optrafair - Optometry Today

optrafair - Optometry Today

optrafair - Optometry Today


Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

optometrytoday<br />

Four CET<br />

credits<br />

Survey on<br />

visual field<br />

screening<br />

Unveiled at<br />

www.optometry.co.uk March 25 2011 vol 51:6 £4.95<br />

Optrafair<br />

We preview next month’s show




INTERNATIONALeyewear<br />

The Eschenbach Group

optometrytoday<br />

Comment<br />

Who advises the advisors?<br />

AOP clinical advisor Trevor Warburton<br />

discusses a new survey – see pages 42<br />

and 43 – on domiciliary services<br />

News<br />

News<br />

Beatles for Sale<br />

A range of sunglasses utilising the<br />

Fab Four’s images will be launched in<br />

Britain next month<br />

Letters<br />

Your views<br />

Comments from the GOC chief<br />

executive and others<br />

8<br />

Support in Health Bill discussions<br />

The optical sector’s strengths are highlighted<br />

by an MP as the Health Bill continues its<br />

progress at Westminster<br />

5<br />

Become our<br />

fan on Facebook’<br />

7<br />

18<br />

Industry<br />

Show preview<br />

All the fun of the fair<br />

It’s nearly time to visit the NEC<br />

for Optrafair<br />

24<br />

Step into Spring<br />

The new designer range from<br />

Scandinavian Eyewear 20, 21<br />

Optrafair<br />

22<br />

Education, learning and lunch<br />

What to expect at OT Live<br />

next month 36<br />

New research<br />

Survey on visual field screenings<br />

David Craig and Trevor<br />

Warburton report on a new AOP<br />

survey for those working in<br />

domiciliary settings<br />

42-43<br />

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

Profile<br />

CET<br />

CET<br />

March 25 2011 vol 51:6<br />

7<br />

21<br />

Professor Bruce Evans<br />

The practice owner answers our<br />

20 questions 45<br />

Symptoms of multiple system<br />

atrophy<br />

Dr Richard Armstrong writes in<br />

our ageing vision series 50-54<br />

Intraocular telescopes for macular<br />

degeneration<br />

Brendan Moriarty discusses<br />

this type of treatment 55-58

0151 426 3907<br />

model featured Jaeger London 03<br />


2011<br />

April 9th - 11th<br />

Stand K.40

NEWS<br />

Health Bill: Support for<br />

optics from MP in discussion<br />

THE IMPORTANCE of optical<br />

services has been highlighted<br />

in the latest discussions on the<br />

Health and Social Care Bill.<br />

Nicky Morgan MP (pictured)<br />

raised concerns about the<br />

commissioning of enhanced eye<br />

care schemes in the Standing<br />

Committee stage of the Bill, and<br />

the optical professions have<br />

welcomed her intervention.<br />

The Loughborough MP<br />

applauded the inclusion of<br />

primary ophthalmic services,<br />

particularly the sight testing<br />

service, within the remit of the<br />

NHS commissioning board.<br />

“It makes sense to utilise<br />

optometric practices to deliver<br />

primary eye care, as they are the<br />

logical partners of hospital-based<br />

ophthalmology,” she said. “That has<br />

been demonstrated with great<br />

success in Wales and Scotland,<br />

where people with eye problems<br />

see their optometrist first, rather<br />

than going to their GPs or to<br />

hospital.”<br />

She commented that in her<br />

constituency, GPs work closely<br />

with opticians and optometrists to<br />

secure “decent treatment”.<br />

“Enhanced eye care services,<br />

such as shared care arrangements<br />

with hospitals and GPs, for pre<br />

and post-operation cataract<br />

assessments and stable glaucoma<br />

management, are currently<br />

commissioned locally. My right<br />

honourable friend the minister<br />

has made it clear that the NHS<br />

commissioning board will devolve<br />

enhanced optometric services<br />

to GP commissioners, and, in the<br />

main, that also makes sense.<br />

“However, optometrists are<br />

concerned about glaucoma<br />

referrals under the NICE guidelines<br />

and community-based acute<br />

services. Managing red eye and<br />

minor eye problems are two<br />

small services that are national<br />

in character and, many believe,<br />

should be commissioned<br />

nationally on the same basis as the<br />

NHS sight test. That would ensure<br />

national coverage and appropriate<br />

protocols and accreditation within<br />

an agreed patient pathway, and<br />

would save money and<br />

transaction costs throughout<br />

the system.”<br />

Speaking for the Optical<br />

Confederation AOP chief executive<br />

Bob Hughes said: “We are very<br />

grateful to Nicky Morgan for<br />

raising these issues in the standing<br />

Committee. She has encapsulated<br />

the main areas where we are<br />

looking to the Government to<br />

seize the opportunity to radically<br />

improve the service and take<br />

pressure off hospital eye clinics.”<br />

Scottish roadshow success<br />

THE AOP ran a week of<br />

roadshows in Scotland based<br />

on the newly issued Making<br />

Accurate Claims booklet<br />

earlier this month. Visiting<br />

Perth, Aberdeen, Edinburgh<br />

and Glasgow, the seminars<br />

saw over 200 people attend<br />

to hear Kevin Wallace<br />

(pictured), author of the<br />

booklet, talk about how the<br />

GOS claiming process works<br />

for Scottish practitioners,<br />

how the regulations<br />

should be interpreted and<br />

give guidance on sample<br />

borderline cases.<br />

The AOP’s Scottish legal<br />

advisers, Brodies, also<br />

attended and gave a talk<br />

and answered questions<br />

regarding the new Protecting<br />

Vulnerable Groups<br />

legislation, which came into<br />

force on February 28.<br />

The roadshows were such<br />

a success that two more are<br />

planned – in Inverness and<br />

Ayr. Further details will be<br />

published in OT as soon as<br />

dates have been confirmed.<br />

�� ��<br />


Can you help<br />

recover these<br />

stolen items?<br />


has turned to the optical press<br />

for help after he was robbed of<br />

his optical instruments, some<br />

which he has used for 40 years.<br />

“I feel as if I have lost an<br />

arm,” he said, telling OT that<br />

the items are of great<br />

sentimental value to him.<br />

The robbery, of Mr Denny’s<br />

brown Samsonite case with<br />

the ‘tools of his trade’ inside,<br />

took place in Portsmouth on<br />

March 18.<br />

“I was going to a concert<br />

and foolishly left the case in the<br />

rear foot well of the car,”<br />

he revealed.<br />

“Stolen were various items<br />

including an Occulus Trial Frame<br />

and two Hamblin diagnostic sets<br />

– ophthalmoscope and streak<br />

retinoscopes – one of which I<br />

had been using since I was a<br />

student 40 years ago.<br />

“You might imagine that<br />

besides being functional<br />

instruments and necessary for<br />

my work as I am now doing<br />

locum work, they are of great<br />

sentimental value too.”<br />

If any reader is offered<br />

them please contact Mr Denny –<br />

01243 572 162 – or the police.<br />

5<br />

25/03/11 NEWS

optometrytoday<br />

MARCH 25 2011<br />

VOLUME 51:6<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 2323 E: gemma.trevillion@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, Niall<br />

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

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 issues<br />

EFFORTS to dispel ‘the<br />

myths and fears’ regarding<br />

peer review CET was raised<br />

at yesterday’s meeting of<br />

the GOC.<br />

In its previous meeting<br />

the Council had heard<br />

suggestions that the<br />

College of Optometrists<br />

and Local Optical<br />

Committees could help<br />

with the provision peer<br />

review CET.<br />

It has emerged that the GOC’s<br />

head of education and standards<br />

has met with representatives<br />

from the optical bodies to agree<br />

an action plan to increase the<br />

amount of CET available, and<br />

to also increase the take-up of<br />

continuing education among<br />

optical practitioners.<br />

NEWS<br />

GOC hears of efforts to<br />

widen peer review CET<br />

Part of the development<br />

of these aims include using<br />

optical conferences, websites<br />

and journals to inform optical<br />

professionals about peer review<br />

education, and ‘to dispel the<br />

myths and fears surrounding this<br />

type of CET’.<br />

The Council heard that<br />

Linda Kennaugh will produce<br />

a Podcast, and will conduct<br />

interviews on the subject of<br />

peer review CET, and that<br />

the College of Optometrists<br />

will run peer review training<br />

sessions throughout this year.<br />

Also the approval criteria<br />

has been reviewed and<br />

has created a more flexible<br />

framework for activities that<br />

can be approved for peer<br />

review CET points.<br />

In July a workshop will<br />

be held attended by CET<br />

providers to identify ‘remaining<br />

barriers’. The workshop will also<br />

encourage providers produce<br />

more peer review CET.<br />

Yesterday’s meeting also<br />

discussed the GOC’s budget,<br />

which, for 2011-2012, was<br />

expected to be in deficit of<br />

£16,381 after a concerted period<br />

of cost-cutting measures.<br />

Roadshows start Sunday<br />


giant CooperVision<br />

has announced<br />

the return of its<br />

successful ‘Leading<br />

Thinking’ roadshows<br />

which aim to<br />

educate practitioners<br />

about the latest<br />

developments in<br />

clinical practice and<br />

management.<br />

The free-toattend<br />

conference will<br />

make six stops across the<br />

UK throughout March<br />

and April. Starting in<br />

Manchester on Sunday<br />

(March 27), the event<br />

will then head to Cardiff<br />

(March 29), Leeds (March<br />

31), London (April 3),<br />

Birmingham (April 5) and<br />

then returns to London<br />

(April 7).<br />

Delegates will have the<br />

opportunity to hear from<br />

well-known speakers<br />

Professor Noel Brennan, Dr<br />

Philip Morgan (pictured),<br />

Shelly Bansal, Professor<br />

Bruce Evans and Craig<br />

Wilcox.<br />

Key topics covered<br />

during the day-long events,<br />

which have up to eight<br />

CET points available, will<br />

include: Contact lenses<br />

Comment on the news via www.optometry.co.uk<br />

for children; patient<br />

communication; and<br />

corneal demands for<br />

patients of different<br />

ages.<br />

Karl Aberdeen,<br />

professional<br />

relations manager at<br />

CooperVision, said:<br />

“Following positive<br />

feedback from last<br />

year’s roadshow, we<br />

wanted to ensure that<br />

this year was even bigger<br />

and better and continued<br />

to provide genuine value to<br />

attendees in their continued<br />

education and everyday<br />

clinical practice.”<br />

Spaces are limited so<br />

practitioners are urged<br />

to book early to avoid<br />

disappointment. To book visit<br />

www.thejourneyoflife.co.uk,<br />

or telephone 0845 519 3831.

All together now – UK<br />

Beatles Eyewear launch<br />

BEATLES EYEWEAR, the first<br />

optical range bearing the images<br />

of the world’s most famous pop<br />

band, will make their UK debut at<br />

next month’s Optrafair.<br />

The sunglasses collection,<br />

distributed by Dutch company<br />

TOL Brilmonturen, is based on the<br />

group’s 1968 Yellow Submarine<br />

film, and the ten styles, which<br />

come in two colours each (black<br />

and Tortoise brown), are lavishly<br />

illustrated from the animated<br />

feature.<br />

The collection, which is<br />

manufactured by California-based<br />

Revolution Eyewear, was unveiled<br />

at Vision Expo East in New York<br />

last week.<br />

Revolution has signed a license<br />

agreement with Apple Corps<br />

Ltd., the multi-media company<br />

founded by The Beatles, for the<br />

exclusive worldwide rights to<br />

develop certain Beatles’ songs<br />

and imagery for collections<br />

of sunwear and ophthalmic<br />

frames. Gary Martin, president of<br />

Revolution, told US trade paper<br />

Vision Monday (March 9) he was<br />

“honoured” to be involved in<br />

the project, and confirmed his<br />

company is named after one of<br />

the Beatles’ best-known songs.<br />

2010 was ‘best year’ – Marcolin<br />

EYEWEAR GIANT Marcolin<br />

has said that 2010 was the<br />

best yet in its 50-year history.<br />

The Italian business<br />

reported turnover was<br />

€207.7m to December<br />

31, up 15% on 2009, but<br />

a geographic breakdown<br />

revealed Europe lagging<br />

behind other regions (such as<br />

the US, +13.2%) with a 3.9%<br />

Now TOL Brilmonturen<br />

has booked to exhibit at the<br />

Birmingham show after the<br />

surviving Beatles and the widows<br />

of John Lennon and George<br />

Harrison gave their thumbs-up to<br />

the initial range.<br />

“All of the pieces of the Yellow<br />

Submarine line had to get<br />

unanimous acceptance from<br />

Apple Corps board of directors,<br />

which includes Paul McCartney,<br />

Ringo Starr, Olivia Harrison and<br />

Yoko Ono,” said Daan van Driel,<br />

director of TOL Brilmonturen.<br />

“The high standards that Apple<br />

Corps employs, together with<br />

the creativity of the [collection’s]<br />

designer, make these sunglasses<br />

really unique.”<br />

The sunglasses come with a<br />

contemporary front with<br />

artwork from the film on<br />

the inside of the<br />

turnover rise.<br />

Marcolin’s renewal of its Tom<br />

Ford licence from this month to<br />

2022 was said to be important<br />

in terms of the company’s<br />

profitability and turnover,<br />

and was highlighted in the<br />

results. So too its five-year<br />

exclusive licence with Diesel<br />

for sunglasses and spectacle<br />

frames.<br />

temples, and, for the models in<br />

acetate, on the inside of the front<br />

piece. The artwork is covered in a<br />

high-gloss finish and on the outer<br />

side of the temples each model<br />

carries a ‘subdued decoration’ .<br />

“The ten styles are all<br />

contemporary,” said Mr van Driel,<br />

“varying from the famous John<br />

Lennon frame with near round<br />

lenses to stylish black acetate.”<br />

Mr Driel revealed that the<br />

Yellow Submarine was the<br />

debut range for Beatles Eyewear.<br />

“Assuming it has wide market<br />

acceptance, there will be<br />

further collections,” he said. The<br />

collection will be on display at<br />

stand Q53 at Optrafair.<br />

“We are very satisfied with<br />

the record results achieved<br />

in 2010,” said managing<br />

director Massimo Saracchi.<br />

“Our commitment is now to<br />

significantly improve these<br />

results as from 2011, at the<br />

same time validating the<br />

initiatives looking to ensure<br />

new and important growth for<br />

the years to come.”<br />

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

IN BRIEF<br />

20 year jail term<br />

The trial of Dr Michael Mockovak, the<br />

US laser eye surgery boss featured<br />

in our January 28 edition, has ended<br />

with the surgeon sentenced to 20<br />

years in jail. Dr Mockovak, who cofounded<br />

the Clearly Lasik business,<br />

was found guilty of conspiring to kill<br />

his former business partner. Found<br />

guilty of four of five charges, including<br />

attempted murder and conspiracy<br />

to commit murder against Dr Joseph<br />

King who is Dr Mockovak’s former<br />

brother-in-law, the defendant was<br />

accused of enlisting Russian mobsters<br />

to carry out the crime.<br />

Timing change<br />

The next All Party Parliamentary<br />

Group on Eye Health and Visual<br />

Impairment meeting will take<br />

place earlier than first planned, at<br />

5pm-6pm on Monday (March 28) in<br />

Committee Room 19 at Westminster.<br />

Lord Howe, Parliamentary under<br />

secretary of state for quality at the<br />

Department of Health, will address<br />

the meeting, discussing the Health<br />

and Social Care Bill. To register for the<br />

event, call Philip Chandrapal on 020<br />

7766 4384.<br />

AGMs announced<br />

The annual general meetings of the<br />

AOP and FODO will take place on May<br />

10 at the Novotel St Pancras, London.<br />

The proceedings will start with a<br />

buffet lunch from 12.45pm, followed<br />

by the AGMs, and then a black tie<br />

dinner that evening.<br />

LOC enlists MP<br />

Another MP got behind his local<br />

practice last week with a visit to<br />

discuss issues in the profession and<br />

the Health and Social Care Bill. Henry<br />

Smith, MP for Crawley visited Golding<br />

& Maud where he met owner Mary<br />

Golding and West Sussex LOC chair<br />

Lynn Stacey.<br />

7<br />

25/03/11 NEWS

8<br />

25/03/11 NEWS<br />

NEWS<br />

Ex-director of Sainsbury’s<br />

is new CEO of multiple<br />


has appointed<br />

former J<br />

Sainsbury<br />

director Jonathan<br />

Lawson as<br />

its new chief<br />

executive<br />

o�cer. The<br />

appointment,<br />

which will take e�ect from May, comes at a<br />

time when the multiple has embarked on a<br />

rebranding of its stores.<br />

Mr Lawson was formerly managing director<br />

of Local Pubs, Greene King plc and before that<br />

retail operations director for the J Sainsbury<br />

convenience division. His retail career has<br />

included working for other leading retail brands<br />

such as Asda and Marks and Spencer.<br />

He said: “I’m very excited to be joining Vision<br />

Express and building on the strengths of this<br />

great brand and the people, who are clearly<br />

very proud of their business. The optical market<br />

is highly competitive and has customers<br />

who demand the very highest levels of value,<br />

service and quality, areas that Vision Express has<br />

focussed on for many years.<br />

“I look forward to meeting their customers<br />

and the team, as well as<br />

learning more about the<br />

business so we can work<br />

together and develop<br />

new ways to drive the<br />

best possible service in<br />

the years ahead.“<br />

It has been reported<br />

that a Vision Express in<br />

Lincolnshire has become<br />

one of the �rst to boast the company’s new<br />

logo following a six-�gure store redesign. The<br />

Scunthorpe branch has undergone a renovation<br />

to mark its 15th anniversary, and, reports The<br />

Grimsby Telegraph (March 14) the work coincides<br />

with a nationwide rebranding of the entire chain.<br />

Owner of the Scunthorpe store, Richard Ogden<br />

told OT: “We were given the opportunity to get<br />

the new branding at the same time as our re�t.<br />

The company has been through several rebrands<br />

in the 15 years since we opened, so it was time to<br />

freshen up.<br />

“Franchise stores are being o�ered the new<br />

logo and branding as and when renovation work<br />

takes place, but I believe the plan is that all ‘VE<br />

owned’ stores are getting the change within the<br />

next 12-18 months,” he added.<br />

Vision Express has more than 320 outlets.<br />

SMC donates £5k to OGS<br />

THE WORSHIPFUL Company of Spectacle<br />

Makers has awarded a £5,000 grant to<br />

<strong>Optometry</strong> Giving Sight to fund the<br />

development of two optical workshops in<br />

Malawi.<br />

The workshops, which will be used to train<br />

optical personnel in the East African country,<br />

will be located at the Malawi College of Health<br />

and Mzuzu University.<br />

Future optometric technicians will be trained<br />

at the college, and four-year long optometry<br />

course will be introduced at the university.<br />

John Salmon, clerk of the Worshipful<br />

Company of Spectacle Makers, commented:<br />

“We were incorporated in 1629 to direct the<br />

�ght against visual impairment at home. We<br />

are delighted to also support <strong>Optometry</strong> Giving<br />

Sight’s e�orts to extend that struggle overseas.”<br />

<strong>Optometry</strong> Giving Sight country manager,<br />

Donna Power (pictured) said: “The<br />

development of these workshops form<br />

an integral part of the overall training<br />

programme for the future of eye care in<br />

Malawi. We are incredibly thankful to the<br />

Worshipful Company of Spectacle Makers,<br />

whose grant will assist in this sustainable and<br />

long-term solution to the lack of accessible<br />

eye care in that African country.”<br />

Comment on the news via www.optometry.co.uk<br />




Less than 1% of domiciliary<br />

practitioners frequently or always use<br />

an electronic field screener, as the<br />

survey in today’s issue shows. Clearly<br />

it is not part of mainstream domiciliary<br />

practice. The AOP are challenging a<br />

few PCTs who want to enforce this as a<br />

condition of a domiciliary contract.<br />

Increasingly the AOP has to help<br />

with contract compliance disputes or<br />

performance demands which are well<br />

beyond average practice. One example<br />

is a requirement for motility testing in<br />

everyone, or recording a reason why<br />

not. Just another bizarre requirement<br />

which is out of touch with the real<br />

world of optometry.<br />

In most areas, PCTs receive sound<br />

advice about current standards of<br />

practice from optometric advisors, who<br />

do not receive recognition for their<br />

excellent work.<br />

The problem lies with a tiny handful<br />

of advisors who appear not to live in<br />

the real world, unable to differentiate<br />

between basic safe practice, average<br />

standards and their own personal<br />

views. This creates serious problems<br />

for practitioners and for their PCTs who<br />

face unnecessary legal actions.<br />

PCTs assume that the advice they are<br />

getting is appropriate. This minority<br />

is giving their colleagues a bad name.<br />

A desire to improve standards beyond<br />

average is laudable, but it is not a<br />

matter for contract compliance. There<br />

is no training for advisors or defined<br />

common standard and no code of<br />

conduct. The latter is an important<br />

first step and we support the National<br />

Optometric Advisors’ Association in its<br />

efforts to develop such a code.<br />

Trevor Warburton, Clinical Advisor,<br />

AOP Legal Department

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 less3 , 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 them1 .<br />

Eyes are also shielded by the highest level of UV protection4,5 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.

