Dispensing Optics - ABDO

GOC REGISTRAR PETER COE WAS GUEST SPEAKER AT THE PRESIDENT’S CONSULTATION DAY HELD AT 199
GLOUCESTER TERRACE ON 14 MAY. HE IS PICTURED HERE FLANKED BY ABDO PRESIDENT KEVIN MILSOM
(RIGHT) AND VICE PRESIDENT BARRY DUNCAN. PHOTOGRAPH BY NIGEL HAWKS
dispensing optics
June/July 2007 Volume 22 No 5
2 PRESIDENT’S
CONSULTATION DAY
3 OPTRAFAIR
REVIEW
BRISK BUSINESS
AND RICH REWARDS
6 OPTRAFAIR
REVIEW
MAKING
WAVEFRONTS AT
OPTRAFAIR
11 OPTRAFAIR
REVIEW
FULL SYSTEMS GO
14 CONTINUING
EDUCATION AND
TRAINING
THE CHALLENGES OF
THE AGEING EYE
by Angela McNamee
20 STUDENT
TRAINING
DISPENSING
LOGBOOK
by Sally Bates
24 P&PM
MANAGING PATIENT
EXPECTATIONS - 3
by Wendy Sethi
25 LOW VISION
SIGHT LOSS: HOW
DOS CAN MAKE A
DIFFERENCE
by Amanda Reeves
28 NEWSBRIEF
34 DISJOINTED
JOTTINGS
by Phil Wilson
Dispensing Optics, PO Box 233, Crowborough TN6 9BD
Tel: 01892 667626 Fax: 01892 667626 Email: do@abdo.uk.com Website: www.abdo.org.uk
35 CET ANSWERS
36 DIARY OF EVENTS

2 DISPENSING OPTICS JUNE/JULY 2007
DISPENSING
OPTICS
The Professional Journal of the Association
of British Dispensing Opticians
Volume 22 No 5
Editorial staff
Editor: Sir Anthony Garrett CBE
Assistant Editor: Barbara Doris BSc
Production Editor: Sheila Hope
Email: shope@abdo.uk.com
Journal Consultant: Ann Johnson
Email: ajohnson@abdo.uk.com
Administration Manager: Deanne Gray
Email: dgray@abdo.uk.com
Dispensing Optics, PO Box 233, Crowborough
TN6 9BD
Telephone: 01892 667626
Facsimile: 01892 668547
Email: do@abdo.uk.com
Website: www.abdo.org.uk
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Facsimile: 01892 668547
Email: do@abdo.uk.com
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ABDO CET
CET Officer: Paula Stevens BSc (Hons), MCOptom,
FBDO CL (Hons) AD, SMC (Tech), Cert Ed
Address: ABDO CET, Courtyard Suite 6, Braxted
Park, Great Braxted, Essex CM8 3GA
Telephone: 01621 890200
Fax: 01621 890203
Email: pstevens@abdocet.infoman.org.uk
Email: pstevens@abdo.org.uk
Website: www.abdo.org.uk
CONTINUING EDUCATION REVIEW PANEL
Jennifer Brower FBDO(Hons)LVA Cert Ed
Andrew Cripps FBDO(Hons)
Richard Harsant FBDO(Hons)CL (Hons)LVA
Elvin Montlake FADO (Hons), CL LVA FFDO
Linda Rapley BSc(Hons), FCOptom Cert Ed
Alicia Thompson FBDO(Hons)SLD
JOURNAL ADVISORY COMMITTEE
Nick Atkins FBDO (Hons) CL
Richard Crook FBDO
David Goad FBDO(Hons) CL
Ros Kirk FBDO
Dispensing Optics is published by
ABDO, 199 Gloucester Terrace, London W2 6LD
Printed by The Lavenham Press, Lavenham, Suffolk.
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ISSN 0954 3201.
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ISSUE - ABDO BOARD CERTIFICATION
President’s
Consultation
Day
JOINED UP ACTIVITY
Despite the disappointing outcome of the
GOS review, the professional optical
bodies were working closely together in
promoting eye care over a range of key
areas. This upbeat message was
delivered by Tony Garrett at the
President’s Consultation Day held on 14
May at 199 Gloucester Terrace.
Tony explained that ABDO, FODO and the
AOP are working together in continuing to
regularly negotiate with not only the
Department of Health in England, but with
the three other devolved governments in
Scotland, Wales and Northern Ireland,
each of which has a different
governmental culture and style of
operation. The President is particularly
active in Wales and it is hoped that the
Welsh Assembly government will formally
recognise DOs. Tony reported that while
Scotland is more cautious regarding the
change to the status of DOs he thought it
likely that Scotland would follow Wales in
due course. Regarding Northern Ireland
he said, “Northern Ireland is listening and
negotiations are under way.” He
continued, “If we succeed in the other
three countries, this will help us
considerably in putting pressure on
Westminster for the changes that we
need for England.”
Tony reported “. . . huge co-operation
between the professional bodies” in
generally raising the profile of optics and
eye care. Joint meetings have been
conducted with GPs and
ophthalmologists and a presence
established at the conferences of other
health care professionals. In addition, a
new support body (the LOC Central
Support Unit) has been set up. This
organisation will offer advice and help for
local negotiators in order for them to
engage at PCT level with decision
makers. More joint initiatives are planned
for the future.
KEVIN FINAN AND LYNN MACKEY FROM NORTHERN
IRELAND. PHOTOGRAPH: NIGEL HAWKS
Tony went on to explain how the
Association would be talking with the
GOC about how the CET scheme should
develop in the future, before introducing
guest speaker Peter Coe, Registrar of the
GOC, describing him as “One who has
been a considerable friend to ABDO.”
Peter Coe presented a thorough and
informative overview of GOC work around
a range of current and future issues. A
further report will follow in the
August/September issue of Dispensing
Optics.
FIRST CET EVENT FOR
NORTHERN IRELAND
Kevin Milsom welcomed to President’s
Consultation Day Kevin Finan FBDO and
Lynn Mackey FBDO CL from the newlyformed
Northern Ireland Area. Treasurer
Kevin said their committee was now set
up and the first CET event arranged for 19
September at the Hilton, Templepatrick,
near the international airport at County
Antrim.
Report: Ann Johnson ■
The next President’s Consultation
Day will be held on 21 November at
199 Gloucester Terrace.

Brisk business
and rich rewards
Optrafair 2007 brought rich rewards for exhibitors who put serious
effort into promoting their products and were proactive about their
Optrafair presence, according to organisers the FMO
Visitor numbers to this year’s exhibition
were virtually identical to the previous two
shows but this year there was a marked
lack of students – just 305 - and families
with children and pushchairs were
replaced by a more focused visitor who
attended with a specific purpose in mind.
Capital equipment suppliers and finance
companies reported brisk business,
particularly for investment in fundus
cameras.
Industry stalwart, Frank Norville,
Chairman of the Norville Group summed
up the mood of many saying Norville
found it to be a very busy show and the
company was pleased, in particular with
the opportunity to meet so many
customers and friends. Frank said,
“Optrafair is the ideal opportunity to
communicate new products and trends. It
was a wonderful arena with no effort
spared by the industry to create an
attractive ambience. If we didn’t have
Optrafair to serve that purpose we would
have to invent it!”
The Association stand, which was
located in the association and charities
area alongside the ABDO College
Distance Learning Institute and
Bookshop, BCLA, the College of
Optometrists, Eyecare Trust, FMO, FODO,
GOC, Optometry Giving Sight, RNIB,
SMC and Vision Aid Overses, proved an
excellent place to meet up with
colleagues and old friends.
ABDO held a prize draw for members to
win a bottle of Veuve Clicquot
Champagne and the winner was Huntly
Taylor from Brighton.
Michelle Derbyshire, Head of The
Distance Learning Institute said she
was delighted by the response to the
ABDO College stand. "It was great to see
so many supervisors, tutors and students
- past, present and future! A constant flow
of interest in both courses and books
helped make Optrafair particularly
successful for us this year."
Chris Tyler, chief executive officer of
Birmingham Optical, who had 55 staff at
the show, said the event had turned out
to be the best Optrafair in the company’s
50 years of trading. He said, “The average
transaction value has doubled in 2007
from the 2005 show. Since our MBO we
have positioned the company as a
OPTRAFAIR REVIEW
THE FMO FRAME OF 2007 AWARDS WERE
ANNOUNCED AT OPTRAFAIR. ANDREW
ACTMAN, CHAIRMAN OF THE FMO SURPRISED
THE WINNERS DURING THE FIRST MORNING OF
THE SHOW WITH THE NEWS THAT THEY HAD
WON. HE VISITED EACH OF THE WINNING
COMPANIES' STANDS AND MADE THE
PRESENTATIONS. OUR PICTURE SHOWS FROM
LEFT: SONNIE BYRLING, MD OF SCANDINAVIAN
EYEWEAR; NEAL GRIMASON, SALES AND
MARKETING DIRECTOR, CONTINENTAL
EYEWEAR; ROBERT MORRIS, OWNER WILLIAM
MORRIS EYEWEAR
technical supplier, rather than an
equipment supplier, and the results have
paid off at Optrafair.” Tony Ellison,
marketing manager of Topcon also
reported a good show. The stand was
busy on all three days with interest across
the board for fundus imaging and
emerging technologies.
SEIKO Optical benefited from promoting
their participation in the event beforehand.
John Conway, general manager of SEIKO
Optical UK said, “It was an excellent
show, but we did have new lenses and
frames to launch. We did loads of prepromotion
and that certainly paid off.”
A newcomer to Optrafair was Sibit. This
company took a small stand and was
delighted with the interest in their IT
support services. Director Simon
Butterworth said, “The show was
CONTINUED ON PAGE 4

4 DISPENSING OPTICS JUNE/JULY 2007 OPTRAFAIR REVIEW
THE BUSY ABDO COLLEGE AND BOOKSHOP STAND
excellent, and the organisation fantastic.
The quality of the visitors was outstanding
and the number of new enquiries that we
took far exceeded our expectations. The
UK optics community made us feel very
welcome and we met enthusiasm from
both visitors and other exhibitors.”
Ron Mulholland, Rodenstock franchise
co-ordinator, reported strong interest in
the company’s franchising scheme, with
many practitioners visiting the stand to
explore the opportunities available. Others
visited to see the ImpressionIST
dispensing tool, which had been
demonstrated constantly throughout the
show.
Boots’ franchise implementation
manager, Deana O’Dare, said there had
been, “. . . a real buzz on Sunday with
some good quality interest from people
wanting to work with us”. Specsavers’
director of professional recruitment, Chris
Howarth, reported fewer students in
attendance but with an estimated 20%
increase in interest for joint venture
partnerships, and many enquiries for
PARTY ATMOSPHERE FOR FRAMES
Robert Morris, managing director of
William Morris Eyewear, and winner of
the Women’s Frame of 2007 Award,
enjoyed what he described as a “Highly
successful” show. He said, “I didn’t leave
the stand for three days. We had a target
that we achieved by Saturday and had
record sales from a mix of new and
existing customers. We had a party on the
stand, creating atmosphere and making
people want to come and see us.”
Pennine Optical chairman, Peter Cowan,
commented: “Our Oliver Goldsmith
Collection had a very strong show and
this was aided by the designer’s
presence. We had a very positive
response to our children’s collection. As
well as home customers we attracted new
export customers from Africa and the
Middle East.”
Another Frame of 2007 Award Winner
was Continental Eyewear. Neal
Grimason, sales and marketing director
said the company had enjoyed a
“Fantastic show” and that there had been
a “Significant bearing on the frame that
won the award”. Like many of the other
successful companies, Continental
Eyewear had done a lot of work before
the show through advertising, PR and
letters to opticians informing them about
new models to be launched. This
included additions to the Jaeger and
award winning X-eyes collections. Neal
said, “I am a very keen exhibitor, and I
think that this is reflected in the reaction
that we get. The stand is open and
inviting.”
Drew McDonald, managing director of
Bluesky which promoted Oscar and Fitch
frames and Loops for children on one of
the show’s most eyecatching stands, said
the show had been “A rip roaring
success”. He continued, “We launched
Oscar and Fitch at the last Optrafair and
we had customers coming to see us from
the US, Germany, New Zealand and
Australia.”
Another ‘party’ stand was Marchon,
showing brands including Fendi, Calvin
Klein, Nautica and Nike. Marketing
manager Sarah Williams said, “We like to
party and our customers love it. We want
to give our customers a good time with
Nike Street dancers, hip-hop dancers and
rugby stars. We smashed our 2005 show
records.”
Brulimar sales director Alexander Harris
said the quality of the visitors had been
superb, with Saturday’s orders exceeding
those of the entire previous Optrafair.
Launching Hooch frame for girls and
extending the Bench collection, he felt
that pre-show ‘teaser’ advertisements had
certainly helped with visitors to the stand. ■
THE OPTICIAN AWARDS WERE HELD ON THE
SATURDAY EVENING AT THE HILTON BIRMINGHAM
METROPOLE HOTEL. MANAGING DIRECTOR OF
BBGR, SHINDHE GUNPUTH, PRESENTED SARAH
THOMAS, OF WEBB & LUCAS OPTOMETRISTS IN
STAFFORD, WITH THE OUTSTANDING DISPENSING
OPTICIAN OF THE YEAR AWARD
people wanting to set up a Specsavers
franchise in Spain.
Bruce Richardson national sales manager
for first-time exhibitor optovision, the
German lens company reported, “. . . a
string of new leads, plus interest from
dormant accounts to be revitalised.”
Another new exhibitor with a small stand
was Two Tower Optics which launched
the Safegel 1 day contact lens. This was
another company that found benefit from
organising pre-show publicity. Marketing
manager Emily Heurlin said, “The show
was very good and it was clear a lot of
people had seen our pre-show publicity.
Being near the restaurant helped the flow
of passing traffic, too. The event exceeded
our expectations by a long way.”
Contact lens company and seasoned
exhibitor Bausch & Lomb offered many
specific promotions and received one
order for £32,000 from a single customer.
Marketing manager Craig Goodison
explained: “We did a lot of promotion
beforehand and that paid off. We also
offered lunch, food and drinks on Sunday
with a room set aside with Playstations
and a kiddy area for drawing. We had
initially catered for 80 people but around
500 wanted to sit down and rest during
the show.”
Daysoft managing director, Mark Hegarty,
said the company had made a lot of new
contacts while also seeing existing
customers: “We don’t run a sales team,
and everything is done by referral and by
coming to exhibitions.”
Some exhibitors reported that they would
like to see changes made and there was
an overall feeling for the event becoming
more creative, with the introduction of
new events taking place around the main
arena of the show. ■

