />

businesses.”<br />

To book a place at one of the<br />

roadshows, contact 0845 310 5347.<br />

Learning disabilities scheme<br />

is deemed a success<br />

A PILOT SCHEME aimed<br />

at increasing access to<br />

eye care for adults with<br />

learning difficulties has<br />

been labelled a success by<br />

Scrivens Opticians.<br />

Introduced at the<br />

independent’s Wokingham<br />

branch a month ago, the Eye<br />

Know project is designed<br />

to encourage Wokingham<br />

residents with learning<br />

disabilities to have their<br />

eyes examined at least<br />

every two years. As well as<br />

highlighting the importance<br />

of eye health to the patient,<br />

it aims to educate social<br />

care professionals and<br />

family carers.<br />

Optometrist Francesca<br />

Wilson will see all patients<br />

who visit the practice under<br />

the scheme throughout the<br />

project’s nine-month period.<br />

Lisa Wingate, managing<br />

director of Scrivens Opticians<br />

in Wokingham, said: “In<br />

the first month we have<br />

received a significant number<br />

of enquires for <strong>this</strong> special<br />

scheme and are hopeful that<br />

its success will continue<br />

for the next nine months,<br />

ensuring the project delivers<br />

on its targets to educate as<br />

many people as possible.<br />

“We take optical health<br />

very seriously and anything<br />

we can do as a store to make<br />

sure local residents know<br />

the importance of getting<br />

their eyes tested on a regular<br />

basis is something we aim to<br />

pioneer.”<br />

The scheme is funded by<br />

the Wokingham Learning<br />

Disability Partnership Board.

NEWS<br />

16<br />

28/01/11 NEWS<br />

IN BRIEF<br />

New Leightons boss<br />

Ryan Leighton has been appointed to<br />

the position of chief executive officer<br />

for Leightons Holdings, which runs<br />

the Leightons Opticians group. In his<br />

new role of CEO, he will provide<br />

strategic direction for Leightons<br />

Opticians, its franchises and<br />

HearingCare business. Mr Leighton<br />

will work closely with Sue Cockayne<br />

in her position of managing<br />

director of Leightons Opticians and<br />

Leightons Franchises. She will also<br />

take on responsibility for Leightons<br />

HearingCare to enable Mr Leighton<br />

to devote more time to his new role.<br />

Found on Facebook<br />

The victim of a robbery and mugging<br />

from a man wearing ‘Elvis Costellostyle<br />

glasses’ turned detective and<br />

recognised his attacker from a<br />

Facebook picture of the man wearing<br />

the distinctive spectacles. Daniel<br />

Bolton found the mugger Christopher<br />

Bleasdale on the social networking<br />

site, he was sentenced to 28 months<br />

in jail for robbery at Burnley Crown<br />

Court, reported the Daily Mail<br />

(January 24).<br />

Glasses impounded<br />

A total of 150,000 pairs of prescription<br />

glasses have been impounded in<br />

Italy, optical news gathering agency<br />

eyesway.com has reported. ‘Non-EU<br />

nationals’ have been charged with<br />

possession of large quantities of<br />

counterfeit goods by Italian Tax Police<br />

at Bari. The 10 non-EU nationals<br />

were arrested at the end of a health<br />

protection operation according to the<br />

source, Ansa.it, and the seized models<br />

were off-the-shelf reading glasses<br />

with a dioptre of +4.00.<br />

Milton Rogovin<br />

One of the world’s most respected<br />

photojournalists, who trained and<br />

worked as an optometrist and<br />

contributed to eye care in the Second<br />

World War, has died. Milton Rogovin,<br />

won fame from his photography<br />

of America’s poor, worked as a<br />

practitioner for the US Army and from<br />

1942-45 ran an optometry business<br />

until he was nearly 70, according to<br />

the Press Association. He died <strong>this</strong><br />

month, aged 101.<br />

J&J roadshows return<br />

next month<br />

JOHNSON & JOHNSON Vision<br />

Care’s educational roadshows<br />

return next month to explore<br />

vision correction for patients<br />

of all ages.<br />

The ‘Vision For Life’ themed<br />

free-to-attend events will run<br />

from February 6-17, making five<br />

stops across the country.<br />

Booking is now open and<br />

there are up to 11 CET points<br />

available to those who attend.<br />

Beginning the nationwide<br />

tour at Birmingham’s Austin<br />

Court on February 6, the<br />

roadshow will then visit the<br />

Royal Armouries in Leeds<br />

(February 7), London’s Royal<br />

College of Physicians (February<br />

10), the Watershed in Bristol<br />

(February 15) and The Lowry in<br />

Manchester (February 17).<br />

Key topics which will be explored<br />

include: ‘Prescribing for children<br />

in optometric practice’; ‘Myopia<br />

control: can we really make a<br />

difference?’; ‘Keeping mums and<br />

dads in contact lenses’; ‘The ageing<br />

eye’; and ‘Keeping eyes young’.<br />

David Ruston, director of<br />

professional affairs for J&J in<br />

Western Europe, said: “Building<br />

on the popularity of a heavily<br />

over-subscribed event in 2010, the<br />

‘Vision For Life’ roadshows from<br />

The Vision Care Institute should<br />

be immensely popular and aim<br />

to help eye care professionals<br />

keep up-to-date with the latest<br />

vision correction techniques for<br />

their patients, both young and<br />

old. We aim to help strengthen<br />

patient satisfaction and loyalty<br />

from all members of the family<br />

and to show practitioners how <strong>this</strong><br />

can help them to develop their<br />

businesses.”<br />

To book a place at one of the<br />

roadshows, contact 0845 310 5347.<br />

Learning disabilities scheme<br />

is deemed a success<br />

A PILOT SCHEME aimed<br />

at increasing access to<br />

eye care for adults with<br />

learning difficulties has<br />

been labelled a success by<br />

Scrivens Opticians.<br />

Introduced at the<br />

independent’s Wokingham<br />

branch a month ago, the Eye<br />

Know project is designed<br />

to encourage Wokingham<br />

residents with learning<br />

disabilities to have their<br />

eyes examined at least<br />

every two years. As well as<br />

highlighting the importance<br />

of eye health to the patient,<br />

it aims to educate social<br />

care professionals and<br />

family carers.<br />

Optometrist Francesca<br />

Wilson will see all patients<br />

who visit the practice under<br />

the scheme throughout the<br />

project’s nine-month period.<br />

Lisa Wingate, managing<br />

director of Scrivens Opticians<br />

in Wokingham, said: “In<br />

the first month we have<br />

received a significant number<br />

of enquires for <strong>this</strong> special<br />

scheme and are hopeful that<br />

its success will continue<br />

for the next nine months,<br />

ensuring the project delivers<br />

on its targets to educate as<br />

many people as possible.<br />

“We take optical health<br />

very seriously and anything<br />

we can do as a store to make<br />

sure local residents know<br />

the importance of getting<br />

their eyes tested on a regular<br />

basis is something we aim to<br />

pioneer.”<br />

The scheme is funded by<br />

the Wokingham Learning<br />

Disability Partnership Board.


Software companies will vie<br />

for your attention at Optrafair<br />

18<br />

28/01/11 SHOW COUNTDOWN<br />


access to patient appointment<br />

books and data, multiple<br />

branch management and<br />

improved communications<br />

will be the key aspects of the<br />

bespoke optical IT systems<br />

promoted at Optrafair – which<br />

is just 71 days away.<br />

Practitioners thinking about<br />

updating their current system<br />

or computerising their practice<br />

for the first time are urged to<br />

attend the show at the NEC,<br />

Birmingham on April 9-11.<br />

Six of the sector’s major<br />

software suppliers – Optix<br />

Software, See 20/20, Optisoft, Opticabase, Optinet and Ocuco – will<br />

be present to offer hands-on demonstrations of their products to<br />

attendees throughout the three-day event.<br />

Managing director, Michael Prais (pictured) commented: “New<br />

features added to Opticabase, include SMS and email messaging, online<br />

tutorials, one-click lens ordering and a link to<br />

frame tracer, a link to receipt printer and cash<br />

drawer, electronic NHS form submission and<br />

much more.”<br />

Elsewhere in the exhibition, Optisoft will be<br />

promoting, among other things, its new ‘easy’<br />

Apple iPad dispensing tool.<br />

Talking about Optisoft’s products,<br />

managing director, Keith<br />

Sheers said: “Our digital diary<br />

and recall, supported with<br />

easy to use SMS and email<br />

functions, are expected to gain<br />

many new users as practices<br />

see the mounting costs of<br />

mailing patients by post. The<br />

electronic GOS forms to PCTs<br />

are also a great talking point.”<br />

Returning to the biannual<br />

show after a “fantastic<br />

response” in 2009, Opticabase<br />

has a number of new additions<br />

to highlight to attendees.<br />

Managing director of Optix<br />

Software, Trevor Rowley,<br />

believes attending Optrafair will give practitioners a unique opportunity<br />

to review the systems on offer across the market. “There tends to be<br />

some inertia in optics about something that does the job but a good IT<br />

system should be paying for itself many time over in revenue.”<br />

To book a place at Optrafair visit www.optrafair.co.uk<br />

• Bookings are now being taken for educational lecture series OT<br />

Live – see news pages – which will have a large presence at the<br />

show. The Platinum sponsors for the event have been confirmed<br />

as Johnson & Johnson and Topcon. Other sponsors include Zeiss,<br />

Optos, Optegra, Grafton and Transitions. To book go to www.<br />

otlive.co.uk or call 0845 1801 318, or to find out more, call Karen<br />

Sparrow on 0207 207 2194.

The AOP and SECO International are pleased to offer AOP<br />

members a complimentary Delegate Pass to the largest<br />

Optometric Continuing Education meeting in the world.<br />

®<br />

Over 400 Hours of Continuing Education / Largest Optometric Meeting Exhibit Hall in the US / Unlimited Networking Events<br />



15 hours of Special Session education<br />


SECO 2011 is The Education Destination ® and will feature more than 400 hours<br />

of continuing education for eye care professionals around the world.<br />


SECO 2011 will host <strong>Optometry</strong>’s Marketplace at SECO , the largest exhibit<br />

hall in optometry. Nearly 275 participating leading industry companies will<br />

feature the latest ophthalmic equipment, products and services.<br />

<strong>Optometry</strong>’s Marketplace at SECO will also feature two FREE lunches, a wine<br />

& cheese reception as well as a daily prize program.<br />

and unlimited access to our Optometrist<br />

Continuing Education Program (COPE/CET)<br />

Breakfast, lunch and dinner SECO Symposiums<br />

Admission to the exhibit hall<br />

VALUED<br />

AT UP TO<br />

$490<br />

Networking receptions and social events:<br />

• The Wednesday Night Opening Reception<br />

• Wine & Cheese Reception, President’s<br />

Reception & Thursday Night Highland’s Hop<br />

• Friday’s Alumni and Special Receptions<br />

• The SECO Saturday Night Party<br />

EVENTS<br />

SECO 2011 will include more than 50 affiliate events and functions, including<br />

nightly social events. SECO 2011 should be your education and entertainment<br />

destination.<br />

Course Handouts CD-ROM<br />

Access to 13 hours of FREE virtual continuing education<br />

For additional information about SECO 2011<br />

please visit www.SECO2011.com<br />

For more information, to register your interest or to book<br />

your trip please contact Karen Sparrow on<br />

0207 207 2194 or email karensparrow@aop.org.uk.<br />


March 2–6, 2011<br />


March 3–5, 2011<br />


Georgia World Congress Center<br />

Atlanta, Georgia USA<br />

SECO2011.COM<br />

The SECO [2010] conference was outstanding in terms of content, subject<br />

matter, presenters, workshops and its organisation.<br />

Graham Park, MCoptom FAAO<br />

Optometrist, North Wales


New frames for<br />

mature women<br />

20<br />

28/01/11 INDUSTRY NEWS<br />

ORANGE EYEWEAR has enhanced its<br />

Contessa label with a number of new<br />

frames for mature women. Designed<br />

specifically for the “from-40+” age<br />

group, Contessa is designed to be an<br />

affordable range available exclusively to<br />

independents.<br />

Contessa features a range of classic<br />

looks with a modern twist, together<br />

with delicate finishes and a variety of<br />

side detailing. A number of frames have<br />

the option of narrower side widths<br />

for women who find bolder sides too<br />

overpowering.<br />

Highlights of the new collection<br />

include model Con105, (pictured<br />

above). Available in two colourways,<br />

pink/lavender and gold/brown, the<br />

soft-coloured supra eye-shape blends<br />

into contrasting metal side detailing.<br />

Together with spring hinges, the model<br />

is enhanced by a subtle criss-cross design<br />

that flows into colour co-ordinated<br />

acetate sides. These have the added<br />

benefit of being shortened, as necessary.<br />

Model Con106 is also available in two<br />

colours, coffee and violet and has a soft<br />

squoval eye-shape, deep enough to<br />

accommodate a progressive lens. It is one<br />

of a selection of petite frames for those<br />

women requiring smaller eye sizes.<br />

Hanna Nussbaum, Orange’s managing<br />

director, said: “The latest additions reflect<br />

a growing desire for a versatile collection,<br />

combining style and subtlety.”<br />

0161 773 5555<br />

Boost your<br />

New Year sales<br />

TO REACH over 20,000 potential<br />

customers, send details of your<br />

product launches with accompanying<br />

photographyany pictures for<br />

OT’s industry news by emailing<br />

robinamoss@optometry.co.uk<br />

Fully automated<br />

camera is launched<br />

HAAG-STREIT UK has launched the new DRS fully automated retinal imaging camera, which<br />

requires “minimal operator training”.<br />

The company believes that the digital system<br />

offers “excellent value for money for the modern<br />

optometric practice, without compromising on<br />

image quality”.<br />

The DRS has been designed to maximise patient<br />

flow, whilst simplifying operation through an<br />

intuitive touch screen interface.<br />

Single button operation enables the DRS to<br />

automatically detect the patient, self-align to<br />

the patient’s eye, focus on the retina, adjust<br />

the flash level and capture a high quality<br />

image in less than 30 seconds. The image can<br />

then<br />

stored on the system or on a USB memory stick,<br />

stick,<br />

printed, or transmitted to another PC or network via<br />

the<br />

integrated Wi-Fi and Eithernet connections.<br />

The design is compact and features an integrated PC with a 160 GB hard drive, enabling the<br />

storage of thousands of images. A low power LED flash helps to ensure patient comfort.<br />