10<br />

25/03/11 NEWS<br />


BCLA to o�er<br />

ophthalmologists<br />

lens training<br />


given an opportunity to train in<br />

�tting contact lenses during this<br />

year’s BCLA Clinical Conference<br />

Exhibition in Manchester.<br />

A special Training Day for<br />

Medics will run on the Friday of<br />

the exhibition (May 27) to increase<br />

their knowledge of contact lens<br />

�tting, types of lenses and how both<br />

regular and coloured contact lenses<br />

can be used for therapeutic cases.<br />

Former BCLA president Dr<br />

Sarah Janikoun, who will present<br />

‘How to �t the irregular cornea’<br />

at the session, said: “The course<br />

is presented by experienced<br />

ophthalmologists under the aegis<br />

of the BCLA and is the opportunity<br />

to gain hands-on manipulation of<br />

various lens types and take part in<br />

an open, friendly discussion about<br />

contact lens management.”<br />

Meanwhile Shelly Bansal<br />

(pictured below) will be the �rst<br />

BCLA president to hold the o�ce for<br />

two consecutive years following a<br />

change in policy by the Association’s<br />

council in London.<br />

Mr Bansal will remain in o�ce<br />

until May 2012 when he will be<br />

succeeded by president elect<br />

Catharine Chisholm.<br />

“Since my term of o�ce began,<br />

there has been a big drive to widen<br />

BCLA membership and to encourage<br />

new delegates to attend the<br />

conference, “ Mr Bansal commented.<br />

“My ambition now is to build on<br />

these initiatives for BCLA 2012 in<br />

Birmingham. I am therefore truly<br />

honoured that the BCLA council has<br />

elected me as president for a<br />

second term.”<br />

NEWS<br />

ID’11 speakers unveiled<br />


Independents<br />

Day have released<br />

details of the<br />

speaker line-up for<br />

this year’s event on<br />

July 4, claiming it is<br />

one of the<br />

best yet.<br />

Keynote<br />

speaker will be<br />

Andy Edwards<br />

(pictured) who runs<br />

training, personal<br />

development and coachingbased<br />

events in the UK, Europe<br />

and the Middle East focusing<br />

on sales relationships and<br />

communication. Mr Edwards,<br />

who is managing director and<br />

lead consultant with business<br />

coaching company Nine 5 Three<br />

Ltd will address the event’s<br />

audience with ‘I’ve Upped<br />

my Sales – Now Up Yours!’ He<br />

combines his sales and marketing<br />

experience with a background<br />

in behavioural psychology and<br />

NHS OPTICAL voucher values<br />

in England will be unchanged<br />

again this year to remain<br />

at levels set in 2009, the<br />

Government has announced.<br />

Disappointed with the<br />

decision, chief executive<br />

of the AOP, Bob Hughes<br />

(pictured) said: “We<br />

understand why they’ve<br />

done it and we understand<br />

the economic position<br />

the country is in, but they<br />

[the Government] have to<br />

understand they may be<br />

damaging the service people<br />

rely on.<br />

has written a number of selfpublished<br />

books and regularly<br />

contributes to national magazines<br />

and journals. Mr Edwards trains,<br />

consults and coaches with<br />

household names and brands,<br />

including Barclays, Paul Smith, the<br />

Highways Agency and Stannah.<br />

Other speakers include<br />

Jonathon Bench, an optometrist<br />

and former commercial manager<br />

at D&A/Boots, who will o�er<br />

insight into the multiple sector<br />

and what the larger companies<br />

do well, focussing on what<br />

independents can learn<br />

from them.<br />

Accountant Marc<br />

Bennett has specialist<br />

experience in optics will<br />

discuss tips for minimising<br />

tax liability. Abi Grute is a<br />

dispensing optician and<br />

specialist behavioural<br />

trainer and will discuss<br />

the practice conditions<br />

required for business<br />

improvement.<br />

Nick Atkins co-director of<br />

organiser Proven Track Record,<br />

said: “I am delighted with this<br />

year’s line-up which is one of<br />

the best we have ever compiled.<br />

Independents Day will, once<br />

again, deliver a stimulating and<br />

thought-provoking programme<br />

focussed on strategies to<br />

better cope with the turbulent<br />

conditions independent practices<br />

continue to face.”<br />

For more information go to<br />

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

Optical voucher values<br />

remain unchanged<br />

“Some colleagues may say<br />

that’s not a great impact on<br />

my practice, but the fact is<br />

cumulatively we are losing<br />

government money.<br />

“We have to explain why<br />

if things go on like this it<br />

will impact on patients.<br />

Eventually this will e�ect<br />

the ability of the profession<br />

to provide the sight<br />

testing service which the<br />

Government relies on.”<br />

In the review of charges<br />

and vouchers, the cost to<br />

patients of prescriptions,<br />

dental charges and hospitalsupplied<br />

items such as<br />

stockings, wigs and fabrics<br />

were increased.

Getting the<br />

balance right<br />

A major educational event coming soon<br />

The latest unique one-day symposium from THE VISION CARE INSTITUTE arrives this April.<br />

Four expert speakers will offer new insights to help you get the clinical balance right in your<br />

practice with your patients. Places are offered without charge to attendees and because<br />

they’re always very popular it’s best to book now to avoid disappointment.<br />

Date Venue Location<br />

Monday 11th April 2011 Royal College of Physicians London<br />

Wednesday 13th April 2011 Royal Armouries Leeds<br />

Key Themes<br />

• Dry eye management<br />

• The science inside contact lenses<br />

• Compliance: latest insights<br />


• UV and the eye: latest research findings<br />

• Getting the balance right with silicone hydrogels<br />

• Current trends and the future of CL practice<br />

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

11 CET POINTS<br />

(including distance learning)<br />

education through inspiration<br />

The speakers are:<br />

Dr Jason Nichols is a<br />

faculty member at the Ohio<br />

State University College<br />

of <strong>Optometry</strong>, where he is<br />

responsible for teaching<br />

coursework on the tear film,<br />

dry eye, corneal physiology<br />

and contact lenses. He has authored over 70<br />

peer-reviewed publications and 130 abstracts on<br />

these topics. He is additionally Editor of Contact<br />

Lens Spectrum and serves on the editorial board<br />

for Eye and Contact Lens. He lectures widely all<br />

around the globe.<br />

Dr Philip Morgan is Director<br />

of Eurolens Research and a<br />

senior lecturer in optometry at<br />

The University of Manchester,<br />

United Kingdom. Philip is vicepresident<br />

of the International<br />

Society for Contact Lens<br />

Research and secretary of the International<br />

Association of Contact Lens Educators. He has<br />

authored over 160 papers, primarily relating to<br />

the clinical performance of contact lenses and the<br />

nature of the UK and international contact lens<br />

markets.<br />

Dr Cris Schnider is Senior<br />

Director, Medical Affairs<br />

for Vistakon, where she<br />

provides medical, clinical and<br />

technical support. She is also<br />

an internationally known<br />

speaker and writer, with<br />

over 14 years experience in the field of contact<br />

lens education and research prior to joining the<br />

industry. She is a diplomat in the American<br />

Academy of <strong>Optometry</strong> and a member of the<br />

International Society for Contact Lens Research.<br />

Lenora Copper is a senior<br />

research and development<br />

scientist at Vistakon. Her<br />

current research is aimed<br />

at the development of the<br />

next generation of products<br />

that will deliver attributes<br />

beyond vision, comfort and health to wearers.<br />

She has participated in numerous research and<br />

development projects in her 15 years including<br />

the role as technical lead for new silicone<br />

hydrogel materials.<br />

Register now at www.thevisioncareinstitute.co.uk or call 0845 310 5347



Results from a global survey shows that the majority of vision-corrected patients are still looking for<br />

more when it comes to their vision. 1 Bausch + Lomb PureVision ® 2 contact lenses with High Definition<br />

Optics offer a solution. The High Definition Optics design helps to reduce halos and glare by<br />

reducing spherical aberration across the entire power range – offering crisp, clear vision, especially<br />

in low light conditions. And because they are amongst the thinnest on the market today 2 , PureVision ® 2<br />

HD contact lenses allow exceptional breathability and comfort, keeping your patients’ eyes bright and<br />

healthy all day long.<br />

Give them hiGh Definition optics<br />

Introducing Bausch + Lomb purevision ® 2<br />

contact lenses with High Definition Optics.<br />

Speak to your Bausch + Lomb Territory Manager today.<br />

Or call customer services on UK: 0845 602 2350<br />

Republic of Ireland: 1800 409 077<br />

1. Results from a global survey across 7 countries, 3,800 vision-corrected consumers aged 15-65. Consumers provided incidence of symptoms (dryness, sensitivity, etc), how impactful, when experienced<br />

and benefits of product features most likely to motivate consumers when it comes to eye health/vision correction products. 2. Data on file. Bausch & Lomb Incorporated<br />

© 2011 Bausch & Lomb Incorporated. ®/ denote trademarks of Bausch & Lomb Incorporated. Other product names/brand names are trademarks of their respective owners.

14<br />

25/03/11 NEWS<br />

IN BRIEF<br />

Independents<br />

get sunglasses<br />

promo help<br />

A MARKETING business aimed to aid<br />

independent opticians has launched<br />

a campaign targeted to help small<br />

practices increase revenue from<br />

prescription sunglasses.<br />

The Independent Marketing<br />

Partnership has unveiled its<br />

promotion called ‘The Sunglasses<br />

Collection’ which tries to push the<br />

bene�ts of wearing good quality<br />

sunglasses to the public.<br />

The campaign’s literature,<br />

designed to be sent with patient<br />

recall letters, explains why patients<br />

should protect their eyes with high<br />

quality, stylish sunglasses available<br />

from their independent practice.<br />

Graham Hutchison, MD of the<br />

Partnership, said there is signi�cant<br />

potential to gain extra sales via<br />

prescription sunglasses.<br />

“But this will only happen if<br />

patients are informed of the bene�ts<br />

of wearing them – and of buying<br />

them from independent practices.<br />

At the moment it is mainly the<br />

multiples who are getting the sales,<br />

but this is only because they actively<br />

promote sunglasses to the public.”<br />

For further details: 020 8224 1595.<br />

NEWS<br />

Deal creates online giant<br />


Glasses Direct has acquired<br />

Sunglasses Shop, a fellow<br />

online optical group,<br />

establishing Europe’s largest<br />

online eyewear retailer.<br />

Prescription Eyewear<br />

Limited, the parent<br />

company of Glasses Direct,<br />

announced that the two<br />

companies will continue to<br />

operate separately, but the<br />

combined companies boast<br />

more than eight million<br />

unique visitors annually<br />

and sells nearly a quarter of a<br />

million pairs per year. Glasses<br />

Direct is Europe’s largest online<br />

retailer of prescription eyewear<br />

and Sunglasses Shop is the<br />

continent’s largest online<br />

retailer of designer sunglasses.<br />

Kevin Cornils, CEO of Glasses<br />

Direct, said: “Sunglasses Shop<br />

is the clear leader in the<br />

sunglasses market, with an<br />

unbeatable selection of over<br />

8,000 frames, all of which are<br />

carried in-stock and available<br />

for guaranteed next-day<br />

delivery. They have unrivalled<br />

knowledge of performance and<br />

sports sunglasses, and are also<br />

the destination for celebrity<br />

MORE THAN 93% of<br />

practitioners successfully<br />

completed retention for<br />

2011/2012 with the GOC by<br />

the Council’s deadline. In total,<br />

93.8% of registrants applied in<br />

time, a 3% increase compared<br />

to 90.4% last year.<br />

For the �rst time this year<br />

registrants were able to<br />

complete their retention<br />

online using the new ‘MyGOC’<br />

system, which allowed them to<br />

submit the registration in a few<br />

minutes.<br />

news and fashion advice, all<br />

key elements for the sunglasses<br />

market.”<br />

Sunglasses Shop, based<br />

in Southend-on-Sea, has<br />

expanded across Europe<br />

with sites now live in twelve<br />

languages, including French,<br />

German, Italian and Spanish.<br />

Its founder and MD, Daniel<br />

Puddick, said: “Working closely<br />

with the management team<br />

and investors at Glasses<br />

Direct will allow us to greatly<br />

accelerate our plans to<br />

grow our business in the<br />

UK, as well as expand our<br />

European business where we<br />

believe there is tremendous<br />

opportunity. We’re excited<br />

to be part of Prescription<br />

Eyewear Limited, and<br />

we share Glasses Direct’s<br />

entrepreneurial vision to<br />

change the way people<br />

feel about buying<br />

eyewear online.”<br />

Both companies’<br />

websites will continue<br />

to operate as separate<br />

brands, with the combined<br />

businesses will have over<br />

100 employees based in<br />

London, Swindon and<br />

Southend-on-Sea. Glasses<br />

Direct’s existing venture capital<br />

investors – Index Ventures,<br />

Highland Capital Partners and<br />

Acton Capital Partners – all<br />

contributed to support the<br />

transaction.<br />

Sunglasses Shop was<br />

established in 2003 Mr Puddick,<br />

a Central St Martin’s graduate,<br />

and marketing director Dagmara<br />

Alicja Barcz, an ex-innovation<br />

consultant.<br />

The company is based in<br />

London and Swindon and<br />

employs 75 sta�. Glasses Direct<br />

was founded in 2004 by Mr<br />

Murray Wells (pictured) and is<br />

now backed by three leading<br />

European venture capital �rms.<br />

GOC gets 93% response<br />

Philip Hallam, GOC head<br />

of registration, said: “We’re<br />

delighted to see so many<br />

more registrants complete<br />

their retention by the<br />

deadline. We’ve had a lot of<br />

good feedback about the<br />

new online system and it’s<br />

really encouraging to see in<br />

these results that it’s making<br />

retention easier for registrants.<br />

We look forward to rolling the<br />

system out for students and<br />

business registrants over the<br />

coming year.”<br />

Practitioners who have<br />

not yet completed their<br />

registration will now be<br />

required to pay a £20 late<br />

application fee. Those who<br />

have still not applied for<br />

retention by March 31 face<br />

removal from the registers on<br />

April 1.<br />

Maintaining GOC registration<br />

is a legal requirement for<br />

practitioners. If removed from<br />

the registers, practitioners are<br />

unable to practise in the UK<br />

until they have been restored.

Do your astigmatic patients<br />

experience fluctuating vision?<br />

Toric contact lens wearers rub their eyes on average 6 times a day with<br />

89% subsequently experiencing visual disruptions. 1<br />

Over 90% of astigmatic patients would be interested in a solution to the<br />

problem of blurred or hazy vision. 2<br />

Bausch + Lomb’s Toric contact lenses feature the unique Quick Alignment<br />

System which is designed to ensure faster rotational recovery to help<br />

your patients maintain consistently clear vision throughout their day. 3<br />

To find out more, contact your Bausch + Lomb Territory Manager<br />

or call customer services on:<br />

UK: 0845 602 2350 Republic of Ireland: 1800 409 077.<br />

1. Rub Your Eyes Consumer Research Report, Decision Analyst. March 2010. Participants totalled 502 soft contact lens wearers of which 250 were toric wearers. 2. Symptom, Incidence and Needs Survey, Market Probe. December 2009. Participants<br />

totalled 1,642 claimed astigmats. 3. Cairns, G et al. Diff erences in Toric lens performance: Lens Orientation and Orientation Recovery. Presented at American Academy of <strong>Optometry</strong>, Orlando. November 2009. Two clinical studies were conducted to<br />

evaluate the rotational recovery abilities of two toric lens designs: Quick Alignment System (Bausch & Lomb, Rochester, NY) and Accelerated Stabilization design (AS) (Vistakon, Jacksonville, FL). In Study 1, the Quick Alignment System of PureVision®<br />

Toric (PVT) (Bausch & Lomb) was compared with the AS design of Acuvue Advance for Astigmatism (AAA). In Study 2, the Quick Alignment System of PVT (Bausch & Lomb) was compared with the AS design of Acuvue Oasys for Astigmatism (AOA).<br />

Image represents the eff ect of a 2.25D cylinder mis-rotated by 45° on an eye with 2.25D of astigmatism.<br />

© 2011 Bausch & Lomb Incorporated. ®/ denote trademarks of Bausch & Lomb Incorporated. Other product names/brand names are trademarks of their respective owners.

16<br />

25/03/11 NEWS<br />


J&J tours with<br />

‘getting the<br />

balance right’<br />

JOHNSON & Johnson is taking its<br />

expertise on the road next month,<br />

sharing contact lens insights and<br />

research in a brief roadshow.<br />

The ‘Getting The Balance Right’<br />

events, to be held in London (April<br />

11) and Leeds (April 13), will hear<br />

from speakers Dr Jason Nichols,<br />

Dr Philip Morgan, Dr Cris Schnider<br />

(pictured) and Lenora Copper<br />

who will o�er practitioners advice<br />

on how they can get the clinical<br />

balance right with contact lenses for<br />

their patients.<br />

A total of<br />

11 CET points<br />

are on o�er<br />

for each of<br />

the free- toattend<br />

and<br />

open-to-all<br />

events, which<br />

are designed to help practitioners<br />

con�dently provide their patients<br />

with the most up-to-date lens<br />

advice. Interactive sessions,<br />

including remote voting, will<br />

encourage the audience to get<br />

involved and the key themes are:<br />

dry eye management; the science<br />

inside contact lenses; compliance:<br />

latest insights; UV and the eye:<br />

latest research �ndings; getting<br />

the balance right with silicone<br />

hydrogels; current trends and the<br />

future of contact lens practice.<br />

David Ruston, director of<br />

professional a�airs for J&J Vision<br />

Care in Western Europe, said: “This<br />

is a unique opportunity for eye care<br />

professionals to learn about the<br />

latest in contact lens research and<br />

have access to some of the industry’s<br />

leading �gures.”<br />

The roadshow will take place at<br />

London’s Royal College of Physicians,<br />

and Leeds’s Royal Armouries.<br />

NEWS<br />

‘New NHS’ is debated<br />


tips and an intense debate about<br />

the future of the profession were<br />

the highlights of this week’s wellattended<br />

<strong>Optometry</strong> Tomorrow<br />

conference in Liverpool.<br />

Over 260 delegates attended<br />

the Aintree Racecourse event,<br />

hosted by the College of<br />

Optometrists, �gures slightly up<br />

from last year’s event in York.<br />

As well as the clinical-led<br />

aspects of the conference, this<br />

year’s programme included<br />

a lively discussion on how<br />

GP commissioning would<br />

a�ect the profession and how<br />

increased training could prepare<br />

practitioners for the ‘new NHS’.<br />

The debate was chaired by<br />

associate editor of the Guardian,<br />

Michael White, and featured<br />

City University Professor John<br />

Lawrenson, GP partner of<br />

Chat�eld Health Centre in South<br />

London, Waqaar Shah, and<br />

optometrist and College treasurer<br />

David Parkins.<br />

Each speaker put forward<br />

their opinions on what the new<br />

primary care landscape may look<br />


praised the LOCSU<br />

roadshows for helping over<br />

250 practitioners hone<br />

negotiation skills and learn<br />

more about commissioning.<br />

Feedback left by<br />

practitioners at the events<br />

held across England and<br />

Wales included: ‘Very<br />

supportive,’ ‘informative<br />

day’ and ‘good quality<br />

empathetic speakers’.<br />

Director of operations and<br />

commissioning for LOCSU,<br />

Katrina Venerus, told OT:<br />

“The success of the<br />

roadshows over the past few<br />

weeks has demonstrated<br />

like, and how practitioners can<br />

enhance their role by further<br />

training and working closely<br />

with ophthalmologists.<br />

Mr Shah told delegates of<br />

how existing commissioned<br />

services worked in his area<br />

of Wandsworth for di�erent<br />

aspects of healthcare.<br />

A new innovation to the<br />

conference this year was the<br />

‘newly quali�ed stream’ series of<br />

seminars and workshops.<br />

Sessions included clinical<br />

decision making, slit lamp skills,<br />

legal aspects of practice and<br />

dealing with members of the<br />

public.<br />

Director of education at the<br />

College, Jackie Martin, told OT<br />

the appetite amongst LOCs<br />

and ROCs for training and<br />

development, which can<br />

equip them to deal with<br />

the challenges they face<br />

when negotiating enhanced<br />

services at a local level.<br />

“Following on from the<br />

roadshows we are offering<br />

the importance of the sessions:<br />

“The newly quali�ed stream<br />

was launched to enable us to<br />

o�er additional support to new<br />

College members. We aimed to<br />

help those who have just entered<br />

the register to develop their skills<br />

for practise.<br />

“This year’s newly quali�ed<br />

stream was a pilot but it was well<br />

received and had broad appeal,<br />

even attracting those with more<br />

experience who wished to refresh<br />

their skills in a particular area. We<br />

will monitor feedback and hope<br />

to review and develop the stream<br />

for future years.”<br />

��Pictured is (l-r) John Lawrenson,<br />

Waqaar Shah, Michael White and<br />

David Parkins.<br />

LOCSU roadshows a success<br />

more individualised<br />

development training for<br />

any LOCS/ ROCs who want<br />

to improve their skills to<br />

enable them to negotiate<br />

more successfully with<br />

the NHS. We will also use<br />

some of the key learning<br />

points from the roadshows<br />

to develop the programme<br />

for the National Optometric<br />

Conference in the Autumn.”<br />

Among the speakers<br />

was specialist optometric<br />

adviser from Primary Care<br />

Commissioning, John<br />

Hearnshaw (pictured). For<br />

a full report, visit www.<br />


18<br />

25/03/11 LETTERS<br />

�<br />

With reference to your news<br />

I have just read with great<br />

interest the possibility<br />

of lowering the visual<br />

requirements for drivers<br />

in the UK (OT News and<br />

Newsletter, February 11).<br />

I would just like to relate<br />

to you our experiences in<br />

Tanzania. Within the Road<br />

Traffic Act of the United<br />

Republic of Tanzania,<br />

standards were agreed<br />

for vision for drivers.<br />

Unfortunately these were<br />


article about Anglia Ruskin<br />

University in <strong>Optometry</strong> <strong>Today</strong><br />

(February 25), I wanted to clarify<br />

the GOC’s position.<br />

We have in fact granted<br />

provisional approval to the<br />

university for a new ophthalmic<br />

dispensing foundation degree<br />

which leads to direct registration.<br />

Full approval status does not<br />

occur until we are satisfied that<br />

the new programme has been<br />

implemented as proposed and is<br />

deemed to meet the standards<br />

required by the GOC.<br />

This process involves a series<br />

of quality assurance visits to<br />

be conducted over the next<br />

three years, when the panel will<br />

satisfy itself that any conditions<br />

applied during this time are met<br />

and that the course has been<br />

appropriately delivered for each<br />

of the three years.<br />

Provisional approval can be<br />

withdrawn at any time if the<br />

panel is not satisfied with what is<br />

being delivered or if conditions<br />

are not met.<br />

Sponsored by<br />

GOC clarifies university position<br />

What is classed as ‘discrimination’?<br />

What is the definition of ‘discrimination’?<br />

Under the PEARS scheme in Wales I have an obligation to see a<br />

patient that is suffering with recent onset of ocular symptoms that<br />

same day or in the next available clinic.<br />

However, if a patient that is housebound and unable to attend<br />

the practice unaccompanied contacts me with the same symptoms<br />

(flashing lights and floaters for example) I must give the health<br />

African difficulties on the road<br />

not being implemented, with<br />

the result that road accidents<br />

were resulting in a severe<br />

loss of life.<br />

The Tanzania Optometric<br />

Association took up the<br />

cause and designed vision<br />

screening certificates and, by<br />

getting them approved by the<br />

licence issuing authorities,<br />

helped to make visual<br />

screening by an optometrists<br />

compulsory before the<br />

issuing or the renewal of<br />

We have written to<br />

Anglia Ruskin to ensure<br />

that any future publicity<br />

surrounding the provisional<br />

approval is appropriately<br />

worded.<br />

Satjit Singh, Chief executive and<br />

registrar, General Optical Council,<br />

Harley Street, London<br />

authority 48 hours written notice before going out to see them.<br />

Is this classed as discrimination? I will let you decide.<br />

I really cannot see any benefit in this requirement to give such<br />

notice. It increases the administrative work of both the practice<br />

and the health authority but ultimately it is the housebound<br />

patient that suffers.<br />

Nick Maydew BScMCOptom, Bridgend<br />

driving licenses.<br />

The screening certificates<br />

were launched in 2002<br />

and initially faced much<br />

opposition. But with the<br />

support of the Ministry of<br />

Health and Social Welfare we<br />

have made the screening an<br />

acceptable part of the process<br />

of obtaining a driving license.<br />

As licenses are renewed every<br />

three years, drivers are being<br />

screened regularly. We have<br />

picked up quite a few high<br />

myopes driving public service<br />

vehicles without correction<br />

and as an association we<br />

believe we are making a<br />

difference to road safety.<br />

Optometrists can play a<br />

significant role in public<br />

health and maintaining good<br />

visual standards for drivers is<br />

a potentially positive role for<br />

the optometrists.<br />

Rajeshwari Sagar (Mrs), BSc MBCOptom<br />

president, Tanzania Optometric<br />

Association<br />

Can you help create some magic for kids?<br />

I would like to ask your readers to help a good cause dedicated to<br />

creating ‘magical’ gardens at children’s hospices across the UK. They can<br />

do this by holding fundraising tea parties at their practices to help our<br />

charity – Greenfingers – with its projects.<br />

A ‘Care for Tea’ pack to help with organising a tea party event can<br />

be sent electronically, via info@greenfingerscharity.org.uk or through<br />

the post to anyone who would like to take part.<br />

Deborah Skillicorn, director of marketing and fundraising, Greenfingers<br />

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

Being a professional has its advantages<br />

Our 90% Professional Mortgage is one of them<br />

� Designed exclusively for select professionals like you<br />

� Our Professional Mortgage lets you borrow up to 90%<br />

of the value of the property<br />

� It has all the benefits of a really flexible mortgage<br />

� Includes the option to offset your savings.<br />

To see if we can help, call us on 0845 845 0829<br />

or visit www.scottishwidowsbank.co.uk<br />

Lines are open 8am to 6pm on weekdays (10am to 6pm Wednesdays)<br />

Y O U R H O M E M A Y B E R E P O S S E S S E D I F Y O U D O N O T K E E P U P R E P A Y M E N T S O N Y O U R M O R T G A G E .<br />

