April 2014

dispensingoptics
Dispensing Optics
PO Box 233, Crowborough TN6 9BD
Telephone: 01892 667626
Fax: 01892 667626
Email: [email protected]
April 2014
Website: www.abdo.org.uk
3
dispensingoptics
CONTENTS
March 2014
Cover point
3
Cover point
4
Continuing Education and
Training
Understanding macular
degeneration
by Louise Stainer
10
Patient and practice
management
Can NLP help your practice?
by Antonia Chitty
Board elections 2014
I am pleased to be able to report on
this year's Board elections (see page
22). First of all, it is good to welcome
back Fiona Anderson who topped the
poll this year. Fiona has done a great
job for the Association in Scotland
and has further enhanced her
reputation for hard work since first
joining the Board. It is also a pleasure
to welcome two new members who
have both worked tirelessly for the
Association over many years in their
respective areas. Clive Marchant from
the Midlands and Jo Holmes from the
South West both bring experience and
enthusiasm to the Board and the
president and I look forward to
working with them in the years ahead.
Ashton Galloway missed re-election
this year and we thank him for his
contribution to the Board's
deliberations over the past three
years. I am pleased to report that
almost immediately after the ABDO
Board results were declared, Ashton
was elected to the Board of
Optometry Wales where he will
represent ABDO with both flair and
energy.
Finally, I would like to thank Ted Moffat
who stood down this year after six
years' service to the Board and a
lifetime's dedication to the profession.
His passion and commitment to the
dispensing profession is unmatched
and he will be missed by all of his
fellow Board colleagues.
This year's election resulted in eight
well qualified candidates standing for
three positions, a very healthy sign
indeed. The result, with three
members representing Areas away
from London and the South East,
showed that the Board does reflect
the Association’s membership
throughout the country.
Thank you to every candidate and
every voter for making the process so
successful.
Tony Garrett n
ABDO works in Partnership with:
ABDO is a member of:
Front cover:
Claudia Schiffer by Rodenstock
Model C 4001 – Sycamore
ABDO also actively works in conjunction with:
The Worshipful Company
of Spectacle Makers
12
Patient and practice
management
A planned approach to frame
buying
by Paul Surridge
14
Business solutions
Five top tips for practice growth
by Rebecca Thompson
16
Member of the month
Brad Parkes: making clubs work
18
20
‘Essential’ new British
Standards Extracts now
available
Black arts
by Peter Black
22
Newsbrief
31
Optician index
31
Frequently asked questions
32
Disjointed jottings from
a DO’s desk . . .
Fifty shades of green
by Nick Howard
35
Diary of Events
4
dispensingoptics April 2014
Understanding
macular
degeneration
by Louise Stainer BSc(Hons)
CompetencIes covered:
Dispensing opticians: Ocular Abnormalities, Ocular Examination, Low Vision
Optometrists:
Ocular Disease, Ocular Examination, Assessment of
Visual Function
ge related macular degeneration
(AMD) is the most common
cause of irreversible loss in the elderly
population globally1. It is a
multifactorial disease in that its
development is due to a combination
of genetic and environmental factors.
It is usually sub-divided into dry (nonexudative) or wet (exudative). Dry
AMD is significantly more common
and 80-90% of cases are of this type2.
The features of early dry and wet
AMD are the same. These include
intermediate to large confluent soft
drusen occurring together with
pigmentary changes of the retinal
pigment epithelium (RPE) that may
A
include focal hyper and
hypopigmentation3. This is due to
changes in melanin levels and either
an increase or aggregation of RPE
cells in the former and their migration
or loss in the latter. These changes in
isolation do not tend to affect retinal
sensitivity4.
Early AMD
The function of the RPE is to remove
old photoreceptors and RPE cells.
With increasing age this process
becomes less efficient. The resultant
drusen are comprised of protein and
lipid metabolic byproducts that
accumulate between the RPE and
Bruch’s membrane (the acellular
layer situated between the RPE and
the choroid). They are visible as
yellow retinal deposits during fundus
examination. There are various types
of drusen. At least one small hard
drusen is observed in the majority of
individuals in their fifties whereas
larger soft drusen (> 125µm) with
indistinct edges have a stronger
association with the development of
advanced AMD (see figure 1)5. The
early stage of AMD is common but
visual acuity is generally good (in the
absence of co-pathology) and
ocular symptoms tend to be mild.
Fortunately only a small percentage
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 online only, to comply with the GOC's Good Practice Guidance for this type
of CET. Insert your answers to the six MCQs online at www.abdo.org.uk. After log-in, go to 'CET
Online'. Questions will be presented in random order. 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
September issue of Dispensing Optics. The closing date is 9 July 2014.
C-35230
Continuing Education and Training
of early AMD patients progress to the
advanced form associated with
significant visual loss4. These
individuals may develop either
advanced dry AMD or wet AMD.
A comprehensive examination should
be performed on patients with early
signs of AMD, and wet AMD ruled out
as much as possible by fundus
assessment (including slit lamp
examination with Volk lens to view a
stereoscopic image to aid with the
detection of any subtle retinal
elevation associated with the
exudative form) and monocular
testing with the Amsler grid (using the
patients reading prescription) for
areas of metamorphopsia and field
loss (scotoma)6. Mild distortion of the
Amsler grid may be observed that is
due to the presence of drusen only6.
Individuals should also be asked
about any changes in their vision and
symptoms they are experiencing. A
drop in visual acuity and an acute
onset of visual distortion such as
door frames appearing bent would
also raise suspicions regarding early
wet AMD. Ocular coherence
tomography (OCT) can greatly aid
differential diagnosis if this is
available. A macular scan can be
performed which shows a crosssectional image of the different
retinal layers of the fovea and
surrounding area due to their different
reflectance properties. It can help
with the detection of subtle RPE
detachments, subretinal fluid and
choroidal neovascularisation (CNV)
as well as confirming the presence of
drusen.
Dry AMD
No effective treatment is currently
available for dry AMD. It is thought
that oxidative stress and lack of
antioxidants and micronutrients may
have a role7. Patients with dry AMD
may be advised to use a multivitamin
supplement. The AREDs study found
that a supplement comprising vitamin
C, vitamin E, beta-carotene, zinc and
copper significantly reduced the
progression rate and extent of visual
loss of individuals with intermediate or
advanced AMD over a five year time
frame6, 7. It is important to check there
are no contraindications. An example
is the link between high dose betacarotene and the increased chance
of lung cancer development in
smokers in which instance a
supplement containing betacarotene may not be advisable6.
In dry AMD the number of soft drusen
and pigmentary changes to the RPE
may slowly progress. The coalescing
of soft drusen can lead to the
separation of the RPE from Bruch’s
membrane. This leads to RPE cell
apoptosis (cell death) and resultant
RPE atrophy, depigmentation and loss
of the dependent photoreceptors in
this area8. The RPE atrophy may
gradually progress in size and
develop clearly defined borders. This
is known as geographic atrophy (GA)
and is a feature of advanced dry
AMD. It is normally preceded by the
regression of any large soft drusen
present. GA initially develops in small
areas around the fovea1. It generally
occurs in both eyes in over half of
affected individuals and often has a
symmetrical presentation when
comparing the two eyes9. As well as
RPE atrophy GA is also associated
with thinning of the choroid with
atrophy of the choriocapillaris
increasing the visibility of larger
choroidal blood vessels beneath
although ultimately these are also
affected. Consequent reduction of
retinal sensitivity corresponding to
these atrophic zones results in visual
field loss (paracentral scotomas)10.
These areas may slowly increase in
size and coalesce. As this occurs the
likelihood of visual symptoms
becomes greater. These may include
visual distortion (metamorphopsia) a
symptom in common with the onset
of wet AMD11. Patients may complain
that they struggle with reading
especially if the lighting is poor, (due
to a reduction in their contrast
sensitivity and scotomas) so increased
lighting may be advisable. Ocular
adaptation may also be difficult
when moving from dark to light areas
and vice-versa and glare (from bright
car headlights or sunlight for
example) more noticeable11,12. Tinted
lenses may prove beneficial for use
outdoors and even inside11. Visual
acuity may be unaffected as long as
the fovea is spared10.
Figure 1: Soft drusen5
There is also a small risk that
individuals with GA may also develop
CNV (the abnormal growth of
choroidal blood vessels) the hallmark
of advanced wet AMD in either the
same or the other eye3. These vessels
develop from the choroidal blood
circulation (choriocapillaris) and grow
through defects in Bruch’s membrane
into the subretinal space.
Wet AMD
Alternatively early AMD may progress
to wet AMD. Studies have shown that
the likelihood of dry AMD progressing
to wet over a given five years is
between 14% and 20%13. In contrast
to the dry form that generally results
in a slow and gradual deterioration in
vision, visual loss in the wet form tends
to be sudden and dramatic. It is
thought that in wet AMD factors such
as oxidation by UV light and aging
result in the formation of metabolic
products14. These compounds may
trigger a cascade of inflammatory
processes resulting in the oversecretion of a growth factor called
Vascular Endothelial Growth Factor
(VEGF) by the RPE14. The uncontrolled
expression of VEGF in wet AMD may
also be caused by hypoxia in these
individuals. Studies have shown that
choroidal capillaries are sparse and
reduced in size in wet AMD sufferers
compromising blood supply14. In
addition Bruch’s membrane becomes
thickened further contributing to
hypoxia11. VEGF binds to specific
receptors stimulating the growth of
the new vessels described above.
These immature vessels (choroidal
neovascular membrane) are fragile
Continued overleaf
6
dispensingoptics April 2014
2a
2b
Figures 2a and b: Fundus photograph and corresponding OCT demonstrating a choroidal
neovascular membrane with associated subretinal fluid5
and may leak fluid or bleed
underneath or within the retina
resulting in subretinal and intraretinal
fluid accumulation or haemorrhages
respectively (see figure 2a and 2b).
This causes elevation and
detachment of the RPE and/or
neurosensory retina. If untreated this
neovascularisation can result in the
development of fibrovascular
(disciform) scarring. This is the end
stage of wet AMD and nearly always
involves the fovea15. This leads to
atrophy of the retinal pigment
epithelium and photoreceptors that
causes a central scotoma and
significantly impairs the patient’s
vision. In addition a pink ring can
initially form around the CNV when it
is active. This indicates that blood is
being diverted from the choroidal
circulation to the CNV. As the CNV
becomes inactive this ring becomes
atrophied and tends to dramatically
increase in size over the subsequent
years significantly increasing the
resultant scotoma15.
Eccentric viewing
The presence of a central scotoma
means that the patient needs to
utilise a different retinal area rather
than the fovea for viewing (eccentric
viewing) to utilise their remaining
vision. This is known as the preferred
retinal locus (PRL). Although patients
may spontaneously favour eccentric
viewing, others do not naturally
adapt (particularly if the visual loss is
sudden) and need guidance on how
to use this technique16. Even those
who are using eccentric viewing
naturally may find training helpful as
there may a retinal locus that gives
more stable or better vision than the
one they are using or multiple retinal
loci best suitable for different tasks16,17.
Eccentric viewing training has been
found to help the patient use their
remaining vision more effectively and
improve their feelings regarding their
vision though professional opinions
differ regarding it’s potential
benefits16, 17. Although the PRL can be
found using a scanning laser
ophthalmoscope this is not readily
available due to its significant
expense and tends to be restricted to
research environments17.
In practice it may be possible to use
the Amsler grid to demonstrate
eccentric viewing to a patient with
advanced AMD. The person can be
asked to move their eyes until they
achieve the clearest view of the
central fixation dot. If this is achieved
and they are not looking centrally the
patient is using eccentric viewing.
Alternatively the Amsler grid with the
diagonal lines bisecting at the centre
can be used. The patient is asked to
look at the centre of this grid or if this
is not possible to imagine where the
two lines cross. They can then
describe the most distorted area in
relation to this. The patient is then
asked to direct their positon of gaze
in the opposite direction in order to
utilise the PRL. Using eccentric viewing
in isolation tends to be difficult and it
is generally best used in conjunction
with Steady Eye Strategy. This involves
moving the text rather than the eyes
to maintain use of the PRL when
trying to read18. There are software
apps available that can be used on
certain tablets and help individuals to
maintain steady eye state whilst
reading e-books19.
Another approach involves the
individual looking at the clinician’s
face and then adjusting their fixation
as if they are looking at successive
numbers on a clock face to see
which provides the best vision (PRL)18.