01279 456261

Water way<br />

with frames<br />


brand Skaga has the design theme<br />

“underwater” for its new collection<br />

for spring. Life on, by, and under the<br />

water has influenced Skaga’s creative<br />

design team, mainly in the choice of<br />

colours and shades.<br />

The details of the frames are<br />

inspired by glittering fish scales, the<br />

shifting, transparent movements of<br />

jellyfish, shimmering seaweed and<br />

billowing reeds as seen in the frame<br />

Skaga 3812, pictured left. The shape<br />

has a slight 1950s influence but with<br />

a modern twist. The frame is available<br />

in purple, black, petrol and golden<br />

brown. There are styles for men as<br />

well, and the frames are the work of<br />

Skaga four-strong team of designers<br />

based in Sweden.<br />

For more information see www.<br />

scandinavianeyewear.se or contact<br />

the UK distributor.<br />

0800 376 1050<br />

A touch of<br />

denim<br />

Ordering is now<br />

child’s play<br />

DUNELM OPTICAL has launched its new website <strong>this</strong> month. It has been updated to make it<br />

easier for practitioners to browse the company’s 900-frame portfolio at www.dunelmoptical.<br />

co.uk. Larger pictures showcase the frames in more detail, and there is a more user-friendly<br />

ordering system.<br />

“We’re really pleased with the new website,” said Dunelm Optical director Peter Beaumont.<br />

“Not only is the functionality much better, we’ve also let the pictures do the talking. We’ve made<br />

model photography more prominent as our customers told us that these types of images have<br />

more impact. We hope people will be pleased with the result.”<br />

01388 420420<br />

21<br />

28/01/11 INDUSTRY NEWS<br />

THE CHARMANT Group has<br />

launched the Esprit optical range for<br />

spring/summer. The designers of the<br />

new urban collection have blended<br />

Esprit’s positive, youthful spirit with<br />

<strong>this</strong> year’s revived passion for denim.<br />

Typical denim features such as fly<br />

buttons are included as in frame<br />

E17302, pictured, a women’s metal<br />

frame available in brown, black,<br />

purple, silver and gold.<br />

The new collection comes in the<br />

latest in saturated primary and neon<br />

colours with light metallic and<br />

bolder two-toned frames some of the<br />

keynotes of the new range.<br />

020 8992 9911<br />

Sales will help charity<br />

MID-OPTIC HAS added the Magnifeyes Ready Reader range to its Guide Dogs product<br />

portfolio, with a donation made to the charity for every product sold.<br />

The Magnifeyes Ready Readers are supplied in 15 clear lens designs and three Sun Reader<br />

designs with UV400 lenses. Powers range from +1.00 to +3.00. Mid-Optic is donating 50p to<br />

the charity for every pair it sells.<br />

The frames can be bought<br />

individually but those purchasing<br />

a selection of 20 frames will<br />

receive a free counter display<br />

unit showing the Guide Dogs<br />

branding.<br />

Mid-Optic has now<br />

sponsored its second Guide<br />

Dogs puppy called Barley,<br />

through sales of its Guide Dogs<br />

Ready Readers and Microfibre<br />

Cleaning cloths.<br />

01332 295001

NEWS<br />

Opti opens with sports theme<br />

22<br />

28/01/11 NEWS<br />

THE TRADITIONAL curtain raiser<br />

to the European optical show<br />

calender, Opti Munich, opened<br />

today with a concentrated<br />

presence of collections for<br />

summer and winter sports.<br />

Over 50 manufacturers of<br />

sports eyewear will present<br />

their latest collections over the<br />

next three days, with the likes of<br />

Adidas, Nike and Oakley lifting<br />

the veil on new developments.<br />

Aimed at all winter sports fans,<br />

Adidas’s Supernova Pro features<br />

a new filter shape which gives a<br />

wider field of view and prevents<br />

sunlight entering from the side,<br />

and is presented at the Silhouette<br />

stand. Sports brand Uvex – at<br />

the Rodenstock display – is<br />

showcasing six new products at<br />

Opti, including a pair of sports<br />

glasses that gives protection for<br />

eyes in all weather conditions.<br />

The variomatic tinted lenses from<br />

Uvex automatically adjust to<br />

changing light conditions.<br />

The Vortex model from<br />

Bushnell, aimed at mountain<br />

bikers, features lightweight,<br />

impact-resistant lenses, which<br />

give protection against stones<br />

kicked up on downhill slopes.<br />

Also for cyclists is the Gozen<br />

model. At the show, Rudy<br />

Project is currently presenting<br />

these sports glasses for the<br />

first time; a special flip-change<br />

technology enables lenses to<br />

be exchanged quickly. ‘Seeing<br />

and being seen’ is the tag-line<br />

from the new Nike sports<br />

eyewear collection Vintage. The<br />

Vintage range is inspired by<br />

1970s design.<br />

The show, which started in<br />

1998, had 434 exhibitors last<br />

year, and has topped the 450-<br />

mark in companies supporting<br />

it <strong>this</strong> time, with over 160<br />

businesses from outside<br />

Germany will be taking part<br />

<strong>this</strong> time from 25 countries.<br />

Britain’s presence includes<br />

Cutler & Gross and Tom Davies.<br />

New at Opti ´11, in the<br />

‘country pavilions’ which<br />

are centred in Hall C1, will<br />

be the presence of seven<br />

Turkish exhibitors showing<br />

their collections for the first<br />

time outside of their home<br />

country. The Turkish products<br />

on show range from frames<br />

and sunglasses to children’s<br />

spectacles. France will have a<br />

total of 13 firms present, among<br />

them François Pinton and<br />

Vuillet Vega.<br />

A full report on the show will be<br />

published by OT next month.<br />

Kilimanjaro climb<br />

raises VAO £5,000<br />

THE STORE director of a<br />

London-based Specsavers has<br />

climbed Mount Kilimanjaro and<br />

raised £5,000 for Vision<br />

Aid Overseas.<br />

Shak Hirani, who runs the<br />

Hammersmith branch of the<br />

multiple, was accompanied<br />

by two friends as he made the<br />

5,900ft climb over five days.<br />

Pictured at the peak of the<br />

Tanzania mountain, Mr Hirani<br />

said: “We began training for<br />

the climb six months before<br />

the departure date to ensure<br />

we were still in peak physical<br />

condition. This included a<br />

gruelling training schedule,<br />

a 12-hour charity football<br />

marathon and a climb to the<br />

peak of Mount Snowdon.<br />

“Nothing though could<br />

have prepared us for what<br />

we faced, including freezing<br />

temperatures, unbearable<br />

altitude sickness and an<br />

extraordinary challenging<br />

climb. Despite all <strong>this</strong> I think it<br />

was also the most exhilarating<br />

experience of my life; just one<br />

that I doubt I’ll repeat anytime<br />



All minds<br />

on Georgia<br />

The fast-growing city of Atlanta,<br />

Georgia, USA is once again hosting<br />

SECO <strong>this</strong> year.<br />

Billed as ‘the education<br />

destination’ as well as the promised<br />

world-class lectures, between<br />

March 2 and 6, almost 300<br />

companies will exhibit at the World<br />

Congress Center.<br />

To book, or for more information,<br />

visit www.seco2011.com<br />

23<br />


1 NEOS, The Harvey Suite, Ravensdene Lodge Hotel, 55 Consett<br />

Road, Lobley Hill, Gateshead, ‘Dots, blots and haemorrhages.<br />

A guide to medical retinal problems’ 7.15pm (simonraw44@<br />

hotmail.com)<br />

NEW… 1 North London AOP, Moorfields Eye Hospital,<br />

London, EC1V, ‘Binocular vision and incomitancy’ 1 CET point<br />

(stevedross10@hotmail.com)<br />

2-3 J&J, The Vision Care Institute, Pinewood, Berkshire,<br />

‘Returning to work confident and refreshed’ two day course,<br />

18 CET points (www.thevisioncareinstitute.co.uk)<br />

9 West Sussex LOC, Post Graduate Medical Centre,<br />

Worthing, ‘Anterior eye – what to refer’ 7pm<br />

(consult@bridleopticians.co.uk)<br />

10 LOCSU, Winchester Royal Hotel, St Peter<br />

Street,Hampshire, Winchester, ‘Regional training<br />

roadshow’ SEE ABOVE<br />

NEW… 10 J&J, Royal College of Physicians, London,<br />

‘Vision for life roadshow’ 11 CET points SEE ABOVE<br />

14 LOCSU, Belfry, Mellor’s Way, Nottingham, ‘Regional<br />

training roadshow’ SEE ABOVE<br />

28/01/11 DIARY DATES<br />

3 LOCSU, Ramada Piccadilly, Portland Street, Manchester, M1<br />

4PH, ‘Regional training roadshow’ SEE ABOVE<br />

NEW… 4 Pinpoint Scotland, 9 Gayfield Square, Edinburgh,<br />

‘Practical OCT course’ (Maureen.broomhall@mcht.nhs.uk)<br />

6 Eyecare 3000, Hilton Hotel, Belfast, 6 CET points on offer<br />

(www.eyecare3000.com)<br />

6 Glasgow Caledonian University and NHS Education for<br />

Scotland, Dundee, venue TBC ‘Communication skills in<br />

optometry’ (Karen.reid@gcal.ac.uk)<br />

NEW… 6 J&J, Austin Court, Birmingham, ‘Vision for life<br />

roadshow’ 11 CET points (0845 310 5347)<br />

NEW… 7 J&J, Royal Armouries, Leeds, ‘Vision for life<br />

roadshow’ 11 CET points SEE ABOVE<br />

NEW… 7 Nottingham and Derby Optical Society, The Village<br />

Hall, Chilwell, ‘Vitreo-retinal disorders’ 7.30pm<br />

(ndos@live.com)<br />

7 LOCSU, Maunsel House, North Newton, Somerset, ‘Regional<br />

training roadshow’ SEE ABOVE<br />

8 CIBA Vision, Bridgewater Hall, Lower Mosley Street,<br />

Manchester, M2, ‘The Big Fit’ (www.cibavisionacademy.co.uk)<br />

14 CIBA Vision, BMA, Tavistock Square, London,<br />

WC1 9JP, ‘The Big Fit’ SEE ABOVE<br />

14 Lancashire Optical Society, Swallow Hotel, Preston,<br />

‘Surgeons’ choice’ (ruthcuth@btinternet.com)<br />

15 BCLA, 76 Portland Place, London, ‘Scientific<br />

evening meeting’ (www.bcla.org.uk)<br />

NEW… 15 J&J, Watershed, Bristol, ‘Vision for life<br />

roadshow’ 11 CET points SEE ABOVE<br />

17 LOCSU, Menzies Hotel, Barr Hill, Cambridge,<br />

‘Regional training roadshow’ SEE ABOVE<br />

NEW… 17 J&J, The Lowry, Manchester, ‘Vision for life<br />

roadshow’ 11 CET points SEE ABOVE<br />

17-18 Innovative Sclerals, 73 Railway Street,<br />

Hertford, ‘An introduction to scleral lens practice’<br />

(www.sclerals.com)<br />

21 TMR, Holiday Inn City Centre, Birmingham,<br />

‘Optical assistant/receptionist course one’<br />

(info@tmr.co.uk)<br />

22 TMR, Holiday Inn City Centre, Birmingham,<br />

‘Optical assistant/receptionist course two’<br />



Sponsored by<br />

Why a hospital placement<br />

shouldn’t be overlooked<br />

Newly qualified optometrist Nadeem Rob discusses his hospital pre-registration placement<br />