Applicants must be aged 21 or over and fully qualified accountants, barristers, solicitors, trainee solicitors, dentists, medical doctors, vets, teachers, optometrists or pharmacists. Telephone calls may be recorded or<br />

monitored. Scottish Widows Bank plc. Registered Office: PO Box 12757, 67 Morrison Street, Edinburgh EH3 8YJ. Registered in Scotland no 154554. Authorised and regulated by the Financial Services Authority (FSA).<br />

Our FSA register number is 201601. Confirmation can be obtained by visiting the FSA website at www.fsa.gov.uk/pages/register 2028

20<br />

25/03/11 INDUSTRY NEWS<br />



Silhouette UK<br />

has appointed<br />

Christopher<br />

Cox (pictured)<br />

as managing<br />

director. He<br />

was UK sales<br />

and marketing<br />

manager from<br />

2001 to 2003. He is very well known, having over<br />

20 years experience and sales success in the UK<br />

optical industry.<br />

Birmingham<br />

Optical Group,<br />

UK and Ireland<br />

distributor<br />

of Nidek and<br />

Oculus and a<br />

principal supplier<br />

of instruments<br />

and machines<br />

to the profession, has a renewed focus to<br />

enhance its client service and after sales care<br />

this year. To deliver this, it has enhanced its<br />

senior management team and created two new<br />

business development director positions. Andrew<br />

Brandi (pictured) and Justin Annett will head up<br />

the independent sector and medical divisions<br />

respectively.<br />

Mr Brandi, business development director for<br />

the independent division, has the responsibility<br />

to grow relationships with the independent<br />

sector and emphasis the after sales care to<br />

practices seeking a stronger partnership with<br />

their suppliers. He has over 24 years’ experience<br />

serving both the optical and medical business<br />

sectors and joins from Buchmann UK where he<br />

was managing director. He has also held senior<br />

positions at Topcon, Tinsley Medical Instruments<br />

and Keeler.<br />

Justin Annett, business development director<br />

for the medical division, has over 10 years’<br />

experience in the healthcare industry and played<br />

a pivotal role in launching and building the<br />

brand reputation of private eye hospital business<br />

Optegra. He was also previously a regional<br />

business manager at Ultralase.<br />

Both directors will be joining the senior<br />

management team of CEO Chris Tyler and MD<br />

Neil Townsend at Birmingham Optical Group’s<br />

25th year at Optrafair.<br />

Former D&A and Boots Opticians contact lens<br />

category manager, Jonathon Bench has joined<br />

forces with in-practice sales and training<br />

company, Positive Impact. He will provide<br />

consultancy for the company’s clients.<br />

Helping to C-Spex<br />

ACP SOFTWARE has launched C-Spex software which is designed to be a �exible answer to enable<br />

patients to see how they look in new frames when they have removed their glasses. The company<br />

will be exhibiting at Optrafair on stand D65. The software can be loaded onto a practice’s present<br />

PC or laptop and linked to a high-de�nition USB webcam. Alternatively, a new all-in-one PC with<br />

touchscreen can be used for the maximum e�ect but “at a much lower cost than current units”.<br />

The computer or laptop can be placed on a dispensing table, wall mounted or portable, making it<br />

suitable for domiciliary work.<br />

“After extensive testing we have developed a great practice builder, a method of increasing<br />

dispensing values and a great talking point,” said optometrist Alan Bellamy, who helped form ACP<br />

Software. He has two independent practices in the Midlands and was a dispensing optician before<br />

re-training as an optometrist. The premier package, a new all-in-one touchscreen PC, HD webcam,<br />

remote unit and C-Spex software, costs under £1000. If the practice uses an existing computer<br />

then only the software, a webcam and remote control unit is needed which costs “far less”.<br />

“We are o�ering a free 28 day trial of the software,” said Mr Bellamy. “It can be downloaded from<br />

our website www.c-spex.com or we can supply a disc.”<br />

� 01780 483894

Power<br />

of pink<br />

SCANDINAVIAN EYEWEAR has launched<br />

the new Spring optical collection from<br />

designer Efva Attling which features<br />

six styles in acetate and metal. The<br />

designer’s favourite is model 8512<br />

Beverly in pink (pictured). It is inspired<br />

by 1950s America and is also o�ered in<br />

black and grey.<br />

“Allowing men to be men and women<br />

to be fabulously feminine, as in the 1950s<br />

and 60s continues to be bang on trend<br />

for Spring and Summer,” said Efva Attling.<br />

“For people who want to re�ect this in<br />

their eyewear, there are several strong<br />

candidates in this collection.”<br />

Other styles include Twisted, a<br />

feminine Hollywood-inspired style with<br />

soft round shapes and a twisted frame,<br />

Rolf which has a strong masculine<br />

feel and Rickey, which is more unisex.<br />

Those who like Ms Attling’s eyewear<br />

for its jewellery-like feel might like<br />

Spikes, which has a diamante pattern.<br />

For more information visit www.<br />

scandinavianeyewear.<br />

��0800 376 1050<br />

Doctor is in<br />

THE BIB Group has added<br />

to its service division,<br />

Optical Doctor, upholstery<br />

repairs as a new service<br />

for UK optical practices.<br />

Recognising the need for a national reupholstery<br />

service specifically for patient<br />

chairs, BiB has signed an agreement<br />

with Ecomaster which has over 10 years<br />

experience providing the specialist<br />

service to market-leading blue chip<br />

brands nationally and internationally.<br />

CEO of the BiB Group, Tim Baker, said:<br />

“Ecomaster offers the perfect solution for<br />

fast, efficient, professional onsite repairs.<br />

As well as being unsightly, cracked or<br />

split, chair coverings can, in extreme<br />

cases, lead to cross contamination<br />

and also fail an NHS inspection. It<br />

is now possible to make savings by<br />

refurbishment rather than replacement.”<br />

For further information email enquiries<br />

to service@opticaldoctor.co.uk<br />

�� 01438 740823<br />

250 new<br />

choices<br />

INTERNATIONAL EYEWEAR has launched<br />

its new Spring/Summer brochure featuring<br />

its largest ever collection of frames for<br />

independents. It illustrates 250 new<br />

models, which have been added across all<br />

ranges.<br />

The new ‘shining star’ of the company’s<br />

product portfolio is Gorgeous Girls, an<br />

exclusive 18-piece collection of frames<br />

for girls aged �ve to 15 at a�ordable<br />

prices. Other featured brands include the<br />

Eschenbach product ranges, including<br />

designer brands Marc O’Polo, Humphrey’s,<br />

Brendel and the technically advanced<br />

TITAN�ex. The established ranges such as<br />

Hero, Zo�ani, Episode, Puccini, Star Wars and Eyestu� are also included.<br />

MD Mark Hobson said: “International Eyewear has once again been able to provide<br />

outstanding value throughout its ranges without compromising innovation, style or quality even<br />

in entry-level ranges. Once again the ever popular OK and Azzuri ranges also feature, with many<br />

opticians �nding these frames top of their best sellers list.”<br />

The brochure is designed to be user-friendly and a useful reference tool.<br />

� 0121 585 6565<br />

Climb in dispensing<br />

HOYA PNX 1.53, a tough,<br />

durable and safe option<br />

for children’s lenses,<br />

has enjoyed a 40%<br />

increase in dispensing<br />

since a two-year antibreakage<br />

guarantee was<br />

introduced by Hoya.<br />

The company believes<br />

it is an ideal introductory<br />

lens material and brings<br />

peace of mind for<br />

dispensers due to its<br />

100% built-in UV protection and high impact resistance, as it can withstand a one kilogram<br />

steel ball dropped at 1.20 metres.<br />

“This is the most shock resistant material available for lenses and is great for active lifestyle<br />

patients,” said Hoya Lens UK’s product manager, Steve Roberts, FBDO. “Being ultra lightweight<br />

it is ideal for rimless and supra styles, and not just for children. Many dispensers are seeing<br />

that selecting this lens, which is three times stronger than a standard option, saves a lot of<br />

problems.”<br />

Hoya PNX 1.53 is produced in the UK and is available in a choice of Hoya lens designs and<br />

with a range of coatings, tints and Transitions options.<br />

� 0845 3300 984<br />

21<br />


22<br />

25/03/11 SHOW PREVIEW<br />


All the fun<br />

of the fair<br />

IT’S ALMOST here. Once every two<br />

years the UK optical profession gets<br />

its chance to gather at Birmingham’s<br />

NEC for Optrafair to see what’s new<br />

and what’s relevant for their respective<br />

businesses.<br />

This year’s show promises to be an<br />

important one for companies looking<br />

to climb away from the economic<br />

difficulties of the past two or three years<br />

and improve their profitability.<br />

Around 200 exhibitors of all shapes and<br />

sizes will be present, all aiming to grab<br />

the attention of the wide variety of visitors<br />

Optrafair attracts. Over the next few pages<br />

we will preview what some of them will be<br />

bringing to the event.<br />

No doubt some exhibitors will highlight tempting<br />

money-off promotions or other kind of offers, such as<br />

prize draw competitions, available during the three days<br />

of the show. And there will be numerous new ranges and<br />

collections on display for the spring and summer months.<br />

In addition to the exhibition, our education event OT Live has<br />

expanded – further details of the subjects up for discussion are<br />

featured on page 36.<br />

“Around 200 exhibitors of all<br />

shapes and sizes will be present”<br />

Show organisers will host a poster trail, a display on<br />

the history of Optrafair, and new for 2011, a contact lens<br />

pavilion.<br />

For those interested in designer wear there is the show’s<br />

‘Fashion Quarter’ which offers visitors the chance to view the<br />

latest displays from manufacturers of designer frames, fashion,<br />

sports and children’s eyewear. Attendees are also invited to<br />

enjoy the refreshments provided at the Quarter’s champagne<br />

and cocktail bars.<br />

With the fashion theme in mind, the OptraAwards<br />

competition will take place highlighting new designs for<br />

fashion frames.<br />

The show also promises some free-to-attend seminars to help<br />

individuals build their business, improve consumer satisfaction<br />

and keep abreast of the latest technological advances and<br />

product innovations.<br />

The next Optrafair won’t<br />

come round until 2013 – so,<br />

if you mean to go, spare some<br />

time for what might be a<br />

valuable journey.

ColorMatic IQ ®<br />

The thinking specs.<br />

* refers to all ColorMatic ® high index lenses<br />

NEW<br />

Quickly light.<br />

Quickly dark.<br />

Depending on the incident<br />

light, ColorMatic IQ ® darkens<br />

and fades faster than any other<br />

self-tinting lens*. You can rely<br />

on the outstanding quality of<br />

this Rodenstock brand product.<br />

������������������������� �<br />

noticeably faster lightening<br />

�����������������������������<br />

� �����������������������<br />

protection<br />

���������������������������������<br />

nature colour reproduction<br />

�����������������������������<br />

����������������������<br />

�������������������������<br />

������������<br />


24<br />

25/03/11 SHOW PREVIEW<br />


Show<br />

business<br />

Optrafair gives optics the chance to really<br />

put on a show to help UK practices boost<br />

their business. OT’s Robina Moss looks at<br />

some of the new frame launches set to<br />

inspire practitioners and patients alike.<br />

Jai Kudo<br />

Jai Kudo is celebrating its 10th anniversary at Optrafair and will be promoting the two current<br />

frame collections of Jai Kudo and JK London on stand FQ20 plus Wideview Signature lenses.<br />

The debut Jai Kudo frame collection was launched 10 years ago at the 2001 show. The di�usion<br />

line JK London was launched in 2008 for the younger age group. Ten years on and both brands<br />

continue ‘to go from strength to strength’. In March 2010, the company expanded and relocated<br />

to new premises in Elstree, Hertfordshire. There are plans for a new brand later in the year.<br />

Dunelm<br />

Optical<br />

Dunelm Optical will be exclusively<br />

previewing range additions<br />

from its 2011 brochure at this<br />

year’s Optrafair. All ranges will be<br />

showcased on stand M40 in Hall<br />

20, with a total of 150 new styles<br />

from the likes of Paul Costelloe,<br />

Janet Reger, and John Rocha’s<br />

designer collections, to Dunelm’s<br />

own Julian Beaumont, Retro, and<br />

Whiz Kids ranges. Dunelm will also<br />

showcase its popular cases and<br />

accessories range.<br />

Orange Eyewear<br />

Orange Eyewear is launching a new designer collection for independents<br />

at this year’s Optrafair from internationally renowned women’s clothing<br />

line, CC. Fronted by actress Jane Seymour (pictured), the new frames<br />

complement CC classic clothing which is available in 232 stores across<br />

the UK.<br />

Orange Eyewear will be on stands FQ12 and FQ16 and will also unveil<br />

new models from its own label, Orange. In addition, there will be new<br />

designs from French fashion label, Guy Laroche. The latest models from<br />

the Été collection, which incorporate beautiful pheasant feathers, will<br />

also be on show.<br />

Caseco<br />

Caseco, featured on the OT cover, will showcase all its ranges<br />

and latest models on stand N20. Brands featured will be JF<br />

Rey, Boz, Henry Jullien, Öga, Koali, Derapage, Shoc, Julbo and<br />

Hello Kitty eyewear. New will be Levi’s Eyewear and the o�cial<br />

launch of Pinfeel 2, a series of titanium models utilising the<br />

Pinfeel patented rimless glazing system. Julbo will show its<br />

sunglasses including ranges for children and teenagers, and<br />

will be introducing ‘RX-Trem’, its Silmo d’Or award winning<br />

freeform glazing system.

C A N Y O U<br />

S E E T H I S I N<br />

Y O U R P R A C T I C E ?<br />

Visit us at stand O50<br />

The new 200Dx ultra-widefield imaging system gives you the ability<br />

to see more. Use the power of early detection to protect your patients‘<br />

vision and overall health. Your vision is our focus.<br />

For details of our Optrafair programme<br />

please go to www.optos.com<br />

New business models and ownership options for all systems!<br />

optos.com<br />

© 2011 Optos. All rights reserved. Optos is a registered trademark and 200Dx is a trademark of Optos plc. P/N 453001v1

26<br />

25/03/11 SHOW PREVIEW<br />

International<br />

Eyewear<br />

International Eyewear is launching<br />

Gorgeous Girls, a new designer range<br />

for girls. Designed to appeal to young<br />

fashionistas between the ages of �ve and<br />

12, the debut collection of nine models on<br />

stand L40 has drawn its inspiration from<br />

catwalk trends and features diamantes,<br />

designer detailing and Italian acetate<br />

materials.<br />

For a limited period, International<br />

Eyewear is o�ering a free designer display<br />

unit with the purchase of any eight frames<br />

from the range. All frames are accessorised<br />

with a stylish pink handbag-style case.<br />

In creating the collection, extensive and<br />

planned market research was carried out<br />

involving focus groups and consultation<br />

with dispensing opticians.<br />


Rodenstock<br />

Rodenstock will be debuting Merecedes Benz frames on stand O40 plus new models from<br />

dunhill, Porsche Design and uvex as well as presenting new correction spectacles, marking<br />

a new direction for Rodenstock. This year, besides a special rimless frames concept, the<br />

presentation mainly focuses on the women’s frames, which are characterised by sophisticated<br />

design, high-quality materials and details.<br />

Continental Eyewear<br />

A henna tattooist/face painter for the children plus a prize draw and pen freebies are some of<br />

the attractions on Continental’s stand K40. Customers will be greeted with a familiar face when<br />

they walk on the stand as all the sales team will be present and there will be a comfortable<br />

seating area to rest weary legs.<br />

The latest fashions from Jaeger will be displayed on two mannequins together with a<br />

selection of Jaeger fashion accessories. There will be a plethora of new frames on display in<br />

each range – from the ‘excellent value for money’ Lazer collection to up-to-the minute geek<br />

chic models.<br />

ProDesign<br />

Axiom is a new line under the ProDesign<br />

name, exhibiting on stand H15. “Axiom”<br />

means a self-evident truth and this is a<br />

‘no-nonsense collection’ with integrated<br />

technical solutions, that the viewer can<br />

see and instantly realise how they work.<br />

ProDesign has used a new technology<br />

called PVD, which is said to make it nearly<br />

impossible for the colour of the temples to peel. It is a delicate and time-consuming process<br />

but the company feels that the results are fully worth it. There are four di�erent shapes in<br />

models 6901-04, each o�ered in four colours.<br />

Inspecs<br />

Inspecs will showcase its new luxurious collection of pure titanium frames for women on stand<br />

Q5O. Sheer titanium is a new collection of handcrafted frames, designed to be lightweight yet<br />

chic. They include mother of pearl �nishes and are designed using TR90 Grillamid temples.

�����������<br />

����������������������������<br />

�������������������������<br />

��������������<br />

�����������������������<br />

����������������<br />

���������<br />

������������������<br />

��������������������<br />

01625 618 816<br />

www.spectrum-uk.co.uk<br />

����������������������������<br />

The future of diagnostic imaging<br />

�������������������������������������������������������������������������������<br />

Tel: 01625 618816 Fax: 01625 619959

28<br />

25/03/11 SHOW PREVIEW<br />


The IT factor<br />

Practice management software has developed apace since the last Optrafair. This year’s event<br />

provides the perfect opportunity for practitioners to �nd out how to make their business more<br />

pro�table. OT looks at the new developments and the people behind them.<br />

Optix<br />

Optix is an innovative practice management system developed<br />

by optometrist Trevor Rowley (pictured) and has more than<br />

doubled its customer base since the last Optrafair. On stand H70<br />

the company will show that features include fully integrated<br />

electronic ordering from Essilor, Hoya, Nidek and Rodenstock along<br />

with electronic GOS submissions and integration with leading<br />

technology companies including Nidek and Thomson software.<br />

Optix includes an innovative business Intelligence system.<br />

See20/20<br />

Sales and marketing director Paul Houston (pictured) is aiming to<br />

bring the ‘wow’ factor to Optrafair with the debut of See20/20’s<br />

major upgrade of its practice management system. The company<br />

has invested over half-a-million pounds in a major upgrade,<br />

with its new dispensing, ordering and insurance module being<br />

unveiled on Stand F50. The software features state-of-the-art<br />

advancements in dispensing with seamless integration to<br />

SpesCare insurance, clinical notes and a major revamp of<br />

patient recall.<br />

Over 300 practices and organisations across the UK now use<br />

the See20/20 system and Merseyside’s Silverberg Opticians,<br />

Rawlings Opticians of Surrey and Hampshire, and Gwynns<br />

Opticians of South Wales are among the �rst to use the<br />

enhanced software.