This approach has been indicated to
be particularly helpful when watching
television18. Eccentric viewing training
is generally time consuming
particularly for reading, but can
prove most successful with significant
cooperation from the patient and
input from highly knowledgeable and
experienced rehabilitation
professionals.
If the patient successfully uses a PRL it
is worth bearing in mind that as the
distance of the new locus from the
macula increases the maximum level
of visual acuity that can be achieved
decreases. Magnification with the use
of low vision aids is necessary to
compensate for this. It may be
beneficial for a low vision assessment
to be arranged for an individual with
advanced AMD. An experienced
optometrist or dispensing optician
can assess areas of visual need
depending on the individual’s lifestyle
and try various optical low vision aids
to use in conjunction with eccentric
viewing. They can determine which
would be the most helpful and show
the patient how to use them. These
may include illuminated, hand held
and flat magnifiers. Non-optical low
vision aids may also be
recommended depending on the
level of visual impairment. These may
include reading lamps, talking scales,
liquid level indicators, typoscopes
and telephones with larger keys.
These can often be ordered from the
Royal National Institute of Blind
People (RNIB). For more complex
visual aids (such as spectacle
mounted magnifiers which help
individuals use eccentric viewing
more successfully and electronic
LVAs) a referral to the low vision clinic
at their local eye unit for a low vision
assessment may be useful as they are
often able to provide this equipment
on long-term loan free of charge20.
Registration as severely sight impaired
Continued overleaf
8
dispensingoptics April 2014
(blind) or sight impaired (partially
sighted) may also be performed if not
done previously and if the individual is
eligible and wants to proceed
following discussion and explanation.
Occasionally in wet AMD bleeding
can occur into the vitreous (vitreous
haemorrhage) affecting the person’s
peripheral visual field. RPE
detachment can also occur in the
absence of neovascularisation in wet
AMD. In this type fluid leaking from
the choriocapillaris accumulates
under the RPE.
Treatment of wet AMD
Early treatment of wet AMD is the
ideal in order to reduce the likelihood
of fibrovascular scarring and other
complications associated with the
condition. There are a number of
potential options:
Laser photocoagulation
Laser photocoagulation was
developed to treat
neovascularisation associated with
AMD. It causes full thickness retinal
burns so is only an option for
extrafoveal CNV otherwise the laserinduced scotoma adversely affect
the individual’s visual acuity21.
Although the progression of CNV is
reduced compared to no treatment
at all there is a significant likelihood of
subsequent reoccurrence21. Generally
laser photocoagulation has been
superseded by other treatment
options including anti-VEGF therapy
but is a potential option for certain
cases and is cheaper with only one
application required as opposed to
several.
Photodynamic Therapy (PDT)
PDT provides an alternative treatment
and ultilises a photosensitive drug
called verteporfin that reacts to a low
energy laser of a specific
wavelength. It is administered by
intravenous injection and laser
applied onto the retina when the
chemical has reached the ocular
circulation. The activated compound
is selectively taken up by the
immature endothelial cells of
neovascular vessels resulting in the
formation of chemicals that damage
these vessel walls. A compound
called von Willebrand Factor
released from the injured sites
stimulates the accumulation and
combining of platelets. This
contributes to thrombus formation
effectively sealing off the new
vessels22. However PDT treatment has
been shown to result in increased
VEGF expression.
Anti-VEGF therapy
Anti-VEGF drugs have been
developed that block the activity of
VEGF. Lucentis (Genentech, Inc, San
Francisco, Ca) is the only one
currently approved for use in the UK
by NICE (The National Institute of
Clinical Excellence). It is administered
by intravitreal injection at monthly
intervals for at least three months and
then at regular periods depending on
the patients visual acuity and
macular OCT scan results. An
average of three to four further doses
are needed after the initial three so
individuals have to tolerate numerous
invasive injections23. However studies
have shown that visual stabilisation is
achieved in almost all cases treated
with Lucentis and improvement
occurs in between 15 to 40% of
subjects24.
Oraya therapy
Another potential treatment for wet
AMD is known as Oraya therapy. This
involves irradiation of the macular by
X-ray that disrupts the DNA of the
rapidly growing and proliferating
neovascular cells which have no time
to repair the damage in contrast to
the surrounding slower regenerating
cells. This results in apoptosis or cell
death. It also reduces the
inflammation and development of
fibrovascular scarring associated with
advanced wet macular
degeneration25.
With an aging population AMD is
becoming more prevalent.
Fortunately massive progress has
been made in the treatment of wet
AMD. The need for recognition of this
condition and urgent referral is
essential as patients seen sooner tend
to have better treatment outcomes
as the CNV has had less time to
grow26. Referral to the correct
secondary care facility such as fast
track AMD services if available in a
given area is essential. However
although wet macular degeneration
has rapid and devastating effects on
vision they comprise the minority of
AMD cases. There is currently no
definitive treatment for dry AMD but
advice regarding an up to date
prescription, confirmation that the fit
and condition of patients glasses is
good and they have the optimal
lenses, UV protection, coatings and
tints for their situation can help
individuals maximise their visual
potential. Information regarding AMD
risks with regards to lifestyle, diet and
the potential benefits of supplements
may be helpful. Tips regarding selfmonitoring their condition and action
to take if symptoms change together
with the importance of regular eye
examinations may also prove
invaluable. Finally patients with end
stage AMD may also benefit from low
vision aids to maximise their remaining
vision.
References
1. Nunes RP, Rosenfield PJ, de
Amorim Garcia Filho CA, Yehoshua Z,
Martidis A, Tennant MTS Section 6.
Macular Disorders. Chapter 6.28.
Macular Degeneration. In: M Yanoff,
JS Duker, editors. Ophthalmology. 4th
Ed. Elsevier Saunders, 2013; p580-599.
2. Jonisch J, Shah G. Chapter 3.
Diagnosis of Age-Related Macular
Degeneration. In: AC Ho, CD Regillo,
editors. Age-related Macular
Degeneration Diagnosis and
Treatment. Springer, 2011;p23-39
3. Bressler SB, Bressler NM. Chapter 65
Age-related Macular Degeneration,
Non-neovascular Early AMD,
Intermediate AMD, and Geographic
Atrophy. In: D Hinton, S Sadda, AP
Schachat, CP Wilkinson, P
Wiedemann. Retina. Volume 1. 5th
Ed. Elsevier Saunders, 2013; p1150.
4. Ho L, Van Leeuwen R, de Jong
PTVM Vingerling JR Chapter 1.
Epidemiology of AMD. In: Holz FG,
Pauleikhoff D, Spaide R, Bird AC,
editors. Age-related macular
degeneration. Springer 2013;p3
5. Zacks, D. The Kelloggs Eye Center,
University of Michigan, personal
communication
6. Binns A. Assessment and
Management of AMD. Optometry
Today [online] 2011. P52 -56. Available
from http://www.optometry.co.uk/
uploads/exams/articles/cet_20_may_
Continuing Education and Training
2011_binns.pdf. (accessed 27
November 2013)
7. Damico FM, Gasparin F, Scolari
MR, Pedral LS, Takahashi BS. New
approaches and potential treatments
for dry age-related macular
degeneration. Arq Bras Oftalmol.
[online] 2012;75(1):71-6.Available from
http://www.scielo.br/scielo.php?script
=sci_arttext&pid=S0004-27492012000
100016&lng=en&nrm=iso&tlng=en.
(accessed 24 December 2013)
8. Bhagat N Flaxel CJ. Chapter 6.
Non-exudative macular
degeneration. In: JI Lim, editor. Agerelated macular degeneration 2nd
Ed. Informa Healthcare USA Inc.2008;
p103
9. Yanoff M. Sassani JW. Chapter 11.
Neural (Sensory) Retina. In: Ocular
Pathology. 6th Ed. MosbyElsevier
2009; p428-30
10. Rao RC, George J, Choudry N.
Treatment approaches for
Geographic Atrophy in AMD. Retinal
Physician [online] 2011. Available from
http://www.retinalphysician.com/artic
leviewer.aspx?articleID=106153.
(accessed January 4 2014)
11. Rosenfeld PJ, Martidis A, Tennant
MTS. Chapter 6.27 Age-related
macular degeneration. In: M Yanoff,
JS Duker, editors. Ophthalmology 3rd
Edition. Mosby Elsevier. 2009; p659
12. Bittner AK, Sunness JS. Chapter 5.
Visual Perceptual Effects of LongStanding Vision Loss. In: G Dagnelie,
editor. Visual Prosthetics: physiology,
bioengineering, rehabilitation.
Springer 2011; p101
13. Gurwood AS, Hutchinson JK, Myers
MD. AMD: Counteracting Conversion.
Optometric Management [online]
2011. Available from http://www.opto
metricmanagement.com/articleview
er.aspx?articleid=105537. (accessed 8
December 2013)
14. Moshfeghi DM. The
Pathophysiology of wet AMD [online]
2009. (accessed 27 November 2013)
15. Sarks J, Tang K, Killingsworth M,
Arnold J and Sarks S. Development of
atrophy of the retinal pigment
epithelium around disciform scans. B J
Ophthalmol [online] 2006;90(4):442446. Available from http://www.ncbi.
nlm.nih.gov/pmc/articles/PMC185701
1/. (accessed 8 December 2013)
16. Jeong JH, Moon NJ. A study of
eccentric viewing training for low
vision rehabilitation. Korean J
Ophthalmol. 2011;25(6):409–416.
17. Stelmack JA, Massof RW, Stelmack
TR. Is there a standard of care for
eccentric viewing training. Journal of
Rehabilitation Research and
Development. [online] 2004;41(5):72938. Available from
http://www.rehab.research.va.gov/jo
ur/04/41/5/pdf/stelmack.pdf.
(accessed December 20 2013)
18. Ryan B, Margrain T. A course in low
vision practice. Part 8. Using vision
and other senses effectively. Optician
[online] 2006. Available from
http://www.opticianonline.net/assets/
getAsset.aspx?ItemID=2153.
(accessed December 20 2013)
19. Tools, Macular Society, Available
from
http://www.macularsociety.org/Howwe-help/Eye-careprofessionals/Residual-visiontraining/Tools (accessed January 9
2014)
20. Crossland M. Visual impairment
support. Optometry Today [online]
2011. Available from
http://www.optometry.co.uk/uploads
/exams/articles/cet_01_july_2011_cros
sland.pdf. (accessed December 8
2013)
21. Afshari F, Jacobs C, Fawcett J,
Martin K. Chapter 1. Wet Age Related
Macular Degeneration. In: G-S Ying,
editor. Age related macular
degeneration – The basic advances
in Basic Research and Clinical Care
[online] 2012. Available from
http://cdn.intechopen.com/pdfs/263
28/InTechWet_age_related_macular_degenera
tion.pdf . (accessed 7 December
2013)
22. Hamblin MR. Mroz P (Eds)
Advances in Photodynamic Therapy:
Basic, translational and clinical.
Chapter 21.6 Photodynamic Therapy
for AMD. Engineering in Medicine &
Biology. Artech House, 2008; p399402.
23. Genentech, Inc. Lucentis
(ranibizumab injection, solution
[Genentech, Inc]) [online] 2013 .
Available from
http://dailymed.nlm.nih.gov/dailyme
d/lookup.cfm?setid=de4e66cc-ca054dc9-8262-e00e9b41c36d (accessed
14 January 2014)
24. Tan SZ, Laude A, Aspinall PA,
Ambrecht AM, Vani A, Dhillon B.
Evaluation of Ranibizumab treatment
of Exudative Age-related macular
degeneration using Decisional
Answer Tree Analysis. Journal of
Clinical and Experimental
Opthalmology [online] 2012.
Available from http://www.omics
online.org/2155-9570/2155-9570-3206.php?aid=4193. (accessed 21
December 2013)
25. Oraya Therapeutics [online] 2013.
Available from http://www.oray
ainc.com/physicians-unitedstates/oraya-therapy-united-states/
.(accessed 14 January 2014)
26. Bressler NM, Bressler SB. Chapter
66. Neovascular (Wet or Exudative)
Age-related Macular Degeneration.
In: D Hinton, S Sadda, AP Schachat,
CP Wilkinson, P Wiedemann. Retina.
Volume 1. 5th Ed. Elsevier Saunders,
2013;p1207.
Acknowledgement
Thank you to Professor David Zacks
MD, PhD at the Kelloggs Eye Center,
University of Michigan for kindly
granting me permission to use the
images in this article.
Louise Stainer is a hospital optometrist
at Optegra Eye Hospital, Birmingham.
