optics

Transcription

optics

MAY 2015
DISPENSING
OPTICS
NEWS , I NFORMATION an d
E D UC ATION for OP TICI ANS
Dispensing Optics MAY 2015
Contents
8.
29.
26.
17.
28.
Features
30.
18.
32.
Talking shop with Amy Rothwell
Technology & innovation
Contact lenses in the spotlight
20.
Continuing Education & Training
CET Answers
Plastic fantastic
by Joanne Abbott
26.
Myopia control
Myopia control with contact lenses
by Martin Conway
Preview
BCLA Myopia Day “not to be missed”
34.
Contact lenses with a difference
by Keith Cavaye
25.
Interview
Sports vision
Divergence excess: the tip of an iceberg?
by Geraint Griffiths
Regulars
5.
DO Dispatches
6.
Black Arts
by ABDO president, Peter Black
28.
Business
Building your contact lens practice
by Antonia Chitty
8.
News
9.
Letters
36.
Jottings
FRONT COVER
Just don’t call me ‘Alcon Man’....
by Graeme Stevenson
Image from stock
38.
Jobs & Notices
3
Perfect all-round protection for exceptional vision.
With the new high-tech coatings from Rodenstock.
We can now set the highest possible standards
with the latest generation of the Solitaire® family:
perfect all-round protection - 365 days a year.
The 3-year quality guarantee and additional
12 month no quibble guarantee* also ensures
the highest possible customer satisfaction.
NEW:
7ZLFHDVVFUDWFKUHVLVWDQWDV conventional AR-coated lenses.
2SWLPXP89SURWHFWLRQIURPVXQOLJKW
incident from the front and from the side.
6ROLWDLUH® Protect Balance 2 reduces
WKHDUWL¿FLDOEOXHOLJKWIURPPRQLWRUV
smartphones and tablets - for natural
well-being.
* For Solitaire®3URWHFW%DODQFH6ROLWDLUH® Protect Plus 2
Model: R2364
Solitaire 2
®
DISPENSING OPTICS
The Professional Journal of the Association
of British Dispensing Opticians
VOLUME 30 NO 5
EDITORIAL STAFF
Editor
Assistant Editor
Managing Editor
Email
Design and Production
Email
Admin. Manager
Email
Sir Anthony Garrett CBE HonFBDO
Jane Burnand
Nicky Collinson BA (Hons)
[email protected]
Rosslyn Argent BA (Hons)
[email protected]
Deanne Gray
[email protected]
EDITORIAL/ADVERTISING
Telephone
0781 2734717
Email
[email protected]
Website
www.abdo.org.uk
SUBSCRIPTIONS
UK
£140
Overseas
£150, including postage
Apply to
Tom Veti
Association of British Dispensing Opticians
Godmersham Park, Godmersham, Kent CT4 7DT
Telephone
Email
Website
01227 733922
[email protected]
www.abdo.org.uk
ABDO CET
CET Coordinator
Paula Stevens MA ODE BSc(Hons)
MCOptom FBDO CL (Hons)AD SMC(Tech)
ABDO CET, 5 Kingsford Business Centre, Layer Road,
Kingsford, Colchester CO2 0HT
Telephone
Email
or email
01206 734155
[email protected]
[email protected]
CONTINUING EDUCATION REVIEW PANEL
Joanne Abbott BSc(Hons) FBDO SMC(Tech)
Keith Cavaye FBDO (Hons) CL FBCLA
Andrew Cripps FBDO (Hons) PG Cert HE FHEA
Kim Devlin FBDO (Hons) CL
Stephen Freeman BSc(Hons) MCOptom FBDO (Hons) Cert Ed
Abilene Macdonald Grute FBDO (Hons) SLD (Hons) LVA Dip Dist Ed Cert Ed
Richard Harsant FBDO (Hons) CL (Hons) LVA
Andrew Keirl BOptom (Hons) MCOptom FBDO
Angela McNamee BSc(Hons) MCOptom FBDO (Hons) CL FBCLA Cert Ed
Linda Rapley BSc FCOptom
DO Dispatches
GENERAL ELECTION
WAITING GAME
As this issue of Dispensing Optics goes to
press, we are in the final days of a very long
election campaign. The outcome is very
uncertain and we will have to see what changes, if any, will
affect us in the eyecare sector. Issues such as business rates,
the state of the economy, employment prospects and, of
course, health spending have all been aired. All have an
impact on us as a profession and the wider world of optics.
The head Optical Confederation (OC) public affairs, Jenny
Gowen, has been sifting through the small print of the various
manifestoes and other relevant statements made during the
campaign. This, coupled with the knowledge gained during the
previous parliament from practice visits made by MPs and
candidates, means we are in as good a position as possible to
deal with the new administration when it takes office.
However, like so much else in life, the devil is in the detail.
Although we are electing a new parliament for the whole
United Kingdom, it only directly affects England as far as health
policy goes. The state of play in Scotland, Wales and Northern
Ireland continues to change and diverge and we have to be
aware of the differences between the four nations.
GOS is still the one service that remains constant throughout
the UK and we in the OC will be doing all we can to maintain
that in the years to come.
Sir Anthony Garrett
ABDO general secretary
JOURNAL ADVISORY COMMITTEE
Richard Crook FBDO
Kim Devlin FBDO (Hons) CL
Kevin Gutsell FBDO (Hons) SLD
Ros Kirk FBDO
Angela McNamee BSc(Hons) MCOptom FBDO (Hons) CL FBCLA Cert Ed
DISPENSING OPTICS IS PUBLISHED BY
ABDO, 199 Gloucester Terrace, London W2 6LD
DISPENSING OPTICS IS PRINTED BY
Lavenham Press, Lavenham, Suffolk CO10 9RN
© ABDO: No part of this publication may be reproduced, stored
in a retrieval system, or transmitted in any form or by any means
whatever without the written prior permission of the publishers
Dispensing Optics welcomes contributions for possible
editorial publication. However, contributors warrant to the
publishers that they own all rights to illustrations, artwork or
photographs submitted and also to copy which is factually
accurate and does not infringe any other party’s rights
ISSN 0954 3201
AVERAGE CIRCULATION: 9,025 Jan-Dec 2014
ABDO Board certification
5
PETER BLACK
Our monthly column from the ABDO president


The changing face of GOS
ptics is changing faster
today than at any point I
can remember since
deregulation in the late
1980s and, as usual, it is
not all for the good. The new vigour with
which NHS bodies are pursuing practices
and practitioners following post payment
verification visits is a symptom of this –
and well-meaning practitioners, believing
they are acting in the patient’s best
interest, are now falling foul of the rules.
My comments last month, that
contractors may end up suing performers,
were not meant to inflame tensions as they
appear to have done in some quarters. I still
believe that dispensing opticians working
alongside optometrists remains the dream
team for community optical services, and
where improper claims are alleged it is
absolutely vital that contractors and
performers work together to understand
each other and present a united front, as to
be divided is to be conquered.
One of the published Optical
Confederation (OC) principles on this
subject, agreed by all the members of the OC
including the three representative bodies,
ABDO, the Association of Optometrists and
the Federation of Ophthalmic and
Dispensing Opticians, is: “Contractors and
performers (including locums) should
cooperate in interpreting records, explaining
prescribing and dispensing decisions and in
resolving any claims issues.”
O
DON’T ‘JUST PUT IT THROUGH’
Depending on your location in the country,
the interpretation of the rules by health
authorities responsible for paying GOS
claims has varied quite dramatically over
the years. In the days of primary care trusts
(PCTs) (and FPCs before them) in Wigan, for
example, the rules used to be applied
absolutely rigidly, with no exceptions
except by prior approval. Yet when you had
a patient in real need and rang for help, you
would receive a sympathetic response in
6
almost all cases. And you knew not to ring if
there wasn’t a genuine need.
Yet at the other end of the M58 in
Merseyside, the PCT’s attitude was ‘couldn’t
care less’ and everything was approved so
easily that the PCT effectively allowed
performers to make up their own mind as
to whether the patient was in need. PCT
staff acted as though their time was being
wasted by an unnecessary inconvenience, so
I suspect most practices gave up ringing for
permission and just put through claims for
patients they perceived to be deserving.
Most will have acted in the very best
interests of patients, which is after all a
registrant’s raison d’être according to the
General Optical Council Code of Conduct.
It is clear now, however, wherever you
are in the country, entitlements must be
strictly controlled and precious NHS funds
protected at all costs. It is absolutely
essential that record keeping is exemplary
and any early retest within the rules is
coded correctly, and that the reasons for
issuing vouchers for small changes in Rx or
fair wear and tear are also recorded
correctly on the records and the submitted
forms. If at any point you are not 100 per
cent sure that what you are claiming from
the NHS is within the rules then you should
consult ‘Making Accurate Claims’ via the OC
website and if there is any doubt, contact
your clinical commissioning group (CCG)
for permission before supplying the patient.
It seems ironic that practices are being
held to such strict account by NHS auditors
these days when many PCTs, their forebears
and successors, had such lax systems
themselves. I once remember being overpaid
a substantial five-figure sum one month
and contacting the PCT to explain we had
been paid incorrectly. It seemed beyond
their comprehension that they could have
made a mistake, and they basically implied
we were wrong and they had made the
correct payment.
This particular PCT, like many others,
was completely unable to provide practices
with lists of GOS Voucher patients for
whom it was making payment and it took
many months before the payment error was
sorted out. To this day, although I believe all
CCGs provide lists of sight test patients,
some still do not provide lists of voucher
payments even if they have been sent
duplicate lists in with the claims. It seems
ridiculous that an organisation that insists
its contractors have a robust audit trail
themselves, was until recently incapable of
being audited itself.
PCTs were abolished by the Health and
Social Security Act 2012 and disappeared
on 31 March 2013. At that time I was
working dispensing three or four days per
week and was surprised to see managers
from the PCT calling on practices with
contracts asking them to sign one as they
didn’t seem to have anything on record. Is it
those contracts, signed under pressure and
perhaps false pretences, that are now
coming back to bite?
Perhaps it is time to propose reforms to
GOS as part of our negotiations for more
money. The standard attempt to negotiate
an inflation linked increase in fees and get
nothing or one per cent is wearing pretty
thin with practitioners, so perhaps we
should be asking for reforms to the
information that is provided on the voucher
for example so that illegal supply and
fraudulent claims can be identified from the
voucher itself? A note of the old Rx as well
as the new Rx and the VA with each would
be a good start, as would space for BVD for
higher power prescriptions.
A&E IN THE NEWS AGAIN
Last month saw the publication of the
winter A&E statistics across the UK with
predictably dire results. One in 12 patients
presenting at A&E wait more than four
hours to be seen, considerably worse than
the one in 20 target they wish to get down
to. Every time I see these reports I can’t help
wondering that the answer is staring us in
the face – that community opticians and
optometrists could help reduce this burden
on A&E departments and patients alike.
I’ve seen statistics that between three
and five per cent of A&E appointments are
eye related, and that easily half of those
could be dealt with by ordinary community
optical practices, and half of those could be
dealt with by dispensing opticians, with the
remainder easily looked after by contact lens
opticians and optometrists between them.
Therapeutically qualified optometrists would
extend the practice’s capability to nearer
three quarters of ophthalmic A&E cases.
I have been at pains to mention this
during the ‘everyday eye conditions’ discussion
workshop I have presented at various area
events. It is depressing how few members
work at practices involved in minor eye
conditions services (MECS) yet encouraging
that the service seems to be gaining
widespread support from commissioners in
some regions as a cost-effective scheme that
patients appreciate. Certainly those DOs
who work with a MECS service often act as
triage practitioners and thoroughly enjoy
the variety and interest it offers them.
There is probably an opportunity here
for DOs to follow many other allied health
professions in expanding our role in the
issuing of a limited selection of pharmacy
only medicines – especially for allergic
conjunctivitis – and as it happens the GOC
already has the powers to grant us this right
under Part 5 of the Opticians Act. I would
commend any DO to encourage your
practice to participate in MECS whenever it
becomes available, and if this isn’t looking
likely get involved with your local optical
committee and make it happen for the
benefit of patients.
It is reported that one in six ophthalmic
A&E cases are for dry eye and blepharitis.
What do we think happens to these
patients in a general hospital A&E
department when other patients present via
an emergency ambulance, or with chest
pains, or pregnancy complications? They
inevitably go to the back of the queue and,
as such, probably make up a substantial
portion of the people who have to wait
more than four hours for treatment. Not
only that, they will probably meet up with
an ill equipped doctor with little knowledge
of eye problems who will quite likely give
them poor advice.
For example, we have all read typical
NHS advice (echoed by the College of
Optometrists and the Royal College of
Ophthalmologists) to use baby shampoo for
the treatment of blepharitis. Some go so far
as to say that there are ready prepared
products but they are ‘expensive’. This, of
course, begs the question: why aren’t they
available on prescription when research
proves they are so much more effective?
There is a bigger problem here of uncaring
practitioners within an apathetic
protectionist system that seems to have
no reasonable thought for its patients. To
label a blepharitis product expensive when
a patient loses more than four hours of
their life getting it treated and is then
given poor advice is shameful, and even
factually incorrect. For what it costs to
park at my local hospital for four hours I
can easily buy a month’s supply of
blepharitis treatment – and that’s before
any loss of a patient’s time, earnings,
childcare costs etc, are taken into account.
Many practices worry about patient
waiting times if they get involved in MECS,
PEARS and other on demand enhanced
services, yet research shows that patients
much prefer these services to be provided
at the local community opticians. We need
to consider that, even if we keep patients
waiting for an hour, they will still probably
be seen four times quicker than at
hospital. For the good of your patients, it’s
time your practice got involved.
WHAT’S NEW ON
EYECARE FAQ?
New this month on Eyecare FAQ,
you’ll find an infographic to share
on cataract, FAQs on the disease as
well as an optical lingo bingo card
full of cataract related words. How
many are you using every day? And
do patients know what you mean?
Love images? You can now find Eyecare FAQ on Instagram and Pinterest
• www.pinterest.com/eyecareFAQ
• https://instagram.com/eyecarefaq/
You can use any of the FAQ answers and images on your own blog or website.
Follow, like and share these useful resources on your practice and personal
social media channels, to help the public learn about eyecare and promote the
role of the registered dispensing optician.
Get involved with Eyecare FAQ, ABDO’s campaign to help consumers learn
more about looking after their eyes, and the role of the registered dispensing
optician.
Eyecare FAQ is also at:
• www.facebook.com/eyecarefaq
• www.twitter.com/eyecarefaq
• plus.google.com/+eyecarefaq
• Or visit the website,
www.abdo.org.uk/information-for-the-public/eyecarefaq/
7