For astigmats, even a simple head tilt can<br />

cause lens rotation and blurred vision.<br />

ACUVUE ® has the answer.<br />

Four stabilisation zones deliver clear and stable vision throughout the day regardless<br />

of head 1 or eye 2,3 movements of your patients, no matter how active their lifestyle may be.<br />

ACUVUE ® OASYS ® material with HYDRACLEAR ® Plus technology delivers a unique<br />

combination of UV protection4 , smoothness, breathability, flexibility and wettability. 5<br />

To see for yourself, visit www.jnjvisioncare.co.uk<br />

Studies compared vision performances between ACUVUE ® OASYS ® for ASTIGMATISM and PureVision ® Toric, Proclear ® Toric & Air Optix ® for astigmatism. 1. McIlraith R, Young G, Hunt C. Toric lens orientation and visual acuity in non-standard conditions. CLAE 2010; 33 (1): 23-26. 2. Chamberlain P et<br />

al. A vision chart to quantify disturbances in acuity during wear of toric contact lenses. Optom Vis Sci 2008; E-abstract 85079. 3. Zikos G et al. Rotational Stability of Toric Soft Contact Lenses During Natural Viewing Conditions. Optom Vis Sci 2007; 84 (11): 1039–1045. 4. Class 1 UV Block: 96% UVA;<br />

100% UVB; UV absorbing contact lens are not substitute for UV-blocking sunglasses as they do not completely cover the eye and the surrounding area. 5. JJVC Data on File 2010. All other companies brand names mentioned herein are the trademarks of their respective owners.<br />

ACUVUE ® , ACUVUE ® OASYS ® , HYDRACLEAR ® and SEE WHAT COULD BE are trademarks of Johnson & Johnson Medical Ltd. © Johnson & Johnson Medical Ltd. 2011.

30<br />

25/03/11 SHOW PREVIEW<br />


Ocuco<br />

Ocuco will be having a draw for<br />

an iPad 2 on its stand H50, and<br />

o�ering a free iPad 2 with all<br />

purchases of £10,000 and over. The<br />

latest version of its ‘world leading’<br />

practice management system,<br />

Acuitas will be demonstrated. It<br />

has had over 1500 installations in<br />

practices worldwide and the latest<br />

improvements in SMS technology,<br />

business intelligence KPI reporting<br />

and direct debit processing will be<br />

on show. New innovations such as electronic GOS 3 submission will also be available to view.<br />

Acuitas integrates with almost all clinical diagnostic equipment, providing enhanced value for<br />

money for those planning on purchasing an OCT or Fundus camera at the show. Ocuco will be<br />

running presentations for independents in a room in the NEC adjacent to the main show. For<br />

details visit the stand.<br />

Opticabase<br />

Opticabase exhibited for the �rst time at<br />

Optrafair 2009 and the “fantastic response”<br />

has inspired director and practice owner<br />

Michael Prais (pictured) to exhibit again<br />

this year.<br />

Opticabase was designed “by opticians<br />

for opticians” and now has over 200<br />

practices using it. There are a variety of<br />

low cost, packages available, from the<br />

reception program to a full dispensing<br />

package. A domiciliary package is also<br />

available. Many new features have been added including SMS and email messaging,<br />

on-line tutorials and one-click lens ordering.<br />

The various software packages will be available to view at Stand SB40 along with free<br />

trial CDs to take away.<br />

Mr Prais has been working with NHS Connecting for Health on the electronic submission<br />

of all GOS forms.<br />

Orasis<br />

The MD of Orasis Practice Management Software, Linus<br />

Mason, (pictured) is particularly close to the profession –<br />

he married a quali�ed DO he met through his work with<br />

independents and they now have two young sons.<br />

The work began in 1995 to create a modern,<br />

comprehensive practice management system ‘developed<br />

with opticians for opticians’ to provide a complete solution<br />

whatever the size of the optical business.<br />

The system’s main purpose is to help improve practice<br />

performance. Orasis uses the latest technology to ensure<br />

a reliable system which aims to deliver fast performance<br />

and a stable environment that is not web-based, a huge<br />

advantage when reliant upon quick entry. A demonstration<br />

and show o�ers will be on the stand C50.

Income<br />

protection<br />

important asset<br />

- the ability to earn a living!<br />

Protect your most<br />

AOP<br />

Members<br />

receive 20% off<br />

your first 3 years<br />

contributions!<br />

“The one protection policy every working<br />

adult in the UK does need is the very one<br />

most of us don’t have - income protection”<br />

Which Consumer website 2011<br />

Come and visit us on the AOP stand (T20) at Optrafair<br />

Could you pay the bills if you were too ill to work?<br />

PG can cover you from the first day that you can’t work due to illness or accident,<br />

until either you recover or turn 65.<br />

As a Friendly Society specialising in the Healthcare profession since 1928, we<br />

don’t have outside shareholders but return any surplus to our members.<br />

For more details visit our website or call us today, on:<br />

Freephone: 0800 146307 www.pgprotects.co.uk/aop<br />

Pharmaceutical & General Provident Society Ltd, trading as PG<br />

Registered Office: 11 Parkway, Porters Wood, St. Albans, Hertfordshire AL3 6PA. Tel: 01727 840095 www.pgprotects.co.uk Incorporated in the United Kingdom<br />

under the Friendly Societies Act 1992. Authorised and regulated by the Financial Services Authority, Registered Number 110023.























































During ‘OptraFair’ Specsavers will be running a number of events which are free to attend as follows:<br />

• Relocation Down Under<br />

Running Saturday 9th April, Sunday 10th April and Monday 11th April<br />

Duration one hour, starting 10am; 1pm; 3pm<br />

• Opportunities in Spain<br />

Running Saturday 9th April, Sunday 10th April and Monday 11th April<br />

Duration 30 minutes, starting 12pm<br />

• OCANZ explained<br />

Running Saturday 9th April, Sunday 10th April and Monday 11th April<br />

Duration 30 minutes, starting 11.30am; 2.30pm; 4.30pm<br />

• Funding of Business Acquisition –<br />

featuring Ken Braddock, Senior Franchise Manager of HSBC.<br />

Running Sunday 10th April only<br />

Duration one hour, starting 12pm; 3pm<br />

There is no limit to the number of events you can attend so for more information<br />

and to book a place, please call 01695 554200.<br />

Details await you at http://jobs.specsavers.co.uk

34 28<br />

25/03/11 SHOW PREVIEW<br />


Enter the Tonometry Zone<br />

HANDS-ON demonstrations and<br />

comparisons between different<br />

manufacturers of OCT, retinal<br />

technology, hand-held gadgets<br />

and dispensing systems will<br />

be key attractions for Optrafair<br />

visitors next month.<br />

April’s show will provide<br />

attendees with a renewed look at<br />

what’s new and what has been<br />

developed from international<br />

suppliers.<br />

“Optrafair is the opportunity<br />

to see what is available,” said<br />

Ron Wright, BiB managing<br />

director, whose company will be<br />

promoting a range of products<br />

including its generic Anyview<br />

dispensing and measuring system.<br />

“We have exhibited for the past<br />

five shows and always chase up our<br />

manufacturers so there are always<br />

enticing deals at the show.”<br />

Birmingham Optical Group will be<br />

showcasing its inspiring ‘Practice of the<br />

Future’ which includes a contemporary<br />

refraction unit plus new anterior<br />

imaging solutions, innovations in pre<br />

screening and a link from the Nidek<br />

Auto-Phoropter to the Test Chart 2000.<br />

Also to be featured is a new Oculus<br />

Keratograph, a Tear Film map which<br />

demonstrates tear break up time and<br />

OxiMap simulating contact lens oxygen<br />

permeability.<br />

The company’s partnerships with<br />

Nidek and Oculus will see new<br />

technologies displayed, including the<br />

Nidek Retinal Screeners – the Nidek RS-<br />

3000 OCT with Anterior Segment and<br />

Normative database.<br />

Carlton, will be promoting the Canon<br />

brand, particularly the Canon CR-2<br />

non-myd camera, Optopol imaging,<br />

and perimetry and refraction furniture<br />

solutions.<br />

“Optrafair is the opportunity to<br />

see what is available… ”<br />

“In response to the ever-growing<br />

demand for portability, we now offer a<br />

hand-held autorefractor, a hand-held<br />

non-myd retinal camera, a range of<br />

hand-held tonometers, a hand-held<br />

pachymeter, and a hand-held slit lamp,”<br />

said Krysten Williams, Carlton sales and<br />

marketing manager.<br />

“Visitors can explore the benefits of<br />

the Optopol Spectral OCT combined<br />

with retinal imaging, consider a Pascal<br />

Dynamic Contour Tonometer for the<br />

most accurate IOP independent of<br />

corneal thickness, try the hand-held<br />

Tonopen AVIA applanation tonometer,<br />

and compare the new Takagi Soft Non-<br />

Contact Tonometer and the new Canon<br />

non-contact Tonometer/Pachymeter.”<br />

Rodenstock’s ophthalmic instrument<br />

range is coming back to the UK market<br />

at the show, via Dibble Optical. MD<br />

Barry Dibble said: “This German brand<br />

of high quality refraction, measurement<br />

and diagnostic technology has a<br />

pedigree going back more than 100<br />

years and has been a popular choice<br />

with ophthalmic professionals. The<br />

new product range has been expertly<br />

redeveloped and represents technology<br />

at the leading edge of innovation and<br />

clinical excellence, all with a two year<br />

warranty.”<br />

The Optovue OCT (IVUE and RTVUE)<br />

complete with 3D, Gangling Cell<br />

Complex, Retina, Glaucoma and Cornea<br />

modules will be a highlight at Grafton<br />

Optical’s stand. Also promoted will be<br />

computerised test charts, complete with<br />

For more features go to www.optometry.co.uk/features<br />

iMac and LCD monitors,<br />

along with the Pachymeter<br />

from DGH, and the portable<br />

hand-held Pachmate. The<br />

new non-Mydriatic Camera,<br />

complete with eyescape digital<br />

capture software, which can be<br />

paired up with the Ivue OCT,<br />

will be demonstrated too.<br />

Keeler will be exhibiting its<br />

hand-held ophthalmoscopes<br />

and retinoscopes, lithium<br />

charger upgrade kits, new<br />

digital Volk lenses, and for<br />

domiciliary visits, its Portable<br />

Slit Lamp.<br />

The company’s ‘Tonometry<br />

Zone’ will display the new Pulsair<br />

Desktop, the space-saving wall-mounted<br />

Pulsair intelliPuff, and for the Slit<br />

Lamp, the Keeler Applanation<br />

Tonometer.<br />

Visitors to the Optos stand will get<br />

the chance to have their retinal image<br />

taken on the new 200D ultra widefield<br />

retinal imaging device. Capturing up to<br />

200° of the retina in one image without<br />

mydriasis, it is an upgrade to the P200,<br />

the technology behind the optomap<br />

retinal exam. Its enhanced image<br />

quality and integrated software tools<br />

will be a key promotion for the<br />

company at Optrafair.<br />

Andrew Yorke, director of medical<br />

at Topcon GB, said its presence at the<br />

exhibition will show the company’s<br />

commitment to the “technical revolution<br />

in optometric instrumentation”.<br />

“Practitioners will be able to see<br />

the growing impact of OCT on dayto-day<br />

optometric practice and the<br />

benefits that are being delivered to<br />

practitioner and patient alike. Our<br />

ability to see beneath the surface and<br />

detect disease much earlier will change<br />

the way we practice now, and in the<br />

future. This will strengthen the clinical<br />

ability of all practitioners and present<br />

a huge opportunity to create clinical<br />


4 ways to make your<br />

practice perfect<br />






GOLD<br />




















DRS<br />

LED<br />



LED<br />



OCT CT<br />

OCT CT<br />



DRS: the future of non-mydriatic retinal imaging...<br />

...Can be yours for only £8,995*<br />

� ��������������� ������<br />

� ��������� ����������� ����� ������ ���������� ���� ������� �������� �������� ��������<br />

� ������� ��� ����� ������ ���� ���������� ������� ������� �� ��� ��� �� ���� �����<br />

� ���� ������� ������� �������� ��� ������ �� ���� ���� �� ������� ��� ���<br />

� ��� ������ ������ ����� ��� �������� ������������<br />

� ������� ������������ ����� �� �������<br />

Our world-class products will be on display<br />

at Optrafair, 9-11 April 2011, NEC, Birmingham<br />

����� �� �� ��������� �Stand N10� ����� ����������� �� ���� �� ���������� � �����<br />

�� ����������� ��������� ��������� ��� ���������� ���������� ��� ���� ��� ����<br />

���� ���� ��� ��������� ��� ����������� ��� ���������� ���� ����������<br />

����������� ������� �� ���� ��������������� �������� ��� �������<br />

���������� ��� �������� ��� ������������ ��� ����������� ��� ��� ���<br />

���������� ��� ��������������� ��� ������� �������<br />

������ �������� ��� ��� ������ ����� ��� ����� �������� ���� ����� ��� ��������<br />

Glaucoma<br />

Retina<br />

Cataract/Cornea<br />

Orthoptic<br />

Refractive<br />

����������������<br />

��� ������� ������

36<br />

25/03/11 SHOW PREVIEW<br />


OT Live expands at 2011<br />

OPTRAFAIR WILL once again feature the<br />

popular OT Live educational series. This<br />

year the OT Live Arena has the addition<br />

of a second smaller Satellite Arena site<br />

to give visitors even more choice.<br />

Looking forward to the event, AOP<br />

education advisor Karen Sparrow said:<br />

“The new format of education at 2009’s<br />

Optrafair was well received by delegates<br />

and sponsors alike. It’s great to be back<br />

in 2011 with a bigger programme,<br />

more choice and fantastic support from<br />

industry sponsors.”<br />

On Saturday April 9 there will be<br />

lectures on retinal disease, intraocular<br />

telescopes for macular degeneration,<br />

therapeutics, glaucoma, OCT, peripheral<br />

retinal imaging, and children’s eye<br />

care. There will also be presentations<br />

on helping practitioners with<br />

communications skills both with their<br />

colleagues and customers.<br />

On Sunday April 10, OT Live headline<br />

sponsor Topcon will be providing an<br />

update on the developments in OCT.<br />

Delegates attending this and other<br />

sessions in the middle of the day will be<br />

given a complementary lunch to enjoy<br />

during the presentation.<br />

Also on Sunday you can listen to<br />

lectures about lifestyle dispensing,<br />

‘drivewear’, contact lens materials and<br />

solutions, refractive lens exchange,<br />

vitreoretinal surgery, OCT and peripheral<br />

retinal imaging. In addition to these CET<br />

lectures, the Optical Confederation will<br />

give you the chance to �nd out how to<br />

be involved in its new career initiative<br />

– New Dimensions in Optics. Also the<br />

Worshipful Company of Spectacle Makers<br />

Education Trust is running a taster session<br />

on the level 2 courses for optical support<br />

sta� and technicians.<br />

Rounding o� the show on Monday<br />

April 11 there will be a series of<br />

specialised half-day sessions.<br />

Pre-registration students can attend an<br />

OSCE preparation and ocular pathology<br />

course for just £39 aimed at helping<br />

them prepare for their imminent �nal<br />

assessments (see also page 60 of this<br />

issue). There is also a ‘Careers Ambassador<br />

Experience’, provided by the Optical<br />

Confederation, for anyone interested<br />

in taking the initiative into their local<br />

schools.<br />

To book, visit www.otlive.co.uk

S O F T W A R E W I T H V I S I O N<br />

��������������<br />

������������������������������<br />

������������������������������������������<br />

�����������������������<br />

��������������������������������������������<br />

�����������������������������������������<br />

���������<br />

����������������������������<br />

����������������������<br />


Visit Optimed<br />

at Optrafair<br />

Try some healthy (and not so healthy) ocular cocktails at the Optimed Booth (stand E80)!<br />

Enjoy Brian’s cocktails and let our resident experts take you through innovative technology to set your<br />

practice apart. Whether you want to engage patients in the waiting area (with i-Vue), increase sales & and<br />

retain patients (using CAPTIV8) or simply make your website standout from the rest (ANIM8) there’s a<br />

patient communication platform for your business.<br />

®<br />

(waiting area) (chairside communication) (animations in your website)<br />

Great animations in your waiting area<br />

with captions, narration, live weather<br />

and news! Also, the ability to ‘push’<br />

content updates from your home direct<br />

to your display system!<br />

®<br />

iPad Ready<br />

Increase dispense values using draw<br />

over video. Retain patients by emailing<br />

ACTUAL videos to the home. Increase<br />

patient recommendations to your<br />

practice by allowing patients to share<br />

content with friends and family.<br />

®<br />

Captivate, engage and inform visitors<br />

to your website with amazing quality<br />

animations fully equipped with<br />

voiceover and captions in over<br />

10 languages.<br />

Email: info@optimed.co.uk Web: www.optimed.co.uk<br />



Career chances<br />

to see at NEC<br />

VISITORS TO next month’s Optrafair will have a range of<br />

professional opportunities to explore.<br />

The exhibition will see Specsavers Professional<br />

Recruitment showcasing the latest career options available<br />

across the UK and overseas for those considering working for<br />

one of the sector’s most recognisable names.<br />

“Whether you are looking for employed or self-employed<br />

careers,” said a spokesman for the company, “Specsavers<br />

believes in providing the right opportunity for everyone and<br />

this is your chance to find out more. A visit to the Specsavers<br />

exhibition stand will include advice on vacancies, career<br />

development opportunities and tips for joining the Specsavers<br />

family.”<br />

Visitors who are interested in running their own practice<br />

can learn more about the Joint Venture Partner programme<br />

and discuss current opportunities. Those looking further<br />

afield can ask about Joint Venture Partner openings in<br />

Australia and New Zealand.<br />

As well as expert advice from the recruitment team, there<br />

will be a series of seminars focused on funding for business<br />

partnerships. Keynote speakers include Ken Braddock, senior<br />

franchise manager at HSBC.<br />

Senior members of the Specsavers team will also present<br />

the multiple’s success story in Australia and New Zealand,<br />

where Specsavers has become a major player in both<br />

countries in a little over two years, with 300 stores open and<br />

sales that are projected to surpass $400m in 2010/11.<br />

The presentations will also show the comprehensive<br />

immigration and relocation packages available to retailers,<br />

dispensers and optometrists who qualify for the low cost Joint<br />

Venture programmes in both countries, as well as case studies<br />

of those who have made a new life and new business for<br />

themselves ‘Down Under’.<br />

For more information on Specsavers at Optrafair 2011, or<br />

to book an appointment with one of the company’s team, call<br />

David Markham on 01695 554200.<br />

39<br />


40<br />

25/03/11 VRICS<br />

VRICS<br />




Sponsored by<br />

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

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

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 />

Contact lens aftercare & complications 2<br />

COURSE CODE: C-15794 O/D/CL<br />

A<br />

B<br />

C<br />

Dr Shehzad Naroo BSc (Hons)<br />

MSc PhD MCOptom FIACLE<br />


1. Image A reveals what was found underneath a soft contact lens,<br />

in the eye of a regular wearer. Which of the following is likely to be a<br />

symptom that will be experienced?<br />

a) Lacrimation that is worse upon lens insertion<br />

b) Lacrimation that is worse upon lens removal<br />

c) Dull aching pain throughout lens wear<br />

d) Photophobia throughout lens wear<br />

2. Which of the following is an indicated slit lamp technique for the<br />

person in Question 1 and the �nding shown in Image A?<br />

a) Direct illumination with parallelepiped<br />

b) Retroillumination using the iris<br />

c) Sodium �uorescein staining assessment<br />

d) All of the above<br />

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

Image B is TRUE?<br />

a) It aids visualisation of palpebral conjunctival redness<br />

b) It aids visualisation of bulbar conjunctival redness<br />

c) It aids visualisation of the lid attachment of a RGP contact lens<br />

d) It aids visualisation of a dislodged/split soft contact lens<br />

4. For the patient in Question 3, which of the following stains/dyes<br />

should be used in conjunction with the technique shown in Image B?<br />

a) Rose Bengal<br />

b) Sodium Fluorescein<br />

c) Alcian Blue<br />

d) Lissamine Green<br />

5. The power of the lens shown in Image C was initially selected as<br />

LE: -2.50/-1.25x180 to match the patient’s spectacle prescription.<br />

Based on the �nding shown in Image C, what is the CORRECT lens<br />

power to order?<br />

a) -2.50/-1.25x20<br />

b) -2.50/-1.25x160<br />

c) -2.50/-1.25x90<br />

d) -2.50/-1.25x180<br />

6. Which one of the following is NOT a design typically used for the<br />

type of lens shown in Image C?<br />

a) Front surface toric<br />

b) Back surface toric<br />

c) Toric periphery<br />

d) Bi-toric

Sponsored by<br />

CONFUSED ABOUT CET REQUIREMENTS? www.cetoptics.com/cetusers/faqs/<br />

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

All participants must con�rm these results on www.cetoptics.com so that they can move their points from the “Pending Points<br />

record” into their “Final CET points record”. Full instructions on how to do this are available on their website.<br />

The closing date for this examination is May 6 2011. CET points for this exam will be uploaded to Vantage on May 16 2011.<br />