She is involved in the pre and postoperative care of cataract and
refractive surgery patients and assists
in the macular, glaucoma and retinal
clinics. She has previously lectured on
the ocular component of the Guide
dogs for the Blind guide dog mobility
instructors (GDMI) Bachelors and
Masters degree courses. Louise has
also worked in the Paediatrics
department at Kidderminister
Hospital, in private practice and has
written numerous articles for various
optometric and dispensing optician
journals. n
The multiple-choice questions (MCQs) for this month's CET are available online only, in random order, to comply with
the GOC's Good Practice Guidance for this type of CET
10
dispensingoptics April 2014
This month, Antonia Chitty explores the
use of NLP in practice
Can NLP help your
practice?
ave you heard of neuro-linguistic
programming (NLP)? While the
words seem complex, NLP on one level
is simply about communicating better,
something that every practitioner is
keen to do. In this article, you can
learn more about NLP and how one
optician is using it in practice.
H
We all have five senses, and
throughout the day our senses are
bombarded with enormous amounts
of information. Somehow our brains
process this information: some
consciously and some unconsciously.
We are only consciously aware of a
tiny proportion of what is going on,
and each person’s filtering process is
different. This is how two people can
emerge from a conversation with very
different impressions of what has
occurred.
(neuro), language (linguistic) and
behavioural patterns learned through
experience (programming) and that
these can be changed to achieve
specific goals. The initial idea came
from studying the language used by
psychotherapists, and how language
can change perceptions. Think about
this in the context of your work in
practice; the language you use to
describe different types of lenses will
clearly influence a customer’s decision
about which lenses to purchase.
Rewriting internal
programmes
NLP uses a systematic approach to
help understand the filtering process,
which can be built up on each
individual’s beliefs, values, experiences
and languages. One idea that might
help you get to grips with NLP is the
concept that it is about how we think
rather than what we think: the structure
of our thoughts and how we develop
them rather than their contents.
Wendy Sethi is a certified NLP
practitioner who works in Specsavers in
Hull. She qualified as a DO in 1997, as a
contact lens optician in 2000 and as a
NLP practitioner in 2004. Wendy joined
CIBA Vision’s Practice Academy as a
part-time training consultant in 2009,
and then became a full-time member
of Ciba Vision’s professional services
team in 2011, taking charge of its
Practice Academy for a year. She has
contributed articles to Optometry
Today and Dispensing Optics, and was
awarded the Dispensing Optics Journal
Prize in 2007. Wendy first became
interested in NLP after she did a course
in professional speaking.
Richard Bandler and John Grinder
created NLP in California, USA, in the
1970s. Its creators claim a connection
between the neurological processes
She says: “One of the people running
the course was qualified in NLP and
actually an NLP trainer so I did her
course.” It can be hard to understand
NLP unless you have actually
experienced it. Wendy explains:
“Neuro linguistic programming is
basically to do with the brain and
language. Much like programming a
computer, NLP can take unhelpful
programmes in the brain and rewrite
them to be helpful. For example, if you
are scared of spiders, NLP will teach
you to how to go into a more helpful
state of mind when you see one. You
pick your results; you could choose to
simply feel calm, or even to want to
pick it up.”
There are three central concepts in
NLP: subjectivity, behaviour and
consciousness. The way we understand
the world is subjective, and we
experience the world based on our
subjective impressions through the
senses – described by Bandler and
Grinder as vision, audition, tactition,
olfaction and gustation. If you think
about an activity that you did in the
past, you may remember images,
sounds, smells, how it felt, as well as
any taste associated if relevant.
Behaviour is broadly conceived to
include verbal and non-verbal
communication, incompetent,
maladaptive behaviour as well as
effective behaviour. Your behaviour
and that of others can, according to
NLP theory, be modified by
manipulating these sense-based
subjective representations. Finally,
Patient and practice management
consciousness in NLP is divided into a
conscious component and an
unconscious component. Those
subjective representations that occur
outside of an individual’s awareness
comprise what is referred to as the
‘unconscious mind’.
If you want to understand how NLP
works, Wendy comments: “NLP works
by a series of questions. I don’t make
anyone change anything in their head
– the person picks the end point
themselves. We can get people to do
third party conversations, playing the
other person’s side of a conversation
to gain an insight into how the other
person might think. Alternatively, we
can put someone on a timeline and
walk them forward to the future.”
Using NLP in the
practice
There is a lack of scientific evidence for
NLP, which means that it won’t appeal
to some practitioners, but others find it
a useful technique when
communicating with customers,
patients and staff. Wendy comments:
“There isn’t a scientific basis for NLP –
but it works. I’ve done a lot of NLP with
people with phobias, exam nerves,
and even in my own personal
experience there are situations where it
works and nothing else has. There’s no
guarantees but it can make a huge
difference, and it can help you get
honest answers.”
Wendy finds that NLP helps her in
practice. She says: “The main ways I
find it useful are for better
communication, understanding
people and what they are thinking
and how the brain works. One of the
theories of NLP suggests that if
someone is looking in a particular
direction, they’re accessing something
they remember, and looking to the
other side might indicate that they are
making something up.
“Once I have calibrated a patient and
know how they behave, I can ask
them questions, such as how are they
getting on with their lenses,” Wendy
continues. “For a particular person, if
they look to the left, they’re
remembering how they feel in their
lenses, while if they look to the right
they might be telling me what they
think I want to hear. In this way, NLP
helps me build a rapport, understand
patients’ body language and get to
the root of someone’s visual problems.”
If you’re thinking of trying NLP in
practice, Wendy advises: “We like
people who are like us. If I meet
someone who uses similar phrases,
similar body postures, I feel
comfortable. It’s about different levels
of rapport, tonality of your voice. You
can create or destroy rapport. If I want
advice, I want someone who I’m in
rapport with, so I can trust them. If you
want each patient to feel that they
can rely on your advice, NLP can be
extremely useful.”
NE
W!
I SEE
VISION REDEFINED
through Nikon spectacle lenses
If you want to learn more about NLP,
Wendy says: “There are a lot of really
good books out there. Start by looking
for books by Richard Bandler, one of
the founders of NLP. It can be easier to
learn face-to-face from people than
from a book, and if you’re thinking
about this, look for NLP trainers. Some
people do an introductory course,
while others offer short courses about
NLP in a business environment. This
doesn’t qualify you to practise but may
be just what you need for work.
“Do check out relevant bodies of
accreditation before taking a course.
Go online and research what’s out
there, and you might also want to go
for an NLP session yourself and find if a
particular practitioner makes a
difference to you. Beyond this, I do
talks for ABDO Areas on
communication techniques and
always introduce some NLP techniques
into those.”
Summing up, Wendy says: “One of the
biggest things that I feel about NLP is
that most opticians are fantastic at the
clinical, mathematical, scientific sides
of the business. NLP is a brilliant way of
improving your people skills. I find it
invaluable in my clinics and a lot of
patients ask for me because they feel
comfortable with me, and I put some
of that down to NLP.”
Former optometrist Antonia Chitty now
writes on business topics. She has
written books including Making Money
Online, Blogging: The Essential Guide
and Marketing: The Essential Guide
which will help you if you need
effective ways to grow your practice. n
Nikon’s Most Advanced
Progressive Lenses
Available to order
from Nikon now
01908 214100
www.nikonlenswear.co.uk
12
dispensingoptics April 2014
Buying frames is a subjective
rather than an objective task,
writes Paul Surridge
A planned approach to
frame buying
rom a profit and loss perspective,
buying frames is a vital task, yet so
many practices lack a strategy and
often fail to hire qualified dispensing
staff to manage the process. Buying
frames is a subjective rather than an
objective task, that’s why as much
subjectivity as possible should be
driven-out of the process if frames are
to appeal to patients. It also ensures a
stock turn ratio that makes economic
sense, and delivers maximum profits
for the business.
been suitable; but the sign above
the display clearly stated ‘Men’s
frames’.
In this short article I want to raise a
number of issues. How should frame
displays be organised? What
constitutes a unisex frame? Should
acetate frames be segregated from
metal frames? Should a section be
devoted to designer and budget
frames? What volume of frames
should be purchased over a given
period to achieve an optimum stock
turn, or should this approach be
abandoned in favour of just filling the
frame bars? How should frame
displays be organised? By gender,
brand, price?
Spectacle frames today are of a
higher manufactured quality than in
the past and, as a result, the
difference in quality and design of socalled designer brands and house
brands is not always so obvious. Of
course, the retail price of designer
brands in any sector reflects the
marketing costs in elevating them in
consumers’ minds. One of the quirks
of human nature is that we’re
knowingly taken in by the hype.
That’s not to ridicule the concept of
branding, after all it’s a part of the
economic and business mix, but I
think a wise DO would always want to
look objectively at frame purchases
to ensure they first meet the needs of
their patient profile.
F
I’m not sure a formulaic approach is
always a good idea. For example,
spectacle frames are far less gender
biased today and separating them
out can be a barrier to sales. I’ve
witnessed a dispensing optician at a
loss because she didn’t have any
more suitable ladies frames to show a
patient, although there were so
called men’s frames that would’ve
Displaying frames by designer brand
and having a strong brand presence
works for some practices but not all.
Understandably, the distributors of
brands fight hard for volume
commitment, display space and
positioning to gain maximum sales,
but does it always work for the
practice?
Don’t ignore sale
opportunities
What is undeniable is that we often
under-value the fashion aspect of
spectacle sales. In the USA and
certain parts of Europe, it’s common
for men and women to buy a number
of frames to suit a variety of
occasions, but in the UK we often
ignore sales opportunities. Spectacle
frame designs, colours, sizes and
materials have evolved in recent
years diminishing the differentiators
between men’s and women’s frames,
giving greater choice for both
genders and an opportunity for
practices to manage their collections
more efficiently. Of course, with retro
designs back in fashion, the
distinguishing elements become more
gender acute.
What about the use of the word
budget when presenting lower priced
frames? For me, budget has a
negative connotation, inferring
something is cheap or of poor or
inferior quality and focused on price
parameters. I prefer the word ‘value’
as in ‘value collection’, which has the
emphasis on value for money and the
accent on quality for the price you
pay. Semantics you may think but
psychologically, the words we use are
so important in the sales process.
How should frame stock be
managed? Next to equipment
investment, the frame inventory is
often the largest capital expense of a
practice. Spectacle frames are also
the focal point for patients, and
reflect the aesthetic appeal of the
business and, in most practices,
continue to generate the vast
majority of the profit, so yes
Patient and practice management
Paul Surridge
unequivocally, practices should
establish a stock turn ratio (STR) and
adhere to a given formula. A
practice may be successful in
generating a high turnover but if the
buy-sell ratio is out of kilter, potential
profits may well be tied up in stock
and affect future cash flow and the
ability to refresh ranges on a regular
basis.
One way to approach STR is to
calculate how many frames are
currently dispensed each month
bearing in mind seasonal averages,
then multiply that figure by the
number of months a practice wants
stock to turn. For example, if stock is
to be refreshed every four months
and a practice dispenses 100 frames
a month that indicates a target stock
of 400 frames. If a practice stocks 600
frames and only dispenses 50 frames
a month, the minimum stock to turn
will be 12 months, which will have a
negative impact on a number of KPIs.
Smaller turnover practices, typically
under £100k a year, should aim for a
stock turn of five or six months. For
example, 50 frames sold per month =
250-300 frame stock. The challenge is
ensuring that stock always remains
fresh and relevant for patients, frame
displays don’t look empty, and a
positive cash flow is maintained.
Ideally, frame stock should be
reviewed on a monthly or quarterly
basis to stay on track.
A few guide notes:
• Understand your patient
demographic
• Choose frames they’ll like, not just
what you like
• Think objectively about frame
displays and aesthetics
• Have a formula for a stock turn
ratio and adhere to it
• Don’t just buy frames from reps or
companies you like
• Don’t buy randomly from reps that
‘drop in’ unless you have a real
need
• Don’t be fooled by discounts;
make decisions based on net cost
• Keep abreast of trends, but don’t
be led by them
• Take control of your frame displays;
don’t let manufacturers do it for
you
• Don’t assume a brand name
always means better quality or
higher margins
Sh
o
Ne wca
w sin
‘M g
as Ou
te r B
r’ L ra
en nd
ses
VISIT
US
ON
STAND
H74
A disciplined approach to frame
buying has a positive effect on the
future of a business. Get it right and
the business prospers and patients are
happy. Get it wrong and the reverse
is true.