24<br />

28/01/11 PRE-REG FOCUS<br />

A common myth is that you can’t accomplish<br />

a hospital pre-reg placement unless you’re a<br />

‘super optom’ or the model student, writes<br />

Nadeem Rob (pictured). But I’m here to put all of<br />

you current/future hospital pre-regs at ease.<br />

The demands of hospital optometry are<br />

different to the High Street and often involves<br />

much more patient contact time. Just a simple<br />

refraction with an NHS patient can take up<br />

to an hour. Far more patience is required to<br />

complete tests where you often have to explain<br />

everything to the patient, even if their treatment<br />

doesn’t always involve you. Ultimately, you are<br />

just one piece of the puzzle in the NHS.<br />

Hospital pre-reg timetables are often split<br />

into general clinics. This is broken down into<br />

refractions, contact lenses, low vision aid and<br />

dispensing. However, <strong>this</strong> can vary from place<br />

to place.<br />

Refraction is what it is. During a hospital prereg<br />

placement you may only be expected to do<br />

diagnostic refractions on patients that require<br />

or have already had treatment. Doctors might<br />

just need to know what their best corrected<br />

VA is. Additional tests can be done at your own<br />

discretion, but remember optometry is only one<br />

part of the treatment.<br />

Your contact lens experiences will also be<br />

slightly different to what you’d get on the High<br />

Street as the majority of hospital patients require<br />

RGP lenses rather than soft contact lenses.<br />

However, the beauty about <strong>this</strong> is that you often<br />

get to see the extreme and interesting cases. Be<br />

careful not to forget soft contact lenses as you<br />

become an expert of everything RGP though<br />

because you will suffer for it in your assessments<br />

if you do.<br />

Low vision clinics are something you might<br />

not come across much on the High Street.<br />

In a nutshell, patients referred and treated<br />

by the hospital may still have a low corrected<br />

VA. Therefore they often need additional<br />

help with magnifiers, telescopes and CCTV,<br />

as well as general advice on lifestyle changes<br />

and what help is available to them. Your aim<br />

is to improve their daily activities, including<br />

reading, cooking, shopping, etc. I have found<br />

that it is one of the most rewarding parts of<br />

hospital optometry, even though it is often<br />

given a softer focus during university.<br />

Dispensing can be the most testing part<br />

of your hospital pre-reg unless you have a<br />

specific dispensing department and it is often<br />

the hardest thing to get through. Even though<br />

you get to see a greater range of dispensing<br />

episodes in a hospital, the College focuses<br />

on the number of dispensing episodes you<br />

complete over the period. With 250 as a<br />

minimum requirement you can often face a<br />

struggle to reach <strong>this</strong>, and as a result some<br />

hospitals send their pre-regs out to multiples<br />

to gain these numbers. I would also advise<br />

that you have a weekly target to reach, but be<br />

prepared to be flexible because you can never<br />

predict what will come through the door on<br />

your day of dispensing.<br />

With so much ophthalmology around<br />

you, the chance of seeing something unique is<br />

endless. Let doctors know you are around for<br />

when interesting cases come in and don’t feel<br />

like you’re restricted to your timetable.<br />

Inherently some things, like pathology, will<br />

come naturally to you while routine testing<br />

may not. You may have noticed that the<br />

College Scheme of Registration is geared<br />

towards the work of High Street pre-regs; <strong>this</strong><br />

is not of their fault, there are just far more High<br />

Street candidates. An example which I can<br />

relate to personally is completing a routine<br />

test on a pre-presybopic patient in 45<br />

minutes for an assessment. This may<br />

sound simple to the majority of pre-reg<br />

optometrists, but for hospital candidates<br />

it’s not a daily activity. As a result, I would<br />

suggest trying to arrange regular days out to<br />

your local High Street practice if a scheme is<br />

not already in place at the hospital you are<br />

based. Also, practise on colleagues and on<br />

other staff members. Even though a simple<br />

refraction is enough for you to count as an<br />

episode, keeping to the strict time limit and<br />

compulsory tests for your assessments is<br />

often difficult.<br />

With the wealth of knowledge you<br />

can submerse yourself within a hospital<br />

environment, it is an opportunity you should<br />

not take lightly, the satisfaction you gain is<br />

second to none and it eventually provides you<br />

with the finest foundations to become the<br />

best optometrist you can be in the future.

BEST 50<br />

50 Great<br />

moments...<br />

optometrytoday<br />

To celebrate our half-century we are listing 50<br />

great moments in our sector’s history from the<br />

past 100 years or so.<br />

25<br />

Inventor’s mission: To help<br />

a billion with poor sight<br />

The ambition of the inventor of ‘Ad Specs’<br />

Professor Josh Silver (pictured left) has<br />

come a long way since coming up with<br />

his idea in the mid-1980s. Then, 25 years<br />

ago, he started to consider the way our<br />

eye-brain adaptive optical system works,<br />

and Professor Silver believed that self-refraction with suitable adaptive<br />

lens eyeglasses could be a useful procedure, and potentially for<br />

correcting refractive error.<br />

After trying such a procedure on himself, he made several adaptive<br />

lens eyeglasses (adaptive eyewear), and then carried out research<br />

backed by the Department for International Development. This<br />

revealed that self-refraction with adaptive eyewear was a useful<br />

procedure for bringing vision correction to many of the world’s<br />

population who need, but do not have, corrective eyewear. The<br />

adjustable spectacles work by means of fluid-filled lenses that use the<br />

incompressibility of liquids to change the physical shape of the lens.<br />

The lens is constructed with two flexible membranes on the optical<br />

surfaces, held in place by a solid surround.<br />

The power of the lens is changed by pumping fluid into or out of the<br />

central lens reservoir – less fluid causes the flexible membranes to bow<br />

inwards due to the reduced internal pressure, and more fluid causes<br />

the membranes to expand outwards. This causes the lens to change<br />

refractive power, which makes it suitable for adjustable eyeglasses.<br />

In 1996 Professor Silver formed Adaptive Eyecare to help develop the<br />

invention, and in 2000 he won the Popular Science Best of What’s New<br />

Award.<br />

Professor Silver now directs the Centre for Vision in the Developing<br />

World, and hopes to see a billion people having vision correction by<br />

the year 2020.<br />

What should we include in our 50 great moments<br />

list? To suggest your choice, email David Challinor,<br />

davidchallinor@optometry.co.uk<br />

28/01/11 50 GREAT MOMENTS

GLOBAL<br />

26<br />

28/01/111 ANTARCTIC<br />

Voyage to the<br />

bottom of the world<br />

Contact lens specialist Andrew Gasson reports from Antarctica<br />

on optical pioneering, penguins, and extreme distance learning<br />

DURING MY four-week journey on board<br />

the Kapitan Khlebnikov, with my copies<br />

of <strong>Optometry</strong> <strong>Today</strong>, we visited the<br />

United States Antarctic bases at Palmer<br />

Island and McMurdo; New Zealand’s<br />

Scott Base; and Siple Island. The latter<br />

is a remote spot on the Phantom Coast,<br />

so called because it hadn’t even been<br />

mapped until the 1960s. It is scarcely<br />

ever possible to visit and then only by<br />

means of an icebreaker.<br />

Being some 8,000 miles from London<br />

certainly gives a new meaning to the<br />

concept of ‘distance learning’. Sending<br />

the answers home in time would present<br />

further difficulties since the nearest post<br />

office is at Scott Base about 500 miles<br />

west along the Ross Ice Shelf.<br />

At the Palmer Research Station,<br />

the ship was close to the British Port<br />

Lockroy – established in 1944 – and a<br />

little under 100 miles from Rugg Peak.<br />

Look up these destinations yourselves,<br />

but according to the Geographical Place<br />

Names of Antarctica, <strong>this</strong> is located<br />

at 66.19 S and 65.23 W, on the west<br />

coast of Graham Land on the Antarctic<br />

Peninsula.<br />

It was named in 1959 for Andrew<br />

Rugg-Gunn an English ophthalmologist<br />

who “in 1934 brought together the<br />

relevant data on radiation and protective<br />

glasses to improve the design of snow<br />

goggles.” Rugg-Gunn is also of particular<br />

interest to the contact lens world as he<br />

was one on the pioneers of glass scleral<br />

lens fitting, using afocal Zeiss lenses in<br />

the early 1930s.<br />

He featured in the Contact Lens<br />

Pioneers booklet published by the BCLA<br />

in 2004. This previously unpublished<br />

photograph (right) of him has only<br />

recently come to light, courtesy of his<br />

grandson. More details of Rugg-Gunn<br />

can be found in Contact Lenses – the<br />

Story by Tim Bowden and at www.<br />

andrewgasson.co/pioneers/Rugg-Gunn.<br />

Such a remote voyage also makes one<br />

realise that optical problems are never<br />

far away. The ship’s captain, himself,<br />

was struck with Bell’s Palsy but was<br />

still able to perform some amazing feats<br />

of precision manoeuvring among the<br />

Antarctic icebergs. His practical solution<br />

to the problem was the use of ocular<br />

lubricants and wearing dark glasses at<br />

all times. This did not look unduly out<br />

of place since at these high latitudes in<br />

mid-summer the sun literally never sets<br />

and there is daylight 24 hours a day.<br />

Some passengers were using<br />

scopolamine patches to ward off sea<br />

27<br />

sickness but<br />

as a side effect<br />

encountered<br />

blurred vision<br />

because of<br />

transient<br />

mydriasis and<br />

cycloplegia. It<br />

could have been<br />

worse since<br />

dizziness and<br />

hallucination<br />

might also have occurred. Motion<br />

sickness medications all seem to require<br />

some degree of caution since other<br />

commonly available remedies such as<br />

cinnarizine (Stugeron) and hyoscine<br />

hydrobromide (Kwells) list similar side<br />

effects and all are obviously contraindicated<br />

where there is a risk of narrow<br />

angle glaucoma.<br />

Another participant’s varifocal<br />

spectacles ended up with the right and<br />

left lenses at an angle of approximately<br />

45 degrees to each other which did<br />

little to improve her binocular vision.<br />

Her spare pair languished in her main<br />

luggage which, by courtesy of Iberia,<br />

never arrived in time for the voyage and<br />

spent three or four weeks flying between<br />

Madrid and South America.

One passenger required assistance<br />

with insertion and removal of contact<br />

lenses. She had recently been fitted in<br />

South Africa and not yet mastered the<br />

technique of lens handling. She was<br />

therefore using lenses on an extended<br />

wear basis with no guidance as to the<br />

possible risks involved.<br />

Another passenger confessed to<br />

reusing daily disposables until they<br />

began to irritate and compounded<br />

her indiscretions by keeping them<br />

overnight in saline without cleaning<br />

and disinfection. It’s amazing what<br />

patients will admit to when outside the<br />

constraints of the consulting room.<br />

Antarctica can be regarded as an ice<br />

desert and continuing <strong>this</strong> informal<br />

survey of contact lens wearers on<br />

board predictably showed that silicone<br />

hydrogels performed well in the<br />

extremely dry conditions. There was one<br />

long standing gas-permeable hard lens<br />

wearer who needed to exercise caution<br />

since there was a tendency for lenses to<br />

fall out.<br />

Fortunately there were no cases of<br />

photokeratitis snow blindness amongst<br />

the ice flows since most passengers<br />

wore dark glasses to protect themselves<br />

from the ultraviolet radiation. Contact<br />

lenses which included a UV inhibitor<br />

obviously offered an additional degree of<br />

protection.<br />

During my trip the vision of penguins<br />

seems to have been the subject of some<br />

debate as to how they can see both on<br />

land and at sea.<br />

Most authorities suggest that their<br />

eyes are adapted to give best vision<br />

under water in order to hunt for food<br />

and to spot potential predators such<br />

as leopard seals. Investigations in the<br />

1980s of various species by means of<br />

retinoscopy and photorefraction (Martin<br />

and Young) suggested penguin corneas<br />

are relatively flat with a refractive<br />

power of about 29D which is neutralised<br />

under water.<br />

The major refractive component of the<br />

penguin eye is the crystalline lens has<br />

a power of about 100D and is thought<br />

to have sufficient accommodation to<br />

compensate for the loss of corneal<br />

refractive power. In air render they<br />

are therefore less myopic than would<br />

otherwise be anticipated despite their<br />

commonly observed peering posture<br />

(Sivak, Howland and McGil-Harelstad).<br />

Penguin pupils on land also constrict to<br />

a diameter of about 1mm which would<br />

improve depth of field. In a 1987 New<br />

Scientist article Martin postulated a<br />

mechanism for negative accommodation<br />

by means of a very muscular<br />

ciliary body to reduce the power<br />

of the eye’s refractive system.<br />

Binocular vision is also a problem<br />

with some species since the beak<br />

intrudes into the horizontal field<br />

of vision and partly explains jerky<br />

head movements.<br />

Penguin retinas also show<br />

further adaptation with an<br />

absence of red receptors and a<br />

preponderance of violet, blue<br />

and green cone pigments to<br />

allow better discrimination when<br />

swimming at depth under water.<br />

This particular trip was<br />

organised by Quark Expeditions.<br />

Mainly for environmental reasons,<br />

there will be just one more season<br />

in Antarctica for the Kapitan<br />

Khlebnikov and fellow icebreakers<br />

before they return to full time duties<br />

in Russian waters. After 2011 it is<br />

possible that some of the places visited<br />

- amongst the most remote on the planet<br />

and which cannot be reached except<br />

by specialised vessel - may never be<br />

revisited. <strong>Optometry</strong> <strong>Today</strong> is unlikely<br />

ever to be seen <strong>this</strong><br />

far south again.<br />

27<br />

28/01/111 ANTARCTIC


20 Questions – Garrey Haase<br />

Yorkshire-based optometrist Garrey Haase purchased Michael James Opticians six years ago with<br />

his dispensing optician wife Karen. OT spoke with him for the latest in our Q&A series<br />