��<br />

Approved for Optometrists Approved for DOs Approved for CLPs<br />

About the author<br />

Dr Shehzad Naroo is senior lecturer at Aston University, Birmingham, where he<br />

teaches contact lenses, anterior eye and therapeutics. He is also the global vicepresident<br />

of the International Association of Contact Lens Educators (IACLE),<br />

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

D<br />

E<br />

F<br />

�<br />

��<br />

Associated reading:<br />

1. The Contact Lens Manual: A practical guide to �tting<br />

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

2. Eye Essentials: Rigid Gas-Permeable Lens Fitting by<br />

Ngaire Franklin, Elsevier Health Sciences, 2006<br />

3. Corneal Topography by Amar Agarwal, Elizabeth A.<br />

(FRW) Davis, Anshan, 2009<br />

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

Heinemann, March 2010<br />

7. Which type of contact lens modality is MOST commonly<br />

associated with the complication shown in Image D?<br />

a) Hydrogel monthly disposable lenses worn daily<br />

b) Silicone hydrogel lenses worn daily<br />

c) Silicone hydrogel lenses worn as continuous wear<br />

d) Rigid gas permeable lenses worn daily<br />

8. What is the MOST appropriate management option for the<br />

complication shown in Image D?<br />

a) Change from a multipurpose to hydrogen peroxide cleaning regime<br />

b) Reduce the daily lens wearing time<br />

c) Cease contact lens wear completely<br />

d) No management required. Continue lens wear as now<br />

9. Which of the following is the MOST likely cause of the corneal<br />

complication shown in Image E?<br />

a) Overwear of hydrogel contact lenses<br />

b) Overwear of rigid gas permeable lenses<br />

c) Protein deposits on a hydrogel contact lens<br />

d) A �at �tting hydrogel contact lens<br />

10. Which of the following techniques BEST reveals the location<br />

of the corneal complication shown in Image E?<br />

a) Specular re�ection<br />

b) Sclerotic scatter<br />

c) Retroillumination<br />

d) Indirect illumination<br />

11. Which of the following is the MOST likely problem in the right<br />

eye of a regular contact lens wearer, as found by the technique<br />

shown in Image F?<br />

a) Keratoglobus<br />

b) Pellucid marginal degeneration<br />

c) Corneal warpage<br />

d) Orthokeratology<br />

12. Which of the following would NOT be useful for di�erentiating<br />

the condition shown in Image F from Keratoconus?<br />

a) Review the refraction periodically<br />

b) Measure the corneal pachymetry<br />

c) Review the corneal topography periodically<br />

d) Measure the spherical aberration<br />

41<br />

25/03/11 VRICS

42 28 By David Craig and Trevor Warburton<br />

15/01/10 25/03/11 INTEVIEW<br />

NEW DATA<br />


New survey on visual<br />

�eld screening in the<br />

domiciliary setting<br />

CONTRACTORS PROVIDING General Ophthalmic Services<br />

have to provide appropriate equipment and, in the standard<br />

fixed-site situation, appropriate premises. Exactly what this<br />

means is open to a fair amount of interpretation. Many of<br />

the background requirements such as Health and Safety and<br />

Data Governance are dealt with in Quality in <strong>Optometry</strong> and<br />

in the Primary Care Commissioning contract compliance<br />

inspection form. However, some aspects of equipment<br />

requirements are vague and there is no definition within<br />

the Opticians’ Act or regulations to help. Visual fields<br />

are a case in point, since the testing of visual fields is not<br />

mentioned at all in legislation or regulation, only “other<br />

such examinations as appear to be necessary”.<br />

So, for guidance on what is required in the domiciliary<br />

setting, we must look to advice from the optical<br />

representative bodies via their advisory committee, and<br />

on guidance from the College of Optometrists. However,<br />

the key factor in such cases is what actually happens in<br />

practice. The courts and the GOC both use the standard of<br />

the average, competent practitioner as a yardstick to judge<br />

whether particular actions are reasonable.<br />

It is generally accepted that a threshold-controlled visual<br />

field screener is the instrument of choice in a practice<br />

setting. It is much less clear in the domiciliary setting.<br />

Visual fields tests require considerable concentration and<br />

take some time to complete, and the eligible populations are<br />

very different. The Primary Ophthalmic Regulations 2008<br />

state the requirements for eligibility for a domiciliary sight<br />

test as being “…unable to leave [their place of residence]<br />

unaccompanied because of physical or mental illness or<br />

disability.” Practitioners report that visual fields are difficult<br />

or impossible on many of their domiciliary patients and<br />

even portable electronic threshold-controlled field screeners<br />

(eVFAs) are large and bulky pieces of equipment to add to<br />

the already considerable volume of kit transported from site<br />

to site.<br />

A small handful of PCTs have begun to require contractors<br />

providing domiciliary services to possess a portable<br />

electronic threshold-controlled field screener. The basis for<br />

this requirement is unclear but the reality is that anything<br />

not mentioned in legislation or regulation can only be<br />

required if it represents peer practice. The AOP has been<br />

supporting members placed in this position and, as part of<br />

the evidence gathering, undertook a survey of members in<br />

England and Wales. The survey was conducted online and<br />

a link was sent to all members for whom the AOP has an<br />

email address. This was 6,366 of the 8,107 members in those<br />

regions. There were 667 responses from practitioners who<br />

undertake domiciliary visits.<br />

“The survey response is likely to<br />

represent the views of a signi�cant<br />

percentage of those practitioners<br />

involved in providing home visits”<br />

It is difficult to be certain how many practitioners<br />

undertake domiciliary visits, or even how many contractors<br />

hold contracts to do so as there is no central register of<br />

For more business articles go to www.optometry.co.uk/business

contractors. there<br />

were 12.5 million<br />

sight tests in England<br />

and Wales in the year<br />

ending March 31<br />

2010, and these were<br />

delivered by 11,768<br />

optometrists and 44<br />

oMps. in total, 3.4%<br />

of these tests were<br />

domiciliary tests,<br />

or about 425,000.<br />

it is unlikely that<br />

more that a third<br />

of practitioners<br />

participate in home<br />

visits, and the true<br />

figure is probably<br />

more like a quarter.<br />

thus the survey<br />

response is likely to represent the views of a significant<br />

percentage of those practitioners involved in providing<br />

home visits.<br />

of the 667 who indicated that they undertake home visits,<br />

18.3% say they have access to an electronic threshold<br />

controlled field screener. it is even more revealing to look<br />

at the underlying practice of this subset. of those who have<br />

access to such a screener, 22.5% take it on a visit frequently<br />

or always, whilst 77.5% take it rarely or never.<br />

Looking at the even smaller subset of those who always<br />

take an evFa with them, 9% use it frequently or always,<br />

whilst 91% use it rarely or never.<br />

to put it another way, of the 667 respondents, just five<br />

always or frequently take and always or frequently use an<br />

evFa on visits.<br />

so what do practitioners use for testing visual fields?<br />

not surprisingly, confrontation is the most popular choice,<br />

with 86% indicating it is the method they would normally<br />

use to check visual<br />

fields. of those who use<br />

Tests other than confrontation<br />

confrontation, 34% also<br />

use some other means of<br />

checking the visual field,<br />

though not necessarily on<br />

every occasion. a total of<br />

50% have some means<br />

other than confrontation<br />

of checking the fields.<br />

Most popular of the rest<br />

is the red dot test, with<br />

128 users, followed<br />

by damato with 91.<br />

a further 16 roll up a<br />

Bjerrum screen and take<br />

it with them, whilst 11<br />

mention amsler charts.<br />

the latter may not be<br />

a true reflection of the<br />

usage of an amsler chart as it was not offered as an option<br />

but relied on respondents entering it as a choice under<br />

“other”.<br />

practitioners were asked what proportion of their<br />

domiciliary patients they felt would be capable, physically<br />

and mentally, of taking a meaningful visual field test. the<br />

responses were invited to answer in 10% bands. Half of the<br />

respondents felt that 10% or fewer of their patients would<br />

be capable. Just 3.5% felt that over half their patients would<br />

manage such tests.<br />

Finally, domiciliary practitioners were asked what they<br />

would do if required to purchase a portable electronic<br />

threshold-controlled field screener in order to maintain their<br />

domiciliary visiting contract. only 3.4% said they would be<br />

prepared to purchase one, while 58% said that they would<br />

stop doing home visits. Clearly these would be the smaller<br />

contractors, since the larger national companies often have<br />

evFas available, though usually these are shared within an<br />

area and so are frequently not available to the practitioner<br />

at the time of the sight test. However, it is these smaller<br />

contractors who do a lot of the visits to individuals in their<br />

own homes, as opposed to larger residential or nursing<br />

homes.<br />

it would seem that a policy of requiring portable evFas<br />

for additional service contracts is not in line with the<br />

current practice of the majority of domiciliary practitioners<br />

and is likely to result in a drastic reduction in the<br />

availability of sight tests to patients in their own home.<br />

david Craig is director of operations at the aop. trevor<br />

Warburton is an aop director and clinical advisor to aop<br />

Legal services.<br />

For other business articles go to www.optometry.co.uk/business<br />

43<br />

25/03/11 NEW DATA



Your eyes may be in need of some nutritional support.<br />

Carrots contain the carotenoid betacarotene, an antioxidant important to eye health, but many other<br />

nutrients may also play a vital role in maintaining healthy eyes. Visionace ® is a premium quality,<br />

comprehensive, research based formula † of 23 nutrients including lutein esters, zinc, natural carotenoids,<br />

bilberry and other powerful antioxidants to help maintain healthy eyes and good vision as you get older.<br />

For extra support, Visionace ® Plus dual pack combines the original formula with pharmaceutical quality<br />

omega-3 capsules, plus extra lutein and zeaxanthin.<br />

For further information visit www.visionace.com<br />

Britain’s leading<br />

supplements<br />

for specific life stages<br />

Original Visionace ® Tablets Dual Pack with Omega-3<br />

Recommended & approved<br />

by leading UK optometrists<br />

From Boots, Superdrug, chemists, Tesco, Holland & Barrett, Lloydspharmacy, GNC, health stores & www.vitabiotics.com<br />

Supplements may benefit those with nutritionally inadequate diets. †Tested formula, found in a placebo controlled trial to help maintain normal eye moisture and conjunctival health.

45<br />

25/03/11 20 QUESTIONS<br />

How are you?<br />

Medium rare.<br />


20 Questions – Bruce Evans<br />

Professor Bruce Evans took over at Brentwood independent Cole Martin Tregaskis in 1996 after<br />

working there since 1988<br />

How is business right now?<br />

The practice is very busy and January was a<br />

record month for new patients.<br />

Have you had any promotions<br />

that were especially successful?<br />

No! Part of our USP is that we don’t do<br />

promotions or do anything to lead our<br />

patients to think that our main reason for<br />

existing it to make money from them. Of<br />

course, we need to earn a living, but our<br />

main motivation for going to work each<br />

day is to preserve, enhance and improve<br />

eyesight.<br />

Why do you like about optics?<br />

<strong>Optometry</strong> is a wonderful job since it<br />

combines so many pluses: The job satisfaction<br />

of being a healthcare practitioner, knowing<br />

that you are helping people.<br />

What’s the best thing that’s<br />

happened in the profession<br />

during your time working in it?<br />

It is di�cult to say and many would say<br />

things like imaging, OCT, or disposable<br />

contact lenses. But I think that the best<br />

thing to happen is the development of the<br />

Intuitive Colorimeter by Professor Arnold<br />

Wilkins.<br />

Who do you admire in optics?<br />

I have had the pleasure of working with<br />

people like Neville Drasdo, David Edgar, David<br />

Thomson and Judith Morris, and I have learnt<br />

a huge amount from them.<br />

Where are your favourite places<br />

that optics has taken you?<br />

Sierra Leone (with Vision Aid Overseas), and<br />

recently lecturing in Australia.<br />

Are you superstitious?<br />

No.<br />

If you were granted one wish for<br />

optics what would you wish for?<br />

That my colleagues who work for<br />

employers that advertise “free sight tests”<br />

realise that they devalue their profession<br />

and themselves. Each day we make choices.<br />

We choose who we work for and in so<br />

doing we choose the activities that we<br />

support. We should choose carefully.<br />

Do you have a favourite TV<br />

show?<br />

No.<br />

Outside of the profession, what<br />

are your hobbies?<br />

Anything to do with water. Typically, sailing,<br />

windsur�ng, scuba diving and kayaking.<br />

Sum up your feelings for the<br />

next 12 months.<br />

Mixed.<br />

Where do you go on holiday?<br />

At the moment, West Wales because that is<br />

where my boat is at present. Also, wherever I<br />

am invited to lecture.<br />

What are your favourite products<br />

in the optical sector?<br />

Any contact lenses that are easy for children<br />

to wear. They can be so liberating.<br />

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

what would you be doing?<br />

In the Royal Navy or Merchant Navy.<br />

What’s your favourite singer or<br />

musical group?<br />

I have such wide tastes that I could not name<br />

a favourite.<br />

What do you put down your/your<br />

company’s success to?<br />

The whole team, past and present, that has<br />

built a reputation for placing patient care at<br />

the heart of everything we do.<br />

What’s your favourite season,<br />

and time of year?<br />

Summer.<br />

Where would spend your perfect<br />

day?<br />

Sailing with the family, reading or writing<br />

an optometric article, and then cooking a<br />

barbecue on the beach.<br />

Any �nal thoughts?<br />

That optometry is interesting and ful�lling.<br />

If you don’t �nd it so, then you need to do it<br />

in a di�erent place and in a di�erent way.

optometrytoday<br />


Win a £500 shopping spree<br />

WITH OUR Optrafair draw fast approaching, this issue is<br />

your last chance to enter our Mystery Year contest online<br />

or by post.<br />

As part of our anniversary celebrations, we are giving<br />

one lucky reader £500 worth of shopping vouchers for the<br />

store or website of their choice.<br />

All you have to do to get an entry in our prize draw is<br />

to tell us which year the advertisement appeared below in<br />

OT. Last issue’s Mystery Year, which featured a ‘Goodies’<br />

inspired frame came from 1973. Congratulations to all<br />

who were correct, you each get an entry into our prize<br />

draw.<br />

This issue’s controversial Mystery Year image comes<br />

from the year Celine Dion won the Eurovision Song<br />

Contest for Switzerland.<br />

To enter simply guess the Mystery Year and send the<br />

answer, along with your contact details to: Mystery Year<br />

(March 25), <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 />

Throughout the year in OT we’ll be sharing some of the best<br />

letters we’ve received over the years. This week, we look<br />

back to the controversy surrounding this week’s Mystery<br />

Year image.<br />

Sir – So sex comes to <strong>Optometry</strong> <strong>Today</strong>. I suppose it had<br />

to, sooner or later. All glossy trade magazines eventually<br />

succumb. It appears Rodenstock now advocate the end of<br />

boring old spectacle cases, chains and cords in favour of more<br />

exciting, though less protective and more uncomfortable<br />

means for holding spectacles when they are not in use. Well<br />

this may be all right for sun-worshipping women but is it<br />

going to be followed by ideas for shades-wearing beach-boys?<br />

I would like to propose a series of front covers depicting<br />

hunks modeling brief swimming apparel, each with a<br />

spectacle frame tucked in or hooked over his trunks.<br />

Looking forward, with baited breath and pent up<br />

excitement the forthcoming issues of ‘Optometitlation <strong>Today</strong>’<br />

– A Hampshire-lady-optometrist (April 23).<br />

Sir – I note with a modicum of amusement the fuss over the<br />

Rodenstock cover. The only letter that realised we were now<br />

in the 80s was that of a ‘Hampshire lady optometrist’.<br />

I have looked again and again at that cover for any stimulation<br />

hoping, perhaps, that I could save my subscription to<br />

Playboy. Could we have a full-length photograph of the lady<br />

soon, preferably without the sunspecs? – Reg Herson, Hove<br />

(May 21).<br />

Sir – I have resisted (until now) rising to the bait cleverly laid<br />

for us by your collective correspondents to our ‘sexist’ front<br />

cover advertisement.<br />

As with most things in life, the letters demonstrated<br />

admirably the diverse opinions which exist in all professions,<br />

and who optometrists in particular are such an interesting<br />

mixture to deal with.<br />

To all of your readers, whether ‘prima-donna’ or ‘light<br />

hearted humourist’ on behalf of Rodenstock UK, may I just<br />

say it was a ‘boob’ which will not be repeated. – Chris Hunt,<br />

MD – Rodenstock UK (June 4).<br />

47<br />


OT CET Video<br />

C 15893/O D: An Introduction to<br />

Optical Coherence Tomography<br />

This video aims to provide an introduction to the technology of Optical<br />

Coherence Tomography (OCT) for both Optometrists and Dispensing Opticians.<br />

The video is split into three segments:<br />

In part one, Dr Leon Davies (Senior Lecturer, Aston University) provides an<br />

overview of the theory behind Optical Coherence Tomography, including<br />

details of how the scans are generated, the differences between time domain<br />

and spectral domain systems and tips for interpreting OCT scans.<br />

In the second segment, optometrist Nick Rumney discusses the clinical use of<br />

OCT in optometric practice, including advising when to use the technology, the<br />

appearance of commonly presenting abnormalities and details a series of case<br />

studies based on his experiences with OCT.<br />

Finally, optometrist Nicola Haig-Brown describes her experience of owning<br />

an OCT machine, including discussing the impact OCT has had on her practice.<br />

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

with 2 free CET points for Optometrists and Dispensing Opticians.<br />

You must be logged in to the website before you can watch this video<br />

and take the exam.<br />

A hint button is now available for each question and will take you<br />

to the section of the video that relates to the question.<br />

The closing date for MCQ submissions will be April 30, 2011.<br />



MARCH<br />

NEW… 27 CooperVision, The Lowry Hotel,<br />

Manchester, ‘Leading thinking conferences’<br />

(www.journeyo�ife.co.uk)<br />

28 Maui Jim, Brooklands Hotel, Weybridge,<br />

‘CET party – training with the Hawaiian twist’<br />

free but places are limited (0800 980 1770)<br />

29 Maui Jim, Aztec Hotel, Bristol, ‘CET party<br />

– training with the Hawaiian twist’ free but<br />

places are limited SEE ABOVE<br />

NEW… 29 CooperVision, The Celtic<br />

Manor Resort, Newport, ‘Leading thinking<br />

conferences’ SEE ABOVE<br />

29 Pinpoint Scotland, Postgraduate Centre,<br />

Leighton Hospital, ‘Retinal imaging course’<br />

(Maureen.broomhall@mcht.nhs.uk)<br />

29 BABO, Lesley Arkin Optometrist,<br />

Co�eridge Close, Stony Stratford, Milton<br />

Keynes, ‘Peer review day’ (arkin@eyecare-mk.<br />

co.uk)<br />

30 BABO, Keith Holland & Associates, 27 St<br />

George’s Road, Cheltenham, ‘Peer review<br />

day’ (clare@keithholland.co.uk)<br />

30 Norfolk and Norwich LOC, The Oaklands,<br />

Norwich, ‘AMD part two,’ 6.45pm (caron.<br />

willard@novartis.com)<br />

30 Maui Jim, National Motorcycle Museum,<br />

Birmingham, ‘CET party – training with the<br />

Hawaiian twist’ free but places are limited<br />


31 BABO, John Glover Optometrists, 45<br />

Compsall Road, Romiley, Stockport, ‘Peer<br />

review day’ (john@parkvision.co.uk)<br />

NEW… 31 CooperVision, Oulton Hall, Leeds,<br />

‘Leading thinking conferences’ SEE ABOVE<br />

31 Maui Jim, Hilton Hotel, Manchester<br />

Airport, ‘CET party – training with the<br />

Hawaiian twist’ free but places are limited<br />


APRIL<br />

1 Maui Jim, Holiday Inn, Bloomsbury, London,<br />

‘CET party – training with the Hawaiian twist’<br />

free but places are limited SEE ABOVE<br />

1 International Institute of Colorimetry,<br />

University of Ulster Conference Centre, ‘One<br />

day colorimetry training session’ (info@<br />

colorimetryinstitute.org)<br />

NEW… 3 CooperVision, 195 Piccadilly,<br />

London, W1J, ‘Leading thinking conferences’<br />


4 Maui Jim, Morrison Hotel, Dublin, ‘CET party<br />

– training with the Hawaiian twist’ free but<br />

places are limited SEE ABOVE<br />

NEW… 4 Nottingham and Derby Optical<br />

Society, The Village Hall, Chilwell, ‘Eye<br />

casualty services’ (ndos@live.com)<br />

NEW… 5 North London AOP, Moor�elds Eye<br />

Hospital, London, EC1V, ‘Lecture congenital<br />

colour de�ciencies’ (stevedross10@hotmail.<br />

com)<br />


Party your way to points<br />

Both optometrists and DOs can say ‘aloha’ to CET, earned in<br />

a fun and lively environment with Maui Jim’s series of CET<br />

parties, which are being held around the country between<br />

March 28 and April 4.<br />

Traditional Hawaiian entertainment will be provided on the<br />

night as well as a bu�et and, of course, the lectures explaining<br />

polarised light and the technical bene�ts of the companies<br />

lenses.<br />

Places are limited, so booking is essential on: sales.uk@<br />

mauijim.com<br />

NEW… 5 Hampshire and IOW LOC and<br />

East Hants West Sussex AOP branch, Dame<br />

Judith Professional Centre, Sundridge Close,<br />

Cosham, ‘Corneal grafting and corneal<br />

dystrophies’ (ronald.rabbetts@virgin.net)<br />

NEW… 5 CooperVision, Crowne Plaza Hotel,<br />

Birmingham NEC, Pendugo Way, ‘Leading<br />

thinking conferences’ SEE ABOVE<br />

6 South Sta�s Optical Society, Cannock<br />

Cricket and Hockey Club, Cannock, ‘Contact<br />

lens complications’, 6.30pm (suecutts@<br />

talk21.com)<br />

NEW… 7 CooperVision, The Institute of<br />

Engineering and Technology, London, WC2R,<br />

‘Leading thinking conferences’ SEE ABOVE<br />

9-11 Optrafair, Birmingham NEC (FMO: 020<br />

7298 5123)<br />

NEW… 11 J&J, The Vision Care<br />

Institute, Pinewood, Wokingham,<br />

‘Managing the astigmatic patient’ (www.<br />

thevisioncareinstitute.co.uk)<br />

NEW… 12 J&J, The Vision Care Institute,<br />

Pinewood, Wokingham, ‘Healthy eyes and<br />

healthy practices’ SEE ABOVE<br />

14 BCLA, 76 Portland Place, London,<br />

‘Scienti�c evening meeting’ SEE ABOVE<br />

NEW… 20 UltraVision, Head O�ce, Leighton<br />

Buzzard, Bedfordshire, ‘KeraSoft IC workshop’<br />

workshop and �tting techniques (workshop@<br />

ultravision.co.uk)<br />

MAY<br />

NEW… 6-8 European Academy of<br />

<strong>Optometry</strong> and Optics, Prague, Czech<br />

Republic, ‘Annual conference’ (info@eaoo.<br />

info)<br />

NEW… 9 J&J, The Vision Care Institute,<br />

Pinewood, Wokingham, ‘Healthy eyes and<br />

healthy practices’ SEE ABOVE<br />

NEW… 10 J&J, The Vision Care Institute,<br />

Pinewood, Wokingham, ‘Managing the<br />

astigmatic patient’ SEE ABOVE<br />

NEW… 11 NIOS, Templeton Hotel,<br />

Templepatrick, County Antrim, ‘Contact lens<br />

day’ (lizgillespie.nios@btopenworld.com)<br />

NEW… 18 South Sta�s Optical Society,<br />

Cannock Cricket and Hockey Club, Church<br />

Lane, Hatherton, Cannock, ‘AGM’ with bu�et,<br />

6.30pm SEE ABOVE<br />

NEW… 18-19 J&J, The Vision Care Institute,<br />

Pinewood, Wokingham, ‘Returning to work<br />

con�dent and refreshed’ SEE ABOVE<br />

NEW… 18 ABDO, 199 Gloucester Terrace,<br />

London, W2 ‘President’s consultation day’<br />

(jburnand@abdolondon.org.uk)<br />

NEW… 18 UltraVision, Head O�ce,<br />

Leighton Buzzard, Bedfordshire, ‘KeraSoft IC<br />

workshop’ workshop and �tting techniques<br />

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

NEW… 23 Sportvision, Walkers Stadium,<br />

Leicester, ‘Sportfair’ (www.sportvision.co.uk)<br />

49<br />

25/03/11 DIARY DATES

50<br />

25/03/11 CET<br />



& TRAINING<br />


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

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

Visual Signs & Symptoms<br />

of Multiple System<br />

Atrophy<br />


Dr Richard A. Armstrong BSc DPhil<br />

In this �nal article on ageing vision, the visual features of Multiple System<br />