Paul Surridge is chief executive of
Sight Care, a business and product
resource group for independent
opticians. For more information about
effective frame buying or any aspect
of practice management, email
[email protected] n
www.nikonlenswear.co.uk
14
dispensingoptics April 2014
Rebecca Thompson shares her top five methods
for effective practice growth
Five top tips for
practice growth
Rebecca Thompson
ast year I discovered that practice
growth is far easier than most people
believe it to be. For the practice owners
I know, 2013 was an amazing year; so
in this article I would like to share the
top five most effective methods they
used for growth. These are things that
we know we need to do, yet somehow
just don’t get around to it.
L
A business blog I read recently talked
about how we all like to find discount
and risk free answers to our problems.
We like to find a solution that is
guaranteed to work, takes little time,
small amounts of cash investment and
even less effort. Yet don’t you find that
the problems that lend themselves to
discount and risk free solutions have
already been solved? The blog
resonated with me because in
knowing this, we can start to allocate
resources appropriately and
understand whether the effort
involved will be worth the result.
regularly train and develop their
people:
• Exceed their financial targets year
on year
• Have great morale and a happy
atmosphere
• Keep their A* staff for longer
• Can easily hold individuals
accountable (if your team do not
know what is expected of them,
how can they deliver it or be held
accountable when they don’t do it?)
• Have delighted patients who spend
more, more often and tell all their
friends about them
It is especially important for practice
owners to train and develop
themselves too, so that they can lead
and grow their business effectively.
Remember: training doesn’t work. It
has a half-life of about a week.
Because without great leadership, you
cannot get any training to stick.
Tip 2: Do inspiring leadership
The methods discussed in this article
are not discount or risk free solutions.
They can take a little extra time, a little
extra effort and in some instances a
little extra cash investment. Yet time
and time again over the last year they
have been proven to work. The
practices that do these things are
growing and thriving.
Tip 1: Train and develop
your team
Training and developing your team is
absolutely essential, and if you want
your practice to grow – it is vital. We
have found that those practices who
Great leadership takes times to learn,
but that time is worth investing.
Without it your team will not flourish
and grow. Nor will you always get it
right first time, but that is ok. In my
experience, just the fact that you are
trying to be a great leader and
frequently demonstrating that to your
team gains you much respect. They
see you trying to be better and do
better, and they follow suit.
Those practice owners who have
actively worked on developing these
skills have grown not just their practice
in the last year, but themselves too.
• They have a clear vision of where
their practice is going and a plan
that shows how they will get there
• They have learnt to be proactive,
not reactive
• They spend time working on the
business
• They communicate regularly and
effectively. This means clearly
defining what is expected of
individuals and the teams – then
holding people responsible and
accountable for delivery
• They listen to their teams, allowing
them to have a voice and feel like
they are part of something special
• They develop their B+ and reward
their A* team members
• They thrash the B and C members of
the team . . . quickly
• They have an ethos that means their
teams are happy to work hard, and
it is a great place to be when they
do that
• They get a holiday (and they don’t
have to spend it worrying about the
practice)
Tip 3: Promote your practice
There just isn’t enough space here to
talk about how to do marketing or
what specifically might work for your
practice, in your area, with your
demographics; suffice to say that
those practices that talk about the
look, offer great value for money and
shout about their expertise, are those
practices that are growing.
When doing any kind of marketing or
promotional activity (or indeed at any
time) it is vital that you do two things:
Business solutions
monitor your KPIs (key performance
indicators) weekly and discuss them
daily (you need to know that your
numbers are going up and/or respond
quickly if they are going down); and
ask your patients how they found out
about the promotion (you need to
spend your money on the marketing
that works). The crux of it is that those
practices that actively and regularly
promote themselves in a variety of
ways that work for them are growing.
Aggressively.
astound the patient at every step of
their experience.
Tip 5: Ensure customer experience
is amazing
Tip 4: Focus on brilliant dispensing
If you have done your training and
development, are learning to be a
great leader, have started marketing
your practice and become known for
brilliant dispensing then your customer
must have a breath-taking experience
as well. The last thing you want to do is
attract lots of people to your practice
and then disappoint them once they
arrive.
Many independent practices have a
reputation in their local area for
fantastic eyecare, but can find they
have WPS (Walking Prescription
Syndrome). In other words, everyone
knows they do a great eye test, yet
they are going elsewhere to buy their
glasses. In 2013, there was also
another pattern: practice owners
were phoning to tell us that average
order values were up and test
numbers were down.
Retail excellence essentially means
focusing on the customer experience.
And this means how the practice
looks, frame stock and how it is
displayed, how your team behave,
your communication methods and
even the way your recall is managed
– because ultimately everything you
do gives a message about you and
what you offer to your patients and
prospective patients.
Essentially, this means that those
patients who on average spent more
were staying. Those who wanted great
value (I said great value, not cheap)
were going elsewhere because they
perceived they could get better
value. These practices were perceived
as being expensive.
To combat this, we crafted the
customer promise and helped
practices promote it. We created
material to promote event days, ran
them and tested the numbers to see
what worked best in terms of
promotion and response. Many of
these practices did Net Promoter
Scores to find out what their patients
really thought about their optometry
and their dispensing, and then
responded to the results.
The practices that are now known for
brilliant dispensing are growing. They
focus on the thing that the majority of
patients value most (we’ve asked
them) – which is looking great in their
glasses. They demonstrate their
expertise in style and comfort,
celebrate each patient as an
individual, and really take the time to
find out about their needs and wants.
They have true retail excellence and
In 2013, we had great fun with various
practices helping them to craft their
unique customer promise. None of
them began with the words, “Family
owned, professional, friendly,
independent opticians” – that is not
unique (just have a look at some
websites and Twitter headlines). Better
than the boss telling teams what their
promise would be, we helped them
craft it together. In some cases, this
was one word – one word that
represented everything the practice
stood for and how they wanted
patients to feel after any interaction
with them. We then showed them how
to hold everything, and everyone,
accountable for delivering that
promise.
Ultimately, without a plan and without
action, a goal is just a dream. Change
is inevitable. Growth is optional. So
what will you choose to do to ensure
that your practice grows this year?
Rebecca Thompson is a business
growth expert providing coaching for
opticians at www.practicebuilding.
co.uk. Visit stand B10 at Optrafair for a
free coaching session. Practice
Building is a Finalist in the 2014 Supplier
of the Year category. n
dispensingoptics April 2014
16
Member of the month
Brad Parkes:
making clubs work
rad Parkes qualified as a
dispensing optician in 1989, and as
a contact lens optician in 1991 and
later that year became a Freeman of
the Worshipful Company of Spectacle
Makers (WCSM). He has been a
director of two Specsavers franchises
in the West Midlands since 1993 – and
in that same year, Brad was clothed as
of the WCSM Livery.
B
Describing himself as “one of life’s
belongers”, Brad passionately believes
that society and communities can be
strengthened if more people become
members of more organisations, clubs
and groups, and he even has a book
on the subject due to be published
this year – ‘Making Clubs Work’. He
thus had no hesitation in accepting an
offer to join the WCSM’s Membership
Committee towards the end of 2012.
In December 2013, Brad was
appointed as assistant to the WCSM
Court – joining Huntly Taylor and the
current WCSM Master, Chris Hunt, as
dispensing opticians serving on the
WCSM Court. “Being Assistant on the
Court involves a little commitment,”
says Brad, “and offers some wonderful
opportunities in return. The role means
I have a say in how the organisation
runs, as the Court is the equivalent of a
Board. I also get to meet and host a
number of guests at lunches and
dinners for the Livery Company.”
Visits behind the scenes at the Royal
Albert Hall, Treloars School, being a
part of Lord Mayor’s Show, theatrical
performances at the Old Bailey and
driving sheep over London Bridge –
are all opportunities that have
presented themselves in the last six
months alone.
Brad was brought up in ‘Little England
beyond Wales’ – Tenby, Pembrokeshire
– where he and his wife, Tammy, love
to return to for holidays. “My parents
were hoteliers, who bequeathed me
customer service in my DNA,” says
Brad. “They also inculcated in me a
love of London and all that it has to
offer through visits to the Metropolis. So
when the chance arose to study
optics at the then City and East
London College, I jumped at it.”
In 1993, Brad opened the Specsavers
practice in Solihull, where he has
practised ever since in partnership with
his optometrist brother, Spencer. In
2008, the brothers opened a second
practice in nearby Shirley, and so Brad
is now kept very busy overseeing
operations in both places. In his
professional capacity, he has been
involved with ABDO as a distance
learning tutor, and with Anglia Ruskin
University as a visiting lecturer. More
recently, he has supported the
WCSM’s education programme by
serving as an examiner for its optical
practice support qualifications.
Outside of optics, a keen interest in
Rugby gives away his upbringing in
Wales in the 1970s, although today his
participation in the sport is limited to
the stands and the terraces, as he
declares the only part of his anatomy
that runs today is his nose! “I hope to
eventually re-live my playing days
vicariously through my two-year-old
son, Luke,” he says.
Round Table has also played a huge
part in Brad’s life, as he explains: “I
joined in 1991, and gracefully retired
quite recently upon reaching the upper
age limit of 45, after serving the
organisation at area and national level,
and having sat on the National Board
between 2006 and 2008.” Today, Brad
remains active as a trustee of the
Round Table Trust and of the club for
past members – the 41 Club. n
Have you got a story to tell? Put forward yourself, or someone you know, for Member of the month by
emailing Nicky Collinson at [email protected]
18
dispensingoptics April 2014
Do you have an up-to-date copy
of British Standards available in your
practice? If not, you should . . .
‘Essential’ new British
Standards Extracts now
available
he new and updated British
Standards Extracts 2014 contains
relevant information relating to British
Standards used in everyday optical
practice, and provides a valuable
resource to trainee and qualified
practitioner alike.
T
ABDO College head of operational
services, Michelle Derbyshire who
oversaw production of the latest
edition, said: “We had been hoping
to produce an up-to-date edition of
this book for some time and so we’re
hugely grateful to Paula Stevens for
completing this mammoth task.”
Explaining the need for the book, she
continued: “British Standards are
available to purchase, but
purchasing standards individually
would cost more than £900. This
ABDO College publication provides
what every practice needs – at a
cost of just £53.50.”
Access to British Standards
Explaining further, Alicia Thompson,
ABDO director of professional
examinations, said: “Practice visitors
require that every practice has
access to British Standards. This new
edition includes everything that is
relevant to the profession in one easyto-follow book. It is not only useful for
dispensing opticians – but for
technicians and everyone in the
practice.”
Paula Stevens, ABDO CET coordinator,
who carried out the research to
update the British Standards Extracts,
explains the scope of the project:
“About half of the standards had
changed and some new standards
had overlapped with old ones, which
made the task more complex.” When
asked why British Standards were so
important, Paula said: “Everyone
needs to learn the language of British
Standards so we are all talking the
same language, such as ‘sides’ rather
than ‘arms’ and ‘joints’ rather than
‘hinges’ – a term which seems to be
preferred in the US and has been
gaining currency in the UK too.
spectacle lenses, as well as pertinent
extracts from the following standards:
“Crucially, the British Standards set out
how everyone should write a
prescription, from technicians to
ophthalmologists.” There are further
reasons that every DO should have
knowledge of standards. Paula said:
“From a manufacturing point of view,
the standards are essential, and
dispensing opticians need them so
that they have up-to-date
knowledge of acceptable tolerances
when checking work from
manufacturers. Most importantly,
every practitioner needs to make sure
that they are working to the latest
standards,” Paula added.
• BS 3521: Part 2: 1991 - Terms relating
to ophthalmic lenses and
spectacle frames - Glossary of
terms relating to ophthalmic lenses
The book includes the all-important
tolerance charts for mounted
• BS 2738: 2004+A1: 2008 - Spectacle
lenses - Specification for the
presentation of prescriptions and
prescription orders for ophthalmic
lenses
• BS 8624: 2011 - Ophthalmic optics Spectacle frames - Measuring
system and terminology
• BS 3521: Part 1: 1991 - Terms relating
to ophthalmic lenses and
spectacle frames - Glossary of
terms relating to ophthalmic lenses
• BS 21987: 2009 – Ophthalmic Optics
– Mounted Spectacle Lenses
• BS EN ISO 13666: 2012 - Ophthalmic
optics - Spectacle lenses –
Vocabulary
Purchase a copy of British Standards
Extracts 2014 for your practice for
£53.50 from the ABDO College
Bookshop at www.abdocollege.org.
uk/bookshop. The bookshop offers
delivery within two to five working
days. n
20
dispensingoptics April 2014
Peter Black
Black arts
Working together to deliver
quality CET
In late February I had the
pleasure of visiting the
Northern Ireland Optometric
Society (NIOS) with Barry
Duncan where we
presented ABDO’s
paediatric dispensing
discussion workshop to
nearly 140 registrants. We
received a warm welcome
from the NIOS committee
and a hospitable crowd
comprising around a third of
all the optometrists and DOs
in Northern Ireland.