How are you?<br />

Good question, I think I am fine.<br />

Lake District with the family and golfing to<br />

Florida with my dad and brothers.<br />

28<br />

28/01/11 20 QUESTIONS<br />

How is business generally right<br />

now?<br />

Business is okay but times are tough.<br />

We constantly have to review things to<br />

ensure we keep our heads above water.<br />

Have you had any campaigns/<br />

promotions that were<br />

especially successful?<br />

We have two annual events that bring us<br />

closer to our community. The first is the<br />

annual Santa drawing competition for all<br />

school children in the region.<br />

The second is our charity of the Year.<br />

Since its inception in 2007 we have raised<br />

over £4,000.<br />

What do you like about<br />

working in optics?<br />

I love the diversity of the patients and the<br />

fact that I can work with my wife.<br />

What’s the best thing that’s<br />

happened in the profession<br />

during your time working in<br />

the sector?<br />

This is really hard to answer as I feel the<br />

profession has struggled to maintain<br />

the recognition it deserves since<br />

deregulation. There have been many<br />

good developments in optics over the<br />

last 20 years but we are not good enough<br />

about telling the public about them.<br />

Who do you admire in the<br />

sector in which you work?<br />

There are four people. From an<br />

educational point of view, Dr Alan<br />

Tunnacliffe and Professor David Elliott, the<br />

two best lecturers I had.<br />

From a business point of view I found<br />

that I learnt a huge amount from Neil<br />

Brosgill and Mike Procter.<br />

Where are your favourite places<br />

in the world that optics has<br />

taken you?<br />

Storrs Hall, Windemere, in the Lake District.<br />

I went there to marry my wife, who I met<br />

through optics.<br />

Are you superstitious?<br />

Only in sport.<br />

If you were granted one wish for<br />

the profession what would you<br />

wish for?<br />

Recognition of the clinical side of the job.<br />

Decent fees for the job that optometrists<br />

do.<br />

Do you have a favourite film<br />

or TV show?<br />

Love Actually, The Jazz Singer and Match of<br />

the Day.<br />

Outside of the profession, what<br />

are your hobbies?<br />

Golf, dinning out with Karen and friends,<br />

and walking.<br />

Sum up your feelings for the<br />

next 12 months in five words.<br />

Hard work but great opportunity.<br />

Where do you go on holiday?<br />

When we can get one, Center Parcs or the<br />

What are your favourite<br />

products in the optical sector?<br />

Topcon 2000 OCT and my digital<br />

phoropter.<br />

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

what would you be doing?<br />

Golfing or spending my days with my wife<br />

and the kids.<br />

What’s your favourite singer or<br />

musical group?<br />

I am tone deaf – they all sound the same .<br />

What do you put down your/<br />

your company’s success to?<br />

The great teamwork between Karen and<br />

I. She is the ideas person and I am the<br />

implementer. We also have a great team.<br />

What’s your favourite season,<br />

and time of year?<br />

Winter, I love those cold clear crisp days.<br />

Where would spend your<br />

perfect day?<br />

Augusta, Georgia on the Masters golf<br />

course.<br />

Any final thoughts?<br />

As someone who left school with one ‘O’<br />

level. I always tell people that with the right<br />

determination and attitude as well as some<br />

luck you can achieve what you want. Don’t<br />

let knock-backs put you off.

OT CET Video<br />

C-15345: Contact Lenses: Latest<br />

Technologies and Current<br />

Attitudes Amongst Children<br />

In association with our sponsors CIBA Vision, OT Multimedia is<br />

pleased to bring you two presentations from CIBA’s ‘Maintaining the<br />

Edge’ and ‘Fit for Life’ Roadshows.<br />

Beginning with footage filmed at the CIBA Vision ‘Maintaining the<br />

Edge’ Roadshows, Dr Christine Purslow (Cardiff University) discusses<br />

the latest developments in contact lenses, including approaches<br />

taken to improve comfort and vision.<br />

Section 2 continues with Dr Purslow considering toric and<br />

multifocal lens designs, assessing of the risk of infection in CL<br />

wearers and predicting future applications of contact lenses.<br />

In the final section Professor David Thomson (City University)<br />

provides an overview of the results of an investigation undertaken<br />

study the attitudes of secondary school children to vision correction,<br />

including their attitude towards correction with contact lenses.<br />

You must be logged in to the website before you can watch <strong>this</strong> video and take the exam.<br />

The video is one hour in length and is accompanied by 12 MCQs accredited with 2 free<br />

contact lens CET points for optometrists, dispensing opticians and contact lens opticians.<br />

A hint button is now available for each question<br />

and will take you to the section of the video<br />

that relates to the question.<br />

The closing date for MCQ submission<br />

is February 28 2011.<br />




LOCs must ‘build an attack<br />

plan’ to win enhanced services<br />

LOCSU roadshow begins its tour to advise LOCs on achieving their goals in the ‘new NHS’<br />

30<br />

28/01/11 COMMISSIONING<br />

DELEGATES FROM LOCs from London and the Home Counties were<br />

given vital advice on negotiation skills and dealing with GP consortia<br />

by industry and healthcare experts in the first LOCSU roadshow <strong>this</strong><br />

week. The roadshow will travel across England and Wales between now<br />

and March. This week’s morning session, at the AOP offices in London,<br />

featured specialist optometric adviser from<br />

Primary Care Commissioning, John Hearnshaw<br />

(left) who explained the current GOS contract<br />

in depth and gave his opinion on how the new<br />

commissioning process will work in the future.<br />

Discussing the Government’s new White<br />

Paper, he highlighted the parts most relevant to<br />

optics: “A GP commissioning consortia will not<br />

commission the other family health services [which includes primary<br />

ophthalmic services] – these will be the responsibility of the NHS<br />

commissioning board. However, the consortia will be able to commission<br />

services from primary care contractors, for instance, if they wish to<br />

commission optometrists to help manage glaucoma. “Presumably the<br />

same would apply to all other enhanced care services.”<br />

With <strong>this</strong> in mind, he told LOC representatives that now was the<br />

ideal time to get enhanced optical services on the wider healthcare<br />

agenda. Although he expects the Bill to take a year to go through the<br />

parliamentary process, he believes the earlier that LOCs prepare for the<br />

changes, the more likely they are to achieve their goals.<br />

“Now is a good time to be seeking those new, enhanced optical<br />

services. The new GP commissioning consortia may have open minds,<br />

but empty wallets – that’s not necessarily a bad thing though, if we can<br />

show them some savings,” he said. “Primary eye care will generally be<br />

cheaper than hospital eye care. In 2011-12 the hospital tariff charge is<br />

£112 for first attendance at ophthalmology outpatients plus £65 for a<br />

follow up, the likely high street charge should be much cheaper, but is<br />

up to you to negotiate. If you price yourself too low your members won’t<br />

play ball, too high and you price yourself out of the market.”<br />

Delegates were advised to build an ‘attack plan’ so that as soon as the<br />

new GP consortia come into being, LOC representatives can be ready to<br />

put forward a strong case.<br />

Key to <strong>this</strong>, he added, was<br />

that each LOC had to ask their<br />

colleagues which enhanced<br />

services they felt comfortable<br />

providing and to prioritise<br />

them accordingly, using<br />

feedback from optometrists<br />

and data on which services<br />

would be in most demand<br />

in their community, based<br />

on demographics and the<br />

current costs for treating these<br />

patients in secondary care. “Some enhanced services should be treated<br />

as your birthright,” he added.<br />

Practitioners at the roadshow were given a list of treatments which<br />

have been commissioned and are currently working somewhere in<br />

England:<br />

<br />

<br />

<br />

<br />

<br />

screening services into primary care<br />

<br />

<br />

<br />

With the ‘battle plan’ in their minds, the<br />

afternoon session saw LOC members taken<br />

through negotiation techniques by Dr Mark<br />

Davies (left), a consultant psychiatrist and<br />

director of Res Consortium, which works with<br />

GPs’ consultants and managers on business<br />

development, focusing on commissioning and<br />

healthcare strategy.<br />

“All providers have to give evidence of QIPP – quality, innovation,<br />

productivity and prevention,” said Dr Davies. “You need to pitch<br />

yourselves as the eye care experts who can offer something new and<br />

innovative while also providing a saving.<br />

“The White Paper talks about a patient-centred NHS. What can you<br />

offer to persuade commissioners that you offer a patient-centred<br />

service? It is also very important to tell them what you can offer in terms<br />

of outcomes. The more evidence of clinical success you can supply, the<br />

stronger your case.”<br />

The importance of preparation before entering into negotiations with<br />

commissioners was shown to delegates with the help of actors (one<br />

pictured performing, left) who illustrated scenarios where LOC pitches<br />

to commissioners were going badly. Delegates were then invited to<br />

direct the actor portraying the LOC Chair on how to improve their pitch.<br />

Highlights of the evening session included FODO chief executive<br />

David Hewlett discussing ‘setting the scene for the optical sector’ and an<br />

update on LOCSU activity with its director of operations, Katrina Venerus.<br />

Each roadshow will feature a local expert to discuss GP<br />

commissioning in their area, at Monday’s London roadshow <strong>this</strong><br />

was Dr Naz Jivani from the Kingston GP consortium. Yesterday the<br />

LOCSU roadshow visited Birmingham (January 27) and will address<br />

delegates in Tunbridge Wells (January 31), Manchester (February 3),<br />

Taunton (February 7), Winchester (February 10), Nottingham (February<br />

14), Cambridge (February 17), Newcastle (February 28), Leeds (March<br />

3), Cardiff (March 7) and finally Oswestry (March 10). To book, email<br />


Book your<br />

place by<br />

11 March 2011<br />

to receive<br />

the early bird<br />

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32<br />

28/01/11 MEMBER BENEFITS<br />

How is the current downturn<br />

affecting practice values?<br />

Director of R A Valuations Mark Ridout looks at the current state of play in the sector’s business<br />

property market, and details the essential things to do to increase a practice’s worth<br />