Atrophy (MSA) are discussed and described. Previous articles in the series<br />

have shown how systemic ageing changes, particularly those a�ecting<br />

the brain, can have signi�cant detrimental e�ects on vision. MSA is a rare<br />

movement disorder and a member of a group of neurodegenerative diseases,<br />

which include Parkinson’s disease (PD) and progressive supranuclear palsy<br />

(PSP), and are referred to as the ‘Parkinsonian syndromes’. Although primarily<br />

a neurological disorder, patients with MSA may also develop visual signs<br />

and symptoms that could be useful in di�erential diagnosis. In addition,<br />

the eye care practitioner may contribute to the management of visual<br />

problems of patients with MSA and therefore help to improve quality of life.<br />

Visual signs and symptoms<br />

Several of the brain areas affected in<br />

MSA may be involved in visual function<br />

(Figure 1) including areas of the<br />

cerebral cortex, striatum, midbrain, and<br />

cerebellum. A variety of visual problems<br />

have been reported in patients with<br />

MSA, involving these brain areas, and<br />

the major signs and symptoms identified<br />

to date are summarised in Table 1.<br />

Primary vision<br />

There is little detailed information<br />

concerning changes in visual acuity<br />

(VA) in MSA. Patients with PD and<br />

PSP, however, will often complain of<br />

poor vision especially as the disease<br />

progresses, and this is also possible in<br />

MSA. In PD, vision has been reported<br />

to be blurred in response to coloured<br />

stimuli, 1 with reduced colour fusion<br />

times, 2 which indicates the acuity of<br />

perception of monochromatic contours.<br />

There is little evidence however,<br />

that colour vision itself is affected in<br />

MSA. Consistent with this suggestion,<br />

abnormal visual evoked potentials<br />

(VEP) using coloured stimuli have not<br />

been reported in MSA. 3 There have<br />

been few studies of visual field defects<br />

in patients with any of the Parkinsonian<br />

syndromes, a reflection of the specific<br />

difficulties of conducting such tests<br />

in patients with a movement disorder.<br />

Eye movement<br />

Eye movement problems are an<br />

important aspect of the Parkinsonian<br />

syndromes in general. For example,<br />

spontaneous and voluntary eyelid<br />

mobility are often abnormal in PSP<br />

but are usually less affected in PD<br />

and MSA. 4 Abnormal ocular fixation,<br />

however, may occur in a significant<br />

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

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

proportion of patients with MSA. 5<br />

In a patient with MSA where a<br />

combination of olivopontocerebellar<br />

atrophy and striato-nigral degeneration<br />

was present, the typical impairments<br />

of eye movement characteristic of<br />

PD were evident, viz., abnormal eye<br />

movements, 6 in combination with<br />

a vertical optokinetic nystagmus. 7<br />

However, smooth pursuit and saccadic<br />

movements in the vertical direction were<br />

only slightly affected. In a recent study<br />

of oculomotor function in thirty patients<br />

with MSA, 8 excessive square-wave jerks<br />

were observed in 21 of the patients, a<br />

mild supranuclear gaze palsy in eight<br />

patients, a gaze-evoked nystagmus in<br />

12 patients, a positioning down-beat<br />

nystagmus in 10 out of 25 patients,<br />

mild-moderate saccadic hypometria<br />

in 22 patients, impaired smooth<br />

pursuit movements in 28 patients, and<br />

reduced vestibulo-ocular reflex (VOR)<br />

suppression in 16 out of 24 patients.<br />

The VOR is a reflex eye movement<br />

that stabilizes images on the retina<br />

during movements of the head. This is<br />

achieved by the central nervous system,<br />

which induces an eye movement in<br />

the opposite direction to that of the<br />

head. It can be tested by the ‘rapid<br />

head impulse test’ in which the head<br />

is rapidly moved to the side. Normally<br />

the eyes will remain looking in the same<br />

direction but in diseases such as MSA,<br />

no compensatory eye movement may<br />

be apparent. The ‘gain’ of the VOR is<br />

the ratio of the change in eye angle to<br />

head angle during a head turn. If the<br />

gain is impaired (ratio not equal to<br />

unity), head movements result in image<br />

motion on the retina and blurred vision.<br />

The gain of the VOR in the dark may be<br />

cancelled by fixation. Both patients with<br />

MSA and PSP show this cancellation<br />

compared with both normal subjects<br />

and patients with PD, 5 which could<br />

be related to cerebellar dysfunction.

Hence, eye movement problems<br />

and especially those related<br />

to oculomotor dysfunction are<br />

likely to be an important feature<br />

of MSA. Nevertheless, many of<br />

the visual signs and symptoms<br />

associated with eye movement<br />

are controversial and may not<br />

occur in all patients. Hence, some<br />

authors believe that oculomotor<br />

anomalies are not present in MSA<br />

consistently enough to make them<br />

useful in differential diagnosis. 9<br />

Pupil reactivity<br />

Examination of the pupil<br />

reactions is an opportunity to<br />

detect disturbances in autonomic<br />

innervation of the eye, a likely<br />

feature of MSA. 10 Infra-red<br />

pupillography can be used to<br />

measure pupil diameter in the<br />

light and dark, the light reflex<br />

response, and pupil reactions<br />

associated with the administration<br />

of pharmacological agents. 10 In a<br />

study of pupil reactivity in MSA,<br />

about a quarter of patients tested<br />

had abnormal pupil reactions<br />

and in the majority, the defects were<br />

bilateral and symmetrical. Pupil<br />

defects were not usually apparent to<br />

the patients themselves or to their<br />

physicians. In addition, in normal<br />

subjects, pupil size will often increase in<br />

response to stress but no such change is<br />

apparent in MSA. 11 Horner’s syndrome<br />

(abnormally small pupil diameter) has<br />

rarely been observed in neuropathies<br />

such as MSA, although such a change<br />

has been reported in one case. 12<br />

Psychophysics<br />

Contrast sensitivity (CS) is affected in<br />

PD at least in a proportion of patients 13,14<br />

but there is little evidence to date<br />

for an effect in MSA. Visual spatial<br />

contrast threshold and suprathreshold<br />

Figure 1<br />

The major brain areas a�ected in multiple system atrophy (MSA) which may be involved in visual function:<br />

Basal ganglia (BG), Cerebellum (CB), Inferior olive (ION), Locus caeruleus (LC), Motor cortex (MC), Premotor<br />

cortex (PMC), Pontine nuclei (PT), Spinal cord (SC), Substantia nigra (SN), Thalamus (Th)<br />

contrast match to high-contrast sine-<br />

wave gratings have been compared in<br />

patients with PD and MSA to normal<br />

control subjects. 15 The response<br />

of patients with PD was reduced<br />

compared with the controls but this<br />

was not the case in patients with MSA.<br />

Visual evoked potentials<br />

Evoked responses to motor stimuli have<br />

been reported to be normal in MSA. 16<br />

Similarly, although significant effects<br />

on the electroretinogram (ERG) and<br />

VEP have been found in PD and PSP,<br />

the results reported in MSA are more<br />

controversial. For example, the pattern<br />

reversal ERG to a coloured stimulus<br />

(ChPERG) was recorded in both PD and<br />

MSA. 3 Although reduced amplitude and<br />

increased latency of evoked components<br />

were observed in PD, especially when a<br />

blue-yellow horizontal grating was used<br />

as a stimulus, no such effects were seen<br />

in MSA. 3 Similarly, using a horizontal<br />

sinusoidal grating, there were no effects<br />

on the VEP in MSA although effects<br />

were demonstrated in PD. 17 Significantly<br />

less impairment has also been observed<br />

in MSA to a full-field flash stimulus<br />

compared to PD and PSP. 18 Nevertheless,<br />

in some studies, VEP abnormalities have<br />

been reported in patients with MSA,<br />

51<br />

25/03/11 CET

52<br />

25/03/11 CET<br />



& TRAINING<br />


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

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

of event-related potentials in MSA,<br />

which elicit the ‘P300’ evoked response,<br />

believed to reflect orientation, attention,<br />

stimulus evaluation, and memory. These<br />

evoked responses may be associated<br />

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

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

Ocular aspect Change in MSA References<br />

Primary vision Little evidence at present for defects in acuity, colour vision, or<br />

with no detectable differences between<br />

the MSA-C and MSA-P subtypes. 16<br />

Event-related evoked potentials<br />

There have been a number of studies<br />

visual �elds<br />

Eyelid mobility Spontaneous and voluntary eyelid mobility normal VallSole et al., 1991<br />

Fixation Abnormal in many patients Rascol et al., 1991<br />

Square-wave jerks Present in a signi�cant proportion of patients Anderson et al., 2008<br />

Supranuclear gaze palsy Mild defect in some patients Anderson et al., 2008<br />

Nystagmus Gaze-evoked nystagmus in a proportion of patient Anderson et al., 2008<br />

Saccadic hypometria Mild to moderate Anderson et al., 2008<br />

Smooth pursuit<br />

movement<br />

Impaired in a signi�cant number of patients Anderson et al., 2008<br />

VOR Reduced suppression in a proportion of patients Anderson et al., 2008<br />

Pupil reactivity Abnormal pupils in many patients<br />

No response due to stress<br />

-<br />

Kuruda et al.,<br />

Contrast sensitivity No evidence for impairment van Elst et al., 1997<br />

Evoked potentials Normal motor-evoked potentials<br />

Normal chromatic PERG<br />

VEP defects controversial<br />

Abnormal event-related potentials<br />

in some patients (P300)<br />

1998<br />

Abele et al., 2001<br />

Sartucci et al., 2006<br />

Delalande et al., 1998<br />

Delalande et al., 1998<br />

Wang et al., 2000<br />

Sleep disorder iREM in many patients Turner, 2002<br />

Reading speed Mildly a�ected Sachin et al., 2008<br />

Visual hallucinations Rare, unrelated to medication Kumbler and<br />

Kornhuber, 2002<br />

Table 1<br />

Visual changes in Multiple System Atrophy (MSA). Abbreviations: iREM = idiopathic rapid eye movement sleep disorder, PERG = pattern elctroretinogram, VEP =<br />

Visual evoked responses, VOR = Vestibulo-ocular re�ex<br />

with neural activity in the temporal<br />

lobe, pre-frontal lobe, limbic system,<br />

and thalamus. 19 In one of the first<br />

studies of event-related potentials in<br />

MSA, 20 it was observed that the P300,

elicited using visual stimuli, could be<br />

recorded even when a severe motor<br />

disability was present. Reaction times<br />

to rare target stimuli were significantly<br />

decreased in PD and MSA compared<br />

with PSP. 19 Kamitani 21 studied event<br />

related potentials in MSA-C and MSA-P.<br />

No significant change was found in the<br />

latency of the N1 or N2 components in<br />

either subtype of the disease suggesting<br />

that the early stages of visual processing<br />

were preserved in MSA. Nevertheless,<br />

the P3a peak was more difficult to<br />

distinguish and there were decreases in<br />

amplitude of the response in both MSA<br />

subtypes. By contrast, the P3b component<br />

was only affected in the MSA-C subtype<br />

and exhibited both increased latency and<br />

reduced amplitude. The reduced size of<br />

the pons, claustrum, perisylvian area and<br />

the deep cerebral gray matter in MSA<br />

may be responsible for these responses.<br />

Complex visual functions<br />

Speech abnormalities are common in<br />

all of the Parkinsonian syndromes and<br />

in MSA, and there is often a mixed<br />

dysarthria (problems in articulating<br />

speech) with ataxic and spastic<br />

elements. 22 Maximum phonation time<br />

and reading speed are also affected<br />

in MSA but to a lesser extent than in<br />

PSP. 22 There is also ‘idiopathic rapid eye<br />

movement’ (iREM) disorder (abnormal<br />

behaviour during sleep accompanied<br />

with rapid eye movements) in MSA,<br />

which probably results from neuronal<br />

losses in the pigmented monoaminergic<br />

nuclei such as the locus caeruleus and<br />

substantia nigra. 23 So common is this<br />

type of disorder in the Parkinsonian<br />

syndromes generally, that the presence<br />

of iREM is often regarded as a strong<br />

indicator that a patient may be<br />

developing a Parkinsonian-type disorder.<br />

Visual hallucinations, unrelated to<br />

medication, are rare in MSA however,<br />

compared with the other Parkinsonian<br />

syndromes, and especially in PD.<br />

Di�erential diagnosis<br />

The Parkinsonian syndromes often<br />

exhibit overlapping signs and symptoms<br />

and therefore, can be very difficult to<br />

diagnose correctly. Hence, there is the<br />

question of whether visual symptoms<br />

can help in the clinical diagnosis of<br />

these disorders. A summary of the most<br />

useful visual features in differential<br />

diagnosis is shown in Table 2. Patients<br />

with MSA often exhibit a combination<br />

of extrapyramidal, cerebellar,<br />

pyramidal, and autonomic dysfunction<br />

signs, many of which can also be seen<br />

in other Parkinsonian disorders. The<br />

presence of visual hallucinations,<br />

unrelated to medication, however,<br />

are rare in MSA and their presence<br />

can often exclude MSA as a possible<br />

diagnosis. 24 In addition, there is greater<br />

retinal pathology in PD, which results<br />

in significant defects in CS, and in the<br />

early components of the VEP, which are<br />

also not likely to be seen in MSA. Colour<br />

VEPs are also affected in PD but not in<br />

MSA. 3 Where defects in the VEP are<br />

seen in MSA, they will normally involve<br />

event-related evoked potentials such as<br />

the P300. 19,20 Additional features that<br />

may be helpful in differential diagnosis<br />

include fixation, which is abnormal in a<br />

significant proportion of PSP and MSA<br />

cases but less so in PD, 5 eyelid mobility<br />

which is abnormal in PSP but more<br />

likely to be normal in PD and MSA, 4<br />

and the slowing of saccadic movements<br />

especially in the vertical direction<br />

which occurs most significantly in PSP. 25<br />

Anderson et al. 8 have recently<br />

published a list of ‘red flag’ criteria that<br />

are strongly suggestive of a diagnosis of<br />

MSA and include excessive square-wave<br />

jerks, mild to moderate hypometria of<br />

saccades, impaired VOR, and nystagmus.<br />

By contrast, if clinically slow saccades<br />

are present together with a moderate to<br />

severe vertical gaze palsy, the diagnosis<br />

is more likely to be one of the other<br />

Parkinsonian syndromes such as PSP.<br />

Discussion and conclusions<br />

Middle-aged to elderly patients who have<br />

not been diagnosed with MSA may exhibit<br />

visual signs and symptoms suggestive of<br />

a Parkinsonian-type disorder. The most<br />

important of these signs are related to<br />

the primary defects of the disease, viz.,<br />

extrapyramidal, cerebellar, pyramidal,<br />

and autonomic dysfunction. The<br />

most important visual signs include<br />

oculomotor dysfunction and pupil<br />

reactivity, but with relatively preserved<br />

primary vision. Hence, a patient with<br />

unexplained signs of this type should be<br />

referred for neurological examination.<br />

Nevertheless, the exact presentation of<br />

MSA is highly variable and patients can<br />

be visually asymptomatic. It is difficult<br />

to separate MSA from other disorders<br />

with Parkinsonism such as PD and<br />

PSP especially before visual symptoms<br />

become apparent. If ocular signs and<br />

symptoms are present, then they may aid<br />

differential diagnosis. Atypical features<br />

of MSA include slowing of saccades,<br />

presence of vertical gaze palsy, and<br />

absence of square-wave jerks. Particularly<br />

useful in separating MSA from other<br />

Parkinsonian syndromes is the presence<br />

in the former of excessive square-wave<br />

jerks, mild to moderate hypometria of<br />

saccades, impaired VOR, and nystagmus.<br />

Patients who have been diagnosed<br />

with MSA may develop a range of<br />

visual problems during the course of the<br />

disease. Visual deficits in Parkinsonian-<br />

type syndromes are often important<br />

in influencing overall motor function.<br />

Hence, identifying and correcting the<br />

visual problems of a patient with MSA as<br />

far as possible can significantly improve<br />

quality of life. Clinical examination<br />

requires sensitivity to the physical<br />

and mental state of the patient and the<br />

53<br />

25/03/11 CET

54<br />

25/03/11 CET<br />



& TRAINING<br />


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

problems involved in the Parkinsonian<br />

syndromes have been described in<br />

detail by Naylor. 26 In addition, some<br />

of the visual problems may be adverse<br />

reactions to treatment. Side effects<br />

may occur relatively rapidly at the<br />

beginning of, or after a change in, drug<br />

treatment, but can also occur after a long<br />

latent period. It is important that those<br />

symptoms due to adverse reactions are<br />

distinguished from those due to the<br />

disease process itself. If ocular side<br />

effects are identified in a patient with<br />

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

MSA and become severe, then it is<br />

essential that these be monitored and the<br />

patient referred back to their physician<br />

for further clinical assessment.<br />

About the author<br />

Syndrome<br />

Richard Armstrong was educated<br />

at King’s College London and St.<br />

Catherine’s College Oxford. He has<br />

been a lecturer in Botany, Microbiology,<br />

Ecology, Neuroscience, and <strong>Optometry</strong><br />

during his 34 years at Aston University.<br />

His research interests include the<br />

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

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

Feature MSA PD PSP<br />

Eyelid mobility Normal Normal Eyelid opening apraxia<br />

Saccadic eye<br />

movements<br />

Mild-moderate<br />

hypometria<br />

Normal Abnormal, slow<br />

Vertical gaze palsy Rare Rare Present<br />

Fixation Abnormal Normal Abnormal<br />

Square-wave jerks Frequent Present Present<br />

Contrast sensitivity Normal (?) Abnormal<br />

(high to intermediate<br />

frequencies)<br />

VEP (early) Normal Abnormal Normal<br />

VEP (colour) Normal Abnormal ?<br />

VEP (P300) Increased L<br />

Reduced A<br />

Visual hallucinations Rare, unrelated to<br />

medication<br />

?<br />

?<br />

Common Rare<br />

?<br />

Increased L<br />

Reduced A<br />

VOR Impaired gain Normal Impaired gain<br />

Nystagmus Various present Abnormal OKN Abnormal OKN<br />

Table 2<br />

Summary of features that can be used to provide a di�erential diagnosis of ‘parkinsonian’ syndromes (MSA = Multiple system atrophy, PD = Parkinson’s disease,<br />

PSP = Progressive supranuclear palsy) based on visual signs and symptoms. A = Amplitude, L = Latency, VEP = Visual evoked potential, VOR = Vestibulo-ocular<br />

re�ex, OKN = Optokinetic nystagmus, ? indicates no reliable data known to the author<br />

neuropathology of neurodegenerative<br />

diseases with special reference to vision<br />

and the visual system. He also has a<br />

particular interest in the application<br />

of statistical methods in research.<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 this<br />

article, please turn to page 59.