David Barnaby cuts the
ribbon at the new practice
FUN, FASHION AND
CELEBRATIONS
Patients, local business people and
members of the optical industry helped
Barnabys Opticians celebrate its 40th
anniversary recently, as the company
launched a new venture in “fashion
and fun”.
To mark a new chapter in the
business’s journey, owner David Barnaby
has joined forces with Louise and Chris
Barrington to take the practice to the next
level with new, larger premises in the
centre of Bournemouth.
Louise said: “Barnabys is now very
much a dispensing focused practice,
started by a dispensing optician 40 years
ago, and now taking its next steps forward
with another two dispensing opticians
driving Barnabys forward.
“We have always, and will always, stay
faithful to our ideals and concepts, keeping
Barnabys an optical boutique full of luxury
eyewear and sunglasses. 2015 looks like
being a year full of celebrations and
exciting challenges as the Dickensian heart
and soul of Barnabys moulds its new
surroundings ensuring none of its charm
and magic is lost,” Louise added.
OPTRAFAIR RUMOURS CONFIRMED
The Federation of Manufacturing Opticians
(FMO) confirmed rumours at last month’s
Optrafair in Birmingham that the show
would return to the NEC in 2016.
Announcing the move during the threeday event from 18-20 April, Optrafair director
Malcolm Polley said: “The NEC is Optrafair’s
natural home and a popular venue with both
exhibitors and visitors. It is accessible from all
parts of the UK and the larger stand space
allows the major technology companies in
particular, to launch, showcase, as well as
demonstrate new and existing products to
maximum effect.
Catching up with members at the Association
“Optrafair is the show people who are
Lounge at Optrafair 2015
serious about doing business attend. It is a
great way for anyone involved in the optical industry to get inspiration each year and
find the means to enhance their business”, added Malcolm.
Optician will once again be the show partner, and the dates are 9-11 April 2016. Read
our Optrafair 2015 report in next month’s issue.
Jil Sander by Rodenstock
HIGH-END RANGE DEBUT
Jil Sander, the high-end luxury brand, has
launched its new eyewear collection in
collaboration with Rodenstock.
Under the creative direction of Rodolfo
Paglialunga, the sunglasses and spectacle
models are divided into two lines: Core and
Volume. Core features temples made of
titanium coordinated with high quality
acetate elements, combined with a
progressive lens shape. Volume boasts
rounded, filigree temples combined with the
frame made of high quality acetate giving the
spectacles their unique look, and the integral
spring hinge ensures extreme comfort.
NEW PARTNERSHIP FOR
MASTER PROGRAMME
The University of Hertfordshire has
announced a new strategic partnership
with Boots Opticians and the College of
Optometrists to support the delivery of
its new undergraduate training programme.
Professor Soraya Dhillon, dean of the
School of Life and Medical Sciences said:
“ Through our partnerships with the
College of Optometrists, Boots Opticians
and clinical ophthalmology teams from
East and North Herts NHS trust and Luton
and Dunstable Hospital NHS Foundation
Trust, we are developing inclusive and
mutually beneficial relations that will
improve the quality of our students
learning experience.”
FOND FAREWELL TO TRIO
Frank Norville with Peter Turner
8
Three long-serving members of the Norville Group have hung up their lab whites for
the final time.
Ray Simms enjoyed 45 years’ service with the group, all in Harrogate, starting under
the Stigmat flag previously known as Harrogate Optical before its purchase by Norville.
Peter Turner from the Norville Optical engineering field sales group and John Lane, operations
director, have also now retired after 49 years of ophthalmic manufacturing across the
Norville Rx network, including the start-up of the company’s Livingston laboratory.
Frank Norville commented: “You cannot begin to even contemplate their huge
contribution to manufacturing optics, only to say how lucky yesterday’s opticians were to
benefit from such lifetime individual contributions – something the next generation is
unlikely to ever see again.”
@
HAVE YOUR SAY
Email [email protected] or
write to Dispensing Optics, PO Box
233, Crowborough TN27 3AB
Letters
DIVERGENCE EXCESS IN QUESTION
Nick Howard recognised with historic award
CLO ACCEPTS FREEDOM OF THE CITY
Nick Howard, specialist contact lens optician at Benjamin’s Opticians
in Skipton, has been awarded the Freedom of the City of London.
Originally granted to allow professionals to carry out their trade or
craft in the City, it is one of the oldest surviving traditional ceremonies in
England, which today recognises those who have made a significant
contribution in their field.
Nick said: “As a northern lad who works from time to time in London, I
am amazed and a touch overwhelmed that I was invited to apply for the
Freedom. As a Freeman of the Worshipful Company of Spectacle Makers, I
was given the opportunity to become part of the splendid tradition and
heritage associated with this walled City.”
Known as a key opinion leader on contact lenses, Nick is a regular
speaker at conferences and events and has lectured at just about every
university in the UK. He is pictured accepting the Freedom of the City
with the Chamberlain of the Court and the Beadle.
FREE PRODUCT DATA DIRECTORY
The ADP Consultancy, owned and run by contact lens optician Andrew
Price, has launched a free-to-use web-based directory of some 200
plus ocular health products.
“The ethos of my company is to support and help practitioners and to
provide better care for their patients, which directly helps build their
practices,” said Andrew. “The Eye Drops Database fits in completely with
that ethos.”
Merton Beck Opticians is just one practice already using the database
on all IT linked technology in its practice. Colin Jones, practice owner,
said: “When it comes to advice and purchase of ocular health products, I
want my patients to automatically think of me, not the supermarket or
retailers of other non-eyecare products. There is a large market and
clinical need, I have the skills and education, and now this excellent
professional resource to help me help my patients.”
The continuously updated directory is fully searchable, containing
data on product indications, contra-indications/cautions, formulations
and more. Visit www.eyedropsdatabase.co.uk
MOVING ON UP
Mark Keaney and David Straithe have been promoted to the role of
senior sales manager at Continental Eyewear, to help the company
expand and develop in the UK and overseas markets.
“Having worked with both Mark and David for more than 10 years, I
look forward to their further involvement in the company and continuing
our success,” said Neal Grimason, sales and marketing director. “Mark will
be concentrating on building our social media presence and export
development, while David supports our exhibitions presence and
promotional work.”
I would like to say how much I enjoyed the March issue of
Dispensing Optics, especially the sports vision articles.
However, I would like to make a comment or two.
On page 32, Geraint Griffiths says: “With divergence excess,
it is vital to make sure that there is no latent hyperopia
indicating over-accommodation”. Perhaps he could look at
that statement carefully and then explain why, as I believe
(digging myself a hole), that he has it backwards and he
meant “convergence excess”.
Later in the article, Geraint describes a patient as: “…slightly
myopic by half a dioptre with some astigmatism and initially
he appeared to be esophoric. When this small amount of
myopia was corrected he became exophoric. He was controlling
a decompensated phoria by using accommodation, habituated
by a convergence insufficiency”.
It would be very interesting to have an article dedicated to
ideas like this with more explanation. Of course, as dispensing
opticians we can all promote sports ability/confidence by
suggesting sports specific eyewear to children – especially
those who would struggle when told they cannot wear their
everyday specs on the court/field.
David Bridle FBDO
West Sussex
Geraint Griffiths replies
David’s questions are certainly perceptive and I agree that my
statement on divergence excess is, as David suspects, not as
straightforward as it appears – and I should have elaborated on
it. David’s second point about low myopes appearing to be
esophoric also needs expanding – and I hope my response to
Dispensing Optics goes some way to explaining both.
Geraint Griffiths BSc Mech Eng, Dip Schoolvision, Dip Sportvision,
MASvP, MSc Optometry MCOptom
Leicester
Turn to page 34 to read Geraint’s full explanatory response.
We kindly reserve the right to edit
contributions prior to publication.
Follow us on Twitter @ABDOCollege
and @MembershipABDO
ABDO events and booking
information can be found at
www.abdo.org.uk/events
9

Beauty lens event
Helen Perkins
Dr Gary Gerber
NICHE SPEAKERS
AND TOPICS
Proven Track Record (PTR) has announced
the speaker line-up for its 10th anniversary
Independents Day (i-Day) to be held on
6 and 7 July at the Hilton Birmingham
Metropole.
Themed ‘Niches for riches:
supplementary services for happy patients
and healthy profits’, this year’s event will
feature a keynote from the USA’s Dr Gary
Gerber, founder and ‘chief dream officer’
for the Power Practice, a practice building
and consulting company whose mission is
to help optometrists ‘power their
professional and personal dreams’.
Dr Gerber is also a prolific writer and
speaker as well as an accomplished
mentalist and magician. He is also the host
of the Power Hour, US optometry’s only
live talk radio show. Another highlight will
be a session chaired by Andy Clark, where
leading UK practice owners will share how
they have successfully carved out a niche
in their practices.
PTR director, David Goad, said: “These
speakers have top performing businesses
and have successfully commercialised socalled niche supplementary services such
as dry eye, advanced retinal care and
sports vision. They will share their journey
and key learnings on how to successfully
implement these services.”
Fellow director Nick Atkins added: “We
plan to celebrate this landmark meeting
with the most exciting and pertinent i-Day
ever. We look forward to welcoming back
many of the 600 plus ‘friends’ that have
attended i-Day since 2005.”
For more information and to book
visit www.independentsday.co.uk
COMPANY APPOINTS
24TH CLERK
Helen Perkins will take over as clerk and
chief executive officer of the Worshipful
Company of Spectacle Makers (WCSM) at
the WCSM’s court meeting on 2 June.
Helen is the 24th recorded clerk and
has more than 25 years’ experience as a
chartered company secretary. She is
currently company secretary of an AIMlisted global recruitment business based in
the city.
She said: “Prevention and treatment of
visual impairment is just as important now
as it was to the 17th century spectacle
makers who founded the livery company. I
am very pleased to have the opportunity
to put my professional skills and
experience to use as the new clerk.”
WCSM master, Dr Christine Tomkins,
said: “Helen will bring new skills to the
post of clerk tempered with the right
degree of respect for custom and practice
that is required in this exacting
appointment. We wish her great success
and happiness in her new role.”
MEDIA EVENT
PROMOTES NEW LENS
The Vision Express store on London’s
Oxford Street hosted a consumer media
event recently to celebrate the launch of
1-Day Acuvue Define contact lenses
across its national network of stores.
A glitzy roll-call of fashion editors were
given the opportunity to trial the eyeenhancing contact lens from Johnson &
Johnson Vision Care, and enjoy a personal
make-up consultation with celebrity makeup artist Collette Casey. Consumers were
also invited to experience the Eye Define
Studio, which uses advanced digital imaging
technology to show how the lens can
accentuate the eyes.
Ruth Graesser, Johnson & Johnson
Vision Care marketing manager, said: “The
iris-inspired design of 1-Day Acuvue Define
enhances the natural appearance of a
patient’s eyes and is a pioneering
advancement, bridging the gap between
standard contact lenses and coloured
contact lenses. The opportunity for guests
to trial the lenses at this event with Vision
Express meant guests could see for
themselves the difference the lenses make
in enhancing the natural eye.”
CONSULTATION ON NEW CODE OF CONDUCT
The Association for Independent Optometrists and Dispensing Opticians (AIO)
invited delegates at Optrafair last month to participate in a consultation process to
help inform the provisions of a new consumer facing AIO Code of Conduct.
AIO chairman, Peter Warren, said: “We have now set a timeline for the launch of our
new Code of Practice that is designed to help inform consumers and prospective patients
of the different service offerings that are available in the High Street and provide a
distinguishing mark for independent practitioners who are committed to providing the
highest quality of eyecare.”
The consultation is seeking input under a number of key headings, which will then be
considered by the AIO council in July. The AIO will start accepting Code registration
applications from AIO members at its conference in Nottingham in October.
For information about AIO membership and/or attending the AIO conference,
telephone 0800 1300 486 or email [email protected]
FOR THE MOST UP-TO-DATE ABDO EVENT DETAILS keep an eye out for the eNews landing in your in box, and the events
section of the website, visit www.abdo.org.uk/events
10
STEPPER titanium frames are half the weight of conventional
metal frames, corrosion resistant and hypo-allergenic
EYEWEAR FASHION THAT FITS
Stepper UK Limited
11 Tannery Road
Tonbridge
Kent
TN9 1RF
01732 375975

Stepper model 60068
New Polarised 1.6 sunlenses from Rodenstock
NEXT GENERATION
OF COATINGS
Rodenstock has launched its latest
generation Solitaire technology with new
Solitaire 2 high-tech coatings.
The functions of the ‘super’ antireflection (AR) coating include dust, dirt and
water-repelling properties, climate-resistance,
anti-static properties as well as an antifogging effect with Rodenstock FogFree.
In addition, lenses with Solitaire 2
have special protection against scratches
and are said to be twice as robust as
conventional lenses with an AR coating.
Through optimised UV protection against
light that is incident from the front as
well as the side, strain on the eyes is also
reduced. In addition to these protective
properties, the new high-tech Solitaire
Protect Balance 2 coating reduces artificial
blue light.
Solitaire 2 demonstration lenses and
modules for the Rodenstock Competence
Centre are available from regional lens
managers.
* Rodenstock has extended its lens
portfolio with new Polarised 1.6 sunlenses –
available with either a Solitaire Silver Moon
mirror coat or Solitaire Protect Sun coat.
DAWSON IS DO OF THE YEAR
James Dawson, a consultant dispensing optician at
Serendipity Optical Consultants, took home the
title of Dispensing Optician of the Year at the
Optician Awards held in Birmingham last month.
A self-confessed ‘industry geek’, James also works
with Bondeye to develop a range of eye health
products, and has been in the profession for 26 years.
Hosted by comedian Ed Byrne in the Hilton
Metropole Hotel on Saturday 18 April, the Optician
Awards saw 17 awards handed out including Contact
Lens Practitioner of the Year, which went to
optometrist Ian Cameron, Fashion Practice of the Year
James with comedian Ed Byrne
to Eyeworks London, Family Practice of the Year to
Curtis Opticians, Optical Assistant Team of the Year to Edmonds and Slatter, and
Independent Practice of the Year to Buchanan Optometrists.
CHECT POSTER CAMPAIGN
The Childhood Eye Cancer Trust launched a new awareness campaign at Optrafair
last month.
A series of four posters, made using reflective ink, shows a close up shot of the eye of a
real retinoblastoma survivor aged between two and five years old. The aim is for people to
take a picture of the poster on their smartphones; the pupil of the child’s eye will appear
bright white in the photo, in contrast to the seemingly healthy-looking eye in the poster.
Optrafair visitors were able to try out the technology and find out more about
retinoblastoma. www.chect.org.uk
12
COMFORTABLE
AND CLASSIC
The new Stepper 60068 men’s frame has
been styled to project a classic look that
is lightweight and comfortable.
“Frames like this are one of the Stepper
brand’s cornerstones,” said Richard Crook,
managing director of Stepper UK. “The SI
60068 is certain to become one of our
best sellers. Constructed from titanium the
frame’s weight is kept to a minimum so
that despite its sturdy looks the frame
doesn’t sit heavily on the face.”
The style is available in Gold, Olive and
Blue colourways.
VISION UK
SPEAKERS REVEALED
The speaker line-up for next month’s
Vision UK 2015 conference in London
will include Dr Stephen Hicks, who is
developing smart glasses for the visually
impaired as part of the Oxford Smart
Specs Research Group.
Entitled ‘Working together to deliver
the UK Vision Strategy’, the conference
will be held on Thursday 18 June at Central
Hall Westminster. For the first time
delegates will be able to choose from one
of five conference streams, focused on
delivering aspects of the UK Vision
Strategy and tailored for different
professional interests.
Other high profile speakers include:
David Allen, chief executive of the Faculty
of Public Health; David Cartwright, chair of
National Eye Health Week; ‘Fashioneyesta’
and sight loss blogger, Emily Davison; and
Paul Wood, Social Care Policy & Legislation,
Department of Health.
Find out more at www.ukvisionstrategy.
org.uk and look out for our preview in next
month’s issue.
Looking for something different?
Tel: 01452 510321 Fax: 01452 510331 Email: [email protected]