OVERALL, optical practices have not<br />

suffered the knocks that other small<br />

businesses have. However, many have,<br />

nonetheless, taken a significant hit on<br />

their profits in the last two years.<br />

Overheads have risen against static<br />

sales levels as patients strive to save<br />

money by extending intervals between<br />

eye tests and shopping around for lower<br />

dispensing charges.<br />

The credit crunch is taking its toll<br />

on practice ownership transfers too.<br />

Bottlenecks are occurring as purchasing<br />

parties struggle in their attempt to raise<br />

finance after an internal or open market<br />

deal has otherwise been successfully<br />

agreed. Indeed, banks will continue to<br />

request firm evidence of a achievable<br />

return on any investment well after the<br />

green shoots of recovery have genuinely<br />

sprung.<br />

As a result of <strong>this</strong>, common sense<br />

suggests that if a practice is going on the<br />

open market today, it will be restricted<br />

by fewer potential purchasers in its<br />

catchment area compared with a few<br />

years ago.<br />

An economic downturn inevitably<br />

creates opportunities for the shrewd,<br />

such as those seeking to buy up smaller<br />

practices to form a multi-site business.<br />

However, ambitious owners of single<br />

site practices seeking to build a group of<br />

networked practices should be mindful<br />

that overheads incurred in running more<br />

than one site can be disproportionately<br />

high when compared to the enlarged<br />

revenue.<br />

Market value<br />

Business valuation for professional<br />

practices is a prerequisite for many<br />

circumstances including partnership<br />

or director change, practice sale or<br />

purchase, incorporation, tax negotiations,<br />

divorce settlements and so on. Arriving<br />

at an accurate valuation is not easy; it<br />

depends very much on the individual<br />

business and the intended purpose of<br />

the valuation.<br />

A ‘market value’ is determined by<br />

valuation professionals as the price a<br />

practice should be able to justify and<br />

achieve on the open market; reflecting<br />

a justifiable return on investment (ROI),<br />

and what a willing purchaser is likely<br />

to pay and a willing vendor likely to<br />

accept in the current market conditions.<br />

Market value may or may not include<br />

a margin for negotiation. A ‘fair<br />

price’ also takes both ROI and market<br />

value into consideration to derive a<br />

pinpointed figure without a negotiating<br />

margin. It is typically used for the<br />

purposes of incorporation, internal<br />

transfers, partnership or director<br />

change, matrimonial and litigation, and<br />

so on, ie, purposes where no one party<br />

should perceive a gain over and above

the Goodwill from the value held within<br />

the business.<br />

Goodwill usually represents the bulk<br />

of the business value. It is, therefore,<br />

the most critical and influential figure<br />

effecting a valuation figure. Goodwill<br />

valuation is a function of the profit – or<br />

surplus – left after taking account of all<br />

legitimate trading expenses and making<br />

appropriate adjustments necessary to<br />

arrive at a ‘true’ trading value.<br />

The days when an asking price was<br />

arrived at using empirical means such<br />

as a multiple of Annual Turnover (Sales)<br />

are, thankfully, long since gone. It is rare<br />

for two practices having the same level<br />

of turnover to show identical levels of<br />

profit and, therefore, Goodwill. The RA<br />

Valuation Services database contains<br />

many examples of <strong>this</strong> comparison.<br />

Clearly, a practice having, say, £500,000<br />

annual turnover and a surplus (or pre-tax<br />

profit) of £100,000 is worth more than<br />

another practice also showing £500,000<br />

turnover but a surplus of only £50,000.<br />

That said, a practice with little or<br />

no surplus (or profit) may still have a<br />

useful market value and could appeal<br />

to a prospective owner not wanting the<br />

hassle of setting up an organic – or green<br />

field – business from scratch. There is,<br />

however, no substitute in valuation for<br />

a recent set of trading accounts showing<br />

healthy profits.<br />

Valuation process<br />

Other criteria that can influence value,<br />

and should be taken into consideration<br />

in the valuation process, include<br />

external factors, such as the economic<br />

climate, the market conditions<br />

within the business sector, location/<br />

demographics/competition, regulation,<br />

red tape and threat of litigation. Also<br />

internal influences, turnover (sales<br />

or income), gross profit (sales less<br />

cost of sales), trading trends, practice<br />

presentation, premises and permanence<br />

of location, and potential.<br />

Whilst it requires complete<br />

independence, expertise, experience and<br />

industry knowledge to value a particular<br />

business, it is the business owners who,<br />

knowingly or not, exercise the greatest<br />

influence on Goodwill by the way they<br />

run their business. If they do it right,<br />

they could be enhancing their retirement<br />

plans. If they get it wrong, they could be<br />

Mark Ridout<br />

“There is no substitute for a recent set of<br />

trading accounts showing healthy profits”<br />

in for a prolonged struggle to realise the<br />

full potential value of their business.<br />

When thinking of how to increase<br />

your practice’s value during a<br />

downturn, there are steps that can be<br />

taken to maintain, or even increase, the<br />

potential value of your practice.<br />

Firstly, exit strategy. All business<br />

owners should have in mind an exit<br />

strategy. This may simply be a ‘wish<br />

list’ reflecting the owners’ desires, or it<br />

could comprise part of a detailed formal<br />

business plan. Either way, an exit<br />

strategy should, ideally, be planned at<br />

least three years ahead if a satisfactory<br />

valuation and successful sale or transfer<br />

are to be achieved. If you feel you<br />

haven’t got the experience or the time<br />

to develop a plan, hire a consultant or<br />

someone who can help you.<br />

In addition you must prepare your<br />

business for sale. There are many things<br />

to do, most of them simple, if you are<br />

planning to put your practice on the<br />

open market. For example, you must<br />

ensure that the physical appearance<br />

is up to scratch. As with selling a<br />

house, so called ‘kerb appeal’ is vitally<br />

important. When a homeowner wants to<br />

sell their house, they may paint it and<br />

fix up a couple of things that needed<br />

to have been done during the last few<br />

years. First impressions count and can<br />

be the difference between a successful<br />

or unsuccessful sale.<br />

Last but not least profits – and profit<br />

growth – are the most important.<br />

Clearly, financial performance - and<br />

growing trading profit in particular<br />

– must validate that the practice is<br />

performing well. As an example of<br />

the dramatic effect of profit growth<br />

on business value, in a recent oneyear<br />

update valuation of a business<br />

undertaken by R A for a client one<br />

year after the original valuation, sales<br />

had increased over the last year by an<br />

insignificant 5% but purchases were<br />

maintained at the same level and<br />

overheads cut by 5%. The resultant<br />

goodwill was valued at over 40% higher<br />

than the previous year solely as a result<br />

of these changes.<br />

Keep purchases of supplies at sensible<br />

and pragmatic levels, and a close eye<br />

on all overheads, effectively manage<br />

budgeting and cash flow, and be realistic<br />

about the value of your practice. Don’t<br />

underestimate it, but do be realistic.<br />

Remember that the bank will want to<br />

see that the potential buyer can pay<br />

back the loan. Ultimately, it all comes<br />

down to profit. Get all of the above<br />

right and the financial figures will<br />

speak for themselves.<br />


In celebration of its long association with<br />

the AOP, R A Valuations has agreed to<br />

offer members a 10% discount for the<br />

provision of a business valuation – <strong>this</strong><br />

is in addition to the normal membership<br />

discount, and additionally gives a<br />

considerable reduction against<br />

its fees to non-members. The offer runs<br />

until February 28 2011.<br />

33<br />


VRICS<br />




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there is only one correct answer for each MCQ. Successful completion will result in two CET points. VRICS<br />

regularly appears in <strong>Optometry</strong> <strong>Today</strong>.<br />

Anterior Eye & Contact Lens Assessment<br />

COURSE CODE: C-15341 O/D/CL<br />

Dr Shehzad Naroo BSc (Hons)<br />

MSc PhD MCOptom FIACLE<br />


34<br />

1. Which of the following statements about the technique shown<br />

in Image A is FALSE?<br />

a) The observation and illumination should be decoupled<br />

b) Illumination should be placed at the limbus<br />

c) The angle between observation and illumination should be about 45°<br />

d) Magnification should be set at 16-25x<br />

28/01/11 VRICS<br />

A<br />

2. For which of the following can the technique shown in Image<br />

A be used to assess?<br />

a) The location of a corneal foreign body<br />

b) The depth of a corneal foreign body<br />

c) Corneal thickness<br />

d) The presence of corneal staining<br />

3. Which of the following statements about the instrument<br />

shown in Image B is FALSE?<br />

a) It has a cold light source<br />

b) It allows quantitative assessment of tear break-up time (TBUT) over the<br />

whole cornea<br />

c) It allows measurement of corneal curvature<br />

d) It allows qualitative assessment of the lipid layer of the tear film<br />

B<br />

C<br />

4. Which of the following filters CANNOT be used with the<br />

instrument shown in Image B?<br />

a) Blue filter for sodium fluorescein assessment of the tear film<br />

b) Placido disc filter for assessment of corneal shape<br />

c) A filter for assessment of tear osmolarity<br />

d) Grid filter for measurement of non-invasive tear break-up time (NIBUT)<br />

5. Which of the following statements regarding the instrument<br />

shown in Image C is FALSE?<br />

a) It is a one-position keratometer<br />

b) It is a two-position keratometer<br />

c) It can be used to measure tear break-up time (TBUT)<br />

d) It can be used to measure irregular astigmatism<br />

6. When looking through the eye piece of the instrument shown<br />

in Image C, what is indicated by the appearance shown in the far<br />

right panel of Image C?<br />

a) There is mild keratoconus present<br />

b) The subject is not fixating steadily<br />

c) There is corneal warpage present<br />

d) There is regular astigmatism of over 1.50D

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<br />

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<br />

<br />

About the author<br />

Dr Shehzad Naroo is senior lecturer at Aston University where his teaching<br />

responsibilities include contact lenses, anterior eye and therapeutics. He is<br />

global vice-president of the International Association of Contact Lens Educators<br />

(IACLE), and editor-in-chief for the journal, Contact Lens & Anterior Eye.<br />

Associated reading:<br />

The Contact Lens Manual: A practical guide to fitting<br />

(fourth edition) by Andrew Gasson and Judith A. Morris.<br />

Eye essentials: Rigid Gas-Permeable Lens Fitting by Ngaire<br />

Franklin, Elsevier Health Sciences, 2006<br />

Corneal Topography by Amar Agarwal, Elizabeth A. (FRW)<br />

Davis, Anshan, 2009<br />

Contact Lens Practice by Nathan Efron, Butterworth-<br />

Heinemann, March 2010<br />

7. Which of the following statements regarding the output<br />

shown in Image D is FALSE?<br />

a) Steep points are represented by hotter colours eg, red<br />

b) Flat points are represented by cooler colours eg, blue<br />

c) Bow tie shapes indicate irregular astigmatism<br />

d) Nipple shapes indicate an area of steepening<br />

35<br />

D<br />

8. Which of the following statements about the technique<br />

used to obtain Image D is TRUE?<br />

a) A diameter of 2-3mm is measured with 5-20 data points captured<br />

b) A diameter of 5-6mm is measured with 50-200 data points captured<br />

c) A diameter of 9-10mm is measured with 500-2000 data points captured<br />

d) A diameter of 9-10mm is measured with 5000-20000 data points<br />

captured<br />

9. Based on the readings shown in Image E, how much corneal<br />

astigmatism is present in the right eye?<br />

a) 0.25DC<br />

b) 0.75DC<br />

c) 1.50DC<br />

d) 3.00DC<br />

28/01/11 VRICS<br />

E<br />

F<br />

10. Based on the readings shown in Image E, what would be<br />

the most appropriate back optic zone radius (BOZR) of an RGP<br />

contact lens to select initially for <strong>this</strong> eye?<br />

a) 7.70<br />

b) 7.75<br />

c) 7.85<br />

d) 7.95<br />

11. Which of the following parameters can be evaluated using<br />

the instrument shown in Image F?<br />

a) Back optic zone radius (BOZR) and lens thickness<br />

b) Back optic zone radius (BOZR) and back optic zone diameter (BOZD)<br />

c) Back optic zone radius (BOZR) and back vertex power (BVP)<br />

d) Back optic zone diameter (BOZD) and lens thickness<br />

12. If a reading of 0.15mm is obtained using the instrument<br />

shown in Image F, which of the following is <strong>this</strong> likely to<br />

represent?<br />

a) Centre thickness of an RGP contact lens<br />

b) Peripheral thickness of an RGP contact lens<br />

c) Back optic zone radius of an RGP contact lens<br />

d) Back optic zone diameter of an RGP contact lens


Win with OT’s Mystery Year<br />

competition – Week two<br />

36<br />

28/01/11 MYSTERY YEAR<br />

As part of our 50th anniversary celebrations, we are<br />

giving one lucky reader £500 worth of shopping vouchers<br />

for the store or website of their choice.<br />

In each <strong>issue</strong> before Optrafair we will print an<br />

advertisement from an archive copy of OT and all you<br />

have to do to get an entry in our prize draw, is to tell<br />

us which year the image was first printed. Last <strong>issue</strong>’s<br />

answer was 1965, congratulations to all those who got<br />

that correct, you each get an entry into the big Optrafair<br />

draw.<br />

The second Mystery Year image is pictured below, the<br />

first two paragraphs read: ‘One Style Fits All? It’s just a<br />

harmless 3D movie, but it looks like something straight<br />

out George Orwell. He had a grim version of mass society<br />

with standard clothing and universal inhumanity. That<br />

vision didn’t come true, and we couldn’t be happier.<br />

We stand for a society of individuals who dress, adorn<br />

themselves, fit in, or stand out as their own desires<br />

dictate.’ Followed by an advertisement for Optyl’s ranges.<br />

To enter simply guess the Mystery Year and send the<br />

answer, along with your contact details to: Mystery Year<br />

(January 28), <strong>Optometry</strong> <strong>Today</strong>, 61 Southwark Street,<br />