These kinds of events are
now a strategic priority for
ABDO as they make perfect
sense. Working across the
sector to deliver CET to
mixed groups of registrants
enables better use of
scarce funds, enables
better access to interactive
CET in remote areas, and
perhaps most importantly
helps safeguard further
against isolated practice.
Mixed audiences generally
have wider discussions and
view scenarios from
different perspectives to
everyone’s benefit.
It also makes perfect sense
for all but the largest of
practices – when the
optometrists are out for a
day of CET the DO/CLO
likely has little to do – and
going forward we hope to
develop closer relationships
with our Optical
Confederation partner the
Association of Optometrists
to develop joint CET events.
Joint events mean the
whole practice team can
travel together and train
together. Of course,
sometimes we need
separate training for it to be
relevant, but even then
collaboration can keep
costs down and make a
multi-stream event even
more attractive to
registrants. ABDO CET has
worked hard to develop
peer discussion scenarios
that can be adapted
depending on whether the
group is mixed or
comprised exclusively of
DOs, CLOs or optometrists.
Great news on peer
discussion
Thankfully, the General
Optical Council (GOC) has
now reduced the minimum
time requirement for peer
discussion from two hours to
one hour for three CET
points, making it easier for
contact lens opticians and
optometrists to access this
compulsory requirement.
This reduces the cost of
providing multiple sessions
of peer discussion for CLOs
and optometrists at full-day
events, as facilitators will be
able to see twice as many
groups in a given length of
time.
Engaging with your LOC
Another priority is helping
our members to engage
with their Local Optical
Committee (or equivalent in
the devolved nations). DOs
can sit on LOCs as
representatives of
contractors, and in
enlightened areas in their
own right, where they can
have an input into the
development and
commissioning of
enhanced services. Where
DOs and CLOs are
welcomed, we have found
that our members are also
very involved in enhanced
services themselves, most
notably low vision but also
CLOs can get involved in
minor eye injury schemes
(including removing
eyelashes and foreign
bodies), ocular prosthesis
and complex lens fitting,
and more.
In due course, ABDO will be
producing guidance on
how to get involved with
your LOC and what ABDO
can offer them. In the
meantime, ABDO is happy
to help LOCs offering
accredited presentations
and workshops in
paediatric
dispensing/supervision of
regulated functions free of
charge to any LOC
providing the dispensing
opticians in the area are
also invited to attend. A
typical evening event that
we can provide is worth four
to seven interactive points.
Paediatric dispensing: is
your registration at risk?
ABDO has now presented its
paediatric dispensing
discussion workshop and
similar peer discussion
events to well over 1,000
registered opticians across
the UK. The response from
dispensing opticians and
optometrists is both
simultaneously very
encouraging and also very
disturbing.
It is encouraging that so
many registrants, especially
optometrists, are keen to
learn about paediatric
dispensing. My experience
has been that despite some
initial apprehension at
group discussion, everyone
seems to enjoy themselves
and feedback has been
very positive. Without
exception, registrants have
engaged fully and shared
some great ideas on how to
deal with what can be
some of our most
challenging patients.
It is, however, very
disturbing how lax
supervision of regulated
dispensing still appears to
be in some quarters. It is
clear that many
optometrists working
without the benefit of a
dispensing optician have
not fully understood their
responsibilities in terms of
supervision. Similarly, many
dispensing opticians have
reported that they have
concern for the way their
practice handles regulated
dispensing when they are
not in attendance.
Those colleagues who have
presented discussion
workshops or facilitated
peer discussion around
paediatric dispensing report
Black arts
that the most concerning
evidence of poor
compliance with
supervision of regulated
function has happened
when presenting to mixed
groups of both registered
practitioners and nonqualified dispensing
assistants – as is the norm at
NHS Education Scotland
(NES) events.
NES rightly takes the view
that it is beneficial to train
practitioners together and
not isolate, for example,
optometrists for their training
in professional conduct,
optical appliances and
other competency areas
that are shared with
dispensing opticians. NES
also believes that the whole
practice team needs to be
trained and, therefore,
when it hosts an event on
ophthalmic dispensing you
will find not just dispensing
opticians and optometrists
there, but also dispensing
assistants who may well
dispense to children under
supervision. I have
personally come across
several dispensing
assistants and optometrists,
and I’m sad to say one or
two dispensing opticians,
who until being exposed to
paediatric dispensing CET
were completely unaware
of the rules for supervision.
NES was concerned enough
to support ABDO in the
development of the
paediatric heads workshops
in 2013 because of the
feedback from peer
discussion the year before,
where it was clear that
many practitioners had a lot
to learn and many optical
assistants had no idea until
that point that they were
breaking the law and
putting their supervisor’s or
practice’s registration at
risk.
Inspiration in Wales
Following the great success
of our heads workshop and
with the help of Dr Maggie
Woodhouse of WOPEC,
phase two of this project is
now underway. Maggie
introduced Alicia Thompson
and Barry Duncan to a
delightful five-year-old girl
named Maisie, and after
two hours of work and play
Alicia had taken sufficient
hand-made frame
measurements for our new
Down’s syndrome heads to
be manufactured by a
special effects company
based in the south of
England. Barry reported that
Maisie was truly an
inspiration, and so that you
too can be inspired in the
future, ITN were there to film
the whole experience for
EyeTV.
Whistle-blowing at CET
events
The number of fitness to
practise cases against
registrants shows the GOC
takes supervision of
regulated functions very
seriously. However,
following enquiries from
concerned members I must
point out that the GOC has
stated that CET must never
be used as a means of
reporting illegal practice.
For the trust of registrants to
be maintained, all peer
discussion CET is held under
the Chatham House Rule:
participants may freely use
the information received,
but neither the identity nor
the affiliation of speakers,
nor that of any other
participant, may be
revealed. So whistleblowing is not permitted. In
my experience, dubious
practice can be addressed
by the discussion group
itself if well facilitated.
Don’t miss Optrafair London
It’s not long to go now until
Optrafair London, being
held at Olympia National
from 11-13 April. The event
will be a great opportunity
to see what’s new in optics
from 140 exhibitors from
around the world. ABDO has
worked with the organiser,
the Federation of
Manufacturing Opticians, to
ensure there is plenty of free
CET for our members. We
need all the help we can
get in London to ensure
sufficient interactive CET is
available to meet the
requirements of the GOC.
All Friday and Sunday CET
sessions and most of those
on Saturday have CET
points for both DOs and
optometrists (a few on
Saturday are CLO and
optometrist only). To preregister for the free
exhibition or to book CET
visit www.optrafairlondon.co.uk
Illegal practice
Registrants will now be well
aware of the current GOC
consultation on illegal
practice and although
ABDO will be responding
both as part of the Optical
Confederation and in its
own right, I would
encourage individual
members, many of whom
have strong views on
internet supply of optical
appliances, paediatric
dispensing and unqualified
dispensers portraying
themselves as dispensing
opticians, to submit their
own response at
www.optical.org
Peter Black n
Correction
Please note that, due to an error, an incorrect statement was published in the March CET article in
Dispensing Optics ‘What are you on? – part two’. The statement that appeared on page 8 is partially
incorrect: ‘Fluorets are and fluorescein in Minims form is classified as a pharmacy medicine (P) which
means that both of these products cannot legally be used by dispensing opticians and contact lens
opticians’. In fact, CLOs may safely and legally use fluorescein in the course of their practice. The online
version on the ABDO website has now been updated. The issue of the use of fluorescein by dispensing
opticians who are not on the GOC's contact lens specialty register is being addressed by ABDO's advice
& guidelines working group, who will issue guidelines soon. n
22
dispensingoptics April 2014
Our photograph shows (from left): Neil McDonald, Kerrie Eastaugh, Alison
Blake and Maciek Dudkiewicz
Fiona Anderson
New team at
Norfolk practice
ABDO Board election
results announced
Family-owned Norfolk
opticians, Dipple &
Conway, has made four
key appointments.
ABDO has announced the results of its recent Board
elections. Fiona Anderson of Area 12 (Scotland) returns to
serve a second term, while Clive Marchant of Area 5
(Midlands) and Jo Holmes of Area 7 (West Country and
Channel Islands) join as new members.
Neil McDonald has been
made practice manager
and will work across the
company’s practices in
Norwich, Swaffham and
Diss. Dispensing optician
and optometrist, Alison
Blake, has joined from
Optegra private eye
hospital, Maciek
Dudkiewicz has qualified as
a dispensing optician, and
Kerrie Easthaugh has
qualified as a clinical
assistant. n
Clive Marchant
Jo Holmes
The successful candidates will serve on the ABDO Board for
the next three years as of 9 April 2014. Profiles of the new
Board members will appear in a future issue Dispensing
Optics. n
Solicitors to run consumer complaints service
Following an open tender
process launched last year,
the General Optical Council
(GOC) has appointed
Nockolds Solicitors to run its
independent mediation
service for optical
consumers from 1 April
2014.
The mediation service for
optical consumers does not
have formal powers but
acts as a mediator in
disputes between
consumers and
practitioners. For example,
the service may help
consumers resolve
customer service issues
such as obtaining refunds
for faulty glasses. The
service can also advise
registrants who receive
consumer complaints.
Complaints that call a
registrant’s fitness to
practise into question will
continue to be dealt with
by the GOC.
Gareth Hadley, GOC chair,
said: “We are delighted to
have appointed Nockolds
to run our independent
mediation service and we
look forward to working
with them. We would like to
thank Richard Wilshin and
his team at the OCCS
[Optical Consumer
Complaints Service] for
their hard work and
dedication to the interests
of optical consumers over
many years.
“We would also like to thank
the professional bodies –
ABDO, AOP, FODO, and the
College of Optometrists –
that established the OCCS
and continued to support it
after responsibility for funding
and overseeing the service
passed to the GOC.” n
Specsavers confirmed as DVLA bid winner
Following the end of the ‘standstill’
period at midnight on 4 March without
further extension, LOCSU was
subsequently informed by the DVLA
that it had awarded its contract for
the Provision of Vision Testing Services
to Specsavers Optical Superstores
Limited.
“We have not been advised of the
date of commencement of the new
contract or what the transitional
arrangements will be for current
contract holders,” said LOCSU. “We
will of course publish any further
information we receive to assist
current contract holders.”
Alan Tinger, LOCSU chairman, added:
“I have previously stated that the
DVLA has reached a regrettable and
destabilising conclusion for the UK
Optical sector and that view is only
strengthened by the support LOCSU
received from within the sector to
explore every possible rationale to
mount a legal challenge within the
‘standstill’ period. Unfortunately, the
legal advice we received made it
clear that such a challenge would
have been fruitless.
“I have expressed in no uncertain
terms to the DVLA the concerns of
the sector to the outcome and I
await their response, which they
have said would follow after the end
of the ‘standstill’ period,” added
Alan. n
Newsbrief
Gary O’Donoghue
Eyecare3000 success
BBC journalist to speak at
Vision UK 2014
Glasgow meeting
breaks record
Gary O’Donoghue, BBC
Radio 4’s chief political
correspondent and long
serving journalist, has been
confirmed as the chair of
the ‘Question Time’ panel
at this year’s Vision UK
conference, the leading
eye health and sight loss
sector conference.
In addition he has made
several documentaries for
Radio 4. Gary has also been
a contributor to and
presenter of the In Touch
programme for blind and
partially sighted people.
A record 261 delegates from
eight different countries, and
118 exhibitors on 50
exhibition stands, took part
in Eyecare3000 2014 at the
Glagsow Hilton on 19 and 20
January.
Mr O’Donoghue said: “I look
forward to chairing the
Question Time panel at this
year’s Vision UK conference.
I think this will be a great
forum to openly discuss
developments and the big
issues in the eye health and
sight loss sector, and will
hopefully get delegates
thinking about what actions
need to be taken to
improve services for blind
and partially sighted
people.’’
Ophthalmologist Mike Lavin
kicked off the conference
with a presentation on the
latest treatments for retinal
vein occlusion. Over the two
days there were 14 lectures
and 12 workshops on a
diverse range of topics from
binocular vision and
children’s vision to red eye
workshops, marketing
seminars and contact lens
peer review.