& TRAINING<br />


Approved for: Optometrists �� Dispensing opticians<br />

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

Intraocular Telescopes<br />

For Macular<br />

Degeneration<br />

COURSE CODE C-15909 O/D<br />

Brendan J Moriarty MA (Cantab), MBBChir, FRCS, FRCOphth, MD.<br />

Age related macular degeneration (AMD) is the leading cause of blindness in the<br />

population above 65 years of age in the western world. 1 In the UK, 3.7% of people<br />

over 75 years old and 14% of those over 90 years of age have visual impairment<br />

attributable to AMD. 2 The central scotoma arising from AMD also limits most<br />

daily living activities resulting in dependency, depression and impaired quality<br />

of life. 3,4 The demographics of our societies would indicate that this problem will<br />

signi�cantly increase every decade, with an estimated 54% increase in the over<br />

75 years age-group in the next 25 years. 2 This article describes an innovative<br />

and promising method of vision correction for those with AMD, the intraocular<br />

implantation of telescopes, which could in the future become commonplace.<br />

A number of treatments are available or<br />

are being developed for the treatment<br />

of neovascular (‘wet’) AMD, including<br />

intra-vitreal anti-vascular endothelial<br />

growth factor (anti-VEGF) injections.<br />

However, wet AMD only constitutes<br />

10-15% of cases of AMD. In contrast<br />

‘dry’ AMD constitutes 85-90% with<br />

limited treatment options available; 5<br />

most notably, this typically involves<br />

advice on increased dietary intake of<br />

anti-oxidants through healthy eating<br />

and supplementation with lutein- and<br />

zeaxanthin-containing vitamins, and<br />

protection of the eyes from ultraviolet<br />

(UV) and blue-light radiation with<br />

sunglasses. Those of you familiar with<br />

low visual aid clinics will attest to the<br />

frustration and despair that patients<br />

with dry AMD experience in an attempt<br />

to regain their reading and navigation<br />

ability. Therefore, it is fitting that<br />

intraocular telescope implantation<br />

�<br />

offers a promising hope for the future.<br />

Optical principles<br />

Intraocular telescopes are most commonly<br />

based on the Galilean telescopic system<br />

(Figure 1), whereby a high minus powered<br />

bi-concave eye piece lens is combined<br />

with a high positive powered bi-convex<br />

objective lens, to produce a magnified,<br />

erect, virtual image. Magnification of such<br />

systems approximates to the dioptric<br />

ratio of the eye piece lens to the objective<br />

lens. In the Implantable Miniature<br />

Telescope (IMT) the magnification is<br />

between 2.2x and 3x. 6 The Intraocular<br />

Lens for Visually Impaired Persons<br />

(IOLVIP) has a magnification of 1.3x<br />

with “a small prismatic effect due to<br />

misalignment (planned) of the IOLs”. 7<br />

Once a patient receives an intraocular<br />

telescope implant, the post-operative<br />

refraction is influenced by the separation<br />

of the two lenses. This is fixed in<br />

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

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

the IMT system and in the IOLVIP<br />

system, particularly in hyperopes,<br />

this can give rise to high (5.00-<br />

7.00DS) degrees of residual hyperopia.<br />

The IMT<br />

The IMT (Figure 2) consists of a quartz<br />

tube that houses two wide angle micro-<br />

lenses. The diameter of the IMT is<br />

3.6mm and the length is 4.4mm with<br />

a carrier haptic of 13.5mm diameter.<br />

The IMT recently completed a two-year<br />

trial study that included 28 centres, 6<br />

and has received FDA approval. In this<br />

study, 206 patients were enrolled and<br />

174 were analysed at two years after<br />

implantation. The study mandated the<br />

IMT to be implanted in the worse eye of<br />

the patient and it was found that the best-<br />

corrected visual acuity (VA) improved<br />

by three lines (doubling of the visual<br />

angle) in over 60% of patients, and by 5<br />

lines of acuity in nearly 20% of patients.<br />

There were initial concerns from<br />

ophthalmologists about corneal<br />

endothelial cell loss, and this was<br />

reported to be 25% cell loss at one year<br />

following implantation. However, this<br />

cell loss does not appear to be cumulative<br />

with only 2.4% additional loss reported<br />

between years 1 and 2. 6 This endothelial<br />

cell loss is largely due to the wide<br />

incision required for implantation;<br />

it is much longer than an incision<br />

made for phacoemulsification cataract<br />

extraction (2.8mm) or an extracapsular<br />

cataract extraction (7–10mm).<br />

By necessity, this system causes<br />

a restriction in visual field of about<br />

25% loss. As such, at present it is<br />

recommended that the IMT only be<br />

used in the worst eye of a patient, in<br />

order to enhance reading ability. The<br />

better eye is left as a navigational eye.<br />

The IMT is currently completing<br />

mandatory “pre-marketing” assessment<br />

and the author has been invited to<br />

collaborate with the FDA and the<br />

55<br />

25/03/11 CET

56<br />

25/03/11 CET<br />



& TRAINING<br />


Approved for: Optometrists �� Dispensing opticians<br />

Figure 1<br />

The Galilean telescopic system<br />

manufacturers when introducing<br />

the IMT to the UK in 2011. Further<br />

outcomes data will also, hopefully, be<br />

obtained and published in the future,<br />

but it is already clear that the outcomes<br />

with the IMT look very promising.<br />

The IOLVIP<br />

The IOLVIP typically comprises lenses<br />

of power +53D as the anterior optic<br />

and -64D as the posterior optic. It is a<br />

lower magnification system than the<br />

IMT but incorporates a “prismatic”<br />

effect, thereby diverting the image onto<br />

a preferred retinal locus (PRL), which is<br />

a point on the retina that is away from a<br />

macular area affected by AMD (Figure 3).<br />

Pre-operatively the PRL is determined<br />

using a simulator (Figure 4), which<br />

Figure 2<br />

Implantable Miniature Telescope<br />

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

�<br />

allows an assessment of the likely visual<br />

improvement that will be obtained. In the<br />

IOLVIP system, the prismatic simulator is<br />

placed in a trial frame over the optimal<br />

distance vision refraction. The simulator<br />

is rotated to determine the point at<br />

which visual improvement is maximal.<br />

This tells the surgeon which way to<br />

orientate the IOLs during the operation.<br />

The author introduced implantation<br />

of the IOLVIP in the UK in 2007 and at<br />

six months noted that 89% of patients<br />

had doubled their distance vision (pre-<br />

operative distance VA was logMAR 1.52<br />

whilst post-operative distance VA was<br />

logMAR 0.69) (Figure 5). 8 In addition,<br />

the visual outcomes predicted by the<br />

simulator closely reflected the actual<br />

visual outcome. Indeed, in some patients<br />

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

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

the outcomes were better than predicted<br />

by the simulator, because of extraction of<br />

the lens opacity at the time of surgery. This<br />

predictability of outcome carries many<br />

benefits. Principally, the patient and the<br />

surgeon can determine with substantial<br />

confidence the likely outcome prior to<br />

surgery, whilst also giving the patient<br />

and their family a realistic prognosis.<br />

The outcomes observed by the author in<br />

his own work are similar to the outcomes<br />

observed elsewhere. In the Milan study<br />

group 7 the pre-operative distance VA<br />

was logMAR 1.30 whilst post-operatively<br />

this improved to logMAR 0.72. In the<br />

Valencia study group 9 the pre-operative<br />

distance VA was reported to be logMAR<br />

1.37 and this improved post-operatively<br />

to logMAR 0.68. Longer term follow-<br />

up at 18 months post-operatively has<br />

revealed that in some patients the<br />

initial improvement in VA was lost,<br />

due to advancement of AMD and<br />

corneal decompensation. 10 Indeed, this<br />

highlights the importance of making all<br />

patients aware of the risks and that there<br />

is no guarantee of a long-term, sustainable<br />

improvement in VA. Furthermore, it<br />

is important to counsel patients and<br />

communicate to them and their families<br />

that surgery does not prevent AMD, it<br />

merely compensates for it for a period<br />

of time. Otherwise, it can be distressing<br />

for these patients if at a later stage they

Figure 3<br />

The Intraocular Lens for Visually Impaired<br />

Persons (IOLVIP)<br />

find that their initial improvement in<br />

vision has declined thereafter. It is<br />

also important to clarify to patients<br />

that there will be substantial induced<br />

hyperopia post-operatively; indeed,<br />

the research reported above has clearly<br />

noted misgivings about post-operative<br />

hyperopia within patient groups. 7,8,9,10<br />

Note that it is important to assess<br />

visual function in terms of logMAR<br />

acuity as opposed to traditional Snellen<br />

acuity, due to design flaws in the latter<br />

that may over-estimate true VA. Indeed,<br />

logMAR charts such as the Bailey-Lovie<br />

chart are advantageous in that task<br />

difficulty remains consistent across all<br />

levels of acuity, with equal number of<br />

optotypes presented per line, and there<br />

Figure 4<br />

The IOLVIP simulator<br />

is a regular logarithmic progression of<br />

acuity such that each line is a scaled<br />

version of the preceding line, allowing<br />

each individual letter to contribute to<br />

the VA measure, increasing the accuracy.<br />

CE marking<br />

The IOLVIP and IMT have CE marks and<br />

are supported by NICE Guidelines (IPG<br />

272). Only the IMT has FDA approval.<br />

Although the telescopes are CE marked<br />

and have NICE guidelines with regard<br />

to audit, funding for surgery on the<br />

NHS is unpredictable. The author has<br />

been successful on many occasions in<br />

presenting patients to their Primary<br />

Care Trusts as “special circumstances”.<br />

Indeed, lately the approval for NHS<br />

funded surgery has become rare.<br />

Interestingly, it is likely that the IMT<br />

may be approved by Medicare in the<br />

USA, which perhaps indicates a more<br />

sympathetic appreciation of the enhanced<br />

quality of life that the device offers.<br />

Top ten tips<br />

Patients that may be deemed suitable for<br />

implantation of intraocular telescopes<br />

have a lot to gain by undergoing the<br />

procedure. It is important however to<br />

consider the following factors and advice,<br />

in order to optimise the possible outcomes:<br />

1) Patient selection is all important. It<br />

is the author’s experience that visual<br />

outcomes are dependent on the extent of<br />

AMD. As a rule of thumb, good outcomes<br />

can only be expected with less than 2<br />

disc diameters (DD) of AMD (Figure 6).<br />

2) Patients need to be highly<br />

motivated with a clearly defined<br />

PRL for eccentric fixation.<br />

3) This procedure does not have a<br />

“wow” factor, and it is important<br />

not to mislead patients to expect an<br />

outcome that is akin to the change<br />

people may experience following<br />

routine cataract extraction or corneal<br />

laser refractive surgery for refractive<br />

error correction. Visual improvement<br />

can be slow and needs encouragement.<br />

4) Some patients with moderate AMD<br />

alongside cataract may benefit from<br />

cataract extraction alone. However,<br />

cataract surgery in advanced<br />

AMD is generally of limited value.<br />

5) Optometric input is vital in helping<br />

with patient selection and post-<br />

operative refraction. In general terms,<br />

the author advises patients to have<br />

separate distance and reading glasses<br />

for one year post-operatively. Ancillary<br />

devices eg, Eschenbach magnifiers,<br />

can still be used if required. The<br />

author works in conjunction with an<br />

experienced low vision aid optometrist<br />

in his clinics to ensure optimal post-<br />

operative visual function can be gained.<br />

6) Patients need to be counselled<br />

carefully about visual expectations.<br />

The author generally only discusses<br />

surgery with patients who show at<br />

least 3 lines improvement with a<br />

simulator. Advising patients that their<br />

AMD is too far advanced for surgery<br />

can often be met with great dismay<br />

and requires sympathetic counselling.<br />

7) Great dismay can be encountered<br />

when vision improves for a time and<br />

then regresses due to advancement of<br />

AMD, after surgery. It is important for the<br />

surgeon to emphasise that the surgery<br />

does not delay the advancement of AMD<br />

but it merely reduces its visual impact<br />

for an unpredictable period of time.<br />

8) Both IOLVIP and IMT telescopic<br />

systems have a rehabilitation programme<br />

that is directed by the surgeon/<br />

optometrist. The author finds these<br />

of limited value since if a patient has<br />

well established eccentric fixation<br />

they do not need to be taught how<br />

to utilise it; for those that do not<br />

eccentrically fixate, the rehabilitation<br />

program may be of some use though.<br />

9) The family input is vital. The author<br />

usually insists on as many family<br />

57<br />

25/03/11 CET

58<br />

25/03/11 CET<br />



& TRAINING<br />


Approved for: Optometrists �� Dispensing opticians �<br />

Post op distance vision (logMAR)<br />

members being present at the assessment<br />

and follow-up appointments as possible.<br />

They can see the visual improvement<br />

afforded by the simulator and thereby<br />

aid counselling of the patient about the<br />

expected visual outcomes. Indeed, they<br />

can avoid the patient getting “carried<br />

away” with perceptions of “miracles”.<br />

10) Surgeons and optometrists need<br />

to advise patients with honesty and<br />

Pre op distance vision (logMAR)<br />

Figure 5<br />

Improvement in distance VA with implantation of the IOLVIP<br />

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

integrity. These patients may have had a<br />

harrowing time in the past and surgery<br />

is a “last chance saloon” for many. They<br />

need careful selection and counselling.<br />

Future Developments<br />

Figure 6<br />

Best prognosis with the IOLVIP and IMT is if the AMD is less than 2DD in size<br />

Two new ‘telescopic’ systems are<br />

currently undergoing trials for improving<br />

visual function in AMD and the outcomes<br />

of these are awaited in anticipation.<br />

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

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

The Lipshitz Macular Implant (LMI)<br />

uses a Cassegrain (Newtonian)<br />

telescopic system and magnifies the<br />

central image using a concave mirror<br />

system. The Nu-lens system is a<br />

sulcus fixated IOL that can reportedly<br />

provide 10-14D of accommodation.<br />

It was originally designed for use in<br />

cataract surgery for the correction of<br />

presbyopia, but it has clear possibilities<br />

for use in patients with AMD too.<br />

We all eagerly await the potential<br />

improvements afforded by gene therapy<br />

and stem cell therapy too. While<br />

much research in this field shows great<br />

promise, we may have to wait many<br />

more years yet before this becomes<br />

a distinct clinical treatment option.<br />

About the author<br />

Brendan Moriarty trained in medicine at<br />

the Middlesex Hospital in London and<br />

gained his FRCS in 1984. He then worked<br />

as fellow and medical director for Project<br />

Orbis, the internationally renowned<br />

flying eye hospital. He became Fellow in<br />

glaucoma at Moorfields Eye Hospital in<br />

1987 and he is now head of glaucoma at<br />

Leighton Hospital, Crewe. His expertise<br />

in intraocular telescope surgery has been<br />

recognised by his role as Special Advisor<br />

to NICE. He was awarded “Best Original<br />

Work” by the American Academy in<br />

2008. He consults privately at The<br />

Prospect Eye Clinic in Altrincham but<br />

does not accept paid consultancies with<br />

industry; his fees have been donated<br />

to the Save the Children Fund. He has<br />

no financial interests in the products<br />

discussed. Visit www.prospecteyeclinic.<br />

com for more information about<br />

ophthalmic techniques and procedures.<br />

References<br />

See http://www.optometry.co.uk/<br />

clinical/index. Click on the article<br />

title and then download “references.”


Module questions<br />

Course code: C-15734 O<br />

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

1. Which of the following statements regarding the primary aspects of<br />

vision in MSA is FALSE?<br />

(a) Poor vision is likely to be observed in MSA<br />

(b) Blurred vision in response to coloured stimuli has been reported in Parkinsons’s<br />

disease<br />

(c) Abnormal VEP to coloured stimuli have been reported in MSA<br />

(d) The degree to which visual �elds may be a�ected in MSA is largely unknown<br />

2. Which of the following features occurs in a signi�cant proportion of<br />

MSA patients?<br />

(a) Abnormal �xation<br />

(b) Abnormal eyelid mobility<br />

(c) Abnormal vertical saccadic eye movements<br />

(d) Abnormal vertical smooth pursuit movements<br />

3. Which of the following VEP abnormalities have been reported in MSA?<br />

(a) Motor evoked responses<br />

(b) ERG<br />

(c) Pattern-reversal VEP<br />

(d) Event-related VEP<br />

4. Which of the following statements regarding complex visual<br />

functions in MSA is FALSE?<br />

(a) Speech abnormalities are common in MSA<br />

(b) A mixed dysarthria with ataxic and spastic elements may be present in MSA<br />

(c) Reading speed is a�ected to a greater extent in MSA compared with PSP<br />

(d) Idiopathic rapid eye movement (iREM) disorder is present in MSA<br />

5. Which of the following statements regarding the di�erential<br />

diagnosis of MSA is TRUE?<br />

(a) Visual hallucinations are common in MSA<br />

(b) There is greater retinal pathology in MSA compared with PD<br />

(c) The early components of the VEP are signi�cantly a�ected in MSA<br />

(d) Fixation is abnormal in a signi�cant proportion of MSA patients compared<br />

with PD<br />

6. Which of the following is NOT a ‘red �ag’ criterion for the<br />

identi�cation of MSA?<br />

(a) Excessive square-wave jerks<br />

(b) Impaired vestibulo-ocular re�ex (VOR)<br />

(c) Moderate to severe vertical gaze palsy<br />

(d) Nystagmus<br />

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

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

PLEASE NOTE There is only one correct answer. All CET is now FREE. Enter online. Please complete online by midnight<br />

on April 22 2011 - You will be unable to submit exams after this date – answers to the module will be published on<br />

www.optometry.co.uk. CET points for these exams will be uploaded to Vantage on May 2 2011 .<br />

Course code: C-15909 O/D<br />

1. Which of the following statements about intraocular telescopes is<br />

TRUE?<br />

a) They are an alternative to anti-VEGF treatment<br />

b) They produce a magni�ed, erect image<br />

c) They use a Newtonian telescopic system<br />

d) They are suitable for most cases of AMD<br />

2. Which of the following statements about the Implantable<br />

Miniature Telescope (IMT) is TRUE?<br />

a) It incorporates a prism<br />

b) It is suitable for the better eye<br />

c) It magni�es by between 2.2x and 3x<br />

d) It can cause progressive corneal epithelial cell loss<br />

3. Which of the following statements about the IOLVIP is TRUE?<br />

a) It incorporates a 3x magni�cation with a prismatic e�ect<br />

b) It has FDA approval<br />

c) It induces hyperopia<br />

d) It is as e�ective as cataract surgery in advanced AMD<br />

4. Favourable outcomes with the use of intraocular telescopes may be<br />

seen with which of the following?<br />

a) Cataracts<br />

b) Less than 1 disc diameter of AMD<br />

c) Recent onset dry AMD<br />

d) Unilateral cases of AMD<br />

5. Which of the following statements about post-operative<br />

rehabilitation is TRUE?<br />

a) It is essential in all cases<br />

b) It is of great value in advanced disease<br />

c) It is often not necessary in patients with well established eccentric �xation<br />

d) It requires continued monitoring<br />

6. Which of the following statements about intraocular telescope<br />

surgery is TRUE?<br />

a) It causes advancement of AMD<br />

b) It can delay AMD<br />

c) It has no e�ect on progress of AMD<br />

d) It induces glaucoma<br />

59<br />

25/03/11 CET

60<br />

25/03/11 PRE-REG FOCUS<br />


THE AOP will hold its �rst OSCE session<br />

for pre-reg trainees at Optrafair (NEC,<br />

Birmingham, April 9-11). The pre-reg OSCE<br />

Preparation & Ocular Pathology course will<br />

run in the morning on April 11.<br />

As all trainees know, the OSCEs now<br />

form a fundamental part of the scheme for<br />

registration and they are their �nal hurdle<br />

before trainees are able to join the GOC<br />

register, writes Professor Steve Parrish and Dr<br />

Anna Kwartz, directors of Innovative Optical<br />

Training Limited (IOT), who will deliver the<br />

three-hour session.<br />

OSCE stands for Objective Structured<br />

Clinical Examination. This method of<br />

assessment was introduced by the College<br />

of Optometrists into the Scheme for<br />

Registration in the summer of 2010. The<br />

exam involves a series of 5 minute stations<br />

designed to test di�erent aspects of the<br />

syllabus. The aim of OSCEs, which have<br />

previously been used in other disciplines<br />

such as medicine and nursing since 1975,<br />

is to remove some of the examiner and<br />

patient-based traditionally associated with<br />

conventional forms of clinical examination.<br />

The recent inclusion of OSCEs in the<br />

qualifying examinations for optometrists<br />

means that there is not yet an archive of<br />

information which has been established over<br />

several years to draw on. Consequently, for<br />

some candidates, there is an understandable<br />

degree of uncertainty about what will<br />

be involved. As a result, the timing of the<br />

training course at OT Live is ideal as many<br />

trainees will be attempting the exam in the<br />

summer of this year.<br />

The session will focus on skills which<br />

will be invaluable for OSCE candidates. For<br />

example, history taking and formulating<br />

a di�erential diagnosis. Whilst these are<br />

Sponsored by<br />

AOP schedules timely OSCE<br />

training course for Optrafair<br />

Pictured: Dr Anna Kwartz speaking at the<br />

2010 AOP student conference.<br />

skills in which all trainees are probably very<br />

experienced in, the course will also focus<br />

on exam technique and highlight vital<br />

OSCE skills.<br />

In addition, typical pitfalls of the OSCE will<br />

be highlighted – together with avoidance<br />

strategies. There will also be a question and<br />

answer session, where trainees will be able to<br />

ask any questions – no matter how simple –<br />

they have about the OSCE. This component<br />

is particularly important because, in the<br />

past, trainees often used to turn to their<br />

supervisors with queries about the qualifying<br />

exams, but now their supervisor’s exam<br />

experience is not necessarily relevant to<br />

the OSCE.<br />

�������������������������������������������<br />

have been providing pre-reg training for<br />

over 15 years. They are longstanding College<br />

examiners and assessors for both Stage 1<br />

Pictured: Professor Steven Parrish speaking<br />

at the 2010 AOP student conference.<br />

and Stage 2, and can provide a wealth of<br />

experience to help candidates prepare for the<br />

challenges which lie ahead. IOT is recognised<br />

as an ‘approved supplier’ by the Association<br />

of Optometrists and the two organisations<br />

have previously worked together to provide<br />

courses designed to support trainees at this<br />

critical time in their education.<br />

OT Live returns to Optrafair for a second<br />

year, o�ering visitors to the three-day event<br />

the opportunity to learn and gain CET points.<br />

Session aimed at students, optometrists and<br />

dispensing opticians will run throughout<br />

the show.<br />

The course costs £39. To book a place<br />

on the course visit, www.otlive.co.uk<br />

and then telephone Tracy Symons on<br />

020 7787 1119 to make your payment.