6 DISPENSING OPTICS JUNE/JULY 2007 OPTRAFAIR REVIEW
Making wavefronts
at Optrafair
Robert Callander duck dives through the lens technology jargon at Optrafair to provide a review of the
new products and developments on show
A couple of years ago I had a family
holiday in Newquay and it turned out that
we had, by accident, timed things just
right. Newquay’s Fistral beach is host to a
Grand Prix of the world surfing circuit. We
were treated to stunning displays by
some of the finest surfers on the planet
and seduced by the buzz and hype which
surrounded them.
I don’t know much about surfing but
apparently it depends on judging a
wavefront just right to ensure a smooth
ride. The competition requires certain
prescribed moves to be carried out, but
the real show begins when they are let
loose and go free-style. Surfers need to
take care around rocks where the waves
break-up in less predictable ways. And I’ll
avoid the obvious about the curves
displayed on the beach. Optrafair 2007
should have been held at Fistral
beach.
The buzzwords and phrases of Optrafair
2007 were FreeForm, Wavefront
Technology and Higher Order Aberrations.
The difficulty is that each manufacturer
has their own interpretation of the words,
their own ways of implementing the
technologies and, most frustratingly, their
own marketing departments to confuse
the hell out of the lens buying opticians.
What hope for the lens buying public?
In the run-up to Optrafair the marketing
bumpf was landing on my practice
doormat emblazoned with these buzzwords
- as if we should all know what
they mean. I didn’t understand and none
of my colleagues, optician friends or the
reps could fully or clearly define any of the
terms, largely dismissing it all as
marketing hype.
The power of my Dispensing Optics press
pass gave me access to some very clever
and important people in European lens
manufacture and from those
conversations I give you my distilled
interpretation (ie this is perhaps not
academically exact, but is a good working
model) of new lens technology from
Optrafair 2007.
FREEFORM
Two years ago at Optrafair, most of the
exhibiting lens producers were making a
big song and dance about having
invested in FreeForm surfacing
equipment. Yes, I know that a few brands
have had FreeForm technology for much
longer but it was by last Optrafair that the
kit was universal. Over the past two years
they have gone away and learned how to
use the new technology, and now we are
in a position to enjoy the fruits of their
labour as we dispense on a daily basis.
Perhaps the most immediate benefit back
in practice from FreeForm technology is
that it allows varifocals to be
individualised. Let’s start at the beginning.
There are two major limitations from
conventional design and manufacture of
progressive lenses; base curve and
universal standard measurements.
First they are limited in their performance
by the available library of base curves.
Conventional progressives are produced
from semi-finished blanks with a moulded
front surface which carries the base curve
and the Add. Each of these base curves
is used for a range of final prescriptions
but is really only ideal for one power - and
is never ideal for cyls. You’ve all seen isocylinder
plots or relative acuity plots for
various varifocal brands. These are almost
always taken from a very simple Rx,
perhaps plano in the distance with a
+2.00 Add. The patient whose Rx is
+3.00/ -1.75 x 65 Add.+2.50 gets a very
different, and a whole lot poorer, lens to
look through than the one in the diagram.
FreeForm manufacturing liberates lens
makers from the constraints of the base
curve system by allowing them to, within
reason - the physics of optics does have
limitations - accurately produce the
desired power and progressive design on
a true ‘blank’ or a semi finished lens with
a front surface sphere originally intended
for single vision lenses.
This means that the customer actually
receives the pattern of progression that
the lens designer intended and that the
size, shape and orientation of the visual
fields will be a better match for patients
with anisometropia or other asymmetries,
allowing them all the width of vision
intended and improving their experience
of binocularity.
Universal Standard Measurements: since
conventional progressives have premoulded
front surfaces there have to be
certain assumptions made about the
people who are going to wear the lenses.
For instance, where to put the near centre
in relation to the fitting cross? I don’t
know who made the decisions or when,
but the assumed measurements are: the
wearer will have a PD of 63mm, the frame
will sit 15mm (BVD) from the eyes with a
pantoscopic tilt of 8˚ in a frame with a
face-form angle of 4˚. Every conventional
lens you buy is designed for these fitting
parameters. That’s why your non-tol rate
goes up when you fit little old ladies with
56mm PDs. She has no chance of
reading through her varifocals because
they come standard with a 5mm inset.
FreeForm manufacturing means that the
lens maker no longer has to work to any
pre-determined assumed measurements
but can individualise the lens for that
specific patient, her individual facial

WAVEFRONT ANALYSIS - DETECTION OF ABERRATIONS IN THE EYE (COURTESY OF ZEISS)
measurements and the actual frame she
has chosen.
Beyond individualising these core
fundamental measurements, FreeForm
also allows the manufacturer to tweak the
lens design. For example, the progressive
corridor length can be altered to fit the
available depth of frame and, rather than
providing only general purpose lenses,
emphasis can be given to the Distance
area (for a professional driver) to
Intermediate (for a VDU operator) or the
Near (for a jeweller).
Okay, so FreeForm is wonderful, a
panacea. Well potentially I think that is
true, but FreeForm is only a tool, a
method of production, and its success
when dispensed is dependent on how it is
implemented, the underlying design
principles and the software algorithms.
FreeForm could be used to produce any
lens design and if you have a dodgy
design you’ll still get dodgy results. But
with good design . . .
Manufacturers have chosen to implement
their FreeForm technologies in different
ways. Some are using FreeForm to
produce back-surface progressives,
putting the progressive surface closer to
the eye (arguably increasing the field of
view as a consequence) and correcting
for base-curve limitations but making no
further individualisation. These tend to be
at the entry price level for FreeForm.
Individualisation can then be split into
what I call Physiological or Lifestyle
adjustments. When the lens maker
adjusts for specific physical
measurements (eg BVD, pantoscopic tilt,
near working distance, face-form angle,
corridor length) I’d call that a
Physiological individualisation. Others
may adapt the design based on the
wearer’s usage habits, usually established
by a questionnaire about the things the
wearer does on a daily basis (eg how
much time do you spend reading/driving/
playing sport/ at a computer screen etc?)
And we’re now seeing the emergence of
manufacturers providing different levels of
FreeForm at different price-points and
starting to combine physiological and
lifestyle aspects in the same lens.
As a rough guide, FreeForm with no
individualisation require the normal
measurements (mono PDs and heights)
and are modestly priced, Lifestyle
individualised require the normal
measurements and a short questionnaire
on the manufacturer supplied order form
or PC software and cost a little more,
Physiologically individualised lenses
require a few more measurements
specific to the patient, frame and lens
brand - consequently more talent to
dispense and they carry a premium price.
However, this sort of stuff should be the
forte of a DO; most optometrists won’t
choose to learn these skills and most
optical assistants won’t have the
opportunity to learn. With fewer aspects
of eyewear provision being our exclusive
domain Individual Progressive dispensing
is an opportunity for our profession to
differentiate, for a while at least.
WAVEFRONT TECHNOLOGY
Many lens makers are now invoking the
mighty Wavefront in their designs.
Wavefront Technology, Wavefront
Optimisation, Wavefront Correction and
so on. Sounds clever but what does it
mean?
Unfortunately it doesn’t have just one
meaning and has several applications.
The most common is wavefront analysis
as an element of lens design. Light from a
distant (infinite) source reaches the lens
as a plane wave perpendicular to the lens
surface. Three dimensional analysis of the
wave as it emerges having passed
through the lens can tell the designer a lot
about its performance in wear. Obviously
the intention is not to have a plane wave
exiting the lens (unless it’s plano) but to
induce certain characteristics, which are
actually aberrations - but we don’t call
them that if we want them, just like weeds
SPORTS SOL-UTIONS FILTER TINTS FROM ESSILOR
are the plants we didn’t sow. The incident
wave doesn’t have to be plane either, it
could be from a point source at a
relatively short distance; the wavefront as
it reaches the lens surface would have
known predictable radius of curvature and
analysis of the effect on it by the lens
could be even more valid for real-world
use. To then modify the lens design,
reducing the unwanted aberrations and
verifying this modified design by further
wavefront analysis is to produce a
Wavefront Optimised lens design.
The diameter of the wavefront used in
these analyses is typically 3-5mm, to
mimic the pupil diameter and this has,
coincidentally, some practical benefits
too. You may remember ten years or so
ago that varifocals (all conventional at the
time) were being designed by ray tracing -
the finest possible beam of light passed
through many thousands of points on the
lens surface to optimise the design for the
moulded front surfaces. The lens makers
could invest ages and huge computing
power to do this because once the design
was set it would be duplicated countless
times. Today’s computers and FreeForm
generators are much faster but even so if
the lens surface can be simplified to a
series of 4mm ø ‘wavefronts’ instead of
thousands of ‘rays’ there are
consequently fewer calculations required
and faster delivery of a finished
individualised lens.
Incidently, you may recall from your
college days the phrase ‘pencil of rays’
when considering how light behaved as it
passed through a lens surface. It may be
helpful to think of today’s wavefront
analysis as the natural evolution of that
concept.
Wavefront technology can also be used to
analyse and evaluate a patient’s eye,
which you’ve probably heard of in relation
to refractive surgery, and I’ll cover how
one manufacturer is bringing that
technology to ophthalmic lenses later.
CONTINUED ON PAGE 8

8 DISPENSING OPTICS JUNE/JULY 2007 OPTRAFAIR REVIEW
However, for the most part, manufacturers
who are claiming Wavefront Correction (or
whatever phrase they’ve chosen) mean
that the light leaving the new lens does so
in a more controlled fashion than it did in
their previous designs, and not, as is
perhaps implied, that the ‘wavefronts’
somehow correct for errors inherent to the
patient’s eye.
HIGHER ORDER ABERRATIONS
As opticians we correct aberrations of the
eye by routine. The classification of these
aberrations is routed in mathematics,
specifically the Zernike polynomials. The
first order aberrations are prisms – we can
correct those with spectacle lenses. The
second order are power (defocus) and
astigmatic aberrations and these we deal
in daily. Prisms, spheres and cyls
(including the cyl axis) are the low order
aberrations.
Now we move into those aberrations
which spectacle lenses cannot correct.
The third order contains coma and trefoil.
Since coma is a hot aberration right now
lets have look at what it is all about.
Coma is hard to describe but I’ll try; it’s
like a 3-D sine wave. In fact the closest
thing I can think of is a Quaver (cheesy
snack by Walkers) like two bowls put side
by side with one inverted. Now if you
imagine this coma aberration affecting the
diameter of your pupil and we try to
correct for it in a spectacle lens, we would
produce an impression of that shape on
the lens. When you look straight ahead it
would be perfect (assuming that we’ve
covered prism, sphere and cyl already)
but if you look off axis by half a pupil
diameter it would be twice as bad! So, in
reality, no spectacle lens can correct the
coma present in a human eye.
The fourth order contains, among others,
spherical aberration which, it turns out,
we may be better off not correcting
because it may be required in the eye’s
natural accommodation response. And so
it goes on with secondary, tertiary and
other versions of coma, astigmatism etc.
So we’re back again to claims about
higher level aberration correction being
questionable; if the claim is some new
lens design corrects higher order
aberrations present in the eye, then I have
difficulty in accepting that as credible, if
on the other hand the claim is that
aberrations left behind in previous lens
designs are now reduced or eliminated,
that I can believe and welcome.
But there’s a new approach. Carl Zeiss
Vision have a new toy for the practice
which they call the iProfiler, a wavefront
aberrometer and autorefractor (don’t
worry - it’s the aberrometer we’re
concerned with here). The results from the
normal eye examination are combined by
Zeiss with the data from the iProfiler to
produce what they call the iScription.
Eye examinations are conducted in
certain conditions: relatively dark room,
illuminated test chart, nearly 100%
contrast (black target letters against white
background), looking straight ahead and
using 0.25D steps for the trial lenses. One
set of conditions which hardly ever occur
in the real world. The iProfiler adds to the
standard eye examination an analysis of
the entire pupil diameter in normal lighting
conditions. Combining the results using
Carl Zeiss Vision’s formula produces an
iScription, designed to produce an
advanced FreeForm surface accurate to
0.01D and producing a circle of least
confusion on the retina which is better -
‘better’ meaning improved contrast
sensitivity, reduced aberrations - under
more conditions than a standard
prescription. iScription can be applied to
pretty much every Zeiss lens from SV
through Gradal HS right up to Individual
FrameFit, demonstrating again that
FreeForm is a technology, not a design.
To quote Zeiss: ‘In the field of optometry,
the refractive errors of sphere (defocus)
and cylinder (astigmatism) comprise
aberrations of up to the second order.
These aberrations can be corrected by
spectacle lenses.Higher order aberrations
THE OUTSIDE CLINIC’S TONY NUTLEY WAS THE LUCKY WINNER OF THE
BBGR/RUPP + HUBRACH CRYSTAL MAZE COMPETITION AT OPTRAFAIR.
GUESTS ONTO THE BBGR STAND WERE INVITED TO GRAB TICKETS IN A
TRANSPARENT WIND MACHINE AND THE POINTS DENOTED ON THE
TICKETS WERE ADDED UP WITH ALL PARTICIPANTS GETTING A PRIZE. TONY
COLLECTED THE MOST POINTS DURING THE THREE DAYS TO WIN THE
STAR PRIZE OF TWO ROUND THE WORLD AIR TICKETS. HE IS SEEN HERE
RECEIVING THE TICKETS FROM BBGR’S COMMERCIAL DIRECTOR DAVID
REAL-FIRMAN. TONY IS RESPONSIBLE FOR TRAINING FOR THE DOMICILIARY
EYECARE PROVIDER. HE IS ALSO DIRECTOR OF TRAINING AT THE UK
COLLEGE OF PERSONAL DEVELOPMENT
of the eye – such as coma or trefoil –
cannot be corrected with spectacle
lenses, as they are dependent on the
pupil aperture and therefore to a major
extent on the viewing
eye. However, they have a major influence
on the quality of the retinal image: higherorder
aberrations are the cause of
reduced visual contrast or poor vision in
night or twilight conditions. With
i.Scription, Carl Zeiss Vision has now
developed an optimisation algorithm that
takes into account higher order
aberrations in order to optimise the
corrective power of the lens.’
I think that the Zeiss iProfiler and
iScription represents the state of the art
where wavefront analysis of the eye is
used to optimise a lens design with
regard to higher order aberrations and
then produce the result by FreeForm.
Maybe I’m getting carried away but to me
this is to optics like the Bugatti Veyron to
motorcars; it really pushes the envelope
of what is possible and while iScription
lenses won’t cost as much as a Veyron,
they will carry a premium and it remains
to be seen what percentage of the
spectacle wearing public will appreciate a
lens accurate to 1/100th of a dioptre and
be willing to pay for the privilege.
LENS UPDATE:
BBGR’s Elaine Grisdale was effervescent
with the recent sales figures for Anateo,
their FreeForm progressive lens. In the
first three months of the year between
France and the UK, over 100,000 lenses
have been dispensed with zero returns for
non-tol.
Anateo is based on the concept that the
axial length, curvature and position of the
eye’s centre of rotation each impact upon
the field of vision and swim effect for
progressive lens wearers. To this end, the
lens design differs for myopes who
benefit from a wider field of view and
hyperopes who prefer a softer surface
CONTINUED ON PAGE 10

10 DISPENSING OPTICS JUNE/JULY 2007 OPTRAFAIR REVIEW
pattern. Anateo may be dispensed using
standard measurements or individualised
with the PdM (Personal data
Management) option to take account of
the chosen frame and how it fits.
Anateo, in some cases, uses additional
Add on the back (it’s a front surface
progressive) which allows the progression
to start higher without compressing the
softness of the front surface.
Carl Zeiss Vision were demonstrating the
new iScription service under the Zeiss
banner while the SOLA division
introduced their first short corridor
progressive, the SOLA Compact Ultra.
SOLA’s sister brand AO created a big
splash years ago when they brought us
the AO Compact and re-wrote the script
on varifocal frame selection. So it seems
SOLA are so late with their short design
that they’ve just about missed the boat;
we’ve seen the ultra small fashion frames
(43 - 45mm eyesizes were common) of a
couple of years ago being replaced with
more moderately sized, bolder styles
recently. That said, the Compact Ultra
does seem to be an exceptional lens with
a fantastically short 13mm minimum
fitting height and generous reading area. I
wonder how it will perform in comparison
with the Zeiss Gradal Brevis.
Essilor’s Tracey Burden showed me the
new Sports Sol-Utions range of activity
specific filter tints and the Airwear
Melanin, a synthetic copy of the body’s
natural sun defence pigment. Airwear
Melanin is a blue-blocker transmitting only
2% up to 500nm and will have clinical
and cosmetic applications.
Previews of Essilor’s new TV advertising
campaign were running in a loop.
Targeted at first time presbyopes it’s
intended to raise awareness of the eye
examination by questioning the purchase
of HDTV by people who may not have HD
ready vision.
Essilor’s Varilux Physio lens is produced
using what David Jones calls Advanced
Digital Surfacing (ADS), Essilor’s own
brand of FreeForm. The Physio’s front
surface mould is produced by ADS and
then the fun begins: 1000 pairs of points,
front and back are wavefront analysed at
5mm diameter and a Point by Point
twinning process is applied to control
different aberrations at different zones of
the lens. In the distance, area emphasis is
put on correcting the coma-like aberration
while at intermediate residual astigmatism
is re-aligned to provide a perceptibly
wider corridor.
Kodak ran a series of seminars in the
boulevard area in support of Vision Aid
Overseas and targeted at independent
practitioners with the Kodak Lens Vision
Centre concept. KLVC’s are described as
“. . . keeping the core identity of
independent practice but wrapping it in a
Kodak branded coat.” From signage and
stationery to contact lenses and obviously
spectacle lenses, the Kodak brand can be
given the level of prominence that the
practitioner is comfortable with.
Kodak also recently launched their Unique
lens which is a lifestyle FreeForm
progressive.
Nikon had no new lens product for us at
the show but were enthusiastic about
their new remote edging capabilities and
their improved support for Nikon Eyecare
Professionals (NEP).
The remote edging service comes as a
result of investment in their lab and is
seamlessly integrated with the practice
management software from Optisoft,
see20:20 and ocucoRelcon.
Practice support is in the form of a new
and enhanced website for opticians and
consumers, targeted banner advertising
on yell.com, press advertising in the Daily
Mail and the ongoing concept
development of NEP, a flexible, tailored
partnership which will vary from practice
to practice but always builds on Nikon’s
internationally recognised brand.
I spoke to Justin Baker of Precision
Optical, a small independent lab which
has been on the go for ten years now and
which has made big investments in new
technology to punch well above its
weight. Precision Optical were at
OptraFair to spread the word about their
value for money FreeForm varifocal
options and On-Line ordering facility.
The benefits of Impression Freesign,
launched at OptraFair, were explained by
Michael Potter. Rodenstock were, of
course, one of the pioneers of FreeForm
individualised progressive lenses with the
ImpressionILT around seven years ago.
Michael describes Impression Freesign as
being, “ILT and then some.” The
established successful wearer base of ILT
has validated for Rodenstock that
everything in that concept was right and
Freesign now builds more potential
modification onto that base. In addition to
the specific fitting measurements there
are now Lifestyle or Occupational
modifications available including shifting
the start of the progression up or down by
4mm, progressive corridors from 13 -
20mm and optimisation for specific near
test distance. There are paper and
software based dispensing tools to
support the dispensing of Impression
Freesign.
Rodenstock have also responded to the
trend for more curved and sports frames
by publishing the dihedral and base curve
of the dummy lenses supplied with all
Rodenstock and Porsche frames - so that
prescription lenses can balance the
aesthetics of the display model with
optical performance.
Rupp and Hubrach were represented by
Anne Haussman who emphasised their
sports heritage and market leading
position in Germany. Several interesting
products were discussed including the
newly released Sports-Free. Available in
single vision and progressive, CR39 and
Polycarbonate these FreeForm lenses
boast 30000 points of reference per
surface and are designed to provide
exceptional imaging in highly wrapped
sports frames.
In support of R+H’s sports lens portfolio
they have opened a sports web-shop for
opticians.
YSIS is a beautifully presented
individualised progressive or single vision
lens option. The presentation box carries
an engraved graphical ‘pyramid’ of the
individualisations which have been made
for your customer. Modifications to the
single vision can include a reduction of
-0.4D at 8mm above pupil centre to
emphasise distance for night driving or a
+0.50 at 12mm below for pre-presbyopic
patients.
I was delighted to meet Dan Katzman of
Shamir who had travelled from Israel to
be at Optrafair and explain the benefits of
Autograph FreeForm. Autograph is a lens
which was designed from the original
concept to be FreeForm manufactured.
The fitting is simple requiring only mono
PD and heights, yet if the dispensing
optician provides additional information,
that will be calculated in. Mr Katzman
explained the Autograph’s implementation
of Eye Point Technology - the measured
power on the focimeter differs from the
power experienced at the eye - and
delighted in describing the usefulness of
Wavefront Analysis while debating that
higher order aberration in the eye is
dynamic and therefore not correctable by
spectacle lenses.
Sheila Walker of Seiko introduced to
OptraFair the world’s first FULLY organic
lens, the Seiko Orgatech. While it won’t