Award for Silhouette Titan One
RED DOT AWARD FOR
“MASTERPIECE”
New imagery for the Basebox collection
GLOSSY NEW LOOK-BOOK
Voted 2015 Optical Supplier of the Year at the Optician Awards, Eyespace has launched
its 2015 catalogue showcasing more than 530 frames across 103 pages of glossy,
lifestyle images.
Detailed frame visuals are presented in an easy-to-navigate format, focusing on the
refreshed Basebox collection and the company’s five other lines – on-trend Cocoa Mint,
Jensen for men, luxury Louis Marcel, children’s brand Rock Star, and the Zips budget
range. Brand new point-of-sale for the collections was launched at Optrafair last month.
GLOBAL MYOPIA EXPERTS CONVENE
At a recent joint meeting of the World Health Organisation (WHO) and the Brien
Holden Vision Institute (BHVI), key scientists, researchers and clinical experts
discussed the rapidly increasing prevalence and impact of myopia. They reported that
myopia was now the leading cause of blindness in older people in Tajimi, Japan, and in
Shanghai, China.
Professor Brien Holden reported that the BHVI had estimated that five billion people
would have myopia in 2050, with almost a billion having high myopia. He said that:
“vision impairment and blindness was rising in children from uncorrected myopia and in
adults from the pathological consequences of myopia later in life”.
The meeting reviewed evidence on the epidemiology, aetiology, vision consequences,
pathology, social and economic impact, morbidity associated with, and interventions that
may be helpful in reducing the threat of myopia.
Global public health expert, Dr Serge Resnikoff said that “a major contribution from
the meeting was the definition and description of the retinal condition that causes
blindness with myopia so that future surveys can accurately record the number of people
with vision impairment and blindness from myopia.”
Turn to page 26 to read more about myopia control with contact lenses.
Global scientific meeting on myopia
14
Silhouette’s Titan One frame has received
the renowned Red Dot Design Award.
Made from one continuous piece of
titanium, award judges described the
frames as “state-of-the-art” and “an
impressive piece of design engineering.”.
“The Titan One Signature Collection is
our masterpiece that unites the wearer and
the eyewear,” said Roland Keplinger, head
of design at Silhouette. “Receiving the
award for this innovation, which is unique
in the eyewear industry, is fantastic.”
HANDY, ECO AND
HYGIENIC
EcoHydra, a new range of anti-microbial
hand washes and sanitisers, is now
available from Positive Impact (PI).
The key active ingredient of the
EcoHydra Antimicrobial Handwash is 0.1
per cent benzalkonium chloride, which is
said to kill up to 99.9999 per cent of most
commonly occurring bacteria and
norovirus within 15 to 30 seconds. It also
remains active and effective against
microorganisms for four hours after drying.
The EcoHydra Instant Hand Sanitiser
does not require the use of water and, with
its alcohol-free Base Technology formula,
can be used repeatedly throughout the day
with no damaging effects.
PI joint managing director, Nick Atkins,
said: “It is my
experience that
the products
used in most
consulting rooms
are usually
bought from
local retailers
and are designed
for domestic use.
Guarding against
Hand hygiene
cross-infection
improvements,
such as routinely using EcoHydra, are the
simplest and most effective way to prevent
cross-infection in practice.”
Is ha
ving the righ
having
rightt equipmen
equipmentt
import
ant to
to yyou?
ou?
important
Glasses ar
aree no different...
different...
One pair is never enough!
Boost your sales with our Xperio multi pair promotion!
From 1st January to 30th June 2015 order a pair of Xperio lenses and for an additional £1 per lens,
receive a pair of clear lenses. You can upgrade the clear pair at a greatly reduced cost to match the
design of the Xperio pair.
p
p
g the order for the 2nd pair.
p
To beneﬁt from this offer use the promotional
code “2PAIR” when placing
For
www.bbgr.co.uk
For full terms and conditions please refer to our website
website www
.bbgr.co.uk
www.bbgr.co.uk
www
.bbgr.co.uk
TTel:
eel: 0844
880 1349
Always closer

Brian Ellis at the handover
REFRACTION KIT
DONATED
Hilco’s Signature Series
CREATING A SIGNATURE LOOK
Hilco has introduced its Personalised Signature Series of coordinating personalised
lens cleaner labels and microfibre cloths. Each graphic is available on a 2oz. lens
cleaner spray bottle and matching Classic microfibre cloths, creating an attractive
signature appearance while promoting the practice.
FRENCH CONNECTION
Kirk & Kirk have teamed up with Eye Like of France to create a new collection of
frames in a range of colourful, semi-transparent, sandblasted acetates.
“Our goal was to create eyewear that complements the work of the designers that
Eye Like carry, but that also espouses the values of the group: savoir-faire, passion,
generosity and ethics,” said Karen Kirk, creative director of Kirk & Kirk.
“We were attracted to working with Eye Like because we respect their approach to
being an independent optician in the current environment,” added Jason Kirk, managing
director. “As an independent eyewear designer, we need to work closely with retailers
that reflect our values and have the capacity to sell our products.”
As part of Vision Aid Overseas’ (VAO)
Refraction Room Appeal initiative,
equipment purchased from the UK worth
more than £5,000 has been donated to
four hospitals in rural Ethiopia.
The facilities previously had no
refraction equipment, despite having fully
trained optometrists in place, who were
not able to practise their profession.
A handover ceremony was conducted
at the Ras Amba Hotel in Addis Ababa,
during which Brian Ellis, VAO founding
chairman, gave a short presentation to the
optometrists on some of the technical
aspects of the equipment and how to
maintain and care for them.
NEW IN THE HOOD
John Hood has joined Snowbird Finance as business development director to assist
the company’s expansion in the optical sector.
John joins the team from Carl Zeiss where he spent 20 years as a high-tech
diagnostic equipment salesman. Simon Freeman, Snowbird MD, said: “John is a great
addition to the team and his appointment demonstrates once more our commitment to
being the leading provider of healthcare finance in the UK.”
Niall Balfe of Vision Express
MANCHESTER PRACTICE
JOINS DIABETES STUDY
Murrays Opticians in Moss Side is one of
four Manchester-based practices to have
been invited to work with the National
Institute for Health Research (NIHR)
Collaboration for Leadership in Applied
Health Research and Care (CLAHRC)
Greater Manchester to take part in a study
that will help in the fight against diabetes.
Dr Mitra Tavakoli of the University of
Manchester’s Centre for Endocrinology
explained: “Manchester pioneered work for
establishing the technique of corneal
confocal microscopy (CCM) – a new,
non-invasive eye test which can detect
diabetic neuropathy in limbs in its earliest
stages and used to image the eye – as a
16
tool for diagnosing diabetic neuropathy at
its early stages.
“This study will closely monitor 400
patients over eight months in four
community settings across Manchester to
understand how early diabetic neuropathy
diagnosis compares with retinopathy
results and patient symptoms, and explore
how to incorporate CCM into optometry
practices.”
Suhayel Issa, optometrist at Murrays
Opticians, said: “By conducting this study
we hope to pave the path to playing an
even more important role in the fight
against diabetes.”
The research is funded by CLAHRC
Greater Manchester and Heidelberg
Engineering, with initial study results
expected by the end of 2015.
GREAT FINISH
FOR FUNDRAISERS
A team of runners from Vision Express
Ireland was among over 200 entrants
who battled the tough Aran Half
Marathon for Temple Street Children’s
Hospital recently – with the
Blanchardstown practice’s Niall Balfe
crossing the finish line first in just one
hour 28 minutes.
Cheered on by the hospital’s special
events manager, Angela McNulty (pictured ),
Niall achieved a personal best and posted one
of the quickest half marathon times in the 10
years the renowned Aran Half has been held
in partnership with the hospital. Retail
associate Niall was part of a six-strong team
from Vision Express, which has raised more
than €5,000 for the charity during this event.
Silhouette welcomes guests to its Chiswick head office
RIMLESS CET
DAY SUCCESS
Silhouette hosted its second successful
‘Open office’ and CET rimless training
day on 26 March, welcoming more than
70 customers to its UK head office in
Chiswick, West London.
Peter Black, ABDO president, delivered
four CET rimless workshops and other
activities including a practical dispensing
discussion and an ocular conditions test,
earning each guest five CET points.
Participants travelled from around the
country to take part in the workshops. The
day included a tour of Silhouette’s offices,
Q&A sessions with specialist Silhouette
technicians, exclusive previews of new
Adidas and Silhouette frames, as well as
the chance to network over refreshments.
Guests were also treated with Silhouette
and Adidas goodie bags before they left.
Hatty Scrace, Silhouette UK marketing
and communications manager, said: “Our
rimless training days are a wonderful way
for us to meet our customers face to face
and to spend valuable time together,
helping them to feel confident working
with our rimless glasses. We love meeting
our customers and showing them the
technical side of our frames. Often people
don’t realise how easy it is to work with
Silhouettes and it is very rewarding to
see our customers leave feeling enthused
and confident.”
Silhouette will be running more ‘Open
office’ and CET rimless training days later
in the year. For more information, email
[email protected]
AREA 3 (NORTH EAST
AND ISLE OF MAN):
SOAPY CET AT PORT
SUNLIGHT
Report by Lorraine Wallbank,
vice chairman
On 8 March Area 3 hosted a CET event
at the Leverhulme Hotel in Port
Sunlight – the famous model
village created by the Lever Brothers
to accommodate workers in its
soap factory.
Registration was followed by a selection
of hot food dishes and refreshments, to fuel
Area 3 members participate
in peer discussion


Area 3 CET day’s sponsors
delegates before the lectures got underway.
First in line was an eye-opening lecture by
Essilor’s Nick Hornsby on ‘Filtering blue light’.
This was followed by Angela McNamee and
Keith Cavaye facilitating a peer discussion
session entitled, ‘All in a day’s work’. After a
short break with refreshments, delegates
were able to complete a VRT, ‘What is it to be
done?’ Emmanuel Hannebicque from Bollé
closed the day with her presentation on
prescription sports eyewear, ‘Playing it safe’.
In conjunction with all the lectures, Paul
Hotchkiss from Silhouette ran an informative
workshop on rimless repair and adjustments,
adding his usual good humour to the day. At
5pm everyone seemed to have enjoyed the
day and as we were at Port Sunlight with its
soapy connections, we all made a clean
getaway…
We would like to say a huge thank you
to all of our sponsors – Essilor, Eyespace,
William Morris, Charmant, Bollé, Advanced
Optical, Silhouette, Wolf Eyewear, the
Eyewear Company and OWP, without whom
these events would not be possible.
Email your Area news and reports to
[email protected]
17
Technology and innovation
At the British Contact Lens Association (BCLA) conference and exhibition in Liverpool this month, the great and
the good of the contact lens industry will be showcasing their latest technologies. We take a look at just a few
of the innovations taking contact lens practice to the next level…
Chance to try technology
fused lenses
Expanded sphere range for
increased options
Extended parameter range for unique lens offering
18
INFUSION OF TECHNOLOGY FOR PRESBYOPES
Safilens will be offering live fittings of its Fusion 1day Presbyo contact lenses at
the BCLA conference and exhibition, being held at the ACC Liverpool from 2931 May. The first daily lens for presbyopia based on the company’s patented
Fusion Technology, the Fusion 1day Presbyo is described as ensuring
“incomparable, exceptional depth of field and sharp images for distance,
intermediate and close-up vision, even for the most demanding myopes”.
Fusion Technology incorporates a co-polymer made from Tamarind-Seed
Polysaccharides (TSP) and hyaluronic acid (HA) into the contact lens. This
synergy is said to heighten the well-known properties of TSP and HA in
hydrating, lubricating and protecting the surface of the eye from mechanical
stress caused by wearing contact lenses, thus promoting the re-growth of
epithelial microvilli.
The lenses are said to be quick and easy to apply, whilst offering excellent
hygiene, comfort and practicality. Fusion 1day Presbyo is available with an 8.60mm
base curve, 14.10mm diameter and powers ranging from +8.00D to -10.00D.
TO BIOFINITY AND BEYOND
CooperVision’s Biofinity XR significantly expands the range of sphere powers
available, allowing practitioners to fit a greater number of monthly replacement
lens patients including wearers with significant hyperopia or myopia. Available
in powers from +8.50D to +15.00D (0.50 steps) and -12.50D to -20.00D
(0.50 steps), the existing Biofinity line continues to be available in +8.00D to
-12.00D powers.
“The advanced design incorporated into both Biofinity XR and Biofinity
lenses makes it easy for practitioners to have a high degree of fitting success,
even for patients with more extreme needs,” said Dr Juan Carlos Aragon,
CooperVision senior vice president, global professional and clinical affairs.
Biofinity and Biofinity XR utilise Aquaform Comfort Science, combining a
balance of high oxygen permeability, high water content, a naturally wettable
material that resists deposits for all day comfort and an optimum modulus for a
softer, more flexible lens.
WORLD’S FIRST FLAT PACK CONTACT LENS ON SHOW
The world’s first daily disposable flat pack contact lens, Miru 1day Flat Pack, will
be showcased by David Thomas Contact Lenses/Menicon (DTCL) at the BCLA
conference this month. A Gold Sponsor of the event, DTCL will be discussing
the highly differentiated product which, when opened, presents itself on a
unique dispensing platform with the outer surface of the lens facing upwards.
The aim is to eliminate patient confusion about lens orientation and reduce
the chances of touching the inner surface of the lens, and thus reduce the risk of
harmful microorganisms or debris getting trapped between the lens and eye.
The parameter range has increased recently and now includes plus powers up
to +4.00D.
Also on show will be the company’s Rose K2 Soft lens, an alternative for
fitting the irregular cornea, particularly when rigid lenses are not successful, and
MeniCare Pure, the newest multipurpose solution manufactured by Menicon to
promote healthy RGP lens care. The product is the first solution formulated with
natural ingredients as such -polylysine (instead of PHMB) as a disinfecting
agent as well as vitamin C glucoside and hyaluronic acid.
LENSES WITH THE GENTLE TOUCH
European contact lens manufacturer mark’ennovy has launched additional
designs for its Gentle 59 brand with Gentle 59 multifocal and multifocal toric
for astigmatic and presbyopic patients. The new options join the existing Gentle
59 parameter range, which includes sphere powers of +30.00D to -30.00D in
0.25 steps and cylinder powers of 0.75 to -8.00 in 0.25 steps and all axes in
one-degree steps.
A wide range of parameters, 59 per cent water content, UV blocking and
handling tint are some of the benefits of the range, along with ease of handling,
a low co-efficient of friction of 0.05 and a low dehydration rate of less than
one per cent. Multifocal and multifocal toric designs with different optical
zone diameters for each reading add complete the individually made Gentle
59 contact lens family. Gentle 59 together with Gentle 80 – named Contact
Lens Product of the Year at last month’s Optician Awards – and Saphir RX offer
an optimum solution to meet the diverse needs of contact lens wearers, says
the company.
CONTACT LENS DEBUT WITH DESIGNER EDGE
Mondottica International has launched its Mondottica Vision platform for its
‘designer contact lens business’. The initial programme features the designer
brand, Anna Sui, available in a range of colours and motifs including the Anna Sui
Rose, Lace and natural textures; in plano and a full range of prescription powers.
Agreements have been signed or are pending for six Asian markets in Korea,
China, Hong Kong, Singapore, Malaysia and the Philippines and the products will
only be sold through eyecare professionals. Manufactured in state-of-the-art
facilities in Korea and Taiwan using dual-layer coating technology and
internationally recognised quality control methods, the lenses are licensed and
approved by regulatory authorities worldwide. South Korea will also see the launch
of a technologically refined collection produced with silicone hydrogel materials.
Mondottica chairman, Michael Jardine, said: “After many years of research and
development we are pleased to finally cut the ribbon on this wonderful programme,
and we are thrilled that Anna Sui has agreed to be the leader in this new field of
Designer Contact Lenses.”
POST-SURGERY LENS THAT TICKS ALL THE BOXES
KeraSoft Thin is the latest addition to UltraVision CLPL’s specialist range of KeraSoft
contact lenses, and is designed to fit all irregular corneas, including post-refractive
surgery, pellucid marginal degeneration (PMD) and other corneal irregularities.
According to the company, the main ocular health benefit of KeraSoft Thin
is a reduced centre thickness (0.20CT), which increases oxygen permeability and
improves comfort. KeraSoft Thin is said to be ideal for corneas where reverse
geometry is required or maximum oxygen transmission is the main point of concern.
The lens is available in a choice of two materials: a three-month 74 per cent
water content silicone hydrogel material, and a durable annual lens in a high
water content 77 per cent hydrogel material.