Introduction<br />

Having crisp, clear vision from<br />

waking until bedtime without<br />

experiencing fluctuations in visual<br />

clarity is important to contact<br />

lens wearers. For patients with<br />

astigmatism, achieving this<br />

goal may be more difficult,<br />

especially when the amount of<br />

astigmatism is relatively low (less<br />

than 1.00 DC). These patients<br />

are sometimes treated with<br />

spherical lenses, resulting in less<br />

than optimal vision correction.<br />

For those who are wearing toric<br />

lenses, other circumstances<br />

affect vision such as eye rubbing<br />

and the rotational stability of the<br />

contact lens.<br />

Advertisement Feature<br />

Rotational Stability and Eye Rubbing<br />

in Toric Contact Lens Wear<br />

Gerard Cairns, PhD, MCOptom<br />

In a global study of vision corrected patients,<br />

quality of vision and vision that is as close<br />

to natural as possible were the two most<br />

important needs of astigmatic patients when<br />

selecting eye-related products. 1 Of the 1,624<br />

patients with astigmatism who completed the<br />

survey, 46.5% reported they suffer from blurry<br />

or hazy vision; many of whom (87%) find it<br />

bothersome. These patients report that they<br />

do not have a complete satisfactory solution to<br />

the symptoms but are very interested in finding<br />

one. 1 As 70% of these astigmatic patients<br />

reported going to their ECP for information<br />

concerning eye health and vision correction,<br />

it is the role of the ECP to select the best<br />

modality for their patients with astigmatism. 1 In<br />

many cases, soft toric contact lenses are the<br />

optimal choice; however there are factors that<br />

need to be considered when selecting the best<br />

lens brand.<br />

Eye Rubbing and Rotational Issues<br />

with Soft Toric Contact Lens Wear<br />

Although many advances have been made in<br />

toric contact lens development, lens rotation<br />

continues to affect vision and can occur when<br />

the patient blinks or rubs their eyes. 2 According<br />

to a recent survey of 502 patients between 18<br />

and 44 years of age (toric and spherical lens<br />

wearers), contact lens wearers regularly rub<br />

their eyes and do so for varying reasons. 3 The<br />

most frequent causes of eye rubbing include<br />

itchy eyes, tired eyes, and debris under the<br />

lens (Figure 1). 3 The study reported that 87%<br />

of toric lens wearing patients rub their eyes<br />

approximately 6.3 times per day while wearing<br />

contact lenses, and do so more frequently than<br />

spherical lens wearing patients. 3<br />

Eye rubbing can have visual consequences<br />

for contact lens wearers. Toric lens wearers<br />

note their contact lenses spontaneous move<br />

and then need time to settle into place. 3<br />

Clinically, this manifests as visual disturbances,<br />

Figure 1: Most frequent causes of eye rubbing with toric contact lens wear. 3<br />

Debris under lens<br />

Eyes are itchy<br />

When tired<br />

When heat/AC/fan blows on face<br />

Contact lenses have moved<br />

Allergies are bothersome<br />

evidenced by the fact that 77% of toric lens<br />

wearing patients in this survey experienced<br />

fluctuating, changing, or blurred vision after<br />

rubbing their eyes. Approximately 1/3 of toric<br />

lens wearers say it can take up to 30 seconds<br />

for their vision to normalize. 3 Fluctuating vision<br />

is most bothersome during certain activities,<br />

such as when driving, looking at a computer<br />

screen, or when something is felt on or under<br />

the lens (Figure 2). 3<br />

Stability Is Key to Managing Visual<br />

Fluctuations with Toric Lenses<br />

To best manage fluctuations in vision with toric<br />

lens wear, it is important to prescribe a contact<br />

lens with the ability to return to the primary<br />

gaze orientation following rotation. Rotational<br />

recovery refers to how quickly a lens returns<br />

to the desired orientation following disruption,<br />

such as from eye rubbing. 2<br />

Each lens manufacturer of toric contact<br />

lenses utilises a different lens stabilization<br />

design, which can impact the stability of the<br />

0% 5% 10% 15% 20% 25% 30%<br />

Percentage of Patients<br />

22%<br />

23%<br />

24%<br />

24%<br />

29%<br />

29%<br />

35%<br />

www.academyofvisioncare.co.uk<br />


lens Several stabilization designs are used<br />

to increase stability and rotational recovery<br />

ability of soft toric contact lenses (Table 1).<br />

In a study by Cairns (2010), the rotational<br />

stability of two different lens stabilization<br />

designs was evaluated. 2 Results showed that<br />

when compared to lenses that utilized an<br />

Accelerated Stabilization Design, the Quick<br />

Alignment System design demonstrated<br />

superior mean rotational recovery and greater<br />

rotational recovery to within 10° of primary<br />

gaze orientation within one minute. Lens<br />

stabilization design can have an impact on<br />

vision correction achieved, and is one more<br />

factor to consider when recommending a toric<br />

contact lens for astigmatic patients.<br />

Conclusion<br />

Soft toric contact lens wearers are highly<br />

motivated by the promise of faster rotational<br />

recovery of their lenses. 3 Many wish their<br />

ECP would prescribe a lens that recovers<br />

faster after rubbing their eyes. 3 Therefore,<br />

when choosing the most appropriate soft<br />

toric contact lens for astigmatic patients,<br />

rotational stability needs to be considered.<br />

Practitioners can reduce the incidence<br />

of rotational issues by prescribing a lens<br />

with demonstrated rotational recovery and<br />

stability. Selecting a lens that utilizes Quick<br />

Table 1: Lens Designs Used by Toric Soft Contact Lenses to Promote Stability and Rotational Recovery<br />

Design How it Works<br />

Quick Alignment System The inferior portion of the contact lens has more ballast and a<br />

360-degree comfort chamfer reduces mass at the base of the<br />

lens to help equalize the thickness around the lens periphery. A<br />

refined optic zone helps minimize variations in vertical thickness<br />

profile with power by adjusting the anterior and posterior optic<br />

zone diameters<br />

The balanced thickness profile stabilizes the lens through<br />

dynamic and static forces of the eye lids during a blink and<br />

open lid positions.<br />

Accelerated Stabilization<br />

Design<br />

Figure 2: Occasions when toric lens wearing patients find fluctuating vision bothersome. 3<br />

When driving<br />

When looking at the computer<br />

When something is felt on or under the lens<br />

When tired<br />

When eyes are itchy<br />

When contact lenses have moved<br />

The design utilizes four active zones near the midperiphery<br />

of the lens to help minimize lens rotation. These stabilization<br />

zones have a thicker profile compared to the rest of the lens.<br />

The stabilization zones are designed to be located within the<br />

interpalpebral aperture.<br />

Thin zones at the top and bottom of the lenses allow pressure<br />

from the eyelids to stabilize the lens by hindering its rotation.<br />

Advertisement Feature<br />

0% 5% 10% 15% 20% 25% 30% 35% 40%<br />

Percentage of Patients<br />

Alignment System stabilization has been<br />

shown to have superior rotational recovery<br />

when compared to the Accelerated<br />

Stabilisation design.<br />

References<br />

25%<br />

27%<br />

29%<br />

33%<br />

37%<br />

37%<br />

1. Market Probe Europe. Needs, Symptoms, Incidence, Global<br />

eye Health Trends (NSIGHT) Study. December 2009.<br />

2. Cairns G. Rotational stability of silicone hydrogel toric contact<br />

lenses. Optician. Jan 8, 2010:26-28.<br />

3. Gillmeister E. Decision Analyst. Rub Your Eyes Consumer<br />

Research. March 2010.<br />

© Bausch & Lomb Inc 2011. /® denote trademarks of<br />

Bausch & Lomb Incorporated.<br />

All other brand names remain the trademarks of their<br />

respective companies.<br />

www.academyofvisioncare.co.uk<br />


64 50<br />

17/09/10 25/03/11 RECRUITMENT<br />

JOBS<br />

JOBS<br />

RAY0937 Recruitment Ad March_135x196 21/03/2011 15:58 Page 1<br />

To place an advertisement call 020 7878 2313<br />

or email haley.willmott@tenalps.com<br />

Traditional<br />

Rayner is now in it’s 101st year and has its eyes firmly focussed on the future.<br />

Few wholly UK owned optical groups have been around as long as us – and there<br />

isn’t much about optics we don’t know.<br />

On our retail optics side, we hold an enviable collection of strong and respected<br />

regional names, giving us an almost unique position in the market.<br />

Join us and you’ll be working as part of a dynamic organisation which has diverse<br />

interests in optics across the globe.<br />

If you’d like to join us as we start our second century, please contact us by letter<br />

or email us at the address below.<br />

Established 1910. Join in 2011.<br />

Contact Lens Opticians<br />

All Areas Locum or Employed<br />

Optometrists<br />

West Wales<br />

Wiltshire/Berkshire<br />

Workington and West<br />

Coast of Lincolnshire<br />

Locum Optometrists<br />

Essex/Suffolk<br />

Dispensing Managers<br />

Grantham<br />

Yorkshire<br />

Chester/Wrexham<br />

County Durham<br />

Horsforth<br />

All positions come with exceptional salaries,<br />

private medical care and pension.<br />

Lowndes House, The Bury,<br />

Church Street, Chesham,<br />

Bucks HP5 1DJ<br />

Email: working@rayner.com

JOBS<br />

To place an advertisement call 020 7878 2313<br />

or email haley.willmott@tenalps.com<br />

Visit us at Optrafair - stand number H40<br />

Look into the Magical Eye and see the magic for yourself!<br />

Fill out a form on the day telling us what you see and<br />

you’ll be entered into one of our daily competitions!<br />

For the latest vacancies please visit<br />

follow us on<br />

facebook<br />

4 or 5 days per week<br />

<strong>Optometry</strong> Support<br />

State<br />

CET provider<br />

Registered<br />

Weekends off<br />

Commissio<br />

Competitive Salary<br />

Company Car<br />

Discover the Magic<br />

of The Outside Clinic<br />

www.outsideclinic.com/vacancies.html<br />

Contact Jim Gilbert for more details:<br />

tel: 01793 648607<br />

email: jim@outsideclinic.com

66<br />

25/03/11 JOBS<br />

Nigel Burnett Hodd<br />

JOBS<br />

“Come along and discover the<br />

magic of The Outside Clinic<br />

at Optrafair stand H40”<br />

requires a full time optometric<br />

colleague at his SiDcup Practice,<br />

Full Supporting Staff,<br />

Comprehensive Salary Package.<br />

Brief career resume to;<br />

Chris@bhjenkins.fsnet.co.uk or<br />

in writing to Miss Chris Jenkins,<br />

Burnett Hodd And Jenkins<br />

55 High Street Sidcup, Kent DA14 6ED<br />

To place an advertisement call 020 7878 2313<br />

or email haley.willmott@tenalps.com<br />

Super<br />

Optom<br />

Cornwall, Kent,<br />

Norfolk, Suffolk<br />

Call Jim on 01793 648607 or visit www.outsideclinic.com<br />

An exciting opportunity has arisen<br />

to join a family owned practice in<br />

Milngavie, north of Glasgow. We are<br />

seeking a full time qualified Dispensing<br />

Optician or Optical Assistant with several<br />

years experience. Your focus will be<br />

on providing the highest standard of<br />

customer service. Please email CV to<br />

alan@alanarnotteyecare.co.uk<br />

Technical Advisors &<br />

Dispensing Opticians<br />

OXFORD<br />


OPTICIAN required<br />

A unique opportunity to join part of a highly<br />

professional team, in a busy independent practice<br />

in Oxford, established in 1923. Serving the local<br />

community, as well as Oxford NHS trusts, Oxford<br />

University and Oxford Brookes University.<br />

We focus on providing the highest possible<br />

standards of eye care to every patient.<br />

Applicants must be friendly and patient focused<br />

but also commercially minded.<br />

Our Practice is equipped with the latest<br />

instruments and provides a comfortable, friendly<br />

working environment.<br />

Please apply with full CV to:<br />

James Whittenbury, Gardiners Opticians (Oxford)<br />

Ltd, 5 Manor Buildings, Osler Road, Headington.<br />

Oxford. OX3 7RA<br />

or eyes@gardinersopticians.co.uk<br />

live<br />

optometrytoday bookshop<br />

online enewsletter<br />

Head Offi ce,<br />

Wiltshire<br />

R01 OT Strip.indd 1 18/3/11 11:50:21<br />

Award winning independent practice in Bournemouth, working primarily<br />

in the luxury eyewear market, require a dynamic, well presented locum<br />

optometrist with excellent client communication skills for 2-3 days a<br />

month. Please send C.V. to Margaret Barnaby, Barnabys Opticians Ltd,<br />

152 Charminster Road, Bournemouth. BH8 8UU. No agencies.<br />

Visit our website www.homerton.nhs.uk/workforus<br />

Directorate of General & Emergency Medicine<br />

Retinal Screening Department<br />

Optometrist<br />

Band 6: £30,566 - £40,406 pa. Inc. pro rata<br />

One year fixed-term<br />

We are looking for an optometrist to work for one half-day<br />

session per week grading retinal images as part of our busy and<br />

friendly diabetes eye screening service, working alongside other<br />

professionals in the diabetes team.<br />

Practical knowledge of diabetic eye disease and some knowledge<br />

of the national screening scheme is needed. Full training in the use<br />

of specialised grading software, and in grading skills, will be given.<br />

For further information and/or to arrange an informal visit<br />

please contact James Beckett, Programme Manager,<br />

email: james.beckett@homerton.nhs.uk<br />

For an application pack please visit our website<br />

www.homerton.nhs.uk/workforus and apply online quoting<br />

the reference 293-10637.<br />

Closing date: 8 April 2011.<br />

Visit our website www.homerton.nhs.uk/workforus<br />

The Trust welcomes applications from candidates wishing<br />

to job share, with or without job share partners.<br />

Committed to Equal Opportunities.<br />

MedicsPro<br />

Ophthalmic Recruitment<br />

Visit us at stand P75<br />

Optrafair 9th -11th April<br />

NEC Birmingham<br />

VRICS<br />

Our Vision Is Your Success<br />

Market Leading Salaries Guaranteed<br />

Across The UK<br />

Call now to find out more<br />

• Residential Optometrists<br />

• Mobile Optometrists<br />

• Laser Eye Surgery<br />

Optometrists<br />

full training given<br />

• Contact Lens Opticians<br />

• Dispensing Opticians &<br />

Managers<br />

• Domiciliary Optometrists<br />

For more jobs visit<br />

www.optometry.co.uk/jobs<br />

CET<br />

• Therapeutics<br />

• Behavioural Optometrists<br />

• Orthoptists<br />

• Optical Nurses<br />

• All optical support staff<br />

• All newly qualified<br />

candidates welcome<br />

Contact maria@medicspro.com<br />

Call now on 0208 506 6745<br />

The Urban Recruitment<br />

Group of Companies<br />


O p h t h a l m i c<br />

a c c O u n t a n t s<br />

a n d advisOrs<br />

optometrytoday live<br />

bookshop<br />

online enewsletter<br />


VRICS<br />

Accountants<br />

Computer Systems<br />

• Vat (Including Partial Exemption)<br />

CET<br />

• Business & Taxation Planning<br />

• Locum and Practice Accounts<br />

• Valuations • Payroll Bureau<br />

For A Free Consultation Contact Desirie Lea ACA on: 0151 348 8400<br />

Email: specs@moco.co.uk Web: www.moco.co.uk<br />

Goldline Cases<br />

now Only 35p<br />

Cases<br />

Islington Large Leather Cases<br />

was 55p<br />

now Only 49p Min Order Qty 250<br />

Tel +44(0)121 236 4549 CBS<br />

MORRIS & CO<br />


C H A R T E R E D A C C O U N T A N T S<br />

tv<br />

Min Order Qty 400<br />

now Only 29p<br />

MF Cloths<br />

from<br />

MO<br />

C O<br />

MO<br />

C O<br />

To place an advertisement call<br />

020 7878 2313 or email haley.willmott@tenalps.com<br />

Computer systems<br />

Over 1000 independent UK opticians<br />

use Ocuco software<br />

Affordable software to suit Independent’s<br />

budget and requirements:<br />

Reception, Retail, <strong>Optometry</strong><br />

Imaging, Workshop<br />

In-store or hosted remotely<br />

Purchase, lease or rent<br />

We have the solution, now is the time<br />

PH: 0800 912 1004 info@ocuco.co.uk<br />

* Indicative, based on typical 5 year lease costs<br />

S O F T W A R E W I T H V I S I O N<br />

From<br />

only £55<br />

per month *<br />

100701_OT Ad_Orange_Purple.indd 1<br />

Optix<br />

04/08/2010 15:04:11<br />

Min Order Qty 400<br />

Equipment/low vision aids<br />

For more marketplace visit<br />

www.optometry.co.uk/jobs<br />

www.optix.co.uk<br />

software<br />

Business Management System<br />

Software made Simple<br />

From £50 per month<br />

Instrument Repairs<br />

Tel: 01904 606611<br />

www.optisoft.co.uk 0845 2301230<br />

For more<br />

marketplace visit<br />

www.optometry.co.uk/jobs<br />

67<br />

25/03/11 MARKETPLACE<br />

optometrytoday live

68<br />

25/03/11 MARKETPLACE<br />



Now i-Pad compatible<br />

Finance<br />



I.T. FINANCE<br />



t: 01536 52 96 96<br />

e: info@performancefinance.co.uk<br />

w: www.performancefinance.co.uk<br />

Educate & demonstrate<br />

chair-side<br />

(with draw over animation<br />

technology)<br />

Retain patients<br />

(email ACTUAL animations<br />

to patients)<br />

Market your practice<br />

(allow patients to<br />

recommend you and<br />

allow patients to book<br />

appointments online)<br />

See us at Optrafair April 9-11 stand E80<br />

®<br />

Call: +44 (0) 2476 444 118<br />

Web: www.optimed.co.uk<br />

www.captiv8online.com<br />

Email: info@optimed.co.uk<br />

�������������������������������<br />

���������������������������������������������<br />

��������������������<br />

���������<br />

����<br />

���������������<br />

������������������<br />

��������������������<br />

����������������<br />

Instruments<br />

Equipment<br />

optometrytoday<br />

If you would like<br />

to reach 19, 842<br />

professionals in<br />

<strong>Optometry</strong> <strong>Today</strong><br />

and 18,000<br />

on the <strong>Optometry</strong><br />

<strong>Today</strong> website<br />

please call<br />

020 7878 2313<br />

Computer systems<br />

��<br />

��������<br />

�������� ����������<br />

����������� �������<br />

������� ����������<br />

�������� �����<br />

���������� � ��������<br />

Frames<br />

To place an advertisement call<br />

020 7878 2313 or email haley.willmott@tenalps.com<br />

����������������<br />

����������������<br />

Frames<br />

������� ���������<br />

��� ������� ����� ���������� ����������<br />

�������� ���������� ��������<br />

�������� � �����<br />

������ ����� ������� �������<br />

���� � ����� ���������<br />

�������� ������������ ���������<br />

������ ���� ���� ��� �����������������<br />

Finance<br />

����=���%<br />

����=���%<br />

���������������������������<br />

�������������<br />

���������������������<br />

���������<br />

�����������������<br />

���������������<br />

���������������<br />

�����������������<br />

�����������������<br />

���������<br />

�������<br />

���������<br />

���������<br />

����<br />

�����<br />


Call : 0845 644 7778<br />

E-mail : info@pfsleasing.co.uk<br />

Web: www.pfsleasing.co.uk<br />

Frames<br />

optometrytoday<br />

�����<br />

������<br />

�����<br />

������<br />

�����<br />

Hot Compress<br />

���������������������������������<br />

Instruments<br />

�����������������������������������������<br />

����������������������������<br />

����������������������������������������������<br />

������<br />

�����������������������������������������������<br />

�����������������������������������������������<br />

������������������������������������������������������<br />

��������������������������������������������������<br />

������������������������������������������������<br />

������������<br />

��������������������������������������������������<br />

���������������������������������������������<br />

��������������� ���������������������������<br />

���������������������������������������������<br />

��������������������<br />

�����������������������������������������<br />

��<br />



Grafton Optical<br />

Visit us<br />

at Optrafair<br />

Stand No:E+F 20<br />

Optovue OCT, DGH Pachmate<br />

Reichert Non Contact Tonometers<br />

LCD ClearChart<br />

Frastema Combi units<br />

Eyescape / Retinal imaging<br />

Shin Nippon Slit Lamps & Tonometers<br />

Oasis Punctum Plugs<br />

Pre-owned equipment<br />

Reliable competitive servicing<br />

Visit graftonoptical.com for more details on all<br />

our products and services.<br />

Grafton Optical Company Limited<br />

Crown Hall, The Crescent<br />

T: 01923 233980<br />

Watford, Hertfordshire<br />

E-mail: sales@graftonoptical.com<br />

WD18 OQW<br />

Tel : 01527 501077<br />

Saving You Money<br />

ONE ONLY<br />




With<br />

88MC CHAIR<br />

BE QUICK !!<br />


EX-DEMO Frastema 3 instrument combi unit<br />

Meccanottica Mazza 3 instrument combi unit<br />

Keeler SL40 Haag Streit style Slit Lamp 6-40x,3DJ<br />

Nidek SL250 Zoom H/S style Slit Lamp 6-33x, 3DJ<br />

NikonNS-V1 Zoom H/S style Slit Lamp 6-33x, 3DJ<br />

Topcon OM4 Keratometer, 3DJ, internal read<br />

EX-DEMO Nidek AFC210 Fundus Camera<br />

Nidek KM50 Hand held Keratometer<br />

Henson 3200 Field Screener c/w table & Printer<br />

Dicon LD400 Field Screener c/w table & printer<br />

Henson 4000 DVLA Field Screener<br />

Oculus Centrefield Field Screener<br />

CALL US NOW ON 01527 501077<br />


Minimum six month parts & labour return to base warranty<br />

Hanson Instruments, 8 Little Forge Rd, Redditch. B98 7SF<br />

Instruments<br />

Lenses<br />

To place an advertisement call<br />

020 7878 2313 or email haley.willmott@tenalps.com<br />

Practice � ttings<br />

Optom today advert .indd 1 26/01/2011 10:33<br />

Practice � ttings<br />

100<br />

95<br />

75<br />

25<br />

5<br />

0<br />

Lens cleaning cloths<br />

optometrytoday live<br />

For more<br />

marketplace visit<br />

www.optometry.<br />

co.uk/jobs<br />

Practice � ttings<br />

69<br />

25/03/11 MARKETPLACE<br />

online enewsletter

70<br />

25/03/11 MARKETPLACE<br />


Invest in a sales driven Store Graphics interior<br />

with our exclusive low cost finance package.<br />

Practice � tting<br />

Sales Driven<br />

interiors<br />

One-stop service<br />

I N T E R I O R S I N O P T I C S<br />

To place an advertisement call<br />

020 7878 2313 or email haley.willmott@tenalps.com<br />

Contact us now for your free practice appraisal<br />

01454 413 000 www.storegraphics.co.uk sales@storegraphics.co.uk<br />

The UK’s Leading Practice Designers and Manufactures<br />

“Nice People to deal<br />

with and we found their<br />

quote to be the<br />

most competitive”<br />

Designed Interiors and Bespoke Furniture<br />

To discuss your options with one of our designers or<br />

for a copy of our “Directory of Practice Design” phone: 01594 546385<br />

The Style Design Company - www.style-design.com

35 th BCLA<br />


2011<br />

Manchester Central<br />

Conference 26-29 May 2011 | Exhibition<br />

27-29 May 2011<br />



NOW OPEN<br />

www.bcla.org.uk<br />

NEW for 2011<br />

n Clinical spotlight on Anti-Myopia<br />

n Clinical workshops<br />

n Corneal dystrophy session<br />

n General health & contact lenses<br />

n Sessions for those new and<br />

returning to contact lenses<br />

n Free Exhibition<br />

Not a member of the BCLA? Join today and save over £100 on your delegate fee<br />

Join our Facebook group ‘BCLA 2011’<br />

Patron - New Delegates Platinum - New Delegates Gold - New Delegates Gold<br />

British Contact Lens Association, 7/8 Market Place, London, W1W 8AG I T:+44(0)207 580 6661 I F:+44(0)207 580 6669 | Email: conf@bcla.org.uk<br />

Pantone 549 EC (C60 M8 Y9 K21)<br />

Bausch + Lomb<br />

Topcon<br />

AMO<br />

<strong>Optometry</strong> <strong>Today</strong>

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!