RODENSTOCK PORSCHE READING TOOL DAVID NICOLL OF SEIKO DEMONSTRATING TO AMAZED ONLOOKERS HOW SEIKO ORGATECH 1.67 LENSES
CAN BE BOILED WITHOUT THE AR COATING BEING AFFECTED
be picking up a Soil Association
certificate, it is, according to Seiko,
manufactured entirely by organic
chemistry - no mineral content and that
includes the coatings. The benefits are
enhanced scratch resistance, impact
resistance and heat resistance which was
demonstrated by dunking the lens in
boiling water. Impact resistant as it is,
Seiko were clear that this is not a safety
lens but did encourage the use of this
1.67 index material for rimless and supra
use.
Seiko were early adopters of FreeForm,
inner surface progressives claiming visual
field increases of up to 35% by shifting
the progression from the front to the
back. Their portfolio now consists of a
‘standard’ FreeForm and a Lifestyle
Freeform each in a broad range of indices
from 1.5 up to 1.74 facilitated by their
LensNet software which is designed to
be, “simple to understand and dispense”.
LABTECH 2007
Running concurrent with OptraFair was
LabTech 2007, an optical trade fair
specifically for lens manufacturers,
technicians and glazing labs. Dispensing
Optics was invited as guests of Optical
World to get a behind the scenes look at
the future of Lens Laboratories.
International equipment manufacturers
presented their latest tools and
technologies, emphasising the efficiency,
especially of reduced semi-finished stock
(SKUs), when working with FreeForm cut
to polish - not just a few percent less but
a decimation of the number of variants
needed. Latest coating technologies were
Full systems go
Was this year’s Optrafair smaller and less
well-attended than previous shows? This
is an impression I’ve come away with over
the last couple of shows and attendance
figures have subsequently proved me
wrong. Nonetheless, many of the people I
spoke to shared my feelings with a
number quoting the ease and cheapness
of air travel prompting more UK visitors to
the big European exhibitions. It was as
interesting to note who was not exhibiting
- as who was!
So, in alphabetical and not order of
preference, I’ll meander through the
contact lens stands that I visited.
Fairly new to the UK scene is Avisor
International, marketed here by Sigma
Eyewear the company established in
1980. Referring to cleaning systems rather
than solutions, the range includes a
welcome introduction of a peroxide
solution called Everclean. The peroxide is
neutralised by a dual action tablet the first
discussed including the ultra-slippy,
oliophobic finishes. Much was made of
the potential for a lab to carry blank ‘rods’
of lens material, cut off the required disc
and then FreeForm surface lenses to the
exact design of different brand
manufacturers via a licensed software
‘black box’.
Green issues were touched upon with
consideration of the total carbon footprint
of producing a lens and shipping it
halfway around the world - which is why
the licensed software design seems so
attractive in that it can localise the
production of international brand lens
designs.
Robert Callander MBA FBDO is an
independent dispensing optician from
Linlithgow, West Lothian. ■
Products promoting ‘full system’ aspects of complete product ranges, on-line ordering systems,
marketing materials and promotional tools were out in force on contact lens stands at this year’s
Optrafair. David Goad takes a look at the new products.
layer of which aids the cleaning action. Full
neutralisation takes around 90 minutes.
Avisor are keen to stress the ‘full system’
aspect of their products, which include eye
cleaning drops as well as a range of
comfort and moisture drops for dry eyes.
The daily disposable platform is becoming
ever more congested and Bausch &
Lomb are fighting back with the
introduction of the SofLens daily
disposable. New single blister packaging
CONTINUED ON PAGE 12

12 DISPENSING OPTICS JUNE/JULY 2007 OPTRAFAIR REVIEW
ACUVUE FROM JOHNSON & JOHNSON CIBA VISION’S BUSY STAND AT OPTRAFAIR
brings the patient convenience up to date
but it is the redesign lens which B&L feel
will be the real winner. Utilising advanced
aspheric optics, control of spherical
aberration (wavefront technology) is said
to give improved vision, especially in
lower illumination (larger pupil) situations.
The lens has a lower overall mass and
enhanced tensile strength giving better
comfort for all day wear. New technology
is also to the forefront with B&L’s new
online ordering system. The system is far
more user-friendly than before and,
importantly from our point of view, is
freight free. You also have access to
current order status and delivery
projections which will benefit patients and
practice alike. The predicted demise of
the RGP market has not only failed to
come to fruition but an increase in
business is apparent. To help the
experienced and less experienced alike
Bausch’s Madden & Layman have a
dedicated support channel. Email
rgpsupport@bausch.com or telephone
08708507921.
It was surprisingly easy to miss CIBA
Vision’s stand, bereft as it was from
almost all reference to products. This was
a brave departure from the norm and one
that was no doubt designed to draw a line
under the delivery problems surrounding
the Air Optix lens. The good news is that
this is back in its core range with
extended parameters following shortly
and a toric version available soon. CIBA’s
main thrust at the fair was showcasing
their range of practice support initiatives.
As a follow up to their professional fee
development seminars last year, they
have developed a simple business model
to demonstrate how this can benefit
individual practices. CIBA have also
developed marketing models showing the
benefits that can be derived from a more
organised approach to product range
choice and buying strategies. Of course,
raising the profile of contact lenses is also
a vital part of the strategy and CIBA were
demonstrating a full range of marketing
materials. Support staff training was also
high on the agenda with a very
professional looking educational DVD to
inform new and refresh existing staff. The
quality of the educational experience is
assured when I tell you CIBA
commissioned the ever popular Sarah
Morgan to make it. CIBA too, have an
improved online ordering capability with
full order tracking and, apart from their
‘value packs’, is freight free.
Back to daily disposable lenses and
Daysoft were exhibiting their range of
lenses available in 58% and 72% water
content and an extensive -12.50 to +8.00
power range.
The correction of astigmatism was the
main thrust behind the offering of
Johnson & Johnson. Their ‘Accelerated
Stabilisation Design’ is available with
Acuvue Advance for astigmatism and now
with 1-Day Acuvue for Astigmatism. Apart
from demonstrating the speed and ease
with which this design locks to the correct
axis Johnson & Johnson were on hand to
discuss the real time, every day
requirements of astigmats outside of the
consulting room environment.
Interestingly, J&J have found that in a
recent study on the subject three quarters
of toric lenses wearers found visual
fluctuation when wearing their lenses
unsettling. Their claim for Accelerated
Stabilisation Design is that this statistic
can be reversed.
If the smaller, independent laboratory with
optician-only supply is your bag then
Prospect Lenses were on hand. Boasting
a full range of materials including silicone
hydrogels, Prospect say they can offer a
uniquely personal service with a wealth of
technical support.
Also majoring on the optician-only theme
is Sauflon. Traditionally a solution-only
manufacturer in recent years, Sauflon
have now expanded into the contact
lenses market and are showing an
increased range of lens products. Their
big push for this year’s show was Synergi,
a multi purpose, preservative-free solution
developed for silicone hydrogels and
Bioclear, their new biomimetic lens, said
to be ideal for the dryer eye patient as it
encourages the bonding of water to the
lens during wear.
Last but not least of the contact lens
round up is new boy on the block Two
Tower Optics with a new premium daily
disposable Safegel 1-day. Two Tower
promote this new entry to a crowded
market with the slogan “The lens that
thinks it’s an eye drop”. The 1-day lens is
made from a bi-polymer of hydrogel and
sodium hyaluronate. Sodium hyaluronate
is found in many leading eye drops and
the lens acts as a slow release
mechanism to lubricate the eye
throughout the day. Initial trials are said to
indicate enhanced initial as well as
continued comfort throughout the longest
day. Safegel 1-day is available in the UK
through No.7 Contact Lenses.
Although I perceived Optrafair to be
smaller and less busy, I certainly found
enough to keep me interested - not to
mention being buried for a month under a
pile of leaflets and information brochures.
David Goad FBDO(Hons)CL is the author
of a number of published papers on
contact lens-related matters and is an
examiner in contact lens practice for the
ABDO. He is on the ABDO Journal
Advisory Committee and the Contact
Lens Committee as well as being a former
dispensing chairman of the BCLA council.
David is experienced in marketing
strategy and general business
management including specialist business
systems, particularly in relation to
information technology. He is a founding
partner at Proven Track Record which will
be running the third Independents Day on
4 July. David is currently General Manager
for the West Country based independent
group Robert Frith Optometrists and is in
private practice with Jan Goad & Robert
Frith. ■

14 DISPENSING OPTICS JUNE/JULY 2007 CONTINUING EDUCATION AND TRAINING
The challenges of
the ageing eye
Angela McNamee BSc(Hons) MCOptom FBDO (Hons) CL Cert Ed reviews age related changes to the
the anterior eye
COMPETENCIES COVERED: CONTACT LENSES, CONTACT LENS PRACTICE, OCULAR ABNORMALITIES
TARGET GROUP: DISPENSING OPTICIAN, OPTOMETRIST, SPECIALIST
ANTERIOR EYE
The population of the UK is about 60
million; around 20 million of these people
are over 50 years old, and almost all of
this group will need to visit an optical
practice at some time. What is often a
surprise to the younger practitioner is that
so many of these people did not expect
their eyes to age. When changes occur in
the way that older people see the world,
and in the way that their eyes appear to
them in the mirror, they are often unduly
worried and frequently suspect that
something is seriously wrong.
When an over-50-year-old walks into the
practice our first thought is often about
presbyopia and the various ways of
correcting it, but there are a lot more
changes occurring within the normal
ageing eye, including changes to the lids,
cornea, conjunctiva and tears, as well as
to the internal eye. A knowledge and
understanding of these may affect our
choice of vision correction and will also
enable us accurately to counsel our
patients. This article will discuss what
happens to the anterior eye as it ages.
GROSS CHANGES
Enophthalmos
Loss of fat in the orbit means that the
eyes sink deeper and appear smaller with
age, although actually unchanged in size.
Miosis
Pupil size reduces with age. In normal
illumination the average 20-year-old has a
5mm pupil, increasing to 8mm in low light
conditions. By the age of 60 however the
diameter will have reduced to an average
of 3mm in normal light, increasing only to
around 4mm. The smaller pupil will
reduce the amount of light arriving at the
retina. Pupils this small and unreactive
could also make the fitting of most
multifocal soft lenses rather challenging,
since these designs employ a
simultaneous vision design and are, by
their nature, pupil-dependent.
NORMAL LID CHANGES
Ptosis
Involutional (age-related) ptosis occurs,
with the upper eyelid crease appearing
lower or absent, and the lid acquiring a
drooping appearance (Figure 1). This is
due to degeneration of the superior
This article has been awarded 2 CET points by the GOC (2 CL points for CLOs on CL Specialty List and optometrists, or 2 points for DOs).
It is open to all FBDO members, including associate member optometrists. Insert your answers to the twelve multiple choice questions (MCQs)
on the answer sheet inserted in this issue and return by 12 July 2007 to ABDO CET, Courtyard Suite 6, Braxted Park, Great Braxted,
Witham CM8 3GA OR fax to 01621 890203, or complete online at www.abdo.org.uk. Notification of your mark and the correct answers
will be sent to you. If you complete online, please ensure that your email address and GOC number are up-to-date. The pass mark is 60 per
cent. The answers will appear in our October 2007 issue.
[anterior eye]
FIGURE 1: INVOLUTIONAL PTOSIS
extension (aponeurosis) of the levator
muscle, and is thought to be a gradual
change 1 , only becoming obvious in later
years. Ptosis can cause reduced oxygen
supply to the superior cornea 2 .
Dermatochalasis
Sometimes confused with ptosis, in this
condition the skin of the eyelids becomes
looser and less elastic, and may hang
down in a fold over the upper lashes,
obscuring their roots (Figure 2). This can
make good lid hygiene quite difficult,
leading to an increase in anterior blepharitis.
Blepharoplasty, in which some of the
excess tissue is removed surgically, may
be performed by an ophthalmologist for
cosmetic reasons or due to clinical need.
C-5817