The ‘Question Time’ session
will give delegates the
opportunity to question key
leaders on issues
surrounding eye health and
sight loss. Blind since
childhood, Mr O’Donoghue
has had a number of
reporting roles at the BBC.
He has been a general
reporter on the Today
programme and the World
Tonight as well as a
presenter on the BBC World
Service.
Register at
www.vision2020uk.org.uk n
Step up for College
director
Ian Humphreys has moved from the role of director of
membership services and communications at the College
of Optometrists, a position he held for the last six years, to
deputy chief executive.
In this new position, Ian will focus on developing an
integrated and strategic approach across education,
research and other functions in order to meet the evolving
and growing requirements of College members.
Ian said “I am delighted to be appointed to this new role at
this time in the College’s development. There are many
areas of our work, including our research and educational
provision, which are developing fast and we must ensure
they meet the needs of our members, their employers, and
the various policy makers. “ n
Perceptive, the CET
company behind
Eyecare3000 and the
education at Optrafair, also
ran a series of interactive
workshops within the
exhibition hall allowing
delegates to get hands-on
with the latest products from
Zeiss, Spectrum Thea and
Abbott Medical Optics. The
format will be repeated at
Optrafair London this month.
The social side of the event
was an indoor Victorian
funfair complete with hooka-duck, high striker, rifle
range, candyfloss and
fortune teller. The next
Eyecare by Perceptive will
take place on 18 and 19
January 2015, again at the
Glasgow Hilton. n
ABDO CET
Telephone 01206 734155
Fax 01206 734156
NEG joins Facebook and Twitter
The National Eyecare Group
(NEG), the UK’s largest
purchasing group for
independent opticians, has
launched a Facebook
page and Twitter account
(PK_NEG).
“With Facebook and Twitter
now being used so widely
within the independent
profession, it made sense for
us get on board with a new
social media strategy to
develop engagement with
our members and
prospective members,”
explained Phil Mullins, NEG
business development
director.
At Optrafair London this
month, the Group will be
offering 15 months for the
price of 12 on packages of
ECHO – one of the world’s
leading patient education
software package from
Eyemaginations. Visitors to
the stand will also be
offered a free six-month trail
of Optinet FLEX – the latest
software solution from NEG’s
IT division. n
24
dispensingoptics April 2014
Laura Keywood
Coveted award for
homeless project
Laura Keywood, a City
University pre-registration
optometrist working at
Moorfields Eye Hospital, has
been awarded a coveted
Naylor Prize for her
research with the homeless.
Her final year project,
entitled ‘Causes and
prevalence of preventable
visual impairment and eye
disease in homeless people
in East London’, used
information provided by
Vision Care for Homeless
People. With several
centres in the capital and
others around the country,
Laura took her data from
visitors to the clinic in
Whitechapel, which
operates as part of the
New guide to LOC
company model
Crisis Centre. The project
was supervised by Dr
Penny D’Ath, at City
University.
Elaine Styles, chair of the
charity, said: “The Naylor
Prize was set up in memory
of the late Dr John Naylor
at Manchester and it
solicits applications from all
UK optometry schools so it
is a great achievement for
Laura to have won one of
these highly sought after
awards. We hope the
awareness created will
encourage more within the
world of optics to support
our very worthwhile charity
– volunteers and
fundraisers are always
needed. n
LOCSU has published a new
guide aimed at
commissioners, which
explains the benefits of the
LOC Company Model.
‘The commissioners’ guide
to primary eyecare
companies’ has been sent
to every Clinical
Commissioning Group in
England, and outlines the
benefits to commissioners
in using a company set up
by a Local Optical
Committee. It also
summarises how
commissioning community
eye health pathways can
reduce pressure on existing
NHS services and help
prevent avoidable sight
loss.
Katrina Venerus, managing
director of LOCSU, said:
“LOCSU created the LOC
Company Model in 2008
ready for single provider
commissioning. The model
is now used as a
contracting vehicle to
enable a network of local
practices to deliver
community services –
capitalising on the NHS
reforms. This guidance
explains how Primary
Eyecare Companies
addresses commissioners’
needs by helping them
meet their local health
priorities and national
targets as well as reduce
the administrative burden
through managing a single
contract.” n
Illegal online contact lens sales targeted
The General Optical Council (GOC)
has launched a consultation on its
approach to tackling illegal practice
– including online contact lens sales
that do not comply with UK law.
The regulator is proposing to take a
more creative and proactive
approach to reducing public harm
through measures such as raising
awareness among contact lens
wearers of the importance of regular
check-ups and following aftercare
advice, promoting a voluntary code
of practice for online contact lens
suppliers and extending its
collaboration with other bodies with a
role in enforcement and promoting
public health.
Other proposed measures include
producing new consumer guidance
and continuing to handle cases in
line with the GOC’s prosecution
protocol.
Alistair Bridge, GOC director of policy
and communications, said: “We face
significant challenges in stopping
certain types of illegal practice such
as the supply of contact lenses via
overseas websites that do not
comply with UK law. That is why we
are proposing to take a more
creative and proactive approach.
“It will be vital for all interested parties
to work together to effectively tackle
these issues, so I look forward to
hearing our stakeholders' views on
the proposed strategy and how we
can collaborate to take it forward,”
added Alistair.
The strategy has been informed by
independent research commissioned
last year into the risks to the public
posed by illegal practice. The GOC
has published this research alongside
the consultation, which will run until 3
June. Visit www.optical.org n
Newsbrief
Formby branch celebrates
Peter Black receives Long Service
Award
Celebrations at annual
Input sought
for EDI scheme conference
Registrants have until 19 May
to take part in a consultation
on the General Optical
Council’s (GOC) proposed
Equality, Diversity and
Inclusion (EDI) Scheme, which
is designed to ensure these
principles are embedded
throughout its work.
The scheme includes
proposals to ensure fair
access to GOC services; to
ensure that all staff,
registrants, council and
committee members are
adequately trained and
informed of their duties in
respect of equality, diversity
and inclusion; and to
gather more data to better
understand the makeup of
the optical professions.
Gareth Hadley, GOC chair,
said: “Reaffirming and
reinforcing our commitment
to the values of equality,
diversity and inclusion is
important to ensure that our
services and those provided
by our registrants,
businesses and individuals
alike, are accessible to all
members of the public.
“I encourage all
stakeholders, and
particularly individuals and
groups representing those
with protected
characteristics, to take a
look at our draft scheme
and let us know if we've got
it right,” Gareth added. Visit
www.optical.org n
Conlons Opticians’ Formby
practice was announced
the branch with the highest
increase in Zeiss lens sales
over the year at the
company’s recent
conference at the Marriott
Hotel in Broughton, Preston.
Conlons director, Peter
Barton, said: “I would like to
thank Carl Zeiss Vision for
their continued support
and we were delighted to
have Suzie Walder and
Keith Cockram both from
Carl Zeiss to share our gala
dinner with us and to help
present the prizes. The
Formby branch have had a
fantastic year and I would
like to thank each and
every one of them for the
hard work they put in.”
Situations Vacant
If you have a job vacancy in your practice, please remember that the
Situations Vacant section in the Bulletin Board area of the ABDO
website provides you with a quick and easy facility to
advertise completely free-of-charge.
Also during the event,
ABDO president Peter Black
received a Long Service
Award for his time and
dedication to the
company. Peter lives in
Ormskirk and joined
Conlons Opticians 25 years
ago. Presenting him with his
award, Peter Barton said:
“Peter has had a hugely
positive impact on our
business and he has
consistently provided a top
level of service to the
company. He has proved
that his positive attitude
and excellent customer
service and management
skills are a winning formula
for success.” n
New sight loss stats
Voucher values fall short
The Optometric Fees Negotiating Committee (OFNC) has
been told of the proposed increases in optical voucher
values in England, Wales and Scotland from 1 April 2014,
while awaiting confirmation of the increase in Northern
Ireland.
OFNC secretary, Richard Carswell, said: “The two per cent
increase offered by the government is welcome. It does
not, however, compensate providers for the rises in the
cost of spectacles, which they will have to fund whilst
striving to offer a range of high quality frames and lenses
to meet all prescriptions.
“The OFNC had asked for a reasonable increase of 3.5 per
cent. Clearly, the Treasury felt unable to oblige. However,
the long-term undermining of voucher values for NHS
patients can only be detrimental to those patients at high
risk or on low incomes who require vision correction as this
may deter them from seeking care.” n
The UK Vision Strategy
Partnership has launched a
comprehensive eye health
and sight loss statistics
report for England.
The report brings together
data for England on all
aspects of eye health and
sight loss including: the rate
of Certification of Vision
Impairment; the numbers
registered with sight loss or
severe sight loss; sight tests;
outpatient and inpatient
information including
waiting times; and
expenditure on eye care
and treatments. To read
the report visit
www.vision2020uk.org.uk/uk
visionstrategy/statistics n
26
dispensingoptics April 2014
Rawlings scoops Menrad prize
Professor Sunil Shah will undertake a
‘live’ surgery session at #BCLA2014
Window display scores
top marks
New two-day package
for #BCLA2014
Rawlings Opticians of Chandlers Ford has been rewarded
for achieving the top spot in Menrad Optics’ winter 2013
‘Best dressed window competition’.
The British Contact Lens
Association (BCLA) has
launched a new two-day
value package for its 38th
conference and exhibition,
being held at the ICC
Birmingham from 6-9 June
(official hashtag #BCLA2014).
Chris Beal, managing director of Menrad Optics,
presented the prize of £250 worth of vouchers for Pride of
Britain hotels and restaurants to staff at the practice
following the competition close.
Chris said: “We were delighted with the response to the
competition and judging an outright winner proved
immensely difficult given such a high standard. We
certainly have worthy winners in Rawlings Opticians.
Menrad believe window displays are hugely important in
helping to get brand messages across to patients and as
such support independent practices by providing point of
sale marketing material free of charge.”
Pictured from left are: Sue Barker (receptionist), Pauline
Herbert (frame stylist and buyer), Chris Beal and Claire
Shipway (practice manager and dispensing optician). n
Situations Vacant
If you have a job vacancy in your practice, please remember
that the Situations Vacant section in the Bulletin Board area of
the ABDO website provides you with a quick and easy
facility to advertise completely free-of-charge.
The package covers Sunday
8 June and Monday 9 June
and is aimed at
independent practitioners
who find it difficult to take a
Friday and/or Saturday out
of practice. It provides a
saving of £50 when
compared to booking the
two days separately, and
includes entry to CET
sessions, the exhibition,
Exhibitors’ Pavilion and a
new Sunday night
‘Unceremonious Event’ – a
free and informal networking
evening with drinks and a
‘Best of British’ buffet.
Highlights of Sunday’s
programme include: a
business session; therapeutics
and contact lens peer
review; Professor Bruce
Evans’ keynote address on
paediatric contact lens
practice; and a new ‘On the
sofa’ session with Professors
Phil Morgan and Lyndon
Jones. Meanwhile, Monday
will see the conference’s firstever ‘live surgery’ event with
Professor Sunil Shah, CET
workshops, a specialty lens
spotlight, and Professor Phil
Morgan’s BCLA Medal
Address, ‘Changing the
world with contact lenses’.
Any full BCLA member who
has not attended a BCLA
conference since 2010 can
apply for one of 100 free
delegate places. This
package also covers the
Sunday and Monday,
overnight accommodation
on Sunday night, and entry
to Sunday’s ‘Unceremonious
Event’. For details visit
www.bcla.org.uk n
Survey reveals poor vision behind the wheel
More than a third of drivers questioned in a survey by the
Sight Care Group admitted that they can’t see properly
when they drive.
A quarter said that they couldn’t see well when driving at
night, and 11 per cent revealed that their daytime vision
was ‘blurry’ when they were in their cars.
Five per cent of new drivers surveyed admitted that they
struggled to see the registration plate during the brief
vision assessment that was part of their driving test – but
were given their driving licence anyway.
The survey results come as a consortium, led by the road
safety charity Brake, is urging the government to look
again at legislation that governs the sight testing
standards for new drivers. The consortium recommends
that all new drivers should have their vision tested by a
qualified optician when they first apply for a licence.