New options for astigmatic
and presbyopic patients
Designer lenses
launch in Asia
markets
Specialist lens
with ocular
health benefits
THREE CLEAR REASONS TO EXPLORE THE RANGE
Following the success of its first biocompatible silicone hydrogel monthly
contact lens, Beyond, Clearlab’s new Beyond for Astigmatism range offers a
complete range of cylinders (up to -2.25) and axes (by 10) from +4.00D to
-8.00D. Based on the same material as Beyond, Beyond for Astigmatism uses
Clearlab’s patented dynamically stabilised lens design.
Also new from the company is Eyedia, a multipurpose solution equipped with
conditioning agents and moisturiser to improve comfort and promote the hydration
of the lens. Eyedia effectively removes proteins and lipid deposits, and eliminates
loose debris, caused by environmental contamination, from the lens. The
solution is approved for use with hydrogel and silicone hydrogel contact lenses.
See these products at the BCLA conference, as well as Clearlab’s Clearcolor
1-day cosmetic lenses. Stand visitors will also be in with the chance of winning
a premium make-up experience in a luxury spa hotel.
Next month’s product spotlight is on dispensing tools and instruments
Clearlab’s Beyond range has been expanded
19

COMPETENCIES COVERED
Dispensing opticians: Contact Lenses
Contact lens opticians: Verification and Identification, Contact Lenses
Optometrists: Contact Lenses
IMPORTANT: CLO competency requirement
Contact lens opticians will notice that this article is approved for the Contact Lens competency of Verification and Identification. This
competency is rarely offered by CET Providers, so will remain active until December 2015. CLO ABDO members are strongly recommended
to complete the article and answer the multiple choice questions so that they can ensure that their CLO competency requirements are met.
Contact lenses
with a difference
n modern contact lens practice,
opticians could be forgiven for
feeling that nearly all contact
lenses, especially those on a regular
disposable modality, are all very
similar. However, when details of products
are closely examined, most offer some
differences of design, material or packaging.
A review of the Association of Contact
Lens Manufacturers’ (ACLM) Contact Lens
Year Book1 soon demonstrates this. But
beyond this, and without delving into the
true specialist contact lens types, there is
also a group of contact lenses that clearly
demonstrate some unique features, making
them worthy of note for contact lens
I
by Keith Cavaye FBDO(Hons)CL FBCLA
opticians (CLOs) and all other optical
practitioners with an interest in different
product availability.
The purpose of this article is to describe
a small number of these differing lenses,
pointing out their usually unique feature(s)
and particular benefits. It must be emphasised
that this list is not exhaustive, but limited
by space on this occasion. The author would
like to make it clear that inclusion in this
article is not a recommendation or guarantee
of all benefits explained, but generally
based on the manufacturer’s descriptions
and guides. Only single vision lenses will be
described here, although some products are
available as astigmatic or multifocal options.
DAILY DISPOSABLES
This extremely popular modality has seen a
large expansion of choices over the last few
years, sometimes leaving the practitioner
uncertain of the genuine differences. Indeed
the 2014 edition of the ACLM Contact Lens
Year Book, which only includes products
produced by its members, lists 102 single
vision choices from just four manufacturers2.
A brief summary of parameters and
specifications available for the three daily
disposable lenses described here are shown
in Table 1.
MIRU 1 DAY
The Miru 1 day Menicon Flat Pack, by David
Material
Water Content
DK
(traditional units)
TD (mm)
BOZR (mm)
Power Range
(D)
Miru 1 Day
hioxifilcon A
57%
19
14.20
8.60
-0.50 to -10.00
Dailies
Total 1
delefilcon A
33% core
>80% surface
140
14.10
8.50
-0.50 to -10.00
Proclear
1 Day
Omafilcon A
60%
25
14.20
8.70
+8.00 to -12.00
Table1. Key features of the daily disposable lenses described
This article has been approved for 1 CET point by the GOC. It is open to all FBDO members, including associate
member optometrists. The multiple-choice questions (MCQs) for this month’s CET are available on page 24
and online. An answer sheet for posted or faxed entries is available for download on ABDO’s Dispensing Optics
log-in page. Online entry: log in to www.abdo.org.uk, and follow the centre section link to ‘CET 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 the January 2016 issue of Dispensing Optics. The closing date is 12 December 2015.
20
C-39983
Figure 2. The outer surface prominent
on opening Miru
Figure 1. Extremely thin packaging of Miru 3 pack
Thomas Contact Lenses/Menicon, is a daily
disposable contact lens made of hioxifilcon
A, with a water content of 57 per cent and
an oxygen permeability of 19 traditional
units3. As with many lenses, claims are
made regarding excellent wettability and
low dehydration rates3, but the obvious
difference with Miru is the packaging, which
leads to improved patient handling and
reduced risks of microbial contamination4.
Each foil strip contains three lenses, but
can realistically be described as ‘flat packed’,
as the total thickness is only 1mm or 0.04
of an inch thick. As there is just 0.2ml of
solution in each foil, its lightweight
packaging makes it very portable in a wallet
or handbag (Figure 1). When opened
correctly, the outer surface of the lens is
always facing up, ready to be picked up and
placed on the eye (Figure 2). This reduces
the possibility of a lens being inside out –
surely a step forward for patients who
struggle with this aspect of wear. It also
reduces any chance of touching the inner
surface of the lens, minimising the risk of
microorganisms or debris being trapped
under a lens.
In an ‘in house’ test conducted by
Menicon4, fingers were contaminated with a
standard sample of staphylococcus aureus
bacteria before removing lenses from the
package. Inner and outer surfaces of the
lenses were then cultured separately so that
bacterial growth could be observed for each
surface individually. On the inner surface of
the Miru 1day lens, no bacterial growth was
observed.
DAILIES TOTAL 1
Described by Alcon as the first water
gradient contact lens5, this interesting
concept aims to combine the benefits of
silicone hydrogel with both high and low
water content material in one lens. Made
from delefilcon A, the structure of this
design has a core of silicone hydrogel, low
water content (33 per cent) material
forming the bulk of the lens, leading to a
claimed transmissibility of 156 traditional
units at -3.00D5, with a Dk of 140 units.
This is the highest transmissibility of any
daily disposable available to date.
But perhaps the really unique feature is
that as the surfaces of the lens are
approached from the centre, both front and
back, a transition occurs in the water
content, leaving the surface of the lens with
a water content of more than 80 per cent
(Figure 3). These two surfaces each account
for around six per cent of the central lens
thickness. The anticipated benefits are a
very breathable contact lens, but with a
wettable, lubricious and extremely low
modulus surface giving improved comfort.
PROCLEAR 1 DAY
Proclear 1 Day from CooperVision has been
on the market for a number of years, so
why would it be included in this article?
Well, it still has some ‘differences’ that
make it stand out from the crowd. Between
50 and 75 per cent of all contact lens
wearers suffer from dry eye symptoms6.
Proclear was designed to combat
dehydration, making lens wear comfortable
for longer periods. It was developed with
phosphorylcholine (PC) technology, which
has both positive and negative charges on
the molecules. Such molecules are known
as zwitterionic7, with the intended benefit
of allowing the lens to bind tightly with
water, thereby resisting dehydration. The
manufacturer claims this also reduces
dry spots and protein deposition on the
lens surface.
Another benefit of this product, which
warrants inclusion here, is the extended
power range available. It is one of a very
few lenses that a myope of -12.00D can
wear (Johnson & Johnson Vision Care also
offer this high power in their daily range),
but more unusually for a daily disposable
Figure 3. Schematic of cross section of Dailies Total 1
21

lens, hypermetropic patients requiring
+8.00D can also be accommodated, making
it a very useful tool to have in the practice
armoury (Figure 4).
Figure 4. Proclear 1 Day from CooperVision
Figure 5. Lathing process as used by mark’ennovy
Steps
BOZR (mm)
6.80 to 9.80
0.30
Total Diameter
(mm)
13.00 to 16.00
0.50
Power (D)
-30.00 to +30.00
0.25
Cylinder (DC)
-0.75 to -8.00
0.25
Axis (degrees)
All
1
Addition (D)
+0.50 to +4.00
0.50
Table 2. Parameter range of Saphir Rx by mark’ennovoy
22
SAPHIR RX
The range of contact lenses expands rapidly
as we move into disposable modality of up
to one month, which generally encompasses
weekly, two weekly and monthly disposable
lenses. Indeed, the ACLM Contact Lens Year
Book lists 29 products in this category8,
with an increasing share of the products
(more than 40 per cent) now being silicone
hydrogel material. Generally, these lenses
are moulded, needing extremely accurate
moulds to be manufactured at high cost.
This, in turn, tends to limit the parameter
range available to the practitioner.
Unusually for a monthly replacement
lens, mark’ennovy uses a lathing process to
produce Saphir Rx (Figure 5). This offers the
opportunity to produce an almost unlimited
range, by individually making lenses in
Filcon V3, a silicone hydrogel material.
Filcon V3 has a high water content of 75
per cent, which in turn leads to its low
modulus of 0.29 (MPa)9, and mid to high
oxygen transmission of 60Dk9. The actual
parameter range includes powers from
-30.00D to +30.00D and total diameters
up to 16mm, whilst also including a choice
of radii.
The full range is shown in Table 2,
which can also incorporate toric,
multifocals and toric multifocals. Due to
this unusual availability, apart from the
more standard prescriptions, the
manufacturer recommends Saphir Rx be
considered for high refractive error, steep or
flat corneal curvature, irregular cornea and
patients who need differing overall
diameters. With these choices, there will
surely be very few patients that are
unsuitable to try monthly disposable
contact lenses.
DUETTE HD
Moving away from everyday contact lens
practice a little, the Duette HD range
(there is a Duette HD progressive for
presbyopes) from No7 Contact Lenses seeks
to offer a premium performance by
combining the optical performance of rigid
lenses with the comfort of soft lenses. This
is a true hybrid lens, with a central rigid gas
permeable (RGP) portion of 8.5mm in
diameter, bounded by a soft skirt of 14.5mm
diameter (Figure 6). Good oxygen
permeability is achieved by using silicone
hydrogel for the skirt, of hemlarafilcon A
lenses are described as ‘reverse geometry’
designs and are usually, but not always,
fitted with the aid of a topographer. They
also need to be worn overnight to achieve
the required modification to the prescription.
They are available from a number of UK
suppliers including Scotlens, David Thomas
Contact Lenses, Bausch + Lomb, Northern
Lenses and No 7 Contact Lenses.
Hopefully, this short review of easily
available, but slightly different contact
lenses on the UK market will open the eyes
of readers and encourage opticians to
research all options available to better serve
our patients.
Figure 6. The Duette HD hybrid design
material with 84 Dk (traditional units) and
Petrafocon A, 130Dk for the rigid centre.
Visually, rigid lenses are usually
considered to give the best quality and
naturally correct the majority of corneal
astigmatism with the tear layer that is
trapped between the lens and cornea. The
manufacturer suggests up to 6.00DC may
be corrected without the need to
incorporate toroidal surfaces on the lens.
Due to the soft skirt, there is less lid
interaction compared to traditional RGP
lenses, resulting in initial comfort
approaching that of a soft lens. No 7
Contact Lenses suggests that patients who
would benefit from a fitting would include
astigmats unhappy with soft lens vision,
RGP wearers who are finding their lenses
less comfortable and those who have failed
with other options. The recommended
BOZR (mm)
7.10 to 8.30
in 0.20 steps
Total Diameter
(mm)
14.50
Power (D)
+10.00 to -15.00
Water Content
Skirt
32%
Skirt Curvature
Flat, Medium,
Steep
Table 3. Parameter range of Duette HD
by No7 Contact Lenses
replacement schedule is six months. As
more than one material is being used in
these lenses, the care procedure is a little
more complicated. One option is to
disinfect using a peroxide system and store
in a multipurpose solution. Parameters are
shown in Table 3.
CONCLUSION
In conclusion, and somewhat out of the
remit of this article, the author points out
that there are also true specialist lenses to
be explored. An example of this category
are RGP lenses for orthokeratology. In
general, these lenses go against the
traditional mode of RGP fitting, where the
back surface of the lens attempts to follow
the curvature of the cornea by a series
of increasingly flatter curves as the lens
edge is approached from the centre or by
using an aspheric design following the
same principle.
Orthokeratology aims to reduce
ametropia, usually myopia, by reshaping the
cornea. Simply, this is achieved by fitting a
lens with a central curve flatter than the
cornea, surrounded by a steeper first
peripheral curve, then with more traditional
‘fitting’ curves outside this to aid
stabilisation and tear exchange. An unusual
‘bulls eye’ fluorescein pattern results. The
combination of a flat central curve and steep
mid-peripheral curve induces central corneal
flattening (and so reduces myopia) as a
result of changes in fluid pressure10. Such
REFERENCES
1. Association of Contact Lens
Manufacturers (ACLM) Contact Lens
Year Book 2014.
2. ACLM Contact Lens Year Book 2014. p. 30.
3. Technical details from David Thomas
Contact Lenses.
4. Menicon in-house test data.
5. Alcon Product Guide (September 2014).
6. The epidemiology of dry eye disease:
report of the Epidemiology
Subcommittee of the International Dry
Eye Workshop. Ocul. Surf. 2007 5 (2):
93-107.
7. Collins English Dictionary.
8. ACLM Contact Lens Year Book 2014.
Pages 34-36.
9. Made-to-Measure Contact Lenses,
mark’ennovy.
10. Downie L, Orthokeratology: a clinical
overview. Optometry Today 2015
10 January, pp 44-48
KEITH CAVAYE FBDO(HONS)CL, SMC,
FBCLA is currently working as an
independent locum contact lens optician
and consultant. For nine years he was a
sessional lecturer at Anglia Ruskin
University. His previous positions include
professional services manager
Indigolighthouse Group, contact lens
product manager at Dollond & Aitchison,
and contact lens services manager at
Boots Opticians. He is also a past British
Contact Lens Association council
member, ABDO board member and past
GOC council member, still serving on
various GOC committees. Other optical
interests include ABDO contact lens
practical examiner, member of the ABDO
Contact Lens Committee and chairman
of ABDO CET Committee. He has
published various articles on contact
lens-related subjects.
23
MCQs
Multiple choice questions:
1. Which statement is incorrect regarding the Miru 1 day
Menicon Flat Pack lens?
a. There is 0.2ml of solution surrounding each packaged lens
b. This lens is made of hioxifilcon A
c. In its package the outer surface of the lens is always
facing down
d. Each foil strip contains three lenses
4. Complete the sentence correctly. The Proclear 1 Day
lens is designed…
a. with special technology enabling molecules to have only
positive charges
b. with the power range from -8.00 to -12.00
c. in delefilcon A material
d. to reduce dehydration
2. Complete the sentence correctly. Orthokeratology
attempts to reduce myopia by…
5. Which statement is correct?
a. The Saphir Rx lens is available with an addition from
+1.00 to +3.00
b. Hemlarafilcon A material has a traditional unit Dk value of 84
c. Filcon V3 is a true hybrid material
d. The ACLM Contact Lens Year Book 2014 shows that more
than 60 per cent of listed disposable extended wear lenses
are made from silicone hydrogel material
a.
b.
c.
d.
fitting a lens with a central curve flatter than the cornea
employing a lens with inverse geometry design
having a flatter mid-peripheral curve
restricting wear to daytime only
3. Complete the sentence correctly. The Duette HD
contact lens…
a. attempts to link the optical performance of soft lenses
with the comfort of rigid lenses.
b. has the peripheral area made of hemlarafilcon A material
c. has a central portion with a diameter of 14.5mm
d. is available with a back optic zone radius between 7.40
and 8.60
6. Complete the sentence correctly. A ‘bull’s eye’
fluorescein pattern may result from…
a. prolonged use of extended wear lenses
b. high water content lenses with a low modulus
c. fitting a lens with a central curve flatter than the cornea,
and a steeper first peripheral curve
d. a well-fitting rigid gas permeable lens
www.abdo.org.uk
Contact lenses with a difference by Keith Cavaye FBDO(Hons)CL FBCLA
THE DEADLINE FOR POSTED OR FAXED RESPONSE IS 12 DECEMBER 2015. The module code is C-39983.
Online completion - www.abdo.org.uk - after member log-in go to ‘CET online’
After the closing date, the answers can be viewed on the 'CET Online' page of www.abdo.org.uk. To download, print or save your results letter, go to 'View your
CET record’ after the closing date. If you would prefer to receive a posted results letter, contact the CET Office 01206 734155 or email [email protected]
Occasionally, printing errors are spotted after the journal has gone to print. Notifications can be viewed at www.abdo.org.uk on the CET Online page
ALCON ‘GIVES IT A GO’ WITH £5K CAMPAIGN
GIVE IT A GO!
FREE first mon
m th’s
supply for your next
6 patients!
Sector growth initiative
24
Alcon is investing £500,000 in a ‘Give it a go’
campaign to drive contact lens sales in the
independent sector.
A range of point-of-sale materials, designed to
encourage patients browsing frames to plump for a
contact lens trial, includes frame tags, mirror
clings, posters, strut cards and placement
guidelines. Specially designed frame tags means
contact lens and frames can be promoted
simultaneously.
Patients are offered a free month’s supply of
the latest products in the Alcon portfolio.
The company stated: “Alcon understands the
importance of growing the contact lens patient
base in the independent channel and hopes that
independent practitioners will use the ‘Give it a go’
campaign to engage their patients with contact
lenses and generate incremental sales.”
GIVE IT A GO!
Fra
ame tags
A5 strut card
ds
Mirro
or stickers