FIGURE 2: DERMATOCHALASIS FIGURE 3: INVOLUTIONAL ECTROPION FIGURE 4: INVOLUTIONAL ENTROPION
Lid margin changes
There is also a general increase in anterior
blepharitis with increasing age, including
seborrheic (dandruff-like) scales and
telangiectasia (dilated capillaries). Since
this may increase infection risk, it should
be treated before commencing contact
lens fitting, by giving the relevant advice
regarding ongoing lid hygiene.
Changes occur in the meibomian glands
(responsible for producing the lipid
content of the tears): their openings
narrow with age, their rate of secretion
reduces and there is a reduction in their
number (meibomian gland dropout). The
lid margins thicken and may appear
notched 4,5 . Whilst warm compresses and
lid massage may stimulate the secretions
of the remaining meibomian glands,
ocular lubricants will often still be
required, to supplement the decreased
lipid component of the tears.
Loss of lid tension
Occurring in both the upper and lower
eyelids, loss of tonus can make rigid
contact lenses more difficult to remove,
as the lids become less tight against the
eye. It can also preclude the fitting of rigid
alternating (translating) bifocal contact
lenses, which rely on good apposition
between lower lid and globe in order to
elevate the lens on downgaze.
Ectropion
Involutional ectropion (literally ‘turning
out’) may occur in the lower lids, due to
degenerative changes in the ligaments of
the inner and/or outer canthi, and in the
tarsal plate (Figure 3). A complication of
this is punctal eversion, in which the
punctum is clearly visible because it is no
longer in contact with the globe or with
the lower tear meniscus, resulting in
epiphora as the tears are unable to find
their natural drainage hole and thus spill
down the cheek. Patients with ectropion
frequently rub their eyes with a
handkerchief, exacerbating the problem
and irritating the surrounding skin. The
problem may also be made worse by
frequent contact lens insertion and
removal 2 . Inadequate contact between the
lids and the globe may prevent efficient
spreading of the tear film across the
cornea and contact lens.
Again, alternating bifocal contact lens
designs would be unsuitable and indeed
the fitting of any contact lens may be
contraindicated, depending upon the
severity of the problem. Also, when
assessing seg top position in bifocal
spectacle lenses, remember to be guided
by the lower limbus, not by the lower lid.
Entropion
The most common type of entropion
(‘turning in’) is also age-related, and
usually affects the lower lid (Figure 4).
There is a combination of causes for
involutional entropion, including changes
occurring in the orbicularis muscle, where
its preseptal (inferior) portion becomes
more mobile, allowing it to override the
pretarsal (eyelid) portion, thus turning the
eyelid in. The lower lid retractors,
responsible for depressing the lower lid
on downgaze, may become looser or
disinserted. Lid laxity is also a factor. The
obvious result of entropion is that the
eyelashes turn inwards, causing inferior
corneal and conjunctival abrasion. For
therapeutic protection from the lashes,
silicone hydrogel contact lenses may be
considered in mild cases, and sclerals in
the more advanced. However it should be
remembered that both entropion and
ectropion may be amenable to a variety of
corrective surgical techniques and are not
necessarily conditions which patients
simply have to accept as part of getting
old.
BENIGN LID LESIONS
Xanthelasma
More common in older age groups, and
usually seen on the lids, superior and
inferior to the medial canthi, these
elevated, yellowish, plaque-like lesions
are composed of a type of connective
tissue cell, filled with lipid material (Figure
5). Although harmless, they are often
associated with elevated blood
cholesterol levels. Patients may therefore
be at risk from cardiovascular disease and
should be counselled to seek medical
advice. Xanthelasma are removed only for
cosmetic reasons, when surgical excision
or carbon dioxide laser may be used.
Interestingly, one study 19 showed that
xanthelasma resolved without trace some
years after commencing treatment with
cholesterol lowering drugs (statins).
Squamous cell papilloma
This is the most common benign eyelid
lesion and usually represents an overgrowth
of normal epithelium, with varying levels
of pigmentation, over a core of fibrous
connective tissue. It appears in middleaged
or older people and is attached to
the lid margin either by a pedicle (stalk) or
a broad base. It can be removed for
reasons of cosmesis or comfort.
Occasionally the human papilloma (wart)
virus may be involved, but this is more
common in younger people.
Actinic keratosis
Also known as solar keratosis, this lesion
is more common in elderly, fair-skinned
people. It has a rough, scaly appearance
and is usually flat or slightly raised, but
occasionally nodular; it is skin-coloured to
yellowish and the underlying skin may be
pinker than usual. As its name suggests,
there is an association with UV exposure.
Although commonly benign, a small
percentage of these may transform into a,
more serious, squamous cell carcinoma,
so all should be referred for investigation.
Keratoacanthoma
This lesion can be the most alarming to a
patient, as it is rapidly-growing and can
develop in weeks from a single pink spot
to a dome shaped swelling up to 4cm in
diameter, with a central, keratin-filled
crater (Figure 6). Like actinic keratosis, it
is more common in the elderly and fair-
CONTINUED ON PAGE 16

16 DISPENSING OPTICS JUNE/JULY 2007 CONTINUING EDUCATION AND TRAINING
FIGURE 5: XANTHELASMA FIGURE 6:KERATOACANTHOMA FIGURE 7: CUTANEOUS HORN
skinned and has a probable association
with UV exposure. Spontaneous
resolution can take up to a year and
leaves a scar. It is often confused with
squamous cell carcinoma, so patients
should be referred for confirmation of
diagnosis.
Cutaneous horn
This consists of an over-production of
keratin and protrudes from the skin like a
piece of fingernail (Figure 7). It may be
associated with actinic keratosis and/or
squamous cell carcinoma, and should be
referred for investigation.
Basal cell papilloma
Also known as seborrheic keratosis, this
is the most common pigmented lesion in
the over-50s and can vary greatly in
appearance, being either flat, slightly
raised, domed or wart-like. It reaches 1-2
cm in diameter and is usually brown in
colour and greasy-looking. It is often
surgically removed, either to confirm its
diagnosis or for cosmetic reasons, but
frequently recurs.
CONJUNCTIVA
Ageing produces a reduction in the
number of layers of epithelial cells in the
conjunctiva, in the amount of collagen in
its stroma and in the number of goblet
cells, responsible for producing the
mucous component of the tear film. The
conjunctiva also becomes less
transparent, more yellow in colour, and its
blood vessels appear more tortuous and
irregular 3 . It is no longer tightly attached to
the underlying tissue, so that a large
diameter soft contact lens may appear to
move on the push-up test or with
blinking, when it may in fact be dragging
the conjunctiva with it. It is important
then, when assessing movement, to
watch the edge of the lens relative to the
adjacent conjunctival vessels.
Pinguecula
Becoming more prevalent with increasing
age, pingueculae (Figure 8) appear as
elevations in the bulbar conjunctiva, near
the limbus, at the 3 and 9 o’clock
positions, more commonly nasally but
often in all four positions. Varying in
colour from transparent to white to yellow,
they may also be calcified (having white
flecks) and are sometimes hyperaemic.
The underlying cause is degeneration of
the conjunctival stromal collagen and
thinning of the overlying epithelium, due
to exposure. The presence of pingueculae
may affect the fit of soft contact lenses,
but is not a contraindication. It is often
also a source of concern to patients , CL
wearers or not, when they first become
aware of it. This can sometimes be when
they get their first, overdue, reading
correction and can actually see them. A
few words of reassurance at this stage
will be gratefully received.
Pterygium
The incidence of pterygium increases with
age, particularly in combination with
cumulative exposure to hot, dry, sunny
conditions. It appears as a fibrovascular
growth, initially on the limbal conjunctiva,
at the 3 and/or 9 o’clock positions, and
eventually encroaching on the cornea
(Figure 9). It is generally accepted that
pterygia should be surgically removed
prior to contact lens fitting, and the area
then closely monitored, since recurrence
is common. Advanced pterygium can
result in irregular astigmatism, persisting
after surgery, but it may be possible to
correct this with rigid contact lenses 6 .
SCLERA
It is a commonly held view that the sclera
thins with age (although this has been
disputed by some researchers 12 ) and this
thinning becomes apparent, particularly,
anterior to the insertions of the hardworking
medial and lateral recti muscles,
where an area of translucency is often
observed as a bluish colouration, with the
underlying choroid showing through
(Figure 10). The thickness of the sclera is
naturally reduced in these areas, even in
younger eyes, being around 0.3mm,
compared to around 0.8mm at the limbus.
There is also an increase in lipid content
of the sclera with age, giving it a yellowish
appearance, this increase being common
to other collagenous tissues in the body,
including the cornea, as discussed later.
Minor blood vessels in the sclera, like
those in the conjunctiva, become more
tortuous with age.
TEARS
The traditional model of the tear film
describes three layers: a superficial lipid
layer, secreted by the meibomian glands
and the glands of Zeis, and responsible
for retarding evaporation of the tears; an
aqueous layer, secreted mainly by the
lacrimal gland, with a lesser input from
the accessory lacrimal glands of Krause
and Wolfring; and a mucous layer,
secreted mainly by the goblet cells of the
conjunctiva, which ensures adhesion of
the aqueous layer to the ocular surface.
Two sub-classes of dry eye have been
suggested 8 . Tear-deficient dry eye occurs
when there is a reduction in tear aqueous
production from the lacrimal gland. In
evaporative dry eye, lacrimal gland
aqueous production is normal but tears
are lost due to excessive evaporation.
It has been shown that there is a
significant increase in both types of dry
eye in subjects over the age of 40
(18.1%), compared with those under 40
(7.1%) and this affects both genders,
although that caused by decreased tear
aqueous production is more common in
females 7 . 15% of over-65s have reported
at least one symptom of dry eye often or
all of the time 9 .
Lacrimal gland function decreases at the
menopause, due to a reduction in
circulating sex hormones; and a ‘vicious
circle’ feedback model has been
described, whereby reduced lacrimal
output causes corneal surface damage,
resulting in reduced corneal sensation,

FIGURE 8: PINGUECULA FIGURE 9: PTERYGIUM
FIGURE 10: SCLERAL THINNING
which in turn feeds back to the lacrimal
gland causing a further reduction in
lacrimal output, and ultimately damage to
the gland itself 10 . Corneal sensitivity also
reduces in both genders with age, as
discussed later.
Sjorgen’s syndrome, an auto-immune
disease affecting both lacrimal and
salivary gland output, and another cause
of tear-deficient dry eye, is much more
common in the over-40s, particularly in
females.
Many medications also cause reduced
lacrimal secretion, and those that are
more likely to be used by the elderly
population include the cardiovascular
drugs Digoxin and Amiodarone, betablockers
such as Atenolol, and thiazide
diuretics, such as Bendrofluazide, the
latter pair being commonly used in the
treatment of hypertension.
Diabetes is also more common in the
elderly, and has been shown to lead to a
decrease in corneal sensitivity and an
increase in dry eye 11 .
As discussed previously, meibomian
glands reduce in number with age, and
their rate of secretion drops. There is
therefore likely to be a disruption to the
lipid layer of the tears, leading to an
increase in evaporative dry eye. Also,
since the goblet cells in the conjunctiva
reduce in number with increasing age,
aqueous adhesion will be affected.
Hence the elderly population can suffer
increasing signs and symptoms of dry
eye, with obvious implications for contact
lens wear and general ocular comfort.
CORNEA
Curvature
Studies 13 have shown that most young
corneae exhibit with-the-rule astigmatism,
ie the vertical meridian is steeper than the
horizontal, and that after about the age of
40 14 there is a gradual change towards
against-the-rule. An early theory for this
change 15 suggests that the natural shape
is against-the-rule, but that pressure from
young, tight lids deforms it, causing it to
bulge in the vertical meridian. In later
years then, as lid tension reduces, the
cornea begins to revert to its natural form.
The cornea of the average 60 to70-yearold
has been shown to be spherical, with
against-the-rule astigmatism becoming
the norm after the age of 70 16 .
Epithelium
Sensitivity
Corneal touch sensitivity decreases with
age, with the threshold for touch almost
doubling between the ages of 10 and 80,
the majority of this change occurring after
the age of 40 17 . Cataract surgery further
decreases sensitivity.
Fragility
At the same time as sensitivity decreases,
corneal fragility increases at an almost
identical rate, whilst the speed of healing
reduces 18 . This potentially dangerous
combination means that older contact
lens wearers are more likely to suffer
corneal damage whilst at the same time
being unaware that there is a problem.
Hence there may be an argument for
increasing the frequency of aftercare
checks in line with increasing age.
Epithelial basement membrane dystrophy
(EBMD)
Also known as Cogan’s or Map-dotfingerprint
dystrophy, this is the most
common corneal dystrophy and its
prevalence increases with age. Most
patients are asymptomatic and the typical
corneal epithelial changes of map-like
shapes, dots, and whorls like fingerprints
are found only on routine examination. It
is caused by a defect in the adhesion of
the epithelium to the underlying basement
membrane.
Some patients may progress to develop
recurrent corneal erosion syndrome
(RCES), and those who do may awake in
the morning with extreme discomfort and
lacrimation, as the epithelium lifts from
the membrane. In mild cases this will
resolve in a matter of hours, and it is not
uncommon for patients to mention this at
a routine examination, when often
explanation and reassurance are all that is
required. The use of ocular lubricants at
night will often be helpful. More severe
cases may be treated surgically, often
with an excimer laser (photo therapeutic
keratectomy). RCES also frequently
occurs without a preceding EBMD,
usually following a corneal abrasion.
Routine contact lens fitting would be
inadvisable in patients with EBMD and/or
RCES although, once referred, they will
sometimes be fitted with a continuous
wear silicone hydrogel as a bandage lens.
Hudson-Stahli line
This finding, very common in the elderly,
represents a deposit of iron in the corneal
epithelial cells. It is best seen with cobalt
blue light on the slit lamp, when it
appears as a fine, brownish line in roughly
the same position as the lower tear prism,
from which the iron is derived. It is
harmless and of little significance.
Bowman’s membrane
Anterior crocodile shagreen (anterior
corneal mosaic)
More commonly seen after light pressure,
eg applanation tonometry or a flat fitting
rigid contact lens, this occurs as a result
of a loosening in the collagen fibrils of
Bowman’s and the anterior stroma, the
mosaic pattern resembling the
appearance of crocodile skin (Figure 11),
with polygonal greyish opacities in the
central cornea.
Stroma
Arcus senilis
As in the conjunctiva, there is a
generalised increase in the lipid
(cholesterol) content of the cornea with
age. This is particularly apparent in the
CONTINUED ON PAGE 18

18 DISPENSING OPTICS JUNE/JULY 2007 CONTINUING EDUCATION AND TRAINING
FIGURE 11: CROCODILE SHAGREEN FIGURE 12: ARCUS SENILIS FIGURE 13: GIRDLE OF VOGT
white ring seen in the periphery, known as
arcus senilis or arcus lipoides (Figure 12).
This lipid deposit usually occurs
bilaterally, and is seen in 60% of 40 to 60year-olds,
80% of 60 to 70-year-olds, and
100% of those over 80 (22). It appears
initially at the inferior and superior
peripheral cornea, gradually increasing
until eventually a complete white ring may
be formed, separated from the limbus by
a clear zone known as Vogt’s lucid space.
Arcus represents a deposition of
cholesterol in the anterior and posterior
stroma. It is not a contraindication to
contact lens fitting.
Many studies, often contradictory, have
been carried out in an attempt to correlate
this corneal sign with the development of
coronary artery disease, and one has
shown that in males under 50 there may
be a positive link 20 . Another study has
shown that corneal arcus is more frequent
in males, and increases in frequency and
size with age and with the levels of
cholesterol and low-density lipoproteins 21 .
Low density lipoproteins (LDLs) are often
known as the ‘bad cholesterols’ because
they carry cholesterol from the liver to the
cells of the body, where they may deposit
in artery walls; high density lipoproteins
(HDLs), known as the ‘good cholesterols’,
carry cholesterol away from the cells.
It would seem from all of this that if we
spot arcus in anyone over the age of 60
we may probably consider it to be a
completely normal finding. If seen in those
under 60, the extent and size of the
deposit, considered together with the
actual age of the individual, may
determine whether we advise patients to
consult their GP for a cholesterol test.
When seen in the under 40s, familial
hypocholesterolaemia (an inherited
tendency to have a high cholesterol level)
may be suspected and referral is
advisable.
Limbal girdle of Vogt
Sometimes confused with arcus, this
white, crescent-shaped deposit appears
only at the nasal and/or temporal limbus,
and is more rough in appearance, often
having tiny irregular extensions (Figure
13). It is extremely common in the elderly,
completely harmless, and represents a
degeneration similar to that found in
pinguecula and pterygium. It does not
require referral and presents no barrier to
contact lens wear.
Posterior crocodile shagreen
Similar to anterior crocodile shagreen, this
finding is seen in the posterior stroma and
Descemet’s membrane, both centrally and
peripherally. Both forms are harmless and
vision appears to be unaffected.
Descemet’s and Endothelium
Hassle-Henle bodies (Descemet’s warts)
Caused by an overproduction of
basement membrane material by the
peripheral endothelial cells, these nodular
protrusions may appear in the peripheral
cornea after the age of 30, and are very
common in those over 65.
Cornea guttata
Essentially the same as Hassle-Henle
bodies, but appearing in the central
cornea, guttae appear as tiny droplets
(gutta means ‘drop’), often interspersed
with pigment granules. Although also very
common in the over-40s, they are of more
significance, since they may represent an
early manifestation of Fuch’s endothelial
dystrophy. Six-monthly review may be
advisable.
Fuch’s endothelial dystrophy
Although not a common condition, the
incidence of Fuch’s dystrophy increases
in the over-50s. It is an inherited condition
in which Descemet’s membrane thickens
and the number of endothelial cells
reduces, eventually affecting the pumping
mechanism of the endothelium and
leading to chronic corneal oedema.
Routine contact lens fitting is
contraindicated. A corneal graft may be
necessary in advanced cases.
Other endothelial changes
Endothelial cell numbers reduce, and they
become less regular in shape
(pleomorphism) and size (polymegathism)
with increasing age. These changes in the
endothelium also have a slight detrimental
effect on its pumping mechanism and this
effect is accelerated in diabetes 23 and also
by the use of contact lenses made from
materials with low oxygen transmissibility.
CONCLUSION
As Mark Twain wrote, “Life would be
infinitely happier if we could be born at
the age of eighty and gradually approach
eighteen”. Unfortunately we can’t tell our
older patients not to worry because they’ll
“grow out of it”, but a greater
understanding of the changes which they
are experiencing will enable us better to
advise and reassure them.
REFERENCES
1. Sanke RF. Relationship of senile ptosis
to age. Ann Ophthalmol. 1984; 16(10),
928-931
2. Benjamin WJ, and Borish IM.
Physiology of aging and its influence on
the contact lens prescription. J Am
Optom Assoc. 1991; 62(10), 743-753
3. Records RE. Physiology of the Human
Eye and Visual System. London: Harper &
Row; 1979
4. Den S, Shimizu K, Ikeda t, Tsubota k,
Shimmura S. Association between
meibomian gland changes and aging,
sex, or tear function. Cornea. 2006;
25(6):651-5
5. Hykin PG, and Bron AJ. Age-related
morphological changes in lid margin and
meibomian gland anatomy. Cornea.
1992;11(4):334-42
6. Smith RJ, Hallak J, Vogel M,
Kanellopoulos AJ, Perry HD, Donnenfeld
ED, Rahn EK. Visually debilitating
pterygium: surgical and contact lens
treatment. CLAO J. 1996;22(1):83-6.
7. Albietz J. Prevalence of dry eye
subtypes in clinical optometric practice.
Optom and Vis Sci. 2000;77:357-363
8. Lemp MA, Report of the national eye
institute/industry workshop on clinical