London, SE1 0HL.<br />

For full terms and conditions or to enter online, see<br />

www.optometry.co.uk<br />

Looking back<br />

optometrytoday<br />

Since our first <strong>issue</strong> readers have been writing in to give<br />

their opinions on all things optics. Throughout the year<br />

we’ll be sharing some of the best letters we’ve received<br />

over the years. This week, we look back to 1963 and 1964.<br />

Contact lens fitting by dispensers<br />

Sir – My local AOP committee has raised with the<br />

AOP secretary the question of the position of dispensing<br />

opticians indulging in sight testing techniques when fitting<br />

contact lenses from a prescription.<br />

It is a matter of fact that the final prescription for contact<br />

lenses, as ultimately handed over may be very different from<br />

the prescription as originally presented. The considerable<br />

modification necessary is brought about by the result of<br />

refractive assessment, mostly subjective, at various stages of<br />

contact lens fitting. There is no doubt that, in my opinion,<br />

in doing <strong>this</strong> dispensing opticians are testing sight. This is<br />

contrary to the Opticians Act and no enabling formula can<br />

get away from <strong>this</strong>.<br />

The definition of sight testing in the Act is reasonably<br />

clear and cannot be interpreted in any other way than the<br />

restriction of sight testing to medical men and ophthalmic<br />

opticians.<br />

R G Stephens, Birmingham (October 19 1963)<br />

The fee for the job<br />

Sir – I am wholly at a loss to understand the reluctance on<br />

the part of the appropriate ministry to grant ophthalmic<br />

opticians the very much over-due increase in fees, in view of<br />

the fact that a wage increase appears to have been awarded to<br />

every Tom, Dick and Harry in the country, in many instances<br />

by the same ministry. The last straw is the proposed increase<br />

for MPs. The main point put forward against making <strong>this</strong><br />

much overdue award to opticians appears to be that no one<br />

knows how much opticians earn. Have the same objectors<br />

any idea whatsoever how much MPs earn.<br />

R.N.Birt, Cowes (January 11 1964)<br />

A January rhyme about fees<br />

Bung ho to the optical jester,<br />

Who being an accomplished tester,<br />

At seventy still does the job,<br />

For a miserable sixteen bob.<br />

Robert S. Green, Birmingham (January 11 1964)<br />

For more letters from the era, visit www.optometry.co.uk



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Visual features of<br />

Parkinson’s disease<br />


Visual neurology and<br />

Parkinson’s disease<br />

A number of studies have shown<br />

deficits in magno-, parvo-, and koniocellular<br />

pathways in patients with PD.<br />

Sartucci 5 suggests that the konio-cellular<br />

subpopulation of retinal ganglion cells<br />

(RGC) may be particularly vulnerable in<br />

early stages of PD whilst Silva 4 suggests<br />

that sensory deficits within the visual<br />

domain have been associated with<br />

independent damage to both magno- and<br />

parvo-cellular pathways. People with PD<br />

may demonstrate thinning of RGC axons,<br />

reminiscent of ocular neurodegenerative<br />

diseases such as glaucoma. 6,7 Indeed,<br />

Armstrong 8 suggests that PD is associated<br />

with a range of visual signs and symptoms,<br />

including defects in visual acuity (VA),<br />

colour vision, the blink reflex, pupil<br />

reactivity, saccadic and smooth pursuit<br />

movements and visual evoked potentials.<br />

Scigliano 9 has also identified<br />

compromise of the central and<br />

peripheral autonomic nervous systems<br />

in idiopathic Parkinson’s disease (IPD)<br />

COURSE CODE: C-15421 O<br />

Geoff Shayler BSc FCOptom, FCSO<br />

Ageing causes general loss of visual function. This article investigates the visual<br />

problems that are associated with Parkinson’s disease (PD). A later article in<br />

<strong>this</strong> series will consider a number of tests that can be used to identify which<br />

patients have these visual processing difficulties, as well as to identify those<br />

with the potential to be helped with appropriate optometric vision therapy.<br />

One of the main factors identified in some patients with PD is a<br />

contraction of the functional visual field. 1,2,3 This causes problems with<br />

balance, posture, and stability, as well as reading, concentration and<br />

attention. 4 Based on neurological models of vision, it has been postulated<br />

that these problems occur as a result of both damage and (stressrelated)<br />

dysfunction of the magno-, parvo-, and konio-cellular pathways.<br />

resulting in reduced sympathetic and<br />

parasympathetic function. Pursiainen 10<br />

indicated that long-term parasympathetic<br />

cardiovascular regulation is impaired<br />

in untreated patients with PD, which is<br />

more pronounced at night. 10 Indeed, <strong>this</strong><br />

supports the reported damage that occurs<br />

to the dorsal stream of visual processing<br />

in PD (see part 1 of <strong>this</strong> series) (Figure 1).<br />

What causes Parkinson's<br />

disease?<br />

PD is characterised by loss of nerve cells<br />

in the substantia nigra. 11 These cells are<br />

responsible for producing a chemical<br />

known as dopamine, which allows<br />

messages to be sent to the parts of the<br />

brain that co-ordinate movement. With<br />

the depletion of dopamine-producing<br />

cells, these parts of the brain are unable to<br />

function normally. When about 80% of the<br />

dopamine has been lost, the symptoms of<br />

PD appear and the level of dopamine will<br />

continue to fall slowly over many years.<br />

The cause of the loss of dopamine in<br />

people with PD is currently unknown.<br />

Figure 1<br />

Dorsal/ventral stream processing. Reproduced<br />

with kind permission from Prof Dutton, Glasgow<br />

Caledonian University<br />

Most researchers believe that many factors<br />

play a role and areas of research include<br />

genetics and environmental factors.<br />

Indeed, scientists have, to date, identified<br />

nine genes linked to PD, of which the<br />

“parkin” gene 12 is most commonly<br />

associated with the familial form of PD.<br />

Abnormalities in <strong>this</strong> gene are particularly<br />

prevalent with young-onset PD.<br />

Relationship between Dopamine and<br />

Melatonin<br />

Melatonin 13 is a hormone primarily<br />

produced by the pineal gland 14 at night,<br />

and influences circadian 15 and seasonal<br />

rhythms, 16,17 most notably the sleep–wake<br />

cycle and seasonal reproduction. The<br />

pineal gland and the retina synthesise<br />

melatonin in the absence of light, but light<br />

does not inhibit melatonin synthesis in<br />

other t<strong>issue</strong>s. When light enters the retina,<br />

a signal is sent from the intrinsically<br />

photosensitive RGC 18 through the optic<br />

nerve via the retinohypothalamic tract to<br />

the suprachiasmatic nucleus within the<br />

hypothalamus, situated directly above<br />

the optic chiasm (Figure 2). Exposure<br />

to sunlight suppresses melatonin<br />

production. Melatonin release in turn<br />

inhibits the release of dopamine 19,20<br />

in specific areas of the mammalian<br />

central nervous system (hypothalamus,<br />

37<br />

28/01/11 CET



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38<br />

28/01/11 CET<br />

Figure 2<br />

Pathways taken by melatonin to the brain (see text for details). Blue line represents the retinohypothalamic<br />

tract. Light blue line represents the pupillary light reflex pathway. SCN = suprachiasmatic nucleus; OPN =<br />

olivary pretectal nucleus; EW = Edinger-Westphal nucleus. Reproduced with kind permission from http://<br />