Six of the following questions were presented online to entrants to comply with the GOC’s
best practice specifications for this type of CET
1. The term polymer, in the context of spectacle frame
production, means:
a. The substance has in-built tensile strength and elasticity
b. The bonds between molecules in chains can be broken and
re-attached
c. Molecules are bonded together in long repeating chains
d. Combining many large monomer molecules into a chain
held together by covalent bonds
c is the correct answer. A polymer is a chemical
compound where molecules are bonded together in long
repeating chains. These materials have unique properties and
can be tailored depending on their intended purpose. They
can be man-made and occur naturally as in rubber.
2. Complete the sentence correctly. The quality of
cellulose acetate material is largely determined by:
a. the filtration process and the quality of the fine, silky
fibres which adhere to the seeds of the cotton plant
b. the type of plasticiser used in the paste and its reaction
with acetic acid
c. the method of extrusion employed to form the basic
material
d. the length of time taken for the partial hydrolysis process
to occur
a is the correct answer. Best quality cotton linters and
an extensive filtering procedure are required to produce the
best quality product.
3. Which statement is true about cellulose propionate?
a. It is a thermosetting epoxy resin
b. It is less transparent than cellulose acetate
c. The production process is by injection moulding
d. The material is lighter than SPX
c is the correct answer. The routing technique is not
appropriate for this material.
4. Spectacle frames made from SPX material sometimes
have in-line glazing. This is because:
a. it has a tendency to shrink when heated
b. of the need for cold glazing
c. the rims can be made very thin
d. an injection moulding process is used in frame manufacture
c is the correct answer. Because the material can be
made very thin and remain stable, there would not be
sufficient material to include a conventional groove to
accept the lens bevel.
5. Which statement is false concerning the material
Grilamid?
a. The softening point is 85 degrees C
b. Frames need to be cold glazed
c. It is made up of four sub-groups of long-chain aliphatic
polyamides
d. There is an average of 16 or more carbon atoms in the
basic structure.
d is the correct answer. There is an average of 12 or
more carbon atoms.
6. Complete the sentence correctly. The epoxy resin
Optyl is:
a. 20 per cent lighter than other thermo plastics
b. successfully adjusted at up to 80 degrees C
c. affected by some types of cosmetics
d. considered to be hyperallergenic
a is the correct answer. At least 80 -120˚C is needed to
adjust this material; it is not affected by chemicals or
cosmetics and is hypoallergenic.
7. Which statement best describes the injection
moulding process?
a. There are four stages in which temperature and pressure
are gradually increased
b. Pressure, friction and heat are used to force molten
material into machined moulds
c. Polymer is forced into a mould in three zones, the second
allowing air to intrude
d. A mould is machined to an accuracy of 1/100mm and
molten polymer poured in
b is the correct answer. All three factors are required to
prepare the polymer for moulding.
8. Which statement is true?
a. Cellulose acetate frames are generally produced by
moulding
b. Nylon polymers contain a high percentage of plasticisers
c. In-line glazing requires a nylon cord
d. Cellulose propionate is likely to shrink if over heated
d is the correct answer. This becomes critical over
about 70˚C.
To download, print or save your CET result letter, go to
www.abdo.org.uk. Log-in and go to 'View your CET record'.
Plastic fantastic by Joanne Abbott BSc(Hons) FBDO SMC(Tech)
FOR THE MOST UP-TO-DATE ABDO EVENT DETAILS keep an eye out for the eNews landing in your in-box, and the
events section of the website, visit www.abdo.org.uk/events
25
Do current designs provide sufficient control
of the development of myopia in children?
asks Martin Conway’


Myopia control
with contact lenses
he growth in the prevalence of
myopia in children has been
well documented and is now
acknowledged to be of epidemic
proportions. Theories as to the
cause of myopia in children have been
suggested for centuries, but in recent years
well-controlled studies have provided us
with vital clues as to what can trigger
the eye to elongate.
At present, the prevalence of myopia is
highest in Asia. A study published in
Investigative Ophthalmology and Visual Science
(IOVS) in November 2012 by Jing Sun, Jubo
Zhou, Peiquan Zhou et al, showed that of
5,060 university students examined, 95.5 per
cent were myopic, with a mean prescription
of -4.12D. More worrying was the finding
that 19.5 per cent of them had myopia of
-6.00D or more, with all the attendant
problems that this might cause in later life.
T
FOCUS ON ENVIRONMENTAL FACTORS
The problem of myopia is also worldwide
and has developed within two generations.
Whilst there may be a predisposing genetic
link making the Asian eye more prone, the
fact that it has developed so quickly means
Time spent outdoors may reduce the
progression of myopia
26
that most researchers are looking at
environmental factors as the main culprits.
The changes that have occurred in the
way children are spending their playtime
has dramatically altered over the decades.
Children growing up in the 1950s and 1960s
spent little time in front of the TV and were
allowed to play outdoors. Today’s parents live
in fear, real or imagined, of traffic and/or
predators and are less likely to allow children
unsupervised playtime outside of the home.
TV and other screen-based activities such
as game consoles have kept children glued
to a screen, sometimes at distances much
shorter than the normal reading distance.
A study published in IOVS in December
2012 by Cindy Karouta and Regan Scott
Ashley, into the correlation between light
levels and the development of form
deprivation myopia (FDM), concluded that
the level of protection against FDM
increases with increasing light intensity and
daily exposure to 40,000 lux almost
completely prevents the onset of FDM, and
once myopia is established, halts further
progression; 40,000 lux is the equivalent of
sitting outside on a very sunny day. For
comparison, an overcast day would provide
1,000 lux per hour and the average home
250. The time required would be two hours
per day for prevention of FDM.
Despite this evidence, there is little chance
of changing behaviours that have become
such an intrinsic part of modern life, so we
must look for optical solutions to the problem.
For many years, some practitioners
believed that by fully correcting myopia in a
child, we would somehow encourage it to
grow and so they routinely under-corrected
by as much as -0.75D to reduce the
accommodative effort. This has proven to
be not only ineffective, but in fact
contributes to the problem. Bifocal
spectacles, again for the alleviation of
accommodative effort, have also been used
to try to achieve the same effect.
OPTICS OF MYOPIA CONTROL
There is a significant difference between
the minimal impact that GP lenses have on
myopic progression, compared with that
obtained with an ortho-k lens. Why should
that be the case?
There has also been a significant
variance in the rates of retardation obtained
in various studies, conducted using similar
groups and similar lenses. Some have
claimed that myopia progression was
slowed by as much as 63 per cent, whereas
another was as low as 36 per cent. What
could possibly explain those differences?
Studies have shown inconsistent
rates of control
If we look at the way an ortho-k lens
works and the image shell it produces, then
we may find a theoretical answer for what
appears to be a tremendous variance in
outcome. Work done by Jennifer Choo in
2008 showed that in ortho-k, the central
epithelium is compressed, whereas that
under the reverse curve zone is expanded to
produce the typical profile seen in ortho-k.
Topography also reveals that an oblate
curve is produced by the epithelium, which
gives an equal but opposite power at the
periphery of the optic zone. If a -1.00D
change is achieved in the central 2.00mm,
then an equivalent +1.00D effect occurs at
the periphery of the zone.
The studies conducted previously, using
Ortho-k produces an “ equal and opposite” effect on peripheral power
conventional ortho-k designs, recruited
candidates generally with a prescription of
between -1.00D and -4.00D in the spherical
power, and under -1.25D in any cylindrical
error. If the myopia control effect is
dependent upon the amount of plus
generated at the periphery, then those
studies with a cohort of lower-powered
myopes would achieve less retardation than
those studies whose cohorts’ average
myopia was closer to 4.00D. This may
explain why there was such variance in the
outcomes of those studies.
Eddie Chow of Toronto demonstrated an
enhanced myopia control effect when using
an aspheric ortho-k design, which produced
increased plus at the periphery compared
with traditional designs. It would appear,
therefore, that there is a direct link between
the plus power produced in the periphery
and the amount of myopia control exerted.
We need to develop lenses that produce
Ideal image shell required to achieve
full myopia control
an image shell that, independent of the
central power, will produce more plus in the
periphery. This concept applies to both
ortho-k and soft lenses.
PUTTING IT INTO PRACTICE
As the public become more aware of the
prevalence of myopia and the implications
for their children, and as they also become
aware of potential remedies that may exist,
practitioners will increasingly need to be
familiar with the products that are available.
Current contact lenses, whether ortho-k
or soft multifocals, may have an effect on
the development of myopia in a given child,
but at present a practitioner cannot
guarantee what the outcome is likely to be
over a treatment period of several years.
Ortho-k, in the UK at least, is fitted by
very few specialist practitioners. Those who
fit children may well do so in the hope that
the wearing of this type of lens will reduce
the progression of myopia in that child.
Certainly the parents of the child will be
hoping for such an effect, in return for
potentially many years of paying for the
product. At present, it is impossible for a
practitioner to guarantee that outcome, as
most lenses supplied in the UK are of
conventional spherical design.
The correct amount of peripheral plus
required to achieve complete control is yet
to be determined, but best estimates put it
at around three to four dioptres. This means
that using conventional ortho-k lenses, the
child needs to be at least -3.00D to achieve
any meaningful slowing of the myopic
progression. Ideally, we would like to
intervene at the earliest possible time to
nip the myopia in the bud, certainly before
the prescription has reached -1.00D and
that lens needs to produce a central
treatment zone to correct the -1.00D axial
myopia at the fovea, but then produce an
image shell that moves the peripheral
image forward of the retina by the
equivalent of three to four dioptres.
Current lenses do not achieve this. A
child going into ortho-k at -1.00D will have
a slowing down of the rate of increase, but
will still progress, albeit more slowly than
otherwise. As the short-sightedness reaches
the -3.00D to -4.00D level, the increased
plus produced in the periphery will begin to
take effect and the slowing of the
progression will begin to stabilise the
prescription at around the -3.00D to -3.50D
level. Many practitioners will count this as
a success, particularly if the parents are
-6.00D or more.
Lenses do exist which, in clinical trials,
have not only halted the progression of
myopia, but in some cases reversed the
initial level slightly. They do this by creating
an image shell similar to that shown in the
illustration. This optical effect may also be
produced in a soft silicone lens that may
be worn as a conventional daily wear lens
for those parents who do not wish to go
down the ortho-k route. This type of lens
is a ‘work in progress’ and not as well
documented as the ortho-k version, but
initial results are promising.
COMMERCIAL POSSIBILITIES
In January 2015, Contamac entered into a
multi-year intellectual property agreement
to commercialise and distribute custom
silicone hydrogel and GP lenses for myopia
control with the Brien Holden Vision
Institute. Work is now underway to develop
lenses in both soft and ortho-k designs that
will give a more predictable outcome for a
given prescription. We are at the beginning
of an exciting process that will bring
effective and predictable myopia control
with contact lenses.
This has been a brief introduction to
the concept of myopia control using
contact lenses. For more detailed
information and background clinical studies
that have helped formulate the current
understanding of the subject I recommend
http://www.myopiaprevention.org/
Martin Conway FBDO, FIACLE, FBCLA is
head of professional services at Contamac.
27