trials in dry eyes, CLAOJ. 1995; 21:221-
232
9. Schein OD, Tielsch JM, Munoz B,
Bandeen-Roche K, West S. Prevalence of
dry eye among the elderly. Am J
Ophthalmol. 1997;124(6): 723-8
10. Mathers WD. Why the eye becomes
dry: a corneal and lacrimal gland
feedback model. CLAO J. 2000;
26(3):159-65
11. Touzeau, Levet L, Borderie V,
Bouchard P, Laroche L. Anterior segment
of the eye and diabetes mellitus. J Fr
Ophthalmol. 2004;27:859-70
12. Weale RA. A Biography of the Eye.
London: HK Lewis;1982
13. Kratz JD, and Walton WG. A
modification of Javal’s rule for the
correction of astigamatism. Am J Optom
Arch Am Acad Optom. 1949;26:295-306
14. Vihlen FS, and Wilson G. The relation
between eyelid tension, corneal toricity
and age. Invest Ophthalmol Vis Sc.i
1983;24(10): 1367-73
15. Von Helmholtz H. in Physiological
Optics: Optical Society of America;1924
16. Hayashi K, Hayashi H and Hayashi F.
Topographical analysis of the changes in
corneal shape due to aging. Cornea.
1995;14:527-32
17. Millodot M. The influence of age on
the sensitivity of the cornea. Invest
Ophthalmol Vis Sc.i 1977;16:240-72
18. Millodot M, and Owens H. The
influence of age on the fragility of the
cornea. Acta Ophthalmol (Copenh).
1984;62:819-24
19. Shields CL, Mashayekhi A, Shields JA,
and Racciato P. Diasppearance of eyelid
xanthelasma following oral simvastatin. Br
J of Ophthalmol. 2005; 89:639-40
20. Chambless LE, Fuchs FD, Linn S,
Kritchevsky SB Larosa JC, Segal P,
Rifkind BM. The association of corneal
arcus with coronary heart disease and
cardiovascular disease mortality. Am J
Public Health. 1990; 80:1200-4
21. Pe'er J, Vidaurri j, Halfon ST,
Eisenberg S, and Zauberman H.
Association between corneal arcus and
some of the risk factors for coronary
artery disease Br J. Ophthalmol. 1983; 67:
pp 795 - 798
22. Duke Elder S, Corneal degenerations,
dystrophies and pigmentations-age
changes. In Duke-Elder S, and Leigh AG
(eds). System of Ophthalmology. St Louis:
Mosby, 1965 pp 867-80
23. O’Donnell C, and Efron N. Corneal
endothelial cell morphometry and corneal
thickness in diabetic contact lens
wearers. Optom Vis Sci. 2004; 81:858-62
Angela McNamee is a former full-time
lecturer at City & Islington College. She
now works as an optometrist and contact
lens optician in private practice and is an
ABDO theory and practical examiner. ■
Multiple choice questions (MCQs)
1. Eyes appear to look smaller with
advancing age due to
a. Increased orbital fat?
b. Reduced orbital fat?
c. Reduced pupil size?
d. Increased pupil size?
2. The pupil diameter of the average
60-year-old in low light conditions is
a. 8mm?
b. 6mm?
c. 4mm?
d. 2mm?
3. Which one of the following is
incorrect regarding dermatochalasis?
a. It may be confused with ectropion
b. It may be corrected surgically
c. It makes lid hygiene more difficult
d. It may obscure the lash roots
4. Which one of the following is correct?
a. Hassle-Henle bodies are nodules on
Bowman's membrane
b. Meibomian gland numbers reduce with
age
c. Telangiectasia refers to constricted
capillaries
d. Xanthelasma is a pigment deposit
5. Which one of the following is
incorrect?
a. Punctal eversion is a complication of
entropion
b. Entropion and ectropion may be
surgically corrected
c. Corneal abrasion may be a
complication of entropion
d. Lid laxity is a causative factor in
entropion
6. Which one of the following should
always be referred for medical opinion?
a. Squamous cell papilloma
b. Actinic keratosis
c. Entropion
d. Ectropion
7. With increasing age the conjunctiva
a. Becomes more tightly attached to the
underlying sclera?
b. Becomes less transparent?
c. Increases in epithelial cell numbers?
d. Becomes more blue in colour?
8. Which one of the following is true
regarding the sclera?
a. It is naturally thinnest at the limbus
b. It yellows with age
c. Minor blood vessels become less
tortuous with age
d. Translucency is often observed as a
pink colouration
9. Which one of the following is
incorrect?
a. Lacrimal gland function increases at
the menopause
b. The beta-blocker Atenolol causes
reduced lacrimal secretion
c. Sjorgren’s syndrome is more common
in females
d. Conjunctival goblet cell numbers
reduce with age
10. Which one of the following is
correct regarding corneal curvature?
a. The average 65-year-old has a
spherical cornea
b. Most 20-year-old corneae have
against-the-rule astigmatism
c. Most 80-year-old corneae have withthe-rule
astigmatism
d. Tight lids cause against-the-rule
astigmatism
11.Which one of the following is
correct regarding arcus senilis?
a. All patients over 60 with it should be
referred
b. All patients under 40 with it should be
referred
c. It represents a calcium deposit
d. It appears initially at the nasal limbus
12.Which one of the following is true?
a. Posterior crocodile shagreen causes
vision loss
b. Hassle-Henle bodies are rare in the
over-70s
c. Endothelial cell numbers increase with
age
d. The incidence of Fuch’s dystrophy
increases over the age of 50
The deadline for posted or faxed response is 12 July 2007 to the address on page
14. The module code is C-5817
Online completion - www.abdo.org.uk - after member log-in go to ‘CET online’

20 DISPENSING OPTICS JUNE/JULY 2007 STUDENT TRAINING
Dispensing
logbook
As an element of the dispensing student’s pre-registration year, it is a requirement for students to
complete a dispensing logbook. Sally Bates FBDO explains
Dispensing logbooks are provided, on
request, by the ABDO pre-registration
department at Godmersham Park.
Evidence of your practical dispensings
should be entered in your personal ABDO
logbook. Ensure that each dispensing,
matches the patient’s record card
(Figure 1).
If your workplace is selected for a
practice visit during your pre-reg year, the
ABDO practice visitor will ask to assess
your logbook and verify several
dispensings by checking the patient’s
record card.
Your dispensing logbook must include a
variety of 50 dispensings and it is
necessary to include the following
subjects:
• Paediatric (including pre-school)
dispensing
• Prescriptions from +/- 5.00 to +/- 9.75
• Complex prescriptions over +/- 9.75
• Bifocals
• Progressive power lenses including
occupational types
• Trifocals
• Occupational dispensing
• Sports eyewear dispensing
• Anisometropic dispensing
• Prescribed tinted lenses and filters
• Personal eye protection
• Low vision
• Involvement in a referral for
pathological reasons
• Patient with a facial abnormality
TOP TIPS
Also include the following dispensing
topics:
• High myopia and hypermetropia,
including aphakia
• Pseudophakic prescription
• Prism correction
• High astigmatic prescriptions, including
keratoconic patients
• Non - tolerance dispensing
• Occupational spectacles, including
intermediate or VDU spectacles for a
specified working distance
• Recreational spectacles, including
swimming goggles, shooting and snooker
specs etc
• Low vision - including the dispensing of
magnifiers, spectacles and LVAs
• Tinted prescription eyewear
• Post refractive surgery
Take your time to complete the
dispensing logbook. Plan the case
records – you require a variety of
prescriptions, frames and lenses to suit
the patient’s requirements. Include all the
dispensing details – no matter how
unimportant you think they are!
as the frame make, model, colour, eye
size and DBL (all of which should be
marked on the frame). It is also
appropriate to include for every patient:
• Length to bend – measured from the
dowel point to the ear point
• Angle of side – essential for single
vision aspheric lenses (for every 2º of
frame tilt, drop the optical centres by
1mm). Ensure the angle is 10º prior to
fitting PPLs and aspheric bifocals, as the
OCs have been pre-decentred by the lens
manufacturers
• Distance between pad centres –
recommended when dispensing PPLs
into a metal frame; this adjustment affects
the fitting cross height. Also when
dispensing rimless spectacles, in the
situation when the mount has been
supplied and glazed by the lab. This
measurement enables the bridge of the
frame to fit both correctly and
comfortably.
• Head width – recommended when a
new frame will be supplied and glazed
from the lab, rather than using a stock
frame.
• Vertex distance – if the prescription is a
combination of +/- 5.00D or more, the
frame BVD must be recorded in
accordance with BS 2738.
LENS AND CENTRATION
DETAILS
Ensure that the lens manufacturer, type of
lens, index, and any relevant coatings,
tints or filters are included.
When dispensing single vision high
powers, high cyls and aspheric lenses,
ensure that you include the mono CDs
and vertical heights.
FRAME DETAILS
Don’t forget to record the segment top
FIGURE 1 Include all relevant measurements, such
CONTINUED ON PAGE 22

22 DISPENSING OPTICS JUNE/JULY 2007 STUDENT TRAINING
FIGURE 2 FIGURE 3 FIGURE 4
position for bifocals and trifocals, and the
fitting cross position for both standard
and occupational PPLs.
FITTING AND ADJUSTMENTS
Include any details relevant to the frame
fitting, for example:
• Increasing or decreasing the frontal
bow
• Shortening the sides, including the
required measurements
• Altering the pantoscopic tilt
• Changing the material of the adjustable
nose pads
• Converting the sides to curl for children
or sportswear
• Converting to straight sides intended
for a comfortable fitting, used for wearers
of turbans, hearing aids, wigs or
headscarves.
Also include any advice which you may
have given to the patient regarding their
new spectacles.
DISPENSING SUPERVISION
The supervisor must be on hand at all
times to give advice regarding dispensing,
and must check the following dispensing
categories:
• All children under 16 years of age
• All complex prescriptions that are a
combination of 10.00 dioptres or more
• All safety eyewear
FIGURE 5
• All patients who are registered partially
sighted
The supervisor must check the PD
measurement and the frame fitting either
at the time of dispensing, or at the time of
the spectacle collection.
In a busy practice, ensure that fellow staff
are aware of passing over to the trainee
DO the demanding dispensings and
unusual, or interesting, prescriptions. This
will aid you in gaining hands-on
experience and become an entry in your
logbook.
DISPENSING TOP TIPS
• Check the frame fitting (Figure 2).
• Check the pantoscopic tilt of the frame
and the vertical centration.
• For both distance and near vision, for
every 2 degrees of tilt the vertical centres
should be decentred 1mm down.
• The pantoscopic tilt should be
approximately 8-10º
• Check the vertex distance is equal right
and left, and kept to a minimum.
• Check the front isn’t too flat or
excessively bowed, as this may cause
distortion.
• As you can see in Figure 3 the frame
has an excessive retroscopic (negative
tilt); the vertex distance is extreme,
causing the child to look through the top
FIGURE 6
of the lenses. This is an appalling frame
fitting.
FACIAL ABNORMALITY
This could possibly include a patient with
striking asymmetrical features. For
example: the length to bend varies by
10mm between the right and left sides,
the mono CDs vary by 4mm or more, the
eyes are at different levels of 4mm or
more. Alternatively, a patient with ptosis
(droopy upper eyelid) who requires a
ptosis prop (Figures 4 and 5), a patient
with a broken nose who requires different
splay angles and frontal angles of pad, a
tumour or growth that affects the frame
fitting, or Downs Syndrome patients who
are generally hyperopic with a flat bridge
and short length to bend.
LOW VISION DISPENSING
The most important aspects to
communicate to low vision patients are
the need for good illumination (approx
1000 lux) and using the optical device at a
closer working distance. This needs to be
noted in your case records.
Spectacles may be recommended with an
image enhancing filter, such as the
Corning CPF 527 to aid patients with
macula problems.
The distance from the low vision aid to
the reading matter needs to be quite short
(Figure 6), typically 150mm or less
(depending on the lens power and type of
unit.) As a result, the patient must adapt
to holding print closer.
Sally Bates is the proprietor of Identity
Optical Training, specialising in training
courses for practical examination revision
and Optical Assistants VRQ. She is also a
part-time lecturer at the ABDO College,
where she is responsible for teaching all
aspects of practical dispensing. ■

24 DISPENSING OPTICS JUNE/JULY 2007 PATIENT AND PRACTICE MANAGEMENT
Managing patient
expectations - 3
In the final article in this series, Wendy Sethi explains how to put all that has been previously explored
into practical use with your professional working role
Now is the time to relate all that has gone
before to the world of optics, and
specifically to managing patient
expectations. If the words that we use
comprise such a small area of
communication, then they must
necessarily be the right words.
Let’s take an example of a contact lens
patient who is freshly presbyopic and
doesn’t really want to wear a reading
correction in a pair of overspecs (listen for
groans of, “Monovision? Yuk. Lots of
chair time and messing about!”)
I have heard a few variations on the
theme of, “Right, we’re going to make
one eye distance vision and one eye near
vision. You’ll find that generally you won’t
see as clearly for anything, so just make
the best of it. You probably won’t want to
drive in these, and prolonged reading in
monovision is not usually successful.”
As a general rule, this doesn’t have the
population queuing up to have a go, so
let’s make it more attractive. “There’s a
fantastic way of dealing with your
prescription, called monovision. This gives
you distance vision and reading vision, all
from one pair of lenses, and they don’t
cost any more than your current lenses.”
Aha! The answer to all our prayers …
resulting in a queue at the door of hopeful
presbyopes who now expect miracles.
Oops, sorry, fresh out of those. We need
to temper full-on enthusiasm for our
product with honest, useful advice.
Monovision does work for a large number
of patients, provided they’ve read the tin
and know what they can and can’t expect
and, more importantly, how to achieve the
results they need.
So, we should focus on what is
achievable, and give advice on how to
deal with specific tasks for which
monovision might not quite cut the
mustard. “You’ll be able to see to read a
menu, or prices when you’re out
shopping, and most reasonably sized
print. Occasionally, for very fine print or
prolonged close work, you may find you
prefer to either have a small correction in
overspecs, or use your normal reading
glasses.”
Notice I didn’t say, “You won’t manage
fine print or prolonged close work with
monovision.” By suggesting the patient
may prefer the small correction in
overspecs, or their normal glasses, it
becomes a matter of their choice, rather
than the limitations of the lenses. I always
like to offer a positive solution to a
potential challenge, rather than a negative
warning of what won’t work. It’s a small
change in phraseology, and makes a huge
difference in patient perception and
expectation. Managing someone’s
expectations isn’t merely a case of telling
them what they can and can’t do, It
should be an informative discussion on
how to achieve what they are aiming for.
In view of this, a good discussion on
occupation and hobbies is vital - so you
know what it says on their tin!
By the way, the small correction in
overspecs may not be just the reading
add if they have monovision. It’s a
balancing of the two eyes. I have found
that a bit of extra plus in one eye may be
all that’s needed, although some patients
who have low powered near vision specs
just pop them on over the lenses for
some specific, short tasks. A lady who
comes to me for monovision does fine
needlepoint, and puts her normal readers
over monovision just to thread her needle.
Yes, she has to hold it up close to see,
but most people do that to thread a
needle anyway.
Interestingly, I only found out that she
struggled to thread her needle when I
asked how her vision was, and she said
“Fine”, but slightly hunched her shoulders
as she said it. I mirrored the gesture, and
felt uncomfortable and vaguely
displeased, so I went on to ask, “And
when isn’t it fine?” She was slightly
surprised by this, but went on to tell me
how frustrating it was to have to take out
her lenses and revert to readers for
needlepoint. She was on the verge of
giving up the lenses, and a quick look at
her options saved us losing a contact lens
patient who was otherwise content.
EYE PATTERNS
This is a fascinating area which, when
used properly, can give valuable insights
into face to face communication. When
we access information in response to any
given question, there is usually a physical
movement of the eyes at the same time.
In general, recalling a visual memory will
cause us to look upwards. When recalling
sounds, we usually look to the side, and
to remember feelings, the movement is
down and to the side.
That’s interesting but, as it stands, is not
overly useful. Here’s the good bit. For the
majority of ‘normally organised’ right
handed people, recalling a visual memory
of an actual occurrence causes us to look
up and to our left, whereas a visual
memory which has been constructed in
the imagination - for example, an image