flipper.diff.org/app/items/info/2474.<br />

hippocampus, medulla-pons, and retina).<br />

It is possible that <strong>this</strong> in turn plays a<br />

role in the cause of PD since inhibition<br />

of dopamine will have consequences on<br />

bodily movements. However, whereas<br />

melatonin may exacerbate symptoms<br />

in PD, it’s antioxidant nature may<br />

protect against neurodegeneration<br />

by virtue of its antioxidant effects on<br />

mitochondrial activity. 21 Of importance<br />

is that the relationship between<br />

dopamine and melatonin may help<br />

to explain features of PD and open<br />

doors for possible treatment options.<br />

Posture in Parkinson’s disease<br />

Parkinsonian gait (Figure 3) is characterised<br />

by a distinctive unsteady walk, stooped<br />

posture, slowness to start walking, short<br />

shuffling steps and a tendency to run with<br />

reduced arm swing. 22 This develops over<br />

time as a result of bradykinesia (slowness<br />

of movement), loss of postural reflexes, and<br />

rigidity (increased tone). 23 A forward head<br />

and/or head down posture results from a<br />

reduction of normal cervical and lumbar<br />

curvature of the spine, which results in<br />

loss of vital lung capacity by as much as<br />

30%. 24 Arm swing is diminished or absent<br />

and people with PD tend to take small<br />

shuffling steps (called festination). 25 While<br />

freezing of gait is typically considered<br />

a motor impairment of PD, the fact that<br />

it occurs more frequently in confined<br />

spaces suggests that perception of space<br />

might contribute to <strong>this</strong> condition. 26<br />

The importance of posture in PD<br />

is made evident by the possibility<br />

that there is reduced input of light to<br />

the inferior retina (Figure 4), which<br />

may lead to an increase in melatonin<br />

production; therefore a downward head<br />

posture could lead to a reduction of<br />

dopamine and perhaps progression of PD.<br />

Visual problems in Parkinson’s<br />

disease<br />

VA and Eye Movements<br />

Blurred vision or difficulty in focusing may<br />

be due to problems with eye movements<br />

27.28<br />

or due to the side effects of drug<br />

therapy, especially anti-cholinergics. 29 This<br />

problem may occur on starting<br />

treatment but can normally<br />

improve over time. Diplopia<br />

usually occurs in PD due to<br />

problems in moving the eyes<br />

in alignment from side to side,<br />

such as when reading. This may<br />

occur as a result of impaired<br />

coordination and fatigue of the<br />

muscles moving the eyeballs<br />

or a form of hallucination. 30<br />

Difficulty in moving the eyes<br />

may manifest in two ways: (i)<br />

difficulty in starting a movement<br />

of the eyes or (ii) problems with<br />

moving the eyes quickly when<br />

following a fast moving object.<br />

Instead of moving smoothly, the eyes move<br />

in a slow and jerky way. For <strong>this</strong> reason,<br />

driving a vehicle may pose difficulties. 30,31<br />

Excessive tearing of the eyes and/or dry eye<br />

symptoms may also be associated with PD,<br />

most likely due to reduced blinking of the<br />

eyes. 32 Idiopathic blepharospasm may be a<br />

sign of the eventual development of PD. 33<br />

Bálint's syndrome, is a disjointed<br />

psychic paralysis of gaze with haphazard<br />

scanning, found in patients with bilateral<br />

damage to the posterior parietal cortex. It<br />

is characterized by optic ataxia (lack of coordination<br />

of hand and eye movement),<br />

oculomotor apraxia (the inability to<br />

voluntarily guide eye movements/change<br />

to a new location of visual fixation),<br />

and simultanagnosia (the inability to<br />

perceive more than one object at a time,<br />

even when in the same place). It may<br />

also occur or be misdiagnosed in PD. 34<br />

Contrast & Colour<br />

People with PD may experience difficulty<br />

with seeing in dim light, or perceiving<br />

lightly coloured objects against a light<br />

background, or with reading very fine<br />

print. It is thought that <strong>this</strong> is due to<br />

dysfunction of dopamine receptors within<br />

the retina. 35 Colour vision may be affected<br />

due to damage to the optic nerve and

RGC axons, which can cause particular<br />

program, researchers have demonstrated<br />

problems with differentiating between<br />

deficiencies of static form and motion<br />

slight colour differences, especially for<br />

coherence processing in Alzheimers’s<br />

shades of blue or blue-green. 35,36 The<br />

disease (AD) 44 and the present author has<br />

medication levodopa (L-DOPA) has been<br />

identified a similar situation in people<br />

shown to improve colour vision in PD. 37<br />

with PD. In particular, motion processing<br />

Spatial Localisation<br />

Problems with visuo-spatial orientation<br />

or depth perception could be the reason<br />

why a person with PD may have difficulty<br />

in assessing the distance between objects;<br />

is adversely affected to a greater extent<br />

than static processing, but these results are<br />

limited by the numbers of patients seen in<br />

a 'normal' High Street optometric practice;<br />

further controlled studies of <strong>this</strong> nature<br />

are required to investigate <strong>this</strong> possibility.<br />

39<br />

many people with PD may need to reach<br />

out to touch a wall or objects around<br />

them whilst walking. This in turn is<br />

very likely to create problems with<br />

driving too. 38 Indeed, some people with<br />

PD cannot judge the speed of moving<br />

objects, which may be dangerous if<br />

driving or trying to cross the street. 38<br />

Hallucinations, illusions and/or visual<br />

misinterpretations are more likely to occur<br />

in those people who have had PD for a long<br />

time. 39 It may be due to the disease itself,<br />

associated with Charles Bonnet syndrome 40<br />

or due to anti-Parkinson drugs. 41<br />

Useful Field of View test (UFoV)<br />

An individual’s useful field of view (UFoV)<br />

is the area over which information can be<br />

extracted from a rapidly presented display.<br />

The size of ones UFoV is affected by the<br />

amount of clutter in the visual display,<br />

Figure 3<br />

Posture and gait in Parkinson’s disease.<br />

up to five years in some individuals)<br />

and robust in that almost all individuals<br />

with normal age-related cognitive<br />

slowing show a benefit from training.<br />

While speed of processing training<br />

has been applied to a number of subpopulations<br />

(eg, stroke, closed head<br />

injury, PD and Alzheimer’s disease),<br />

Glaucoma, visual field and falls<br />

Individuals affected by glaucoma are<br />

over three times more likely to have<br />

been involved in falls 45 and motor<br />

vehicle accidents 46,47 than persons of<br />

the same age without the condition. In<br />

addition, the prevalence of glaucoma<br />

in people with PD may be increased. 48<br />

Because both PD and glaucoma affect<br />

the same nerve processes, patients<br />

with both conditions are more likely<br />

to have faster progression of visual<br />

loss, and therefore need more frequent<br />

screening/monitoring. Furthermore,<br />

according to the Parkinson’s Disease<br />

Society in the UK, certain medications<br />

such as benztropine, amantadine and<br />

L-DOPA can cause problems in patients<br />

with open-angle glaucoma, and should<br />

therefore be used with caution. 49<br />

28/01/11 CET<br />

foveal task demands, the distance of<br />

critical information from the fovea, and the<br />

length of time the display is available. The<br />

UFoV test 42 is a computer-based program<br />

that captures the effects of these variables<br />

on the size of an individual’s UFoV over<br />

a series of three subtests, which are then<br />

combined to yield an overall measure of<br />

<strong>this</strong> research is very preliminary and<br />

the benefits for these populations,<br />

if any, is not well understood. 43<br />

Static form and motion coherence<br />

processing<br />

Static form visual processing is undertaken<br />

primarily by the central parvo-cellular<br />

Corneal damage and cataract<br />

New research has indicated that<br />

some antidepressant SSRI (selective<br />

serotonin reuptake inhibitor) drugs<br />

used to treat patients with PD both<br />

increase the risk of cataract development<br />

and cause corneal changes. 50<br />

the UFoV. Performance on the UFoV is<br />

highly related to automobile crash risk.<br />

Recent research has also demonstrated<br />

ventral processing stream, whilst motion<br />

processing is performed primarily by the<br />

magno-cellular dorsal stream. Though<br />

Treatment of visual problems<br />

in Parkinson’s disease<br />

that the size of the UFoV can be increased<br />

there is a lot of interaction between the<br />

Blurred vision is usually treated by<br />

with training (speed of processing<br />

two systems, static form and motion<br />

refractive correction and perhaps<br />

training). This training benefit has been<br />

processing are carried out in separate<br />

modification of anti-cholinergic<br />

shown to be relatively enduring (lasting<br />

areas of the brain. Using a computer-based<br />

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40<br />

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management with a patient’s<br />

GP. Diplopia improves with<br />

anti-Parkinson medication<br />

and by resting the eyes, but<br />

prismatic or temporary Fresnel<br />

lenses can be prescribed until<br />

symptoms stabilise. Dry eye<br />

symptoms can be managed by<br />

advising the use of artificial<br />

tear supplements and a<br />

recommendation to avoid<br />

dry, hot and smoky places.<br />

More complex visual<br />

symptoms will need to be<br />

managed by control of the<br />

underlying PD. Appropriate<br />

referral to a patient’s GP<br />

will be required to improve<br />

difficulty with eye movements<br />

through anti-Parkinson drugs.<br />

Indeed, contrast and colour<br />

vision can be enhanced by<br />

treatment with L-DOPA<br />

and other anti-Parkinson<br />

medicines. Hallucinations<br />

and other visual disturbances,<br />

however, will require the<br />

use of neuroleptics such<br />

as clozapine and quetapine.<br />

Light therapy<br />

Light therapy has been used for many<br />

years to treat depression and seasonal<br />

affective disorder (SAD) but has also been<br />

used to treat human motor problems.<br />

Light, when it reaches certain levels<br />

of intensity, can inhibit production of<br />

melatonin, which in turn can increase<br />

production of dopamine. When production<br />

of melatonin can be inhibited, there should<br />

be a consequent increase in the production<br />

and use of dopamine in the brain.<br />

A number of studies have shown that<br />

light therapy can be beneficial in PD. 51<br />

Although bright light therapy (BLT), as<br />

used in typical SAD lamps, suppresses<br />

melatonin release and is an established<br />

treatment for depression and sleep<br />

disturbances, it has only recently been<br />

Figure 4<br />

Exposure of the retina to sunlight in primary gaze eg, straight posture (top of<br />

Figure) and in down gaze eg, forward posture with head-down tilt in Parkinson’s<br />

disease (bottom of Figure)<br />

evaluated in PD. Examination of the effects<br />

of BLT on motor symptoms, depression,<br />

and sleep in PD in a randomised placebocontrolled<br />

double-blind study found<br />

significant improvement of tremor<br />

and depression in the active treatment<br />

group but not in the placebo group. 52<br />

Another study of people with PD exposed<br />

to white fluorescent light with an intensity of<br />

1,000 to 1,500 lux once daily for two weeks<br />

commencing one hour before bedtime,<br />

demonstrated marked improvement in<br />

bradykinesia and rigidity in most patients.<br />

The authors also claim that elevated mood,<br />

improved sleep, decreased seborrhoea,<br />

reduced impotence, and increased appetite<br />

were observed after light therapy. 53<br />

Low-level green light technology as used<br />

in Sunnex Biotechnologies Lo-LIGHT lamps<br />

peaking near 500nm has been shown to be<br />

as effective as BLT, 54 with <strong>this</strong> wavelength<br />

being the most effective for<br />

suppressing melatonin. 55<br />

Conclusion<br />

This article has highlighted the<br />

possible causes of PD and the<br />

consequences that <strong>this</strong> disease<br />

has on visual function. There is<br />

evidence that people with PD are<br />

at risk of co-morbidity such as<br />

glaucoma, and visual problems<br />

that may lead to a greater risk<br />

of falls. Indeed, individuals<br />

with PD are likely to suffer<br />

problems with their functional<br />

visual field, and therefore it<br />

is important to detect such<br />

changes as early as possible, in<br />

order to instigate appropriate<br />

therapy. Neural damage in<br />

the disease cannot be treated,<br />

but deficient neural function,<br />

which is associated with<br />

stress, can be and could lead to<br />

improvement in quality of life<br />

and/or extending the period<br />

before PD symptoms negatively<br />

affect a person’s lifestyle.<br />

About the author<br />

Geoff Shayler qualified as an optometrist<br />

from City University in 1973. He is in<br />

private practice in Dorset. His special<br />

interests involve developing and utilising<br />

new assessment and therapy techniques for<br />

conditions that are affected by dysfunction<br />

or damage to the neural pathways,<br />

such as Streff syndrome, strabismus,<br />

mild traumatic brain injury, stroke,<br />

Alzheimer’s and Parkinson’s diseases.<br />

References<br />

See http://www.optometry.co.uk<br />

clinical/index. Click on the article<br />

title and then download "references"<br />

For the module questions to <strong>this</strong><br />

article, please turn to page 45.



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Sight saver, life changer:<br />

Part of a day’s work for an<br />

eye care practitioner<br />

COURSE CODE: C-15475 O/D/CL<br />

41<br />

Dr Cameron Hudson BSc (Hons) PhD MCOptom<br />

Many practitioners at some point will have been asked the question ‘What<br />

does being an eye care practitioner involve?’ Because of the multidisciplinary<br />

nature of the role, the day-to-day role of an eye care practitioner (ECP) can be<br />

difficult to describe, especially in lay terms. It’s fair to say however that most of<br />

us would provide an answer that includes ‘detecting various eye disorders’ and<br />

‘measuring and correcting common visual disorders/refractive errors’. If indeed<br />

<strong>this</strong> is the case, how can we measure the impact of our work and the benefits<br />

patients gain from our services? What can we do to improve these benefits<br />

for our patients? This article looks at how these questions might be answered.<br />

The role of an eye care practitioner is<br />

rewarded by the piece of mind that<br />

comes from knowing we are helping to<br />

prevent blindness and visual disability<br />

amongst those who seek our expertise.<br />

Many ECPs are fortunate enough to be<br />

able to contribute to ‘sight saving’ on a<br />

greater level, for example, by working<br />

overseas as part of charity projects or<br />

working in secondary or tertiary care<br />

hospital optometry clinics to name<br />

but a few. And, for the vast majority<br />

of primary ECPs, the opportunity to<br />

‘save’ a patient’s sight (for example, by<br />

appropriately dealing with a medical<br />

or emergency condition) is one of the<br />

most rewarding and fulfilling aspects<br />

of the role. However, for the vast<br />

majority of practitioners, opportunities<br />

to ‘save sight’ are a relatively infrequent<br />

occurrence when considering the<br />

proportion of patients who make use<br />

of primary eye care services on an<br />

annual basis. In relative terms therefore,<br />

correcting refractive error with the<br />

aid of spectacles or contact lenses<br />

contributes significantly more to what<br />

the vast majority of practitioners do<br />

within their professional environment.<br />

If correcting peoples vision is, to the<br />

largest extent, ‘what we do’ as ECPs,<br />

is it possible to quantify the impact of<br />

our work and if so, how? How much<br />

fulfilment should we be able to take<br />

from <strong>this</strong> and are there ways to help<br />

patients benefit from and value our<br />

ability to manage refractive error? To<br />

answer these questions it is worth<br />

looking at the measures typically<br />

used to quantify patient ‘satisfaction’<br />

and/or ‘quality of life’ (QoL).<br />

Measuring ‘satisfaction’ and<br />

quality of life<br />

Traditionally, the measurement and<br />

correction of refractive error has been<br />

characterised by clinical measures<br />

such as visual acuity (VA) or contrast<br />

sensitivity (CS). Whilst these measures<br />

provide vital information regarding<br />

a patient’s vision, they provide little<br />

indication of the impact we are<br />

making on the person as a whole.<br />

To obtain a more complete sense<br />

of what a patient feels, it is more<br />

appropriate to assess their satisfaction<br />

with their vision and/or their QoL.<br />

There is no single method of<br />

refractive correction that is appropriate<br />

or appealing to all patients. However,<br />

some patients and practitioners may<br />

restrict their correction options based<br />

on such factors as previous experience,<br />

current knowledge/understanding of a<br />

given correction method, and ease of<br />

provision. However, understanding the<br />

relative impact of different methods<br />

of refractive correction on QoL is<br />

beneficial for ECPs for several reasons:<br />

<br />

positively influence their contribution<br />

to a patient’s QoL<br />

<br />

communicate more effectively and<br />

quantify their patients relative QoL<br />

gain 1<br />

<br />

consistently fulfil their patients<br />

expectations<br />

<br />

which patients stand to gain the most<br />

from a given method of refractive<br />

correction 2<br />

<br />

‘bespoke’ eye care<br />

<br />

and loyalty. 3<br />

What is ‘quality of life’?<br />

In health terms, QoL encompasses<br />

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(PREP). 9 Typically, respondents are<br />