Paul Surridge, Sight Care chief executive, said: “Our
survey shows that more than a third of people admit that
their vision isn’t good enough when they are driving. This is
pretty shocking when you consider what the
consequences could be.” n
28
dispensingoptics April 2014
Staff from Ellis & Killpatrick
‘Lilac ladies’ run
Bath Half
Area 11 (London): lively
meeting with AMD focus
Staff from Ellis & Killpartrick took part in the Bath half
marathon last month, in aid of the Luxottica charity One
Sight.
Report: Ian Anderson
More than 80 members
attended the London Area
meeting on 25 February at
the Holiday Inn, Bloomsbury.
There was a very interesting
and informative lecture on
‘Macular pigment and its
role in vision’ by Dr Mark
Kirby. He pointed out that
AMD sufferers could benefit
from good diet or
supplements, like
Macushield or Macushield
Gold, and that young sports
enthusiasts with a high
protein diet may also suffer
from low pigment at the
macular. A ‘good diet’
meant plenty of fresh fruit
and green vegetables, and
having supplements would
help us deal with the blue
All seven members of the Bath practice team, whose
ages ranged from 17 to 30, finished the 13.1 miles in times
spanning from two hours and 10 minutes to just over three
hours – and all despite the driving rain and wind.
“The team wore matching lilac tops and got the
nickname ‘The lilac ladies’ from other runners,” said Louise
Barrington of the practice. “Only one member had ever
taken part in a running event before, so it really was a
fantastic achievement.” The team is aiming to raise £1,000
from sponsorship. n
Benevolent Fund If you know of a dispensing optician, or a
dependant of a dispensing optician, who might benefit from the
ABDO Benevolent Fund please get in touch with Jane
Burnand on 020 7298 5102 or write to her at ABDO,
199 Gloucester Terrace, London W2 6LD
light around us – and light
scattering at night.
Mark’s presentation was
followed by a great ABDO
workshop on ‘Ocular signs
and symptoms’. In groups of
10, members discussed
various pictures of eye
conditions and what action
should be taken if seen in
the practice. Frances
Mecoy led this session,
asking each group for their
comments. There was lots of
lively chatter and laughter
with new friends made and
some networking done; all
this and four interactive CET
points too. The Area’s next
meeting is on the evening of
15 May, with venue and
content to be announced. n
TV ad takes ‘look through the lens’ tack
A new TV advertising campaign from
Transitions Optical kicks off this month,
featuring the adaptability of Transitions
everyday lenses, giving the viewer a “looking
through the lens” experience.
The new commercial builds on the company’s
Life Well Lit campaign by featuring a dimmer
switch placed in the scene, which adjusts
depending on the conditions the wearer is
experiencing. Through a variety of different
lighting conditions, the TV spot shows how
Transitions lenses are responsive to changing
light outdoors making things look more vivid
and optimising vision throughout the day.
“Transitions Optical is constantly innovating to
create new products that enhance the
everyday visual experience of our wearers,”
said Mylène de Saint Pierre, brand marketing
director EMEA, Transitions Optical. “The new
Transitions campaign is a focused effort to
raise consumer awareness and create desire
for the brand and our lens technology, which
offers them added value beyond what an
ordinary clear lens can give them.”
In testing with consumers, the new TV ad was
shown to create a stronger preference for the
Transitions brand, as well as a view that
Transitions lenses have “the latest technology.”
The spot ends by encouraging the viewer to
ask their optician for a Certificate of
Authenticity. The ad runs to 30 June on most
commercial channels and is supported with
an online campaign. n
Transitions takes to the tube
Newsbrief
William Morris London exhibits at 100% Optical
iDay expands for 2014
100% Optical
“a big hit”
Independents event
spreads its wings
The Association of Optometrists (AOP) has hailed the
inaugural 100% Optical trade show, held in London in
February, as a “big hit” on the back of feedback from
delegates, exhibitors and industry professionals.
Proven Track Record (PTR) is
expanding its annual
Independents Day (i-Day)
and Night (i-Night) events
for 2014.
A major supporter of the show, the AOP reported
attendance figures supplied by 100% Optical organiser,
Media 10, as reaching 5,483 (ABC Audit pending)
optometrists, opticians, buyers and industry figures.
Henrietta Alderman, AOP chief executive, said: “100%
Optical has been a great success, bringing together world
class CET with industry-leading innovators.
“Our members have enjoyed a VIP show experience that
delivered a fresh approach to optics. Our education
programme was a sell-out success, with 101 CET points on
offer throughout the show. With exhibitors already booking
stands for next year’s event, we are delighted that 100%
Optical has become one of the leading events of the
optical calendar,” Henrietta added.
100% Optical will return to London ExCel next year on 7-9
February. www.100percentoptical.com n
Impression lens promotion
Customers are being invited to take part in Rodenstock’s
Impression Promotion 2014, with discounts on list prices
and the chance to win high Bang & Olufsen audio
equipment.
Between now and the end of April, the company is
offering special lens and glazing net prices equating to at
least 40 per cent off list prices for all practices who register
for the promotion. The discounts include glazing and
remote edging. Rodenstock lens product manager,
Debbie Bathgate, said: “This is a great opportunity for
opticians to enjoy pitch perfect prices, together with
superlative sound. This promotion gives independent
practices the chance to continue building their sales of
our range of Impression lenses.”
To register for the promotion 2014, telephone 01474
325555. n
The annual business
symposium, networking
dinner and exhibition,
dedicated to those who
practise in the independent
sector, will this year be held
at the Hilton Birmingham
Alcon begins
rebranding process
Alcon has announced that
it has begun the process of
changing the name on all
existing CIBA Vision products
– to Alcon.
“What this means is that the
same CIBA Vision product is
now supplied with the Alcon
brand name visible on all
packaging of contact lens
and lens care products
including all relevant
labelling and directions for
use,” said a spokesperson,
who added that there
would be a transition period
during which practices may
receive product with either
name.
Alcon customers can
request, through their
relevant Alcon business
development manager, or
via www.myalcon.co.uk,
updated pack shots and
images for all products to
help with updates on
websites and marketing. n
Metropole on Sunday 6 and
Monday 7 July.
The free-to-attend iShow
exhibition extends to one
and a half days, opening
on Sunday lunchtime and
running all day Monday. It
is open to all independent
practitioners whether they
attend i-Day or not.
Similarly, a free Sunday
session is open to all
independents. The theme of
this year’s iDay is
‘Differentiate to thrive: how
to survive in an age of killer
competition’.
PTR co-director, Nick Atkins,
commented: “This year’s
iDay will be focusing on the
importance of independents
differentiating their offering,
not just from the multiples,
but from each other as
well.” Following its
popularity last year, PTR will
repeat its mystery shopping
research, funded by
Johnson & Johnson Vision
Care. It will be carried out
amongst 50 attending
practices and the results
shared during the meeting.
Practitioners planning to
attend who are interested
in having their practice
participate in the mystery
shopping project free-ofcharge, should contact
Nick Atkins on nick.atkins@
proventrackrecord.co.uk.
For full details of the event,
visit www.independents
day.co.uk n
30
dispensingoptics April 2014
BCLA 2013 winning image
Plan ahead with the BCLA app
BCLA launches mobile app and calls for
photo competition entries
The British Contact Lens
Association (BCLA) has set a
deadline of 25 April for keen
image takers to submit their
entries for its 2014
photographic competition.
The competition invites
submissions of images
showing any aspect related
to contact lenses and/or
the anterior eye, and
culminates during the
Association’s annual
conference – this year
being held at the ICC
Birmingham from 6-9 June. It
is open to BCLA members
and non-members alike.
As well as receiving the
accolade of best
photograph of the year and
a great prize, all winning
entries are subsequently
published in the BCLA peerreviewed journal, Contact
Lens & Anterior Eye.
Submissions must be made
online at
www.bcla.org.uk/events.
Our photograph above
shows last year’s winning
image by Fabrizio Zeri from
Italy – ‘Hyperferritinemia
cataract’.
The Association has also
announced the launch of its
first-ever mobile app.
The free app can be
downloaded from the
Google Play Store for
Android or the Apple iTunes
Store for iOS devices –
including desktop
computers. Key features of
the app include: instant
access to the conference
programme, speaker
information, exhibition and
sponsor details, venue,
maps and floorplans; quick
links to the BCLA website for
travel, accommodation,
social events and contacts;
access to social networks;
and exhibitor listings
including product details
and the opportunity to
contact suppliers prior to
the event.
Jashan Bahia, BCLA
marketing manager, said:
“We will be updating the
app at various stages in the
lead-up to the conference
as well as incorporating
additional features. These
will include, for instance,
downloadable abstracts,
venue maps and
programme updates. We
are extremely excited about
this new tool for members
and delegates, and would
encourage all those
planning to attend the
conference to make full use
of all its great features and
benefits.”
* The deadline for BCLA
Fellowship applications is
Monday 14 April. Apply
online at www.bcla.org.uk n
Time to drill down on lab work
Find out what’s new in lab equipment by visiting Optrafair
London at Olympia National from 11-13 April.
machine,” said Danny Van Goethem, director of Norville’s
Equipment Division.
Many exhibitors at the show will be focusing on the
message that new, highly automated technology with
algorithms for modern lens options mean today’s lab skills
are less challenging. Paul Cumber, Essilor Instruments
manager, said: “For many years, Kappa and Gamma
have been the market reference for quality, high
performance edging systems. These models are now
being superseded by a brand new system called Neksia,
which will be launched at the show.”
Mainline Optical connections director, Paul Artley,
believes manufacturing and the glazing laboratory has
sometimes been considered to be the ‘less glamorous’
facet of the industry, but this view is now changing and
will be demonstrated at Optrafair London with working
systems in action. Birmingham Optical is launching a
range of new products with live demonstrations, including
the Nidek LE-700 three-in-one glazing station.
Norville will be promoting the compact Briot equipment
favoured by in-practice labs, and Weco technology for
heavier workloads. “Space is sometimes an issue but we
have a range of footprints to fit the most awkward
locations with technology offering tracing, blocking,
edging, drilling, grooving and finishing all in one
Dibble Optical will be releasing its new workshop
catalogue, plus an assortment of tea-bag tints in all
popular colours plus many other consumables associated
with the tinting process. For those looking to up-skill the
lab team, the Worshipful Company of Spectacle Makers
will be promoting its qualifications to suit all levels of
manufacturing technicians. www.optrafair-london.co.uk n
Newsbrief
Frequently asked
questions
answered by
Kim Devlin FBDO (Hons) CL
New Fusion by Stepper
Niche range ‘on
the nose’
Fusion by Stepper is a new collection of frames designed
specifically to fit those with a more challenging bridge.
“For example, many Asian faces have a very shallow or
wider bridge,” explained MD Richard Crook. “Following
our ‘Eyewear fashion that fits’ mantra, Fusion by Stepper is
a modern, high quality collection with a distinct
positioning within the Stepper portfolio.”
Designer Hans Stepper added: “To achieve a good fit on
the nose you must have knowledge of the best fitting
angles for gender and ethnicity – this understanding
translated into good design makes all the difference.”
Stepper frames are designed in 3D to match the contours
of the face. With Fusion by Stepper, the fitting possibilities
are extended further with exchangeable pads on several
of the TX5 models.
The launch collection comprises seven gents and five
ladies models, each available in three colours. n
Optician Index - January 2014 summary
• Total practice turnover increased by 4 per cent on
last month to 162 Index points but this is 3 per cent
lower than last January
• Total eye examinations improve by 15 per cent on
December 2013 now at 96 Index points which is also
15 per cent lower than last January
• Turnover per eye examination increases by just over
£3 from last January to £170
• Average dispensing rate increases by 2 percentage
points from last month to 64 per cent which is
2 percentage points lower than January last year
• Re-glazes decrease by 1 percentage points to 13 per
cent of spectacles dispensed from last month and
this is 2 percentage points lower than January 2013
• Anti-reflective coatings reduced by 2 percentage
points from last month to 43 per cent and this is
2 percentage points higher than January last year
The full January 2013 Optician Index report was published in the 28
February 2014 issue of Optician
Patients requesting their records
The question this month is a typical one: our member had a
patient who misunderstood a situation and demanded
something the member was not happy to give.
Patients are often well versed in their rights and may demand
that you give them their ‘records’. What do you, as a
registered DO, actually have to give them? The law is quite
clear; the patient is entitled to a copy of their prescription at
the conclusion of their eye examination, this is the case be it
private or NHS. There is a small exception, when a patient is
referred to a medical practitioner, when there may not be a
prescription to issue. Of course, then the practitioner would
give a copy of the referral letter to the patient.