of taking delivery of the dream car, will
cause us to look up and to our right.
Similarly for auditory memory, recalling a
conversation that actually took place
causes us to look to the left, whereas
constructing an imaginary audio
experience generally has us looking to the
right.
Please note all the uses of ‘usually’ and
‘generally’. We’re not all wired the same,
and it’s worth calibrating someone before
making any decisions. This is easily done
in normal conversation, by asking
questions such as “What was your first
car?” (actual visual recall) and “How do
you think it would look if I painted this
room blue?” (constructed visual recall).
Obviously, the most elegant way to
achieve this is to ask questions that
naturally fall into your own conversation
as you are greeting the patient and
ensuring they are seated and comfortable
Once you have observed your subject’s
eye movements in response to questions
like these, it’s time to ask things like, “
How do you clean your spectacles?” or,
“Describe to me what you do with your
contact lenses when you remove them.” It
can be useful to know whether they’re
remembering what actually happened, or
whether they’re constructing the answer
they think you want.
I would never condone challenging a
patient and calling him or her a liar, but it
is useful to be aware of occasions when it
would be prudent to subtly introduce a bit
of re-education or offer alternative
options!
In this series of articles we have dipped a
big toe into a huge pool of subject matter
and I’ve selected just a few tools which,
with practice, can prove invaluable in any
line of work. Some of the techniques may
seem a little unusual, but if you do what
you’ve always done, you’ll get what you
always got. Is what you always got the
best you can have? If not, then perhaps
the more unusual may be worth a try.
Happy communicating!
Wendy Sethi qualified as a DO in 1997
and a CLO in 2000. She is a certified
professional speaker and a neuro
linguistic programming (NLP) practitioner.
Wendy now practises as a locum CLO,
which enables her to work with NLP
clients privately, as well as doing some
work in schools dealing with exam
nerves. She is also a trainer with the
Speakers Academy, coaching people to
speak in public and is currently writing a
cookery book. ■
LOW VISION
Sight loss: how
DOs can make a
difference
Dispensing opticians are in an ideal position to help people in the
early stages of sight loss. They can point them in the right direction
at an early and timely stage in their journey, writes Amanda Reeves
I was working with a group of people with
Macular Disease yesterday and during the
discussion one man was effusive about
his optician. This wasn’t because of his
new spectacles or the speed of referral to
the eye department for treatment. He was
most appreciative of the few minutes at
the end of the eye examination, where his
optician took the trouble and time to give
him a couple of contact numbers and
some information on his eye condition.
Subsequently, this man will remain loyal
to his optician, recommend her to
everyone he meets and is likely to
encourage the rest of his family to go;
they will probably remain good customers
because the optician was so
understanding and helpful to their loved
one.
Time and time again, people coming to
terms with losing their sight report that
they just didn’t know where to start or
who to ask to find out more about what is
happening, or what support and advice
might be available. Often years pass
before they are able to access any
assistance, by which time confidence in
their own abilities has seriously
decreased. It is much harder to learn new
techniques and coping strategies in the
later stages of sight loss. Dispensing
opticians and optometrists are in an ideal
position to point people in the right
direction at an earlier and timely stage in
their journey.
If somebody’s vision is deteriorating and
spectacles are not going to solve all their
problems, you don’t have to wait until all
referrral and treatment options have been
explored before offering basic advice and
help. Often people are not offered any
support until they reach the point of
registration which can be an average of
two years down the line. People are often
surprised at just how much difference
good lighting can make to their vision and
a few minutes taken to demonstrate the
best position for task lighting for a person
can have astounding results. Similiarly,
advice regarding the benefits of using
colour and contrast only take a few
moments but can greatly enhance a
person’s ability to tackle practical
everyday tasks like preparing food.
SUPPORT ORGANISATIONS
Consider developing a quick reference file
for yourself and your colleagues
containing contact numbers for national
and local support organisations for people
losing their sight, these might be
condition specific or generic sight loss
organisations. Many of these
organisations produce flyers outlining
exactly what services they have on offer,
or a quick phone call can provide you
with the information for a bullet point list.
(I have detailed the help and support that
the Macular Disease Society can provide
below).
Most local local authorities have set up a
point of entry single telephone number by
which people can get in touch with the
Social Services Sensory Team. If a person
is experiencing difficulties because of
problems with their sight, they are entitled
to an assessment of need by Social
Services. They do not have to wait until
they have been registered blind/ severely
sight impaired or partially sighted/ sight
impaired. Social Services will be able to
provide information on the advice and
support that is available in your area for
people with sight loss and on any
CONTINUED ON PAGE 26

26 DISPENSING OPTICS JUNE/JULY 2007 LOW VISION
services that individuals may be may be
eligible for. The type and level of services
available differs according to area. In
some areas, rehabilitation workers are
able to provide support, training and
advice to help people with sight loss
improve their mobility both in the home
and out and about, teach techniques to
make daily life easier and to make the
most of any remaining vision including
practical daily living skills and
communication.
The low vision leaflet (LVL) is an
alternative means of contacting Social
Services and was developed to
specifically make it easier for people to
obtain specialist help provided by social
services. This leaflet, is a simple selfreferral
mechanism, which you should
offer to a person experiencing sight loss.
The individual (or someone on their
behalf) needs to fill in their name, address,
date of birth and answer the tick box
questions and then return the form to the
local Social Services Team (the leaflet
should have the address pre-printed on
the form.) This form does not really have
room to add information about specific
difficulties that have already been
identified. The person may have
mentioned during their visit difficulties
with cooking or falling, which you feel
would be essential information for the
Sensory Impairment team. In which case
an optician is perfectly entitled to
complete the Referral for Visual
Impairment (RVI) and submit this to Social
Services.
RECRUITING STUDENT VOLUNTEERS
The ABDO Graduation Office organises and runs the annual Graduation and
Prizegiving Ceremony, and is now recruiting student volunteers to take the roles of
ushers on the day of the ceremony. This year it will take place on Wednesday 14
November 2007.
The role of a Graduation Usher is unpaid but for every ceremony worked you gain
two additional guaranteed guest tickets for your own ceremony. Your guests also
get preferred entrance and seating in the VIP Gold Block for your own ceremony.
Duties include:
• Assisting with the setting up of the Cathedral
• Showing VIP guests to their reserved seating
• Showing graduands’ guests to their seats
• Checking guests’ tickets at the Cathedral
• Checking tickets at the Celebration Reception
• Greeting guests on their arrival at the Cathedral
• Answering general enquiries
• Marshalling guests and graduands on campus
In addition to extra tickets that you may gain from working at Graduation
Ceremonies, you are also welcome to attend the Celebration Reception.
The Graduation Office is now recruiting ushers and spaces are anticipated to fill up
quickly. If you are interested in becoming an usher please contact Gillian Hensley-
Gray by email ghensley-gray@abdo.org.uk ■
Other useful organisations to include in
your file might include contact details for
the local branch of the Citizens Advice
Bureau and Age Concern. Also include in
your file a selection of the leaflets
available explaining the most common
eye conditions.
The Macular Disease Society (MDS) aims
to build confidence and independence for
those with central vision impairment. We
are the only UK charity dedicated to
helping people with macular disease. As
an organisation we represent the interests
of our membership of over 14,000 people,
the majority of whom have some form of
macular disease themselves.
• Information and support to individuals
with sight loss through macular disease
via local rate telephone helpline 0845 241
2041
• Website www.maculardisease.org
• Over 30 information leafletson different
aspects of Macular Disease
• Free telephone counselling
• Member quarterly magazine and annual
journal summarising research
developments
• In some areas - Post diagnosis support
desks run by MDS and other voluntary
groups
In addition to the services listed above,
there are currently 150 local MDS groups
providing a support network throughout
the UK. Support and encouragement is
vital to help an individual re-establish self
confidence and independence, once they
receive a diagnosis of macular disease.
Some of our groups have a membership
of over 70 people and are active in
organising events, outings and regular
speakers on topics of interest. Others
have just a few people who meet in
someone’s home for coffee and a chat.
The helpline is able to let a person know if
there is a group local to them.
If you would like copies of the Macular
Disease patient information leaflet please
fax request to 01732 886345.
Amanda Reeves, a dispensing optician
with the Association’s Low Vision
Honours, is the Low Vision Services
Manager for The Macular Disease Society.
The role includes representing the
Macular Disease Society on National
bodies like the Low Vision Steering
Group, overseeing low vision related
projects for the organisation and providing
low vision advice and support for the
members. ■

28 DISPENSING OPTICS JUNE/JULY 2007 NEWSBRIEF
Newsbrief
JULIAN BOYSEN AND JANETTE DEAN OF SIGNET ARMORLITE KODAK THE NEW SMC BROCHURE FOR
LEVEL 2 AND LEVEL 3 COURSES
Area news
AREA 10 (KENT)
Area 10 got their new
season’s programme of CET
meetings underway on
Tuesday 6 March 2007 with
a presentation about
FreeForm progressive
lenses and how these are
personalised for the patient
or customer. In the
presentation, given by
Julian Boysen regional sales
manager NW for Signet
Armorlite Kodak and
assisted by Janette Dean
regional sales manager for
the SE, we heard that the
over fifties were the second
biggest growing age group
in the UK with over 20m
people falling into that
category. By 2017 the overforty
fives will outnumber
the under forty fives and
over fifties will control 80
per cent of the wealth of the
UK and 60 per cent of the
savings. However, 75 per
cent of the over fifties
would prefer to spend
rather than save. No
inheritance for most of the
kids then!
Following the presentation,
a lively discussion ensued
regarding the views that
had been expressed in
Disjointed Jottings, March
issue of Dispensing Optics.
As the author of the article,
Chris Hunt was in the
audience, he was able to
further expand his views on
the apathy that gripped
optics and what he saw as
a way forward for the
development of the
profession. These included
DOs being able to do
refraction, a change of
name to optician, the
unification of all the
different factions in optics
to just one body, and many
more ideas.
A very interesting evening
thanks to the generous
sponsorship by Signet
Armorlite Kodak.
Tim Bowden ■
STOP PRESS - 2007 EDITION - NOW AVAILABLE!
Ophthalmic Lens Availability by Dr Alan
Tunnacliffe
This superb reference manual, often referred to as the lens bible, is
rapidly becoming an essential tool in modern dispensing practice.
Containing information about all spectacle lenses, coatings and tints
available in the UK it can save valuable time and reduce the number of
calls to the laboratory.
Detailed information is clearly presented in an easy-to-find format
allowing the practitioner to compare single vision, bifocal and progressive
lenses from different suppliers.
The 2007 Edition is now available priced just £41 + p&p
To get your copy contact Justin at the ABDO College Bookshop
T 01227 733904 F 01227 733914
E jhall@abdo.org.uk W www.abdo.org.uk
OPTICAL ASSISTANT CAREER
PATH
The Worshipful Company of
Spectacle Makers (SMC) is
encouraging both
employees and employers
to examine the career path
available for optical
assistants and practice
support staff.
The Level 2 and Level 3
courses and qualifications
in Optical Practice Support
(L2OPS and L3OPS) are
nationally recognised and
the new brochure shows
the two programmes
together for the first time.
Both the distance learning
courses and qualifications
are proving popular, with
hundreds of students
currently studying them.
Gordon Jones, SMC
spokesman, believes that
the combined brochure will
make it easier for students
and their employers to
appreciate the opportunities
for career progression that
are on offer. He said, “The
L2OPS course offers the
chance to gain a respected,
nationally approved
qualification and the
opportunity to proceed on
to the L3OPS, which takes
the student to the next level
– equivalent to A level
standard. Such progression
opens up the possibility of
moving towards a senior
supervisory or managerial
role or a career in
dispensing optics.
“We hope that by making
both employer and
employee fully aware of the
career path and the
benefits, it will allow them
to make clear decisions
regarding training. Having a
skilled workforce trained to
national standards
developed by the profession
and attuned to practice
procedures can only help
staff, the practice and the
customer. Good training
improves skills and
competencies, motivates
and leads to better service.’’
The SMC believes one of
the main attractions of
L2OPS and L3OPS is that
the training offers much
flexibility. Students can
learn at their own pace,
choose whether or not to
take the examination and
then where and when they
should take it.
For more details of these
and other SMC courses
contact Tony Parker on
020 7236 2932, email
administrator@spectaclema
kers.com, visit the website
www.spectaclemakers.com
or write to Apothecaries’
Hall, Black Friars Lane,
London EC4V 6EL. ■
ABDO BENEVOLENT FUND
If you know of a dispensing optician, or a dependant of a dispensing optician,
who might benefit from the ABDO Benevolent Fund, please get in touch with
Barbara Doris on 020 7298 5102 or email bdoris@abdolondon.org.uk

DISPENSING OPTICIAN
OR NEWLY QUALIFIED DISPENSING OPTICIAN
REQUIRED FOR INDEPENDENT PRACTICE IN
LEICESTERSHIRE
Please apply enclosing cv to:
Mr A Bhayat
Narborough Eyecare
3 Royal Court
Leicester Road
Narborough
Leicester LE19 2EG
STUDENT WORK EXPERIENCE
SCHEME
The Sight Care Group, the
business support organisation
for independents, has
recently introduced a new
scheme offering optometry
students an opportunity to
work in an independent
practice during vacation
periods with the objective
of allowing them to see
what independent practice
has to offer. It is anticipated
that some tuition and
guidance will be available
although the experience will
be largely related to
working on the front desk.
Sight Care has created a list
of interested member
practices willing to offer
places. This is being
circulated to UK university
optometry departments
with the objective of giving
students contact details
close to home.
According to the group’s
Chief Executive Paul Surridge,
ACLM CL YEARBOOK 07
The 2007 edition of the
product manual of the
Association of Contact Lens
Manufacturers has now been
published. It lists technical
details for all the contact
lenses, solutions and materials
produced by ACLM member
companies, and covers the
overwhelming bulk of
products available in the UK.
The 2007 edition has around
60 additions or deletions, as
well as a larger number of
parameter changes to
“It is very evident from our
association with universities
that a significant number of
students consider working
for, or owning an independent
practice, as one of their key
goals after qualifying. All
too often however, they are
attracted into the multiples
and group practices
through dedicated pre-reg
schemes and never really
have an opportunity to
sample independent life”.
Sight Care hopes the scheme
will give all optometry
students a taste of
independent working life,
and in doing so will
stimulate an interest in the
sector. Sight Care is to
extend the scheme to
dispensing students in 2008,
and will be writing to their
members in the new year.
For further information
please contact Kate Burge:
kateburge@sightcare.co.uk ■
existing products. There are
new and extended
conversion tables and a
comprehensive guide to
contact lens standards. The
improved layout retains the
phonebook-style page-edge
markings to speed up your
search without reference to
the contents page.
Download an order form
from the ACLM website
www.aclm.org.uk or call the
ACLM on 01380 860418 to
order by credit card. ■
DISPENSING OPTICIAN
OR EXPERIENCED DISPENSER
Required from late June to cover maternity leave
(one year) in a busy independent practice in North
East Lincolnshire.
Full time preferred but part time would be
considered. There may be an opportunity for this
post to continue after the period of maternity
leave has ended.
Please send CV with full or part time preference
by email to robert.marshall720@ntlworld.com
DISPENSING OPTICIAN
South Wales
Required for a friendly, professional
independent practice
Please send CV to C O'Leary
17 Cowbridge Road, Pontyclun CF72 9EA
ABDO Summer School
ABDO College, Godmersham
Once again ABDO College is staging CET Summer
Schools to help you put together your target
points for this three year cycle
On Sunday and Monday 22/23 July
a dispensing session will run, with a wide range
of speakers, on subjects ranging from low vision
to frame materials
On Sunday and Monday 12/13 August
a contact lens event is planned, with only CL
points available
Numbers are limited, so contact Paula Bell for
details and an application form on 01227 733905,
by email pbell@abdo.org.uk, or at ABDO College,
Godmersham Park, Godmersham, Canterbury
Kent CT4 7DT