required to answer each question in<br />

the form of a subjective rating, for<br />

example on a scale between 1 and 5.<br />

This allows the patient greater scope to<br />

express their preferences and opinions;<br />

42<br />

28/01/11 CET<br />

the physical, functional, social and<br />

emotional well-being of an individual.<br />

QoL is an important metric used<br />

routinely in many areas of healthcare<br />

and especially in oncology and chronic<br />

illness where QoL information is used as<br />

a prognostic indicator and aids decisionmaking.<br />

Information about QoL provides<br />

vital detail about a particular course of<br />

action or decision, which is based on<br />

more than clinical opinion alone. There<br />

are over 150,000 published papers that<br />

investigate QoL with 1,700 relating<br />

to vision. As highlighted by Lesley<br />

Fallowfield, Professor of Psychology,<br />

Brighton and Sussex Medical School,<br />

“the challenge remains to encourage more<br />

clinicians to use them [QoL information]<br />

outside of a clinical trial setting.” 4<br />

QoL related to methods of<br />

refractive correction<br />

The QoL contribution made by different<br />

forms of refractive correction has<br />

received growing attention since<br />

methods to measure vision specific-QoL<br />

(VS-QoL) were first described about ten<br />

years ago. Since then researchers have<br />

developed more robust methods and the<br />

standard approach is through the use<br />

of questionnaires (or ‘instruments’). 5,6<br />

Several instruments have shown<br />

promise in accurately measuring VS-<br />

QoL with respect to the different<br />

methods of refractive correction,<br />

including spectacles, hard and soft<br />

contact lenses and refractive surgery 7,8<br />

and also within specific groups, for<br />

example paediatric contact lens wearers 9<br />

and contact lens wearers with abnormal<br />

ocular conditions such as keratoconus. 10<br />

VS-QoL instruments include the<br />

Refractive Status and Vision Profile<br />

(RSVP), 11 National Eye Institute<br />

Visual Function Questionnaire (NEI-<br />

VFQ), 12 the Quality of Life Impact of<br />

Refractive Correction (QIRC) 8 and<br />

the Paediatric Refractive Error Profile<br />

closed questions (ie, ‘yes’ or ‘no’ type<br />

questions) are purposely avoided. By<br />

applying an analysis algorithm such<br />

as Rasch Analysis, investigators are<br />

then able to generate a VS-QoL ‘score’,<br />

which relates to a measure of that<br />

specific method of refractive correction.<br />

Several investigators have compared<br />

VS-QoL scores between different<br />

methods of refractive correction. 8,9<br />

Using the QIRC instrument, Pesudovs<br />

et al. 8 compared the VS-QoL scores<br />

for spectacle wearers, contact lenses<br />

wearers, and individuals who had<br />

undergone refractive surgery. Their<br />

findings indicate significantly better<br />

QoL outcomes for individuals who had<br />

undergone refractive surgery (Mean<br />

score of 50.2±6.3 logits) than those<br />

who wore contact lenses (Mean score<br />

of 46.7±5.5 logits), who in turn were<br />

significantly higher than spectacle<br />

wearers (Mean score of 44.1±5.9 logits);<br />

scores were especially higher in those<br />

people with high refractive error. The<br />

authors suggest that the enhanced<br />

QoL that comes through ‘spectacle<br />

freedom/reduced dependence on<br />

spectacles’ occurs due to factors<br />

including less difficulty with driving<br />

in glare conditions, being able to use<br />

non-prescription sunglasses, greater<br />

convenience during exercise, and being<br />

more confident in their appearance. 8<br />

Spectacle wearers only achieved a<br />

higher QoL score than both contact lens<br />

wearers and refractive surgery patients in<br />

one area, that being ‘concern for medical<br />

complications’. 8 Interestingly the<br />

authors point out that a small proportion<br />

of individuals who had undergone<br />

refractive surgery (6.7%) exhibited

significantly reduced QoL outcomes, as<br />

a result of post-operative complications. 8<br />

In a separate study, Rah et al. 9 utilised<br />

the PREP instrument to assess the benefits<br />

to wearing spectacles versus wearing<br />

contact lenses amongst children under<br />

the age of 12 years. 9 During the three-year<br />

investigation, the study group observed<br />

a significantly greater improvement in<br />

mean QoL score in children who wore<br />

contact lenses (increase of 14.2±18.1<br />

units) compared to children wearing<br />

spectacles only (increase of 2.1±14.6<br />

units) (P



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and opportunities, which in the broadest<br />

terms, contribute to QoL. Indeed, it has<br />

been shown that whilst non-surgical<br />

refractive corrections provide ‘good/<br />

very good health and safety’, refractive<br />

surgery (LASIK) was stated as the<br />

preferred method of refractive correction<br />

under hypothetical conditions where<br />

all methods of refractive correction<br />

had equal health and safety, visual<br />

clarity, doctor recommendation<br />

and cost. 2 This highlights the<br />

understandable desire amongst<br />

ametropes to have ‘normal vision’.<br />

The way in which refractive correction<br />

methods and their associated QoL benefits<br />

are communicated/recommended<br />

to patients has a large influence on<br />

whether or not the recommendation<br />

is (a) acted upon, and (b) understood.<br />

If information provided to patients is<br />

difficult to comprehend it may fail to<br />

achieve the desired change in knowledge<br />

or behaviour. 15 If the information is<br />

understood by the patient but the<br />

practitioner fails to explain the relevance<br />

of the information to the patient,<br />

then the same outcome may occur.<br />

Shared decision making, between<br />

patient and practitioner, appeals to a<br />

patient’s ‘need’ for information regarding<br />

their health and wellbeing 16 and is<br />

commonplace in the medical profession.<br />

Whilst shared decision making is the<br />

gold standard approach, patients also<br />

seek to place the responsibility for<br />

decision making with the practitioner. 17<br />

These findings emphasise the need for<br />

optical practitioners to provide clear,<br />

unambiguous information about the<br />

refractive correction options available<br />

to a patient and also to provide clear<br />

avocation for the most appropriate or<br />

relevant option/s. In combination with<br />

the desire to ‘know’ and ‘understand’,<br />

patients also have a desire to feel<br />

‘known’ and ‘understood’. Making<br />

recommendations that are relevant<br />

to information gathered throughout<br />

the consultation process helps<br />

patients to feel that their ‘needs’<br />

have been acknowledged and acted<br />

upon. The choice of language used<br />

by an ECP is extremely important<br />

in demonstrating <strong>this</strong> to patients.<br />

As an example, it may seem<br />

appropriate to ask patients who are<br />

suitable for contact lenses the question<br />

“have you ever considered contact<br />

lenses?” or “would you like to try contact<br />

lenses?” There are several limitations<br />

to these (or similar) questions: (a) they<br />

do not demonstrate the practitioner’s<br />

understanding of a patients specific<br />

visual requirements (b) they portray no<br />

sense of shared decision making, and (c)<br />

they provide no information regarding<br />

what contact lens wear involves. Thus<br />

the specific language used whilst<br />

communicating a recommendation is<br />

very important. A possible alternative<br />

recommendation may be: “There are<br />

several simple ways to correct your<br />

vision which could provide you with<br />

advantages over spectacles, especially<br />

whilst ... [eg, playing golf]. On a scale<br />

of 1 to 10 how desirable is being able<br />

to see clearly without your spectacles?”<br />

The same ‘principle’ can be applied<br />

to any recommendation made by an<br />

optical practitioner to a patient. The<br />

decision whether or not to accept<br />

the recommendation still remains<br />

with the patient; the support of the<br />

practitioner towards a particular option<br />

is strengthened and the patient gains<br />

an understanding of the ECP’s raison<br />

d’être for presenting the opportunity.<br />

Conclusion and implications<br />

It is important for optical practitioners<br />

to understand the contribution<br />

of different methods of refractive<br />

correction to an individual’s QoL. In<br />

order to measure the significance/<br />

impact of the contribution, Optical<br />

practitioners must employ a reliable<br />

method of measuring QoL both within<br />

a single visit (cross-sectional) and<br />

between visits (longitudinal). Whilst<br />

robust VS-QoL instruments have<br />

been developed for use in research,<br />

appropriately constructed lifestyle<br />

questionnaires may provide ECPs with<br />

a useful surrogate measurement of QoL<br />

in a primary eye care setting. Attitudes<br />

towards refractive corrections appear to<br />

change with time 2 and are influenced<br />

by a range of factors. Therefore,<br />

ECPs need to be aware of how to best<br />

communicate the benefits and risks of<br />

refractive corrections to patients, in<br />

order to facilitate the correct selection<br />

and to maximise satisfaction and QoL.<br />

About the author<br />

Dr Cameron Hudson is the professional<br />

services manager for CIBAVision, UK<br />

References<br />

See http://www.optometry.co.uk/<br />

clinical/index. Click on the article title<br />

and then download “references”

Module questions<br />

PLEASE NOTE There is only one correct answer. All CET is now FREE. Enter online. Please complete online by midnight<br />

on February 25 2011 - You will be unable to submit exams after <strong>this</strong> date – answers to the module will be published on<br />

www.optometry.co.uk. CET points for <strong>this</strong> exam will be uploaded to Vantage on March 7 2011.<br />

Course code: C-15421 O<br />

1. Visual deficits in Parkinson’s disease are caused by neural damage in<br />

which of the following?<br />

<br />

<br />

<br />

<br />

2. Which of the following visual problems is NOT associated with<br />

Parkinson’s disease?<br />

<br />

<br />

<br />

<br />

3. Symptoms of Parkinson’s disease become apparent when dopamine<br />

producing cells within the substantia nigra have been reduced by<br />

what extent?<br />

<br />

<br />

<br />

<br />

4. Which of the following statements about melatonin and dopamine is<br />

FALSE?<br />

<br />

<br />

<br />

<br />

5. Bálint’s syndrome is NOT associated with which of the following?<br />

<br />

<br />

<br />

<br />

Course code: C-15475 O/D/CL<br />

1. Which of the following does NOT contribute to an individual’s<br />

health-specific quality of life (QoL)?<br />

<br />

<br />

<br />

<br />

2. Which of the following can be used as a surrogate measurement of<br />

VS-QoL in a primary eye care setting?<br />

<br />

<br />

<br />

<br />

3. What is the difference in increase of VS-QoL score for children who<br />

wear contact lenses compared to those who wear spectacles only?<br />

<br />

<br />

<br />

<br />

4. Which of the following best describes the questions/answers<br />

typically used in ‘quality of life’ questionnaires?<br />

<br />

<br />

<br />

<br />

5. Which of the following best describes the benefit of understanding<br />

how different methods of refractive correction affect QoL?<br />

<br />

<br />

<br />

<br />

<br />

45<br />

28/01/11 CET<br />

6. Which of the following is NOT a reason why driving can be a<br />

dangerous occupation for patients with Parkinson’s disease?<br />

<br />

<br />

<br />

<br />

6.Using the QIRC instrument which of the following VS-QoL scores<br />

was achieved by spectacle wearers?

JOBS<br />

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We are looking for a friendly, patient-focused Optometrist<br />

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28/01/11 JOBS<br />

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the face of vision care sales and training

Day in the diary of Rubinder Panesar<br />

NAME: Rubinder Panesar<br />

LOCATION: Yorkshire Region<br />

QUALIFICATIONS: BSc (Hons) MCOptom, DIP H.E. Ophthalmic Dispensing<br />

START DATE: 2009<br />

How do you start your day?<br />

We have a team meeting to discuss what our<br />

aims are for that day. after the meeting<br />

i review the records of patients that are<br />

coming in, researching their previous<br />

prescription and lifestyle notes. <strong>this</strong> helps me<br />

to assess if there is an opportunity to improve<br />

their visual outcome. the rest of my day is<br />

filled with patient appointments.<br />

What does your role involve?<br />

mainly eye examinations, fitting glasses and<br />

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i also work with specialist laser optometrists<br />

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at Optical Express we strive to provide a<br />

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What do you enjoy most about<br />

your job?<br />

Working with the public, as no two people<br />

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patients have to trust the advice you give<br />

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How would your colleagues describe<br />

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i have quite a loud personality so in a team<br />

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What motivates you in your job?<br />

delivering the best care to my patients on<br />

a daily basis. it’s hugely rewarding to know<br />

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more clearly. i feel very proud when patients<br />

tell me how much their lives have been<br />

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What do you think differentiates<br />

Optical Express from other optical<br />

providers?<br />

apart from delivering the best service and<br />

being a great company to work for there’s a<br />

whole range of career opportunities available<br />

at Optical Express. as an Optical Express<br />

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company.<br />

What advice would you give<br />

someone considering a career<br />

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go for it. if you’re willing to work hard, have<br />

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with colleagues and patients then<br />

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What qualities should you possess to<br />

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People skills are essential as you are working<br />

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part of a team. Patience is important when<br />

advising elderly patients or young children.<br />

How important do you feel it is to<br />

provide and receive support from<br />

your colleagues?<br />

it’s vital to my work, without each other<br />

we couldn’t deliver the best service to the<br />

patient.<br />

What’s Your Story?<br />

Each of the roles carried out in store is<br />

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my colleague insisted that i stayed in her<br />

house instead of a hotel. Kindness like that is<br />

invaluable in a team and it really brightens<br />

your day.<br />

Are you involved in any additional<br />

training courses as part of your role?<br />

i’ve attended accredited CEt courses and<br />

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Express, all of which i’ve enjoyed.<br />

What is your biggest career goal?<br />

Becoming a fully qualified optometrist was a<br />

huge goal for me. now that i have done that<br />

i think it will be to volunteer for a vision<br />

charity and to keep working my way up the<br />

career ladder at Optical Express.<br />

Describe one career highlight to date<br />

Previously i worked in a large clinic with<br />

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How do you see your career<br />

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With an ever expanding company like<br />

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Reach the top with<br />

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At Optical Express, our unique approach<br />

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opticalexpress.com<br />

UnitEd KingdOm | CROatia | FRanCE | gERmany | HOLLand | iRELand

“I made a<br />

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The UK’s Leading Practice Designers and Manufactures<br />

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To discuss your options with one of our designers or<br />

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The Style Design Company - www.style-design.com

The BIG FIT<br />

Change patients’ lives and grow your practice<br />

one day<br />

conference<br />

February 8th Manchester<br />

February 14th London<br />

Lecturers include:<br />

Prof. James Wolffsohn<br />

Keith Holland<br />

Mohammed Bhojani<br />

Arif Karim<br />

FREE TO<br />

ATTEND<br />

Topics include:<br />

• Gaining more contact lens patients<br />

• The tear film in contact lens wear<br />

• Rapid fire clinical update<br />

• Creating loyalty architecture in your practice<br />

• Clinical trials in practice<br />

• Effective diagnosis and referral of AMD and<br />

Diabetic Macula Oedema<br />

Book now at: www.cibavisionacademy.co.uk<br />

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8 CET POINTS*<br />

© CIBA VISION (UK) Ltd, a Novartis company, 2011. The BIG FIT logo, CIBA VISION and the CIBA VISION logo are trademarks of Novartis AG. The eycon figure is a registered<br />

design mark of Novartis AG. *Up to 8 CET points for Optometrists and Contact Lens Practicioners – includes points from distance learning.

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