This month, Antonia Chitty looks at
strategies to encourage more of your
patients to try contact lenses
Building your
contact lens practice
ontact lenses come with
many benefits. Imagine the
bride who doesn’t want to
wear specs on her wedding
day, but never thought she
was suitable for contact lenses. You’ll earn
her life-long gratitude every time she
looks at her wedding photos if you are
the person who suggests or fits her with
lenses. Consider the keen rugby playing
teen, who is devastated to learn he is
myopic. Again, a thorough discussion of
the pros and cons of contact lenses can
make a difference to this person’s life.
Then, look at the figures, what makes
your practice the most profit? And, looking
in more depth, what offers more profit for
fewer practitioner hours? Contact lenses by
direct debit must come high up the list of
profitable offers for many practices. For a
check every six months, you have money
coming in monthly. It’s good to step back
and take a systematic look at how to
increase the number of people wearing
contact lenses.
C
In this article we will address three key
areas. To start with, have you thought about
ways to attract new people to your
practice? We will then look at converting
existing spectacle wearers to contact lenses.
Finally, we’ll look at ways to encourage
current lens wearers to upgrade or buy
other products.
ATTRACTING NEW PATIENTS
This whole article could be about attracting
new people to your practice. It can be easier
to sell to your existing customer base, but
there is always a turnover in any practice as
patients die or move away, and some
practices, such as those in towns with a
university, may find that their turnover is
much more rapid. Look at the turnover of
patients that you have in your own
practice. Make a point of asking new
patients where they heard of you and what
attracted them to your practice. Whether it
is word of mouth, advertising, a special
offer or an attractive shop window, make
note to build on what succeeds. If there are
Step back and look at how to grow your contact lens business
28
particular barriers to accessing your
practice, think what you can do to
overcome them. Getting permission to put
an A-frame sign at the top of the road,
displaying a big arrow, can help if your
practice is down a side street. If word of
mouth is one of the leading reasons people
come to you, make a point of discussing the
health benefits of an eye examination, and
asking people if they have any friends who
don’t get their eyes examined regularly.
To hone the type of person you attract
to your practice, look at the age and gender
profile of your current contact lens wearers,
and consider how you can approach more
of this type of person. Do more of them live
in a particular part of your area? Think
about where and how you can reach them.
For example, if many of your contact lens
wearers are also commuters, you may
choose to create an advertising campaign
highlighting your contact lens specialisms
with an advert on the wall at the train
station, and back it up with adverts in the
free magazine or newspaper that is on offer
at the station.
Make sure that you include an offer, as
this not only helps attract people, it also
gives you a way of tracking if your
advertising is working. Think carefully about
the exact nature of your offer: it may be
better to offer something extra rather than
simply cut the price because people who
choose where to buy their lenses based on
price may not be loyal customers.
CONVERTING SPECTACLE WEARERS
Once you have looked at attracting more
people to your practice, then the next step
is to convert existing spectacle wearers to
contact lenses. Spectacles and contact
lenses can be complementary products,
suitable for different activities and
occasions. Many people will consider
themselves unsuitable for contact lenses,
perhaps because of their age or because
 
Victoria Loveday is a dispensing optician at
the Eye Centre in Thornton Heath, near
Croydon. She says: “What we try to do to
boost contact lens patients is to offer
comfort trials. This works well as people
try lenses while choosing their specs and
then if they like them, they can book in for
a fitting. The optometrist asks the patient
if they would like to see better while
choosing glasses and when they say yes, they
just explain that they can apply a lens to
their eye so they can see.
“If people are nervous or worry lenses
will hurt, we just offer to let them feel it.
Silicone hydrogel lenses are great and people
are always surprised how comfortable they
are from the start. For people with astigmatism,
try and go for best vision sphere; we also
have a bank of multifocal lenses. The
optometrist does a corneal staining check
before and after insertion and removal.
“The comfort trial boosts the fittings
they were told years ago their prescription
wasn’t suitable.
The range of contact lenses available is
now much greater and many more people
can try lenses, and succeed with them, so it
is up to you and the practice team to show
people that contact lenses are a possibility
for them. Part of this is a numbers game:
the more people you offer lenses to, the
more will try them. Making sure that the
optometrist suggests contacts lenses is one
way to do this; their recommendation will
come with added clinical weight.
It can take up to seven opportunities to
consider a new idea before people try
something new, so make sure that you
explain how contact lenses are now suitable
for more people in your practice newsletter,
and back this up with advertising, staff
recommendations, materials available in
your practice and/or a window display.
Understanding your patient can help
you demonstrate how contact lenses can
help them. For example, a sporty person
may want lenses for one reason, a
fashionista for completely different reasons,
and you need to shape your explanations of
the benefits to match their motivations.
Another suggestion is to offer lenses to
people to aid in choosing frames. This was
done in the EASE study (Enhancing the
Approach to Selecting Eyewear); read the
Victoria Loveday
more than just offering a fitting, we have
found, and it usually only takes an extra five
minutes for the checks. Generally the uptake
of a further contact lens trial is usually about
70 per cent when you get the wording right
and gain confidence offering it.”
case study for one dispensing optician’s
view on how it works in practice1.
of frames, ask the rep if they can help to
ensure that the promotion works for the
practice bottom line as well as offering
value to patients. This is when it is vital to
have the email address of your patients.
Send them a message at the start of the
offer, and remind them again as it comes to
a close. People need several reminders to
act. Point out the benefits in your offer,
such as how your new range of designer
spectacles can complement an outfit, so
people desire the product on offer.
So, if you would like more contact lens
patients in 2015, invest some time this
month in planning a strategy to boost the
numbers of people entering your practice,
the numbers trying contact lenses for the
first time, and the add-on sales to current
patients. Create a plan for your practice
and make sure that every member of
the team is briefed and equipped to make
contact lenses a key part of what you offer
this year.
UP-SELLING TO EXISTING WEARERS
The final element in this strategy to boost
your practice’s contact lens business is to
encourage current contact lens wearers to
spend more. With the dominance of daily
disposables, solutions are no longer a
significant business, but there are plenty of
other purchases that you can encourage
contact lens wearers to make. Remember,
they already know you, like you and trust
you; regular check-ups lead to a good
professional relationship.
Make sure that you offer them
something that makes them feel valued,
because they are of great value to your
practice. Some practices offer an ongoing
discount on spectacles or sunglasses but
this can be taken for granted. Instead, why
not create a programme of shorter, seasonal
offers, perhaps for one month every
quarter: sunglasses for summer, an offer on
coloured lenses in the run up to Halloween
or Christmas, and an offer on spectacles,
plus an explanation of why contact lens
wearers can benefit from having specs too,
at any time of the year.
Make the offer time limited and
compelling; 10 per cent off probably won’t
cut it. If you are offering a particular range
REFERENCE
1. Atkins NP, Morgan SL and Morgan PB
(2009) Enhancing the approach to
selecting eyewear (EASE): A multi-centre,
practice-based study into the effect of
applying contact lenses prior to spectacle
dispensing Contact Lens & Anterior Eye
32: 103–107.
29
Amy Rothwell, Bausch + Lomb head of eyecare marketing
(left), speaks to Nicky Collinson about how the company
is supporting CLOs in practice

Bio-inspired eyecare
NC: What is your primary goal currently
in terms of product and service
development in the UK marketplace?
AR: As a company we have been pioneers in
eyecare for over 160 years and the creators
of many optical ‘firsts’. For instance, we were
responsible for the first soft contact lenses. Just
recently we introduced the Biotrue ONEday
for Presbyopia, an innovative breakthrough
which incorporates 3-Zone Progressive
Design technology to deliver excellent near,
intermediate and distant vision.
Today, the company’s commitment to
excellence in the eyecare profession is
stronger than ever and we continually invest
in research and development to create the
latest eyecare product ‘must haves’. While
product development is key, so too is the
need to support independent eyecare practices.
That’s why we have created and continue to
develop bespoke customer programmes such
as the Biotrue ONEday challenge, to help
practitioners drive patient trials and education.
Those taking part in the Challenge will be
offered customised practice support
materials and a patient incentive
programme. Patients who trial the lens can
enter a free prize draw to win a trip for two to
New York and everyone who takes part will
receive a £10 money off voucher redeemable
at the originating ECP practice1.
NC: How important are supplementary
eyecare products to help build patient
loyalty and practice business?
AR: This sector is very important to our
business. We have diversified our portfolio
to include dry eye products and innovations
like our Biotrue rewetting drops, which can
be used alongside our contact lenses to
provide a healthier eyecare experience for
the patient.
NC: How do your products support CLOs
to encourage new fittings and reduce
patient drop-outs?
AR: Drawing inspiration from nature is a
fundamental part of our strategy. For
30
example, Biotrue ONEday lenses are made
from a premium hydrogel material called
HyperGel, which locks in water during the
manufacturing process. This lack of
dehydration allows the material to stay wet,
maintain its shape and provide consistent
comfort all day. With patients working
longer days, lenses are often worn for more
than eight hours, and Biotrue ONEday lenses
have been shown to retain moisture for up to
16 hours2.
By using innovative materials like
HyperGel, the CLO can be confident fitting
our Biotrue ONEday lenses, and the
customer can immediately feel the
difference. Biotrue ONEday for Presbyopia is
our latest new lens on the market and a very
good example of where we have listened to
the needs of the patient. A common
challenge for patients suffering from
presbyopia can be distorted peripheral
vision, making it difficult to judge stairs for
instance. The lens incorporates 3-Zone
Progressive Design technology to deliver
excellent near, intermediate and distant vision.
NC: What additional support can you
offer the practice team to ensure they
have the right knowledge to tailor
products to their patients’ specific needs?
AR: We can offer a variety of education and
business initiatives for practice teams that
can be bespoke. For instance we have a
dedicated team that go into the practice to
deliver workshops around working hours and
product training geared to all levels of staff.
In addition, we offer CET distance learning
via our academy training scheme.
NC: What role does your company have in
helping to grow the contact lens market
in general?
AR: Comfort, improved eye health and vision
needs remain at the heart of our research
and development. However, what makes us
so different to our competitors is that we
draw inspiration from nature with all of our
lens innovations. Nature is a good starting
point for answers to scientific and technical
problems; scientists and engineers are
increasingly turning to nature for inspiration.
‘Bio-inspiration’, which we created a
few years ago and which is very much our
strategic backbone, is a discipline that
studies and learns from nature’s best ideas
to generate breakthrough products and
technologies. Bio-inspiration is a proven
method for developing new products but
it does not mean the same thing as ‘green’
or ‘natural’.
So, the Biotrue multi-purpose solution
we have on the market makes wearing
contact lenses easier on people’s eyes,
because it matches the pH of the tears and
uses a lubricant found in the eyes, as well as
keeping key beneficial tear proteins active.
This means the wearer gets continuous
comfort and superior disinfection.
NC: It’s the BCLA conference at the end of
this month. What will you be focusing on
during this event?
AR: We’ll be focusing on all areas of our
vision care business, including our full range
of monthly and daily brands as well as our
entire GP portfolio. We will also be telling
visitors to our stand about the exciting, new
innovative sclerals range via live demonstrations
and an ‘Ask the expert’ panel. Come and meet
the team at Stand 25 in the ACC Liverpool
(29-31 May) to hear more.
REFERENCES
1. Subject to terms and conditions.
2. Twenty-four subjects participated in a
randomised, double masked, contralateral
eye study to evaluate water loss of
Biotrue One day, Acuvue Moist and 1 Day
Acuvue Trueeye. After four, eight, 12 and
16 hours of wear, lenses were removed
and immediately weighted (wet weight).
The lenses were then completely dried
and re-weighted (dry weight). The
relative percentage water loss was then
calculated for each lens from the wet
and dry weight.
EVERYTHING A CONFERENCE SHOULD BE
T
he 2015 ABDO Conference and Exhibition
will be held at Manchester Central - an
award winning venue located in the heart of
city centre Manchester. The ABDO Conference
and Exhibition is the premiere event for
dispensing opticians and is also hailed as one
of the most convivial and rewarding networking
events in the UK optical calendar.
SOCIALISE
PARTY
ABDO
FUN
NETWORKING
GALA DINNER
DANCING
GOLF DAY
OLD
FRIENDS
GOOD COMPANY
GOOD
FOOD
CATCH UP
NET WORKING • CONFERENCE • EXHIBITION
NEW CONTACTS RELAX
ALL WELCOME
• A unique event in the 2015
optical calendar
• Opportunities to network
with convivial company
• Meet friends old and new
• Make new contacts
• All optical professionals
and students are welcome
to attend
• To reserve a place at the
pre-conference golf
tournament email
[email protected]
ONLINE BOOKING AVAILABLE SOON via www.abdo.org.uk/events
Association of British Dispensing Opticians
CITY BREAK
ABDO CONFERENCE
AND EXHIBITION
Sunday 20 and Monday 21
September 2015
Manchester Central
PRE-CONFERENCE GOLF
TOURNAMENT
Saturday 19 September 2015
PRE-CONFERENCE
WELCOME PARTY
Saturday 19 September 2015
Wolfson Reading Room,
Manchester Central Library
ABDO GALA DINNER
Sunday 20 September 2015
The Midland Hotel, Manchester