30 DISPENSING OPTICS JUNE/JULY 2007 NEWSBRIEF
THE SEEABILITY LOGO
SEEABILITY’S EYE 2 EYE
CAMPAIGN
SeeAbility is a registered
national charity (formerly
the Royal School for the
Blind) established in 1799,
which works with young
people and adults who are
visually-impaired with
additional disabilities.
SeeAbility offers a range of
support services including
residential and supported
living services, day services,
rehabilitation services and
community development
projects.
A considerable proportion
of people with learning
disabilities (between 30-
40%) will have a significant
impairment of vision.
Existing social care and
health services in the UK
tend to focus on people
who are blind or partially
sighted or those with a
learning disability. Regular
and effective sight tests are
rare among people with
learning disabilities
therefore visual impairment
often goes undetected -
leading to poor eye health,
dependence and, in some
instances, preventable
blindness. Services that
offer specific low vision
support to people with a
combination of both
learning disability and visual
impairment are limited or
non-existent.
The eye 2 eye Campaign
aims to improve eye care
and vision for people with
learning disabilities in a
SEEABILITY PROVIDES EYE TESTS FOR PEOPLE WITH LEARNING DISABILITIES
number of ways. There are
community development
projects across the UK –
currently in Bristol,
Sheffield, Birmingham,
London and West Sussex.
The national Information
service Look Up (launching
June 2007 in collaboration
with the RNIB) is for adults
with learning disabilities,
family carers, eye care
professionals and health
and social care staff.
Lobbying and campaigning
activities are designed to
influence government policy
on eye care and vision for
people with learning
disabilities. A £2million
fundraising strategy aims to
raise awareness and
voluntary income to
resource the Campaign.
Community development
officers are based within
local health or social
services teams working
directly with people who
have learning disabilities,
families and carers, eye
care professionals and a
range of health and social
services staff. Each project
works to ensure that:
• People with learning
disabilities are accessing
regular and effective eye
tests and are aware of the
importance of eye care and
vision.
• Health and social care
professionals and family
carers are aware of the
importance of eye care and
vision for people with
learning disabilities.
• Optometrists are
providing quality, and
accessible, eye tests for
people with learning
disabilities.
• Barriers to effective eye
care and vision for people
with learning disabilities are
identified and
communicated to relevant
local and national
stakeholders and solutions
are sought.
• Methods of improving eye
care and vision for people
with learning disabilities are
embedded within the
culture of the local
community.
• Rehabilitation workers for
the visually impaired and
low vision practitioners are
providing services for
people with learning
disabilities.
The information service
Look Up is a collaboration
between SeeAbility and the
RNIB and will launch in
Learning Disability Week 17-
24 June. The service, for
adults with learning
disabilities, family carers,
eye care professionals and
health and social care staff
will be delivered via a
website
www.lookupinfo.org,
publications, a telephone
line and an email forum.
Look Up will operate across
the UK to:
• Raise awareness of the
prevalence of sight
problems and the high level
of under detection of these
problems amongst people
who have learning
disabilities.
• Improve and increase
access to regular,
accessible and effective eye
care for adults with learning
disabilities.
• Enhance the quality of life
for people with learning
disabilities when a sight
problem has been identified.
• Help social care and
health professionals to
develop better services for
people with learning
disabilities - while working
at all times to improve our
own.
For more information about
the eye 2 eye Campaign
contact: Paula Spinks-
Chamberlain, director of
information and advisory
services, SeeAbility House,
Hook Road, Epsom, Surrey,
KT19 8SQ, telephone 01372
755049, fax 01372 755001,
email p.spinkschamberlain@seeability.org,
website www.seeability.org
for further information. ■
CET ON ABDO WEBSITE
Why not visit the ABDO website where you can complete CET online and
gain more points at www.abdo.org.uk

LEONARD WRAY
OBITUARY - LEONARD WRAY BSC(LOND),
FSMC, FBCO, DORTH, DCLP, MBIM
It is with great sadness that
I write to advise former
colleagues and students of
the death of Leonard Wray
in March of this year. Len
was the first Head of
Department of Applied
Optics at the City College in
London where he taught
from the beginning of the
department in 1964 until he
retired in 1986. Co-author of
Practical Ophthalmic
Lenses, he was not only my
boss, but my chief mentor
throughout our 22 years’
association at the College. I
will never forget his
encouragement and his
careful and thorough tuition,
not only to me personally in
the early years, when I
joined his department as a
raw young teacher, but also
to the thousands of optical
students who have passed
through his hands during
his teaching career. The
Department of Applied
Optics at City College had
been formed to take over
the dispensing courses
from their original home at
Northampton College of
Advanced Technology
which had become the
newly designated City
University.
Len started his teaching
career at Northampton
College. He was a qualified
optometrist who also held a
BSc in Physics from the
University of London. All his
life he remained a student
of applied optics, collecting
in his early years the higher
qualifications then available
to optometrists; in
orthoptics, DOrth, and in
contact lens practice, DCLP.
Dispensing opticians owe a
great personal debt to Len
Wray. It was entirely due to
his efforts that formal
tuition in contact lenses for
DOs was brought about
when in 1966, as soon as
his new department had
settled down, he instituted
both evening and dayrelease
contact lens
courses at City. He also
started evening courses for
optician’s receptionists
which have grown into
today’s optical practice
support courses now also
run by the Worshipful
Company of Spectacle
Makers. At the request of
the scientific instrument
making industry he started
courses in Technical Optics
for Optical Glassworkers,
examinations in which were
overseen at the time by City
& Guilds.
He published many
scientific papers during his
career; his mathematical
mind mastered computers
in their very early days and
he was amongst the first to
publish papers in the optical
press on programming and
future possible uses for
computers in the ophthalmic
world. Dispensing opticians
have lost one of their
greatest supporters and I
am sure that all his former
associates would want to
join me in sending deepest
sympathy to his widow,
Jeanne and to his son and
daughter, Nick and Diana.
Mo Jalie ■
Dispensing Optician (or 3 rd
year Trainee DO)
Nottingham
Specsavers Nottingham is a store with a unique
Team culture
An opportunity now exists for a qualified or
near-qualified Dispensing Optician to join our
team. As Specsavers practice of the year, we
offer the opportunity to develop your career in
optics in a busy, dynamic and friendly
environment. For the right person Specsavers
Nottingham offers a rewarding career and
possible Management opportunities.
If you believe you can make the difference
please contact Simon Dunn on:
0115 9588361 (days)
07793 201 669 (evenings)
dir.nottingham@st.uk.specsavers.com
Dispensing Optician (or 3 rd
year Trainee DO)
Southport
If you enjoy giving great customer service, you
may be just the person we are looking for!
An opportunity now exists for a qualified or
near-qualified Dispensing Optician to join our
team. We offer the opportunity to develop your
career in optics in a busy, go-ahead and
friendly environment.
Our training and development programme will
also cover most of your CET requirements, at
no cost to yourself.
• Competitive salary package
• Excellent working conditions
• Friendly and professional team
Contact Stuart Roberts on
01704 501944 (days)
07762 890004 (eves)
sturob777@yahoo.co.uk

32 DISPENSING OPTICS JUNE/JULY 2007 NEWSBRIEF
CET CDs from
ABDO College
Bookshop
FRAME & FACIAL MEASUREMENTS
ABDO has produced a CD containing tutorials on frame and facial
measurements, which is suitable both as a refreshment of skills/CET
for practitioners and for students learning for the first time. Facial
measurements are explained by Abi Grute FBDO(Hons)LVA (Hons)SLD,
as video tuition in chapter form. The frame measurement section
explains the terms used and there are separate tutorials on use of the
ABDO frame ruler and the City frame ruler. An additional unique
application has been included, which, after entry of facial
measurements by the user, will print to actual size the image of the
frame front. This can then be cut out and used to verify the fit of the
front for a handmade frame. The application, which was designed by
David Pipe from an idea by Paula Stevens, can help avoid costly
mistakes when ordering handmade frames, and could also be used by
frame-makers to send a pattern to the practitioner for verification
before cutting expensive materials. After studying the tutorials, the
user can take part in interactive self-assessments with feedback.
Once the skills are mastered, registered users can then complete the
interactive CET tests to gain up to 6 general CET points. The design
and programming is by ABDO CET's Mark Smith, who has completed
production of the CD with the inclusion of an order form linking
directly with the ABDO website bookshop for the instruments
described in the tutorials. Member price £65, non-members £85,
student price (without CET section) £49.98 inc VAT and postage.
THE RIMLESS RENAISSANCE
This is a CD presentation authored by Paula Stevens MCOptom FBDO
CL(Hons)AD SMC(Tech) which covers all aspects of dispensing rimless
mounts. Chapters include: history of rimless mounts, lens suspension
systems, lens and mount materials, checking and adjustments. 3
general CET points can be gained from successful completion of the
concluding multi-choice assessment section. £25 inc VAT and postage.
COMING LATER IN 2007
FRAME ADJUSTMENTS
This CD is based on a chapter from Anthony I Griffith's textbook
Practical Dispensing. Sections include: frame materials, tools for
adjustment, tackling common adjustments and a chaptered theory
section. There is an interactive self-assessment element, and a CET
assessment for 4 general CET points on successful completion.
Member price £45, non-members £55, student price (without CET
section) £34.99 inc VAT and postage.
COMMUNICATION IN DISPENSING
This innovative CET CD is sponsored by Nikon UK, and is authored by
Kevin Gutsell FBDO. It uses interesting assessment techniques,
designed by Mark Smith, to engage the learner in typical scenarios
encountered in practice, to gain 3 CET points on successful
completion. More details soon. £25 inc VAT and postage.
ABDO's CET CDs are GOC-approved for dispensing opticians and
optometrists. For orders please visit our website at www.abdo.org.uk
where you will also find specific information on our CDs and full and
ever-expanding range of titles. Or call Justin on 01227 733904, fax on
01227 733914, or email jhall@abdo.org.uk
JACKY BUCHMANN CHAIRMAN BUCHMANN OPTICAL HOLDINGS; DANNY VAN
GOETHEM, VICE PRESIDENT, BUCHMANN INTERNATIONAL KEY ACCOUNTS;
BARRY DIBBLE, BUCHMANN UK CEO
BRIOT AND WECO
CONSOLIDATE
UK edging technology is to
be consolidated in a new
supply and service company,
Buchmann UK Limited,
which brings together Briot
and WECO edging machinery,
Rodenstock instruments,
Henson visual field analysers
and Breitfeld & Schliekert
practice accessories.
Paul Artley, CEO of Mainline,
said, “Distributing Briot in
one of Europe’s leading
optical markets has brought
us many joys and we want
to stress that Briot remains
our recommended edging
solution for the future.”
The larger organisation will
be based at WECO’s
headquarters in Rochester,
Kent, with regional sales and
support staff located around
the country. Mainline will
continue to operate from
their Driffield-based
headquarters. Website:
ww.buchmann.co.uk ■
CONTACT LENS PRACTICAL
EXAMINATIONS
IMPORTANT DATES for
WINTER 2007
Supervisor and Practice
Registration
Examination application
forms must be signed by a
supervisor who is on the
ABDO Register of Approved
Supervisors or has
submitted a completed
provisional registration
application. With respect to
the Winter examinations,
the final date for
Supervisor/Practice
Registration applications to
reach the ABDO is 31 July
2007.
Case records
To meet the examination
case record requirements,
the first contact lenses
must have been issued to
the patient by no later than
30 May 2007 so that there is
the opportunity to monitor
contact lens wear over a
minimum period of six
months.
Practical Examination
Winter 2007 Dates
Examinations are to be held
at the following venues on
the dates indicated:
• Birmingham
3, 4 January 2008
• Manchester
14, 15, 16 January 2008
• London
21, 22, 23, 24 January 2008
Contact details
Examinations & Registration
Department, ABDO,
Godmersham Park,
Godmersham, Kent CT4
7DT, telephone 01227
738829
Rosemary Bailey
Director of Contact Lens
Examinations, ABDO ■

TRANSITIONS
E-LEARNING
Transitions Optical has
launched a new web-based
self-training programme ‘Elearning’.
This self-training
system is for optical support
staff and consists of three
short education modules
about Transition lenses,
followed by a quiz to test
participants on their
understanding of the
content. Transitions Elearning
can be easily
accessed through
www.transitions.com ■
WELL DONE
GILL!
GOC ADVISES CET MEETS
TARGET GROUP
Optical professionals are
being advised to check that
CET events have been
approved for their ‘target
group’. The General Optical
Council is reminding
practitioners that they will
not be credited with points
for attending events aimed
at other ‘target groups’.
Deputy registrar and
director of education Dian
Taylor explained, “The CET
scheme is designed to
make sure practitioners
stay up to date in their core
competencies. Having
clearer information about
the content and level of CET
events will help registrants
plan and attend the most
relevant training.”
Any event may be approved
for one or more groups. For
example, a lecture on
GILL ELSTUB
Gill Elstub, who is a lecturer
at ABDO College, must be
congratulated as she ran
the London Marathon in 5
hours 33 minutes and raised
£1950 in total for Fight for
Sight. If anyone would like
to donate they can still do
so on www.justgiving.com/
gelstub, or if you would like
to take part in a sponsored
event for Fight for Sight,
contact the Events Team on
020 7929 7755 or email
events@fightforsight.org.uk ■
contact lens fitting might be
approved for optometrists
and contact lens opticians.
A dispensing optician would
not be awarded points for
attending. If an event is
approved for both general
and specialist points, a
specialist will soon be able
to choose which type of
points they would like to be
credited with.
Providers have been issued
with new logos, and should
make it clear in any
advertising or publicity
material which target
group(s) the CET has been
approved for. Registrants
can also check the target
groups for any event on the
CET Directory on
www.cetoptics.com which
includes a quick reference
system with symbols showing
the relevant target groups. ■
See page 14 for an example of the 'target group' logo. Note that some CLrelated
CET is approved for dispensing opticians as well as CLOs, so do not
assume that CL CET always excludes dispensing opticians - Paula Stevens
Contact Lens Certificate
The next distance learning contact lens course starts in
September. Dispensing opticians wishing to train as contact
lens opticians should apply now to secure a place on this
popular course.
This one year theory course provides the knowledge to back
up the experience gained in practice in preparation for the
ABDO contact lens exams. Block release at ABDO College
in Godmersham compliments the distance learning
assignments and provides an opportunity to meet fellow
students. A practice-based supervisor, the team at ABDO
college and a distance learning tutor will all be on hand to
support you with your studies.
Getting Started on practical
exam preparation
Have you just taken your contact lens theory examinations?
Are you ready to start working towards your practicals but
not sure quite what to do?
This 2 day course, held at ABDO College on 29 & 30
August, is designed to help you. You will be introduced to
the timetable of what must happen when and the exam
format. Also included will be information about related legal
matters, theory knowledge and case record requirements.
Practical sessions will allow you to practice your routine and
rigid lens fitting.
Places are strictly limited so call us now!
Calling all supervisors!
Supervising a trainee on any course is an onerous task in
anyone’s estimation and no less so for a distance-learning
student. This is why we have devised these two courses just
for you!
Dispensing Supervisors Course - 29 August
Contact Lens Supervisors Course - 31 August
Both courses will take place at ABDO College in Kent and
will include essential information about the student journey
as well as your role as a supervisor. A special introduction to
the new core curriculum will be included in the course for
dispensing supervisors this year, as you will not be familiar
with this new course material.
These courses are suitable for the supervisors of any
student studying the first, second or third year of the
Fellowship Dispensing Diploma (FBDO) or the Contact Lens
Certificate Course with ABDO College. They are especially
important for supervisors of first and second year students
who will be taking the new core competency based course
and starting their pre-qualification period in year one.
For more information and application forms contact
ABDO College Distance Learning Institute on 01227
733901, by emailing dli@abdo.org.uk or check out the
website www.abdo.org.uk