But what about when a patient demands their records? What
is your responsibility then? Again, the law is quite clear; a
patient is entitled to a copy of their records – but not the
actual pieces of paper held by an optician. Notice must be
given, 28 days is usual, and a reasonable charge can be made
for the administration of such a request, up to £50, but copies
of all the records held must be given. If a patient doesn’t
understand something on the record, they have the right to
an explanation. If they disagree with some point, they have
the right to have it changed.
You can see this is not a quick procedure, nor something
anyone wishes to do lightly. It is, however, becoming more
common in our litigious society and so is something all
practices should be aware of and have a policy to deal with
any such a request. In this case, it was a misunderstanding;
the patient really wanted their prescription but was confused
and asked for their records. The practitioner, knowing the
patient had been given their prescription, was very troubled
by the request, wondering why on earth the patient would
want such a thing.
Communication is always the key. Patients and customers
rarely ask straightforward questions, which makes helping
them difficult if not impossible. The sketch, now a classic,
from The Two Ronnies, in a hardware shop with Ronnie
Corbett asking for ‘four candles’ – and Ronnie Barker getting
in trouble when he didn’t supply a ‘fork handle’ – illustrates
wonderfully how challenging a simple request can become.
The secret is never to assume that your patient is asking for
something complicated, indeed 99 per cent of the time what
the patient requires is quite simple. The hard part can be
explaining what they actually need.
Kim Devlin is chair of ABDO's Advice and Guidelines Working
Group n
32
dispensingoptics April 2014
Nick Howard reflects on the visual genius of French
impressionist Monet on a trip to the French Riviera
Fifty shades of
green
Nick Howard
C
atapulted away from the relative
comfort zone of the North West of
England to a life on the sunny shores
of East Sussex, where William the
Conqueror rudely excavated King
Harold’s eye almost a thousand years
ago, my ongoing adventures took me
one day to Ashford International, a
hop, skip and a jump from the ABDO
College at Godmersham. The
inevitable wrong turn as I left the
railway terminal made me realise that
it may now be just as easy (and
possibly quicker) to get to Paris as
London. My mind wandered as I
thought briefly of that cultural centre
of France and a little of its legendary
background.
Grinning, I considered how my
perverse sense of direction and inane
ability to take left instead of ‘right’
had resulted in a history of
entertaining detours and accidental,
at times, bizarre encounters, allowing
this raconteur to amass an arsenal of
stories and tales. I thought about a
visual raconteur who, 125 years ago,
had explored the length and breadth
of his own country to experience and
savour all it had to offer.
In the eye of the beholder
In 1888, a remarkable year in which
Jack the Ripper terrorised the streets
of London and the Eiffel Tower first
attacked the Paris skyline, two
Europeans were trying to create a
rather more ‘pleasing on the eye’
sensation. Adolf Fick developed the
first ‘wearable’ contact lens to
challenge the ravages of
keratoconus, whilst Claude Monet,
already a recognised Parisian painter,
moved (temporarily) to capture the
beauty of the south of France. There,
Monet produced more than 40
brilliant pieces of work in just four
months, as he soaked up the sun on
the Mediterranean coast, living and
working in and around Antibes on the
Côte d’Azur – the blue coast.
An avid outdoor painter, he
described the light, particularly the
‘blue’ light. In a letter to one of his
Dutch friends, Monet wrote: “I am
very worried about what I am doing.
It is beautiful here, so clear and
luminous! You are bathed in blue air,
it’s frightening”. Determined never to
be a pauper, Monet’s incredible
output almost matched his talent, but
the determination to work in ‘natural’
light, ‘en plein air’ – out of doors, was
to have a massive impact on his later
years.
Moving back to Giverny on the
outskirts of Paris, Monet could afford
to buy and develop the surrounding
land and gardens where he shaped
the landscape that pleased his vision
and his view. Ever-changing seasons
with ever-changing combinations of
greens and blues pleased his visual
system. The famous Japanese bridge
vaulting the water lilies was a painting
repeated many, many times in
multiple and varied shades of green
over the years. But as the years
passed, Monet developed dense,
nuclear cataracts which altered his
perception of colour – and much of
his ongoing work reflected changes
in the way he saw colour and
interpreted the world.
It seemed that Monet was not the
only Parisian painter seeing the world
in ‘different colours’: his friends
Cezanne and Renoir produced work
which supported the ‘impressionist’
era with their vague and undefined
outlines. But theirs was simply
because they had uncorrected
myopia and struggled to see the
subject matter, whilst Vincent van
Gogh’s xanthopsia resulted in the
very aggressive use of yellow on his
palette, wildly, sometimes violently,
exaggerated by substance abuse.
Cezanne once remarkably
exclaimed: “Take away those vulgar
things!” when presented with a pair of
corrective spectacles. Now, where
have I heard that comment before?
Onset of visual despair
Monet’s abilities extended in time to
being able to make his own personal
reflection statements in his work. The
weeping willows behind the
Japanese bridge and the greying,
tearful green reflections in the water
were his own visual statements of his
sadness and subsequent depression,
as he observed trains packed with
troops being hurriedly transported to
the First World War battlefields. Post
war, Monet’s anger and frustrations
grew as the density of the cataracts
developed.
Having seen several Paris
ophthalmologists, Monet used dilating
drops in his left eye, which for a while
delighted as peripheral vision was just
temporarily restored. He made the
reluctant decision to have surgery on
the right eye in 1923 at the age of 82.
The result of surgery was way below
Monet’s high expectation. It is
reported that he ripped off his
bandages and proclaimed his
Disjointed jottings from a DO’s desk . . .
complete disappointment in visual
standards – adamantly refusing to
have surgery on his left eye –
although it is reported that his
corrected vision in spectacles was
actually quite good following this
invasive procedure.
One can only try to imagine the
scenario now. Colour and vision is
Monet’s life, but the left eye is still
clouded by cataract and the right
eye is aphakic with the correcting
lens presumably around the +10 to
+12 dioptre mark. And although the
surgical technique was considered
quite safe at that time, the resultant
anisometropia, hence diplopia,
combined with influx of additional
‘blue light’ along with a hefty
expectant three-dioptre cylinder in
the post-operative eye, will have
created aberrations and distortions,
leaving the stunningly talented
painter in visual despair. Monet
described the effect of a correcting
spectacle lens in 1923 as ‘utterly
terrifying’, although this was improved
in 1924 by what appears to be an
early ‘best form’ lens.
Challenging visual limitations
Having produced some of the finest
art, with a combination of
brushstroke, colour and hue the world
may never see again, the extensive
galleries in Paris reflect the varied
torment and torture of the visual
system twisted, warped and
handcuffed away from its original
and desired position. More
importantly, the same galleries reflect
the absolute genius, the desire,
courage and dogged determination
to challenge these visual limitations. In
a rage, borne not out of anger but
sheer visual frustration, Monet
smashed and destroyed much of his
later works. Some were rescued,
some were repaired, some were
recovered and repainted by a
repentant Monet himself, but some
were lost forever.
The final years of Monet’s life were
spent painting – massive murals in all
shades of blue and green. At his
beloved home in Giverny, just outside
The famous Japanese bridge vaulting water lilies in Monet's garden
Paris, photographs show a bearded
Monet, sporting a lazy cigarette,
wearing a wide brimmed hat. It is
documented that at this time he
would not go outside in the midday
sun.
and cushioned by contact lenses. I
pulled down on the peak of my cap
and put on my dark green shades –
just in case I was recognised by the
French police . . .
As I sipped a glass of champagne in
a beachside restaurant in the
spectacularly pretty town of
Villefranche, just a hop, skip and a
jump from Antibes on the French
Riviera, I thought again of Monet. The
vista was quite breathtaking: a fusion
of pleasures on the eye – clear, sunny,
beautiful and undisturbed with
myopia fully corrected, protected
Nick Howard FBDO Hons CL, FBCLA, is
a contact lens optician working as
clinical support manager for No7
Contact Lenses and part-time in an
award winning practice in Lancashire.
A BCLA Fellow and Faculty Speaker
with a special interest in complex
contact lenses, he is also a trainer at
universities and conferences at local,
national and international events. n
Diary of events
dispensingoptics
11-13 April
delegate or exhibitor or would like to
Optrafair London - Exhibition, Olympia
find out about sponsorship packages,
National. For details visit
contact the UK Vision Strategy team
www.optrafair-london.co.uk
on [email protected]
11 May
24 & 25 June
Area 3 (North West) - Low vision skills
J&J Vision Care - ‘Practice made
workshop, Manchester Royal Eye
perfect – bringing it all together’, twoHospital, Oxford Road, M13 9WL. Book
day course offering eyecare
online at www.abdoevents.org.uk
professionals in Independent practice
13 May
proven tips to grow their CL business,
ABDO annual meeting - 5pm, Pullman
along with the tools and resources to
Hotel, 100-110 Euston Road, London
do it, at the Vision Care Institute,
NW1 2AJ. For details contact Jane
Wokingham. For details visit www.the
Burnand - [email protected] visioncareinstitute.co.uk/tvci-courses
13 May
26 June
Area 10 (Kent) - CET evening, 6.30pm
Area 7 (West Country) - CET evening,
buffet for 7pm, Canterbury Cathedral
Exeter. Details to follow
Lodge, Canterbury Cathedral, The
6 & 7 July
Precincts, Canterbury, Kent CT1 2EH.
Independents Day - i-Day and i-Night,
For details contact Julian Silburn Hilton Metropole, Birmingham. For
[email protected]
details visit www.independentsday.co.uk
14 May
8 July
ABDO - President’s Consultation Day,
ABDO Golf Society - Challenge Cup
Medical Society of London, Lettsom
competition, Moseley Golf Club,
House, 11 Chandos Street, London
Birmingham. To play in this event or to
W1G 9EB, all ABDO members are
join the ABDO Golf Society please
invited and welcome to attend. To
contact Mike Stokes at
confirm your attendance email Jane
[email protected]
Burnand at jburnand@abdolondon.
16 September
org.uk or call her on 020 7298 5102
ABDO Golf Society - Stercks Martin
15 May
Salver competition, Horsley Lodge Golf
Area 11 (London) - CET evening,
Club and Hotel, Derbyshire. For detials
London. Details to follow. Book online
or to join the ABDO Golf Society
at www.abdoevents.org.uk
contact Mike Stokes at
26 and 27 May
[email protected]
Identity Optical Training - FQE Practical 18 September
Exam Revision courses, £75 per day,
Area 7 (West Country) - CET day,venue
Birmingham. For details contact Sally
one - details to follow
Bates on 020 8504 0967 or email
2 October
sal_bates@hotmail.
Area 7 (West Country) - CET day,venue
6-9 June
two - details to follow
BCLA - 38th BCLA Clinical Conference
27 & 28 October
& Exhibition, Birmingham. For details
J&J Vision Care - ‘Practice made
visit www.bcla.org.uk
perfect – bringing it all together’, two12 June
day course offering eyecare
Vision UK 2014 - Eye health and sight
professionals in Independent practice
loss sector conference, The Queen
proven tips to grow their CL business,
Elizabeth II Conference Centre, Great
along with the tools and resources to
College Street, London SW1P 3RX. If
do it, at the Vision Care Institute,
you would like to register your interest
Wokingham. For details visit www.the
in attending the conference as a
visioncareinstitute.co.uk/tvci-coursesn
Please check event details online for up-to-date information at
www.abdo.org.uk
ABDO members are welcome to attend Area meetings in any area they wish
The Professional Journal of the Association
of British Dispensing Opticians
Volume 29 Number 4 of 12
EDITORIAL STAFF
Editor Sir Anthony Garrett CBE
Assistant Editor Jane Burnand
Production Editor Sheila Hope
Email [email protected]
Features and News Editor Nicky Collinson
Email [email protected]
Administration Manager Deanne Gray
Email [email protected]
ADVERTISEMENT SALES
Telephone 01892 667626
Email [email protected]
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Apply to Tom Veti
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Kent CT4 7DT
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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 01206 734155
Email [email protected]
Email [email protected]
CONTINUING EDUCATION REVIEW PANEL
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
Paul McCarthy FBDO PG Cert HE FHEA
Angela McNamee BSc (Hons) MCOptom
FBDO (Hons) CL FBCLA Cert Ed
Edwin Moffatt FBDO
Linda Rapley BSc FCOptom
JOURNAL ADVISORY COMMITTEE
Richard Crook FBDO
Kim Devlin FBDO (Hons) CL
Kevin Gutsell FBDO
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 2013: 9133 per issue - ABDO
Board certification
www.abdo.org.uk