A unique Myopia Management
Day will open this month’s BCLA
conference in Liverpool
Myopia day
“not to be missed”
unique educational event,
dedicated to current research,
understanding and strategies
in the management and
control of myopia, the British
Contact Lens Association (BCLA) Myopia
Management Day will take place at the
ACC Liverpool on Friday 29 May on the
first day of the Association’s 39th
conference and exhibition.
“With commercial products now in
development to specifically address the
‘global epidemic’ of myopia, the BCLA is
providing eyecare practitioners with a
definitive guide to myopia management in
everyday practice,” said BCLA president,
Susan Bowers. “Never before have we seen
so many global leaders come together in one
room to debate the subject; this is a rare
and exciting opportunity not to let pass.”
A
HOT SCIENTIFIC TOPIC
Taking place as a stand-alone event, the day
will be chaired by Professor James Wolffsohn,
Professor Brien Holden and Dr Noel
Brennan, and will offer attendees the
chance to gain up to five CET points.
The programme, which is subject to
finalisation, will include:
Dr Nicola Logan will make the case for
spectacle treatments
32
• ‘Epidemiology and the public health time
bomb’ by Ian Flitcroft (UK)
• ‘The case for spectacle treatments’ by Dr
Nicola Logan (UK)
• ‘Pharmaceutical treatments’ by Dr Janis
Orr (UK)
• ‘Multifocal contact lens treatments’ by
Professor Brien Holden (Australia)
• ‘Orthokeratology treatments’ by
Professor Pauline Cho (Hong Kong)
• Live ortho-k fitting’ with Shelly Bansal (UK)
• ‘Risk/benefit analysis: can we afford to do
nothing?’ by Kate Gifford (Australia)
• ‘Review of current practice across the
globe: BCLA survey’ by Professor James
Wolffsohn (UK)
The day will conclude with a panel
debate on: ‘Clinical guidelines – what
should we do for the person in my chair and
what will the future look like?’ Dr Brennan,
Professor Pat Caroline
(USA) and keynote
speaker, Dr Loretta
Szczotka-Flynn
(USA), will also
join the panel.
This will be
followed by a
Partner Sponsor
presentation by
CooperVision,
after which
Kate Gifford will focus on
all delegates
the risk/benefit analysis
are invited to
enjoy the BCLA Welcome Reception in the
exhibition hall at 6pm.
Delegates staying on for the Saturday of
the conference will be able to attend a followup session to Shelly Bansal’s live ortho-k
fitting, entitled ‘The morning after….’ This
will take place at 9.30am in Hall 3. There will
be a further follow-up on the Sunday at 3pm.
Commenting ahead of the event,
presenter Kate Gifford said: “Myopia control
is a hot scientific topic, and its translation
Focus will be on the best
solutions for individual patients
into clinical practice is fascinating, evolving
and challenging. Contact lens options
currently have the strongest research results
for myopia control, yet the practitioner must
balance the risk of intervention with the
risks of myopic pathology, which escalate
alarmingly with myopia progression.
“Although future cataract, maculopathy
and retinal detachment may seem quite
distant prospects, the risk comparison to
that of contact lens complications is bound
to surprise you, and motivate you into
determining your approach to myopia
management for your paediatric patients,“
Kate added.
Dispensing and contact lens optician,
Shelly Bansal, added: “This is a ‘must attend’
event for every practitioner – optometrists,
contact lenses opticians and dispensing
opticians – where we can learn how to
manage and create strategies to deal with
an issue that we are faced with on a dayto-day basis. The exciting and unprecedented
programme will provide invaluable insights
into myopia control so that we can offer
our young patients the best advice and care
to safeguard their future.”
The day costs £175 for BCLA members, or
£295 for non-members, and includes lunch,
morning and afternoon refreshments,
exhibition entry and the BCLA welcome drinks
reception from 6pm in the exhibition hall.
Delegates may also attend the day as part
of their full conference delegate package, for
which group booking discounts of up to 20 per
cent for 10 or more delegates are available.
PRACTICAL AND BUSINESS SESSIONS
As well as the Myopia Management Day,
this year’s BCLA conference will run a
dedicated business session on Saturday 30
May, chaired by Ross Grant of ToolBox
Training Consultancy. Speakers include
Justin Bazan on ‘The impact of the online
shopper’, Peter Ivins on ‘Achieving success
BCLA CONFERENCE KEYNOTE ADDRESSES
• Professor Fiona Stapleton (Australia):
BCLA Medal, ‘Can we prevent contact lens related microbial keratitis?’
• Dr Michael Read (UK):
Irving Fatt Memorial Lecture, ‘Understanding contact lens discomfort: in the blink
of an eye’
• Dr Nicole Carnt (Australia):
Dallos Award, ‘The relationship between environmental sources and the
susceptibility and severity of Acanthamoeba keratitis in the UK’
• Professor James Wolffsohn (UK):
‘Presbyopia correction – the final frontier?’
• Dr Loretta Szczotka-Flynn (USA):
‘Ongoing search for factors associated with CIEs during soft lens wear’
on contact lens practice in the digital age’,
Jason Burkinshaw on customer service,
Sarah Morgan on ‘Helping patients with
what they don’t know’ and Ross Grant on
‘Adapting management style to suit your
people’. The session will also include the
2015 BCLA Da Vinci Award Lecture, to be
delivered by Ben Cook on ‘Objective
comparison of counterfeit contact lenses to
genuine contact lenses’.
There are more CET workshops than
ever before this year – 15 in total – and
free for the first time. The workshops will
cover topics such as binocular vision, dry
eye, keratoconus, sclerals, gonioscopy,
presbyopia, communication, slit lamp
techniques and more. Rapid fire sessions
lasting only six minutes each will pepper
the programme, providing delegates with
up-to-the-minute research facts and stats,
supplemented by sponsor showcases
outlining the latest technologies, and 15minute educational courses on subjects
such as binocular vision and contact lenses,
Demodex, dry eye therapies, surgical
correction of presbyopia and how to
miminise contact lens dropouts. Scientific
papers will cover RGPs, UV damage to the
corneal epithelium, the effect of continuous
wear lenses on central corneal thickness
and ocular surface – plus much more.
The 2015 BCLA Industry Award winner
will be announced at the BCLA Dinner, to be
held at the Liverpool Anglican Cathedral. In
keeping with the Liverpool/Beatles
connection, the evening will have a 1960s
pop music theme.
CONTACT LENS AND
TECHNOLOGY SHOWCASE
This year’s BCLA exhibition will get
underway at 1pm on Friday 29 May – with
all visitors invited to stay on for the
aforementioned welcome drinks. As always
there is no charge to enter the BCLA
exhibition and visit the world’s leading
manufacturers and suppliers showcasing
everything from the latest contact lens
technologies and ocular health nutritionals
to practice management software and
anterior eye instrumentation.
Enjoying centre stage in the exhibition
will be the Beatles-themed BCLA stand, where
visitors can find out about the latest
membership offers, and how to be in with the
chance to win one of several great prizes
during the conference. The Exhibitors’ Pavilion
will once again provide visitors with practical
tips and advice at bite-sized drop-in learning
sessions. The timetable of presentations, along
with a complete list of exhibitors, will be
available prior to the event on the BCLA
app and website, www.bcla.org.uk
The Exhibition will also give visitors the
chance to catch up with this year’s
sponsors and premium exhibitors, which
are: Alcon (Partner); CooperVision (Partner);
Johnson & Johnson Vision Care (Partner);
Topcon (Gold & Technology); David Thomas
Contact Lenses (DTCL)/Menicon (Gold);
mark‘ennovy Personalised Care (Premium);
and Scope Ophthalmics (Premium).
Inma Perez, head of professional affairs,
EMEA, Alcon Vision Care, commented:
“Comfort through technology will dominate
Alcon’s programme and stand this year. We
have 13 Alcon supported clinical posters
and other presentations providing delegates
Three-day BCLA exhibition will
showcase the best from industry
with scientific findings on the technologies
that make our company a leader in vision
care, from improved permeability and
wettability technologies in contact lens and
lens care, to consistent surface performance
of our monthly disposables.”
Nigel Mallinson, managing director for the
UK & Ireland at CooperVision, commented:
“We are delighted to be showcasing our newly
expanded portfolio, including the world’s only
full family of silicone hydrogel daily disposable
contact lenses. We’re also going to be
highlighting the Biofinity range of reusable
contact lenses, as well as helping practitioners
grow their practice through offering key
insights as part of the business track sessions.”
Andy Yorke, managing director of Topcon
GB Medical, commented: “With technology
moving faster than ever before, Topcon is
committed to the delivery of an advanced
education programme in support of all of
its ECPs at this year’s BCLA conference in
Liverpool and are once again delighted to
be the preferred equipment provider.”
Gill Narramore, sales and marketing
manager for DTCL, said: “We are delighted
to be a Gold Sponsor once again. It’s an
exciting time for us – and the BCLA – with
a completely new venue this year. As there
isn’t a conference in 2016, we are determined
to make this a year to remember. We have
some new and exciting products for delegates,
with Steve Newman coming over from
Singapore to talk about Miru 1day, Paul
Rose from New Zealand on Rose K2 Soft,
and Jac Santadomingo from Spain to
present on MeniCare Pure RGP Solution.”
Gary Daniels, UK sales director of
mark’ennovy, said: “With this year’s new
location, a strong line-up of presentations
and industry key opinion leaders, the
mark’ennovy team are looking forward to
welcoming BCLA delegates to our stand.
Our theme for this year will be ‘Meeting
every patient’s visual needs’ with premium
custom-made contact lenses. BCLA 2015 is
not to be missed.”
Tom Freyne, commercial director of
Scope Ophthalmics, said: “Scope
Ophthalmics is delighted to be partnering
with the BCLA as it’s a great forum for
leading optical professionals. It gives us the
opportunity to showcase the most
innovative ocular surface disease (OSD)
products and provide education on how to
diagnose and treat OSDs effectively.”
Pre-registration for the exhibition is
available on the BCLA website, but it’s also
possible to register at the ACC on the day.
Download the latest conference programme,
and book a place, at www.bcla.org.uk or
via the BCLA mobile app. Paper abstracts
will be available ahead of the event from
the BCLA app and website.
33


Following statements made in the March issue about
divergence excess1, which led one reader to write in,
Geraint Griffiths expands on this oft-confusing subject
Divergence excess:
the tip of an iceberg?
et’s begin with definitions:
divergence excess (exophoria)
and divergence insufficiency
(esophoria) are descriptions of
heterophoria that occur in the
distance. Convergence insufficiency and
convergence excess occur at near. The
origins of divergence insufficiency and
convergence excess can be confusing. Is it
because the medial recti are very strong,
or that the accommodation is stronger
than normal?
Accommodation insufficiency: both
these conditions in fact are related to weak
accommodation, or a small tight lens, which
requires a lot of innervation to make it
move. The accommodation/vergence reflex
(AVR) triggers the eyes to converge for a
given amount of accommodation, because
invariably when the eyes accommodate it is
to look at, and converge onto, a near object
L
(unless it is flat screen generated 3D – but
that is another story).
Separate to this reflex is the ability to
converge the eyes independently of
accommodation, by direct innervation of
the medial recti. This is needed to rapidly
converge onto an approaching object.
This reflex is separate to the AVR because
accommodation is much slower than
convergence.
Convergence is critical in sport because
this feeds information to the brain based on
depth perception and position, which allows
the subject to anticipate the arrival of the
ball for instance. It is far more important to
judge position and speed than to see detail
clearly. When the eyes are working normally
the extra-ocular muscles allow the eyes to
follow the ball with the accommodation
following on. When the visual system is led
by the accommodation, for instance when
there is a weakness or paresis in one or
Face form, horizontal inclination or dihedral angle is a critical
measure of the wrap in the dispensing of sports appliances
34
both of the medial recti, it becomes very
slow and tight. It finds it very difficult to
change fixation and tracking becomes
inefficient whether it is in sport or tracking
individual characters at near.
COMPARISON WITH HERRING’S LAW
If someone has a small tight crystalline lens
typically in hyperopia, or simply an inability
to accommodate (something from which
many children suffer) a large amount of
innervation to the ciliary muscle achieves
little movement of accommodation. The
same innervation to the extra-ocular
muscles causes a much bigger effect. You
could compare this with Herring’s Law of
equal innervation in sudden onset squint,
when the non-paretic eye overacts.
If the medial recti are also weak, then
it’s possible to believe there is nothing
wrong. In reality, it could be that excess
accommodative effort is being used (via the
AVR) to control the convergence insufficiency.
Adults become very skilled in this and
sometimes the only clue is that they are
myopic. Latent hyperopia associated with
accommodation/convergence insufficiency
can co-exist with divergence excess.
DIVERGENCE EXCESS
Divergence excess is not well understood
and orthoptic textbooks tend to say it is
difficult to treat. Subjects deal with it using
the AVR. In a hyperopic subject, this might
make them appear emmetropic. In a myopic
subject, this might increase their apparent
myopia. Both may exhibit a degree of latent
hyperopia or pseudo myopia.
In my example given in Antonia Chitty’s
article1, which David Bridle questioned (see
Letters page 9), the degree of divergence
excess was being reduced by the AVR.
Therefore, divergence excess could be the tip
of an iceberg; the visual system on the point
of breakdown, attempting to manage a latent
divergent squint by over-accommodating.














Divergence excess controlled in this way
is quite difficult to measure, especially
when it is habituated and co-exists with
convergence insufficiency. In practice, some
of the most intractable visually related
difficulties in children respond well to prism
control. In attention deficit hyperactivity
disorder (ADHD), prism of the order of four
dioptres base-in right and left can change
the personality of the child (or adult). Often
the same prism is needed for reading.
In divergence excess, the possibility of
latent hyperopia must be eliminated by a
careful distance refraction using Humphriss
binocular balance (+0.75 blur), then remeasuring fixation disparity (FD). FD can
increase once the latent hyperopia is revealed.
In habituated accommodation excess, this
investigation is not easy and the process
has to be started at the near point to begin
to unravel the visual stress this causes. This
usually means a near addition supported by
the appropriate base-in prism. This will
gradually weaken the hold of an
accommodation/convergence insufficiency.
IMPORTANCE OF MEASURING
EYE DOMINANCE
This answer to David’s question might
seem complicated, but it follows a logic
based in mainstream optometry and
dispensing principles and an understanding
of eye dominance.
One of the reasons many colleagues
have difficulty with binocular vision is that
the importance of eye dominance has never
been properly taught. To prescribe a prism,
you need to know which is the dominant
eye. Splitting a prism or putting it in front
of the wrong eye will not achieve the
required effect. Mallet always said that the
eye with the slip should be the one with
the prism.
Sport and Schoolvision Assessments are based on seven diagnostic elements of visual
performance. A deficiency in any one of these will lead to occupational deficit
The other reason why knowing the
dominant eye is important is that it divides
the population into two dominance types.
Type I Dominance is right eye, right hand
and right foot; Type II Dominance is a left
tendency in eye, hand or foot. These two
types are physiologically different, not just
visually but in personality and psychology.
This is a reflection of how important vision
is to interpreting the world about us.
When these two types are not taken
into account in sport science or school
vision, any effect will be confounded. The
intervention will have a different effect in
the two types, which effectively cancels out
any statistical significance.
PROBLEMS UNDER THE SURFACE
David’s question to me was perceptive.
What he saw was the tip of the iceberg and
it didn’t make sense. What is revealed under
the water is the extent of the problem our
profession (ophthalmic optics) has in fully
appreciating the importance of the work we
do. The second point David made about low
myopes appearing to be esophoric needs
expanding. I hope the above goes a little
way to achieving that.
One of the problems with academic
research, which informs undergraduate
education, is that it finds it difficult to
relate to general practice. One group by
definition is populated by career academics
who are skillful in the scientific method. In
the other, practitioners are experienced in
the realities of High Street practice, but do
not have the ability or time to describe
these realities in scientific terms to their
academic colleagues. It is likely that if there
is going to be a breakthrough in the
understanding of vision in sport and school
and all other occupations, it will come from
outside the university system.
The discovery of the importance of eye
dominance, which was recently brought upto-date in Dispensing Optics2, led to the
diploma courses in Sport and School Vision.
These takes place over a period of four or
five months and include a project,
statistical course work and revision. It
continues with interactive membership of
the Association of Sport and Schoolvision
Practitioners (ASvP)
This sounds a long time, even though
the didactic part of the course is only three
days, but it is a measure of how entrenched
we are in the traditional approach to
optometry and dispensing. Increasingly, we
are being pushed apart as though one is not
related to the other. In truth, we are part of
the same whole, commercially and
clinically.
Until dispensing optics and optometry
become equal partners, the unique role we
have in the prevention of ocular, systemic
and psychological morbidity will not be
realised.
For more information visit
www.sportvision.co.uk and www.schoolvision.
org.uk
REFERENCES
1. Chitty A (2015) Sports eyewear and
eyecare. Dispensing Optics 30; 3: 31-33.
2. Griffiths GW (2013) Match! Finding the
best lenses of sport – the science.
Dispensing Optics 28; 4: 4-8.
Geraint Griffiths BSc Mech Eng, Dip
Schoolvision, Dip Sportvision, MASvP, MSc
Optometry MCOptom is managing
director of SVUK and Optical3 Ltd in
Leicestershire. He is founder and CEO of
the Association of Sport and Schoolvision
Practitioners (ASv.P), and an examiner for
the College of Optometrists.
35