34 DISPENSING OPTICS JUNE/JULY 2007 FROM A BUSINESS DEVELOPMENT TUTOR’S DESK . . .
Disjointed jottings
“Talking sympathetically is the best bet while comments like “Pull yourself together“ will make things a lot
worse.” Phil Wilson ponders the many aspects of business management
It’s amazing how many people
are way beyond the STOP in
their stressful work
environment. “Stress!” they
exclaim. “Wot me stressed?!”
Read on, there’s a chart that
goes like this:
Expected standards . . .
work hard and get tired
STOP! or become less
effective and feel inadequate
SO . . . work harder; get even
more tired; become even less
effective; get hooked on an
adrenalin high
SO . . . lose perspective;
become out of control; get
totally embroiled in work;
make serious errors of
judgement - or become unable
to make decisions at all . . .
SO . . . nervous breakdown;
physical damage: ulcers to
heart attacks and accidents.
It’s worth helping a colleague if
you spot in them any of the
above signs. Usually they’ll be
half aware of a problem but
not know what to do about it.
Talking sympathetically is the
best bet while comments like
“Pull yourself together” will
make things a lot worse.
Simply making a to-do list and
prioritising jobs into important
and urgent are a start.
Important and non-urgent,
non-important and urgent can
at least save worrying about
forgetting what’s to be done.
Then learning to motivate and
train your team and delegate
effectively can make life a
whole lot better.
Have a look at your Time
Balance - in other words, how
you divide your weekly time.
The acceptable limits are:
• Work - 25% - 30%
• Support - 45%-55%
(including sleep 30%)
• Relaxation - 20% - 25%
If, like one of my students,
your relaxation time is down to
1.5%, buy a relaxation DVD
and see the difference - it
sounds whacky but it can
work! This lady runs a school
cafeteria and, since Jamie
Oliver’s healthy eating has
been the rule, her costs have
escalated - a box of chicken
now costs her over £30
compared with the previous £7
for the equivalent beef
burgers, so she’s had to lose a
staff member in order not to
make a loss. However, she has
now learned to delegate and
has trained staff to do more,
with the result that they are
more motivated. She’s smiling
– and she achieved 77% in the
final test.
THE COLLEGE CAME TO
ME
Lee Redman FBDO, manager
of Millicans Opticians in Wells,
has been working on a
business management course
and this is what he has to say:
“I have been in optics since
1998, qualified in 2003 and
have been manager of this
practice since 2004. I always
wanted to be an optician since
I was a little lad with a squint -
the whole scenario seemed so
fascinating. We signed up for a
‘mystery shopper’ exercise via
the local Chamber of
Commerce and the feedback
was presented by Strode
College’s business
development manager who
subsequently told me about
the business management
course. The first attraction was
that I didn’t need to leave the
practice, except to put my
work through Phil’s letter box -
usually late at night after doing
my course work and when my
son had finally nodded off.
Effectively the college came to
me.
“The four sections of the
Business Management Course
are Effective Management,
Employing People, Managing
Performance and Time and
Stress Management. I had to
complete exercises pertinent
to our business, as I worked
through each section which
was followed by an
assignment consisting of
about ten questions. Phil
returned my work with
constructive feedback which
we would later analyse and
discuss during tutorial
meetings here in the practice.
The important aspect was that
the course was completely
relevant to our business. It’s
been brilliant for me as I have
gained knowledge and
confidence, with the result that
I feel much more positive in
planning the practice’s road
ahead and also in how I can
present these ideas to my
senior directors.“
FALLING ON YOUR
FEET
Primogeniture, pluralistic,
riparian, yerked, neocons,
prostatic, embolism, whorls
and volutes, entablature,
mordant, imperium, passerelle,
bowderlized, syncretic,
sacerdotal, toxoplasmosis,
encephalopathic, pelmanism . . .
all these words appear in Boris
Johnson’s first novel entitled
Seventy Two Virgins (the title
has a very nebulous
connection with the story!).
The interesting thing was that,
while I hadn’t a clue what any
of the words meant
individually, I didn’t once reach
for the ever-handy Oxford
Dictionary because they
somehow made sense in
context. Does anyone know
the name for this
phenomenon? It is, as you’d
expect, quite witty - and about
a fictional American
President’s visit to
Westminster while under the
threat of assassination.
Recently I’ve purposely
chosen a variety of reading
matter including Boris,
Thackeray’s Vanity Fair (took
ages - lots of words), Charles
Dickens’ Christmas Carol
(amazed at the modernity of
his style), a book of short
stories by Douglas Hurd and
Annie Proux‘s Brokeback
Mountain. It proved to be an
eclectic and entertaining mix
and got me thinking that all
these people seem to have
fallen on their feet.
This thought emanated from a
recent experience when I’d
played with a band in the
chapel of our local prison
which houses ‘lifers’
Afterwards, we joined the
prisoners and supporters for
coffee. One chap had been in
prison since 1961, had been
out on licence a couple of
times, but didn’t succeed
socially. Another told me of
having been in for 19 years
and only out for the odd day
accompanied around the local
towns. He found very mixed
reactions to his old fashioned
manners. So here were 185
men who had not ‘fallen on
their feet’. At least half the
audience were supporters and
I naturally tried to figure out
who was who from the stage
but couldn’t - makes you
think!

PHIL WITH LEE REDMAN
AUTUMN LEAVES PAINTED BY PHIL WILSON
This ‘falling on their feet’
thought came after reading an
article on how the cat family
always fall on their feet and I
decided to try painting the
photograph above - Autumn
Leaves - picture of a cat
falling. The association of
ideas can be a great - but
often tenuous.
I subsequently found myself
on a tour of the prison
education department. My
guide Jimmy looked a pretty
hard character but I soon
learned that he’d gained all
sorts of qualifications in prison
and was responsible for each
new inmate’s week-long
Health & Safety training. The
woodwork shop is run by a
young carpenter; the Open
University area is tutored by a
friend of mine and there are
H&S and English classrooms –
along with an enormous IT
suite. If all this sounds
wonderful, the high windows
have small panes without a
view and the stone walls are
about 50 feet high!
A FITTING CHALLENGE
Okay, back to optics. My wife
is always complaining that I
tend to go off on a tangent so
no change here either . . . Her
new specs are Varilux lenses
fitted to a titanium Lindberg
rimless. Not being in optics
now, we used a well respected
optician who gave us first
class service. However, neither
them – nor me - can get the
pad arms to stay where
they’re put, with the result is
that £500 worth of specs are
uncomfortable! I’ve rarely been
beaten be a fitting challenge
so, if anyone has the answer
please email me on
glastphil@aol.com - the
optician’s response is that
“No-one else seems to have
had any trouble“!
Phil Wilson is business
development tutor at Strode
College, Street in Somerset. ■
ANSWERS TO
WHAT’S MY LINE?
1. The topic of this article,
vocational dispensing, can
only be carried out when
preceded by proper and full
open questioning. Which
one of the following is a
closed question?
a. What ranges of vision do
your current spectacles give
you?
b. Are you happy with your
current spectacles?
c. What activities do you take
part in outside work?
d. You mentioned some visual
problems at work, how would
you describe them?
b is correct. It is the only
question in the set which
could be answered with ‘yes’
or ‘no’.
2. If a patient has a need to
see clearly at 65cm to
perform a particular task,
assuming them to have no
remaining useful
accommodation to
contribute, what would be
the reading addition most
likely to give best results?
a. +2.50DS
b. +2.00DS
c. +1.50DS
d. +1.00DS
c is correct. The reciprocal of
65cm, or 0.65 metres, is 1.54
giving +1.50 as the nearest
acceptable power.
3. If dispensing spectacles
for a presbyopic golfer, 55
plus, specifically for golf,
which one of the following
more specific approaches
would be most likely to be
suitable?
a. A large segment flat top
bifocal, fitted 3mm below
lower limbus
b. A R38 segment dispensed
with no inset, on lower limbus
c. A D25 bifocal dispensed
with extra inset 2mm above
lower limbus
d. A small round segment
dispensed offset away from
the direction of swing
d is correct. A small R
CET ANSWERS
segment bifocal, fitted
discreetly to the right for a
right hander (one or two segs)
is enough for the small amount
of close work needed while
playing a round of golf
4. Polycarbonate lenses are
extremely impact resistant.
Using a 6.5mm steel ball,
what impact velocity is the
highest a 3mm thick
uncoated polycarbonate lens
could resist?
a. 285 m/sec
b. 244 m/sec
c. 152 m/sec
d. 49 m/sec
b is correct. An uncoated
polycarbonate lens has a very
high impact resistance. C is
the resistance of a coated
polycarbonate lens and D that
of CR39.
5. Which one of the following
lenses could be described
as an enhanced reading or
‘degressive’ lens?
a. BBGR Extenso
b. Hoyalux Tact
c. Zeiss Gradal RD
d. Essilor Ipseo
a is correct. The Extenso is a
degressive lens which is
available in two ‘modulations’,
1.00 and 1.50. The Tact and
Gradal RD are occupational
progressives, and the Ipseo a
Freeform personal progressive.
6. Why does Miss C’s
prescription state a vertex
distance?
a. Because the sphere powers
are both greater than 4.00
b. Because it refers to the
previous spectacles
c. Because the maximum
meridional power of the pair is
over 7.00
d. Because at least one
maximum meridional power is
over 5.00
d is correct. BS 2738-3:2004
specifies the criterion for the
vertex distance to appear on a
prescription. ■

36 DISPENSING OPTICS JUNE/JULY 2007 DIARY
Diary of events
● June 3, 4, 10, 11, 17 & 18 - Identity Optical Training - ABDO
Final Year Practical Exam Revision Courses, London, £60 per
day. For further details phone Sally Bates on 020 8504 0967 or
email identity@sallybates.com
● June 4 - ABDO College DLI - Low Vision Taster, informative
one-day CET course, 7 CET points, providing an insight into the
field of low vision work, ABDO College, Godmersham, Kent. For
more information contact ABDO College Distance Learning
Institute on 01227 733909 or dli@abdo.org.uk
● June 4 - Sight Care - ‘Promote and network your practice -
innovative marketing techniques course’, Scotland. For further
details contact Annie Dickinson by email info@sightcare.co.uk
● June 5 - ABDO Golfing Society - ABDO Cup, Fulford Heath
Golf Club. For more information, and for anyone wishing to join
the ABDO Golfing Society, contact Mike Stokes 01204 411722
or email m.stokes67@ntlworld.com
● June 5 - Sight Care - ‘Managing for successful business
performance course’, Scotland. For further details contact Annie
Dickinson by email info@sightcare.co.uk
● June 6 - Sight Care - ‘Promote and network your practice -
innovative marketing techniques course’, Newcastle. For further
details contact Annie Dickinson by email info@sightcare.co.uk
● June 7 & 8 - Identity Optical Training - ABDO Final Year
Practical Exam Revision Courses, Dublin, 80euros per day. For
further details phone Sally Bates on 020 8504 0967 or email
identity@sallybates.com
● June 7 - Sight Care - ‘Managing for successful business
performance course’, Newcastle. For further details contact Annie
Dickinson by email info@sightcare.co.uk
● June 11 - Area 5 (Midlands) - CET Day, Arden Hotel, Solihull, 6
CET points, cost for DOs £20. For further details contact Mike Cody
by email mikecody@blueyonder.co.uk or phone 0781 779 6357
● June 11 - Sight Care - ‘Promote and network your practice -
innovative marketing techniques course’, Bristol. For further
details contact Annie Dickinson by email info@sightcare.co.uk
● June 12 - Sight Care - ‘Promote and network your practice -
innovative marketing techniques course’, London. For further
details contact Annie Dickinson by email info@sightcare.co.uk
● June 13 - Identity Optical Training - ABDO Final Year Mock
Practical Exams for all sections of the ABDO Final Year Exams.
Experienced senior examiners will give full and comprehensive
feedback, London, £75 per section. For further details phone
Sally Bates on 020 8504 0967 or email identity@sallybates.com
● June 13 - Sight Care - ‘Promote and network your practice -
innovative marketing techniques course’, Birmingham. For further
details contact Annie Dickinson by email info@sightcare.co.uk
● June 14 - Sight Care - ‘Promote and network your practice -
innovative marketing techniques course’, Manchester. For further
details contact Annie Dickinson by email info@sightcare.co.uk
● July 15 - Area 11 (London) - Charity cricket match, ABDO
College, Godmersham, Kent. For further details contact
Jayshree Vasani by email jaimanvasani@hotmail.com
● July 22-23 - ABDO CET Summer School - General
Dispensing event, ABDO College, Godmersham. For further
details contact Paula Bell on 01227 733905
● August 12-13 - ABDO CET Summer School - Contact Lens
event, ABDO College, Godmersham. For further details contact
Paula Bell on 01227 733905
● August 29 - ABDO College DLI - Dispensing Supervisors
Course - Essential preparation for supervisors of all trainee
LETTER TO
THE EDITOR
dispensing opticians with ABDO College. For an information
pack and application form contact ABDO College Distance
Learning Institute on 01227 733909 or dli@abdo.org.uk
● August 29-30 - ABDO College DLI - Getting Started - Two
day course to help Contact Lens Certificate students plan for
their practical examinations. For an information pack and
application form contact ABDO College Distance Learning
Institute on 01227 733909 or dli@abdo.org.uk
● August 31 - ABDO College DLI - Contact Lens Supervisors
Course - Essential guidance for supervisors of all trainee
contact lens opticians with ABDO College. For an information
pack and application form contact ABDO College Distance
Learning Institute on 01227 733909 or dli@abdo.org.uk
● September 11 - ABDO Golfing Society - Stercks Martin
Salver, Kings Norton Golf Club. For more information, and for
anyone wishing to join the ABDO Golfing Society, contact Mike
Stokes 01204 411722 or email m.stokes67@ntlworld.com
● September 11 - Sight Care - ‘Introduction to optics’, Bristol.
For further details contact Annie Dickinson by email
info@sightcare.co.uk
● September 12 - Sight Care - ‘Introduction to optics’, London.
For further details contact Annie Dickinson by email
info@sightcare.co.uk
● September 13 - Sight Care - ‘Introduction to optics’, Birmingham.
For further details contact Annie Dickinson by email
info@sightcare.co.uk
● September 15-16 - ABDO National CET Weekend -
Majestic Hotel, Harrogate. For more details phone the ABDO
Conference Office on 01491 579058
● September 15 - ABDO AGM - Majestic Hotel, Harrogate. For
more details phone the ABDO Conference Office on 01491
579058
● September 18 - BCLA - BCLA presidential address, Royal
Society of Medicine, London. For further details visit
www.bcla.org.uk, email events@bcla.org.uk, or call Vivien
Freeman on 020 7580 6661.
● September 18 - Sight Care - ‘Introduction to optics’, Manchester.
For further details contact Annie Dickinson by email
info@sightcare.co.uk
● September 20 - Sight Care - ‘Introduction to optics’, Belfast. For
further details contact Annie Dickinson by email
info@sightcare.co.uk
● September 21 - Sight Care - ‘Confident frame styling,
adjustments and dispensing course’, Belfast. For further details
contact Annie Dickinson by email info@sightcare.co.uk
● September 23 - Replay Learning - Clinical Conference,
Bradford. For further details telephone 0870 881 0715 or visit
www.replaylearning.com
● September 25 - Sight Care - ‘Introduction to optics’, Scotland.
For further details contact Annie Dickinson by email
info@sightcare.co.uk
● September 26 - Sight Care - ‘Confident frame styling,
adjustments and dispensing course’, Scotland. For further
details contact Annie Dickinson by email info@sightcare.co.uk
● September 27 - Sight Care - ‘Introduction to optics’, Newcastle.
For further details contact Annie We welcome Dickinson contributions by email to our Letters to the
Editor page which we reserve the right to edit. If
info@sightcare.co.uk
you would like to air your views please write to
● September 28 - Sight Care The Editor, - ‘Confident Dispensing frame Optics, styling, 1B Eridge Road,
adjustments and dispensing Crowborough course’, Newcastle. East Sussex For TN6 further 2SJ or send an
details contact Annie Dickinson e-mail by to do@abdo.uk.com
email info@sightcare.co.uk ■