Contact lens practice is both
tricky and satisfying, writes
Graeme Stevenson


O
ften colleagues say to me that I have the
best job in optics as a contact lens optician.
Well they could be correct in thinking that –
however, it is not an easy job. Let me start by
declaring that the role of a contact lens
optician is wonderfully varied and satisfying and one I have
loved for almost all of my 30 years in optics.
It is the same things that make contact lens practice both
tricky and satisfying at the same time; these being contact
lenses and, of course, patients. There are a huge variety of contact
lenses out there at the moment and the materials and power
ranges ensure that more of our patients than ever before can
wear contact lenses.
Of course finding out about this array of lenses takes a
great deal of our time, in particular, learning about the theoretical
material properties of the lenses. The other problem with all
those lenses is actually fitting them to real life patients and
listening to their personal experiences about them. This is why I
like to try as many different lens types as possible – both in my
own eyes and also in the eyes of my patients.
In doing so, I learn about lots of different lens types and, as
such, I refrain from calling myself a ‘Johnson & Johnson Man’ or
an ‘Alcon Man’. I also don’t get too hung up on knowing the
power ranges and prices of all the available contact lenses. That
is exactly what my Association of Contact Lens Manufacturers
Contact Lens Year Book and company price lists are for. We also
find that the ranges at the extremes of the power ranges are
being expanded so often that it is near impossible to keep
them in our heads.
ARRAY OF PATIENT PERSONALITIES
And now on to the other essential item in contact lens fitting –
and that is the patient. Our contact lens wearers range from
eight years old to 90 years old and, of course, within that age
range there is also a considerable range of personalities. We also
have lenses varying from plano cosmetic lenses to -35.00DS.
In my experience, contact lens wearers are far more
demanding than spectacle only wearers. They are also likely to
do more research on the internet than non contact lens wearing
patients. Many of them can be very demanding of us and our
practice colleagues. However, when it comes to being appreciative
of what we do for patients, our contact lens patients are head
and shoulders above the rest for saying thank you.
I briefly mentioned the range of personalities we have
wearing contact lenses and, indeed, I could write numerous
articles on that subject alone. I still believe that many practice
staff don’t fully understand our contact lens wearers and the
difference that contact lenses make to their lives and, in
particular, to their confidence. When those patients ‘need’ a
contact lens for their Saturday night out, colleagues often say
36
to me, “Why can’t they just wear their specs?” For many of our
contact lens wearers, this is akin to wearing their mum or dad’s
clothes for a special social event! Many of these patients have
really nice spectacles but just don’t feel confident wearing
them in certain social or sporting situations.
For a whole variety of reasons, our contact lens wearers just
love their contact lenses and, thankfully, with modern lenses
many can wear their lenses almost all day with no adverse
effects. The human mind is rather complex and in some
situations, all that matters is how that individual feels and
contact lens wearers certainly tell us that they feel great when
wearing their contact lenses.
CONTACT LENSES OF THE FUTURE
We have benefited greatly from the advances in modern
technology in the contact lenses we use every day for our
demanding patients. Lenses are more breathable, they are
deposit resistant and have hugely wettable lens surfaces. We
even have a range of single use daily disposable silicone
hydrogel lenses for our patients.
However, we have seen reports in the mainstream media of
some really exciting contact lens projects. I am hugely sceptical
of these projects and I seriously doubt that many, if any, will
ever see the light of day as commercial projects. Let us have a
little look at some of these research projects and assess their
prospects for the future.
One of the most interesting projects has been the
Telescopic contact lens from Ecole Polytechnique Fédérale de
Lausanne, Switzerland. The lens is aimed at those suffering from
age-related macular degeneration and similar low vision
patients. The lens works by incorporating an extremely thin
reflective telescope inside a 1.5mm lens. Internal mirrors
bounce light around, thereby expanding the perceived size of
objects and magnifying the view. The lens can provide up to
2.8x magnification, which could be a huge boost to those with
low vision.
In theory this is a wonderful idea – especially if it can bring
hope to those individuals who have lost some of their precious
sight. At this moment in time, the lens is a scleral, which is
1.55mm thick. Even with fenestrations in the lens there are
bound to be severe limitations to oxygen transmission. This will
ultimately have an effect on corneal physiology and also the
physical comfort of the lens. Given that these lenses are being
designed with low vision patients in mind, might they be very
difficult to handle?
There has also been some debate recently regarding
contact lenses to monitor the blood sugar levels of patients.
Presently there is an ongoing research project between Alcon
and Google into this very lens. I understand that the lens would
be linked to a smart phone app, which would be used to detect
colour changes to assess blood sugar levels. The reputations of
the companies involved tell me this project may well be a
success. However, this idea has been postulated for many a long
year and we have yet to see a commercial version come to light.
The best options for success, in my opinion, could well be
lenses that provide the slow release of either a glaucoma
medication or an anti-histamine. The main reason for this is
that such lenses only require an adaption or modification of
currently available lenses, and could be fitted to existing lens
wearers who are either hayfever or glaucoma sufferers.
Whether any or all of the above futuristic lenses will see
the light of day will ultimately depend on companies making a
commercial case for them. Such products will need to be
commercially viable (i.e. make money) for both the
manufacturers and also opticians. Of course, if such projects
were easily made into money-making concerns then many
different and innovative contact lenses would already be
available. There is also the question of how the lenses will be
regarded for product licensing. Such licensing can be hugely
expensive and that could well be the thin red line for many of
the contact lens manufacturers.
MOVES ON MYOPIA CONTROL
One developing product we can be sure will come to the
marketplace is the contact lens designed for myopia control.
We already have the CooperVision MySight lens in the Far East
and many are trialling orthokeratology as a means of
controlling myopia progression. Interestingly, Contamac the
materials development company, has linked up with the worldleading Brien Holden Vision Institute (BHVI) to develop and
commercialise myopia control contact lenses. Given the
reputation of the BHVI for research and bringing these products
to life, we are expecting big things from this collaboration.
The prevelance of myopia is increasing, with numbers of
high and extreme myopia being huge amongst the Far Eastern
Asian population.
Bifocal spectacles and atropine drops have also been tried,
however, the use of contact lenses would appear to have the
greatest potential. It would also appear that two to three hours
per day of outdoor activity may also have a protective effect
from myopia. Of course, there are other benefits to the outdoor
activity, which is not quite within the remit of the regular optician.
Quite what effect myopia control lenses will have on
halting myopia progression remains to be seen. Early intervention
is vital, as is communication that the lenses will not prevent
the patient becoming myopic at all. Is it all worthwhile?
Of course, all these ideas are great in theory and will
continue to excite PhD students and the press alike for many a
year to come. However, I sadly think we will see very few of
these ideas as commercially available products in my lifetime.
Though I may yet be proved wrong on that…
GRAEME STEVENSON FBDO (HONS) CL is a contact lens
optician in Glasgow, is a past chairman of the Scottish
Contact Lens Society and a former member of the ABDO
Contact Lens Committee.
Frequently asked questions
answered by Kim Devlin FBDO (Hons) CL
PRESCRIPTION COPY CONUNDRUMS
“Can I have a copy of my prescription?”: the words that
frustrate every one of us – especially when the patient is
standing there with the very piece of paper in their hand.
”Oh, is that it?” they say, a bit disappointed.
This question from a member is a variation on that
perennial request: a parent wanted the ‘prescription’ of their
child’s spectacles but they had been made to a Hospital Eye
Service (HES) voucher and prescription a year before. How
should that be handled? Such variations to the usual request
set me thinking – is it the practice’s prescription to give?
When an HES prescription is brought in to your practice,
your heart sinks a little. Often a child, the Mum has brought
little Jonny in straight from the eye clinic; they are hyper
having been confined for hours while drops ‘take’ then messed
about with lights and strange frames, the last thing they want
is you.
You, of course, have to explain the peculiarities of the
system to a Mum who is worried and exhausted and in no
position to take in the information. Then you have to crawl
around the floor after little Jonny, coaxing him to stay still
while you take the PD. Meanwhile in the back of your mind you
just know you’ll wait six weeks minimum for the hospital trust
to pay you. Then, when the Mum wants to buy another pair
from somewhere else, you might feel a little hard done by…
The HES form that was brought in to you has long since
been submitted back to the hospital for payment – so what can
you give them? If you’re clever, you might well have taken a
photocopy of the form, to keep on file, should there be a query.
A photocopy of a photocopy isn’t wonderful, especially when
the handwriting is indecipherable anyway. What to do?
This, I think, is best handled by writing out a copy
prescription from your records. Great care must be taken with
the wording of the document; this is a case where checking
on ABDO’s Advice and Guidelines for the exact form of words,
indeed a suggested layout (2.9 and Appendix J), is a very
good idea.
You will notice that it is suggested that the name and
General Optical Council number of the optometrist is stated on
the document which, of course, in this circumstance, you do
not know. It would be sufficient to say: ‘Name of refractionist
not known – eye examination conducted under the HES on
[date on form]’.
As always, when you give such a document you are liable
for any errors you might make, check and double check that
everything is correct and complete before it is handed to the
parent. This is a service you are offering, there is no reason why
you shouldn’t make a charge for such a service. If the parent
doesn’t wish to pay, they may of course seek the information
from the HES. On the other hand, you may feel that as a
gesture of goodwill you are prepared to waive the charge. It is
entirely up to you.
Kim Devlin
is chair of
ABDO’s
Advice and
Guidelines
Working
Group
Past FAQs are available for reference on the ABDO website at http://www.abdo.org.uk/frequently-asked-questions
37

Optician Index - February 2015 summary
• Total practice turnover increased by five per cent from
January to 173 Index points and this is half a per cent
higher than February last year
• Total eye examinations improve by seven per cent to 108
Index points on January and this is five per cent higher than
February last year
• Sample average total dispensing increased by seven per
cent from last month to 100 Index points
• Volume of bi/trifocal and progressive lenses show positive
annual growth
• Percentage of eye examinations which are NHS continues to
increase slightly and this month is just above 76 per cent
The full February 2015 report was published in the
27 March issue of Optician
MANAGERIAL DISPENSING OPTICIAN
OPTISAVERS LTD, LIVERPOOL, UNITED KINGDOM
We are an independent retail Opticians, offering
excellent customer service to patients within the
Merseyside area. The company has been established
for 28 years and has built up a loyal clientele
Desired Skills and Experience
The candidate in question will have a thorough knowledge of
current lenses available on the optical market including all the
latest varifocal spectacle lenses
They should have the ability to communicate at all levels, both
with patients and with staff
They should be experienced in management skills and teamwork
They should be able to achieve set sales targets outlined by
the company
They should be generally highly motivated and be prepared to
set an example to the rest of their team
They should be articulate and of smart appearance
Excellent conditions including good competitive salary,
bonus system, private healthcare
ABILITY TO:
• Exceed expectations.
• Increase Customer Loyalty and Satisfaction
Contact Details:
Mr R. Specter
Director Optisavers Ltd
[email protected]
07768 469 750
NEW ‘THROUGH THE
PIN-HOLE’ SERIES
PARTICIPANTS WANTED
OSCAR WINNING DISPENSING OPTICIAN
REQUIRED FOR BUSY INDEPENDENT PRACTICE
Tired of the mundane 9-5?
Want to be challenged every day?
Can you create order out of chaos?
Can you motivate and articulate well
whilst delighting patients?
COME JOIN OUR PRACTICE IN LONDON SW11
AND MAKE A DIFFERENCE EVERY DAY
(Trainee DOs and those contracted to remain in their current role considered)
DOES YOUR PRACTICE OFFER SPECIALIST SERVICES IN,
Email [email protected] or call 07850 099336
FOR EXAMPLE, DRY EYE, PAEDIATRICS, SPORTS VISION,
LOW VISION AND/OR OTHER NICHE AREAS?
We’re looking for member practices to feature
in a new ‘Through the pin-hole’ series
showcasing the fantastic work that ABDO
members are involved with above and beyond ‘the
everyday job’ of dispensing
ABDO
President’s
Consultation Day
Email [email protected]
to register your interest in taking part
To place an advert, telephone 0781 273 4717
or email [email protected]
20 May 2015
To be held at the offices of the
Association of Optometrists
2 Woodbridge Street
London EC1R 0DG
Booking deadline for the June issue is Thursday 7 May
Special rate for ABDO members
38
To book your place, email Jane Burnand
at [email protected]
abdo
COLLEGE
Let us further your career
ABDO College provides comprehensive
education for dispensing opticians and is
currently accepting applications for a range
of different courses. Some of the reasons
why you should make ABDO College your first
choice to either start or further your career in
optics are:
• An extensive range of courses to suit your
individual needs
• Dedicated and experienced academic staff
• Friendly and supportive learning environment
• Consistently high theory and practical
examination results
• Helpful course tutors
• Vibrant and positive attitude towards students
• Committed to the furtherance of
dispensing optics
• Established by the profession for the profession
• A proven track record of success
CONTACT LENS CERTIFICATE
The Contact Lens Certificate course provides
an ideal opportunity for opticians to further their
career by specialising in contact lenses. The
course leads to the ABDO Level 6 Certificate
in Contact Lens Practice qualification, enabling
registration on the General Optical Council
specialty register for contact lens dispensing.
For further information and application forms
for these and other courses, or to request a
copy of the ABDO College Prospectus, please
contact the ABDO College Courses Team on
Course features
• A one year course commencing in
September 2015
• Two separate weeks block release
at Godmersham
• Block release accommodation can be provided
ABDO College Operational Services,
Godmersham Park, Godmersham,
Canterbury, Kent CT4 7DT
Entry requirements
• ABDO Fellowship Diploma and GOC registration
or for existing students a successful pass in the
final theory examinations
• Qualified, registered optometrists and
ophthalmologists are also eligible to enrol
Application deadline: August 2015
KEEPING EXCELLENCE IN YOUR SIGHTS
01227 738 829 (Option 1)
or email [email protected]
www.abdocollege.org.uk
www.twitter.com/abdocollege
A COAT FOR EVERY OCCASION
FIVE NEW ADVANCED LENS COATINGS FROM SHAMIR
SHAMIR GLACIER PLUS™ UV
First in a line of advanced lens coatings, offering enhanced durability, easy maintenance, extra visual
comfort, and comprehensive double-sided UV protection.
SHAMIR GLACIER™ ACHROMAT
A IC UV
A crystal clear coating, keeping eyes bright and adding no residual colour to the lens.
SHAMIR GLACIER™ BLUE UV
Five times more effective protection against the harmful rays of artiﬁcial light than any existing
conventional lens coating.
SHAMIR GLACIER SUN™ UV
Designed for sunwear, leaves sunglass lens tint unchanged and protected from fading.
SHAMIR GLACIER™ ANTI-FOG
Instead of double-sided UV protection, rear surface of lens repels fogging during strenuous activity.
No special sprays or cloths needed to activate anti-fog feature.
FOR ANY NEED, SHAMIR ADVANCED LENS COATINGS HAVE GOT YOU COVERED!
E-SPF is relevant for Glacier Plus UV, Glacier Achromatic UV
& Glacier Blue UV
With 25X more UV protection than going without eyewear*
* E-SPF® is a global index rating the overall UV protection of a lens.
E-SPF® was developed by Essilor International and endorsed by a 3rd party expert.
A lens rating of E-SPF® 25 means that an eye protected by the lens will receive 25 times
less UV exposure than an unprotected eye. E-SPF and E-SPF design are trademarks of
Essilor International and used with permission.
SHAMIR UK LT
L D.
[email protected]
WWW.SHAMIRLENS.CO.UK

optics

Transcription

Similar documents

25% off the entire frame and lenses price, if the frame retail is below

The author has no financial interest to disclose. How Many of your

The Architecture of the Model

Auto Lensmeter - oftis

Bio 1 Lab 2 review Hadley - Biology-Lab-1

Ray-Ban Photocromic Ambermatic Lens was introduced. It changed

Pellucid Marginal Degeneration

Essilor - Mr. Blue

Ortho-K - Center for Unlimited Vision

acuvue oasys® brand contact lenses 1