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dispensingoptics
Dispensing Optics PO Box 233, Crowborough TN6 9BD Telephone: 01892 667626 Fax: 01892 667626 Email: [email protected] November 2012 Website: www.abdo.org.uk DO November 2012_1 19/10/2012 09:47 Page 2 DO November 2012_1 19/10/2012 09:47 Page 3
3 dispensingoptics CONTENTS
November 2012
3 Cover point
Cover point 4 Continuing Education and Training Single vision lenses - now it’s personal by Anthony Blackman
10 Patient and practice management Practice pricing: what you need to know by Antonia Chitty
important as we are now fully 13 Frequently asked questions compliant with the 2006 Companies by Kim Devlin Act. 14 Ophthalmic lens The motion to change the name of Tint teaser the Association was defeated, so the by Frank Norville A weekend to remember Association name stays as it is. The The Association’s conference in Board kept to the undertaking made 16 ABDO conference and Stratford-upon-Avon at the end of at the AGM held in Brighton in 2009 to exhibition 2012 Much ado about conference September exceeded all bring forward proposals regarding a by Nicky Collinson expectations. Once again, Elaine change of name and to consult the Grisdale and our conference whole membership. This process is 26 BCLA news organisers, Event Exchange, pulled now concluded. Life in the fast lane out all the stops and put on a weekend that all members can be At the conference gala dinner, ABDO 28 Newsbrief proud of. President Jennifer Brower was able to confer Honorary Fellowship on two of 29 The President’s diary the Association’s most stalwart The AGM was well attended and the by Jennifer Brower results of the two key ballots were supporters - Frank Norville OBE and announced. A substantial majority Malcolm Polley. Both Frank and 36 Optician Index Malcolm have done so much for approved the new Articles of August 2012 summary Association – which is particularly optics through their involvement with the FMO that it was a real pleasure to 38 Contact lens practice have them as guests of the The route to practising as a CLO Association and to recognise their by Rosemary Bailey friendship and support. 35 Diary of Events This is the last year that we will be holding our AGM and conference in the autumn. Next spring we will be holding our AGM at Optrafair in April and our next conference will be in the spring of 2014. n
ABDO works in partnership with: Front cover: Boris Becker wears 2013 Wimbledon Sunglass model R9955A from ABDO also activity works in conjunction with: Rodenstock The Worshipful Company of Spectacle Makers DO November 2012_1 19/10/2012 09:47 Page 4
4 dispensingoptics November 2012
Single vision lenses - now it’s personal by Anthony Blackman BSc(Hons) FBDO CL (Hons) SLD SMC(Tech) CertAcc(Open) MSB FRSPH FRI FInstCPD
Competencies covered: Optical appliances Target groups: Dispensing opticians, optometrists
Progressive power lenses (PPLs) that Monocular pupil distance and patient does not experience incorporate freeform surfacing vertical fitting heights unwanted prismatic effects. However techniques are now commonplace in With the use of appropriate horizontal the oblique power experienced by optical practices. Such lenses often and/or vertical centration the the patient as the eye rotates to view require additional measurements and practitioner aims to ensure that the through off axis points on the lens lifestyle information in order to may vary significantly from the provide a personalised lens for the prescribed back vertex power when patient. However, it is often forgotten Lens Brand Lens Name spherical surfaces are used. Figure 1 that the same technology can be BBGR Asphro PdM shows that as the eye rotates and its applied to single vision lenses. This Essilor SV-360 gaze moves across the lens, the article will look at the range of single Hoya Nulux EP power in oblique gaze vision lenses which are now available Kodak Digital SV (+4.25DS/+1.00DC) is significantly that can be customised. We will look Nikon Seemax SV different from the prescribed back at some of the extra measurements SeeStyle vertex power of +4.00DS. By altering required as well as addressing why DAS the lens geometry of the lens surfaces we take them. Norville Nortor SV we can improve the off-axis Rodenstock Impressions Mono performance of the lens, as both Rupp + Hubrach Ysis Single Vision What is available? spherical and aspherical surfaces can Seiko SPGAZ Table 1 shows a selection of Shamir Smart SV As Worn be used to give different effects 1 personalised single vision lenses which Sola Sola HD SV (Figure 2) . If an aspherical surface is are available in the UK; although not Zeiss Clarlet Individual employed surface power changes as an exhaustive list, it demonstrates that the eye rotates away from the vertex all the major manufacturers now offer of the aspheric surface. Aspherical Table 1: Some examples of free form single vision these lenses. lenses available surfaces are said to incorporate
This article has been approved for 1 CET point by the GOC. It is open to all FBDO members, including associate member optometrists. Insert your answers to the six multiple choice questions (MCQs) online at www.abdo.org.uk, or on the answer sheet inserted in this issue and return by 19 December 2012 to ABDO CET, 5 Kingsford Business Centre, Layer Road, Kingsford, Colchester CO2 0HT OR fax to 01206 734156. If you complete online, please ensure that your email address and GOC number are up-to-date. The pass mark is 60 per cent. C-19503 DO November 2012_1 19/10/2012 09:47 Page 5
Continuing Education and Training
T&S ST S T a b 40o 40o 40o
30o 30o 30o
20o 20o 20o Effect of lens is +4.00 Effect of lens is 10o 10o 10o +4.25/+1.00 +4.00 plano convex +4.00 plano convex 0o 0o 0o +3.0 +4.0 +5.0 +3.0 +4.0 +5.0 +3.0 +4.0 +5.0 a +4.00D, -6.00D base b +4.00D, -4.50D base c +4.00D, -4.50D base
Figure 1: How the back vertex power changes as the eye rotates. (Courtesy of Figure 2: The effect on changing the spherical surface curves on off-axis Professor Mo Jalie) performance. (Courtesy of Professor Mo Jalie)
surface astigmatism which is used to points; thus creating a bespoke, neutralise aberrational oblique personalised lens. astigmatism. Aspheric lenses are flatter, lighter and thinner than lenses Let us now look at these three extra with spherical surfaces. Unfortunately measurements which are common to the manufacturer can only produce many of the lenses given in Table 1. what they think is a good lens, Those discussed below are not without knowing how it will be placed universal to all personalised lenses, in front of the eye. The final “as-worn” and some may not require all three effect of the lens may therefore be additional measurements. different to the expected effect. When combined with the frame A Vertex distance and B measurements, the positioning Hopefully we are all used to taking Figure 3: An example of a freeform generator, the Schneider HSC Master of the optical centres will have an this measurement for powers over effect on the thickness of the lenses. +/- 5.00D and that our optometrist We should do our best to ensure that colleagues are recording it on their phoropter used during the refraction. the patient’s PD and the frame box prescriptions (for the trial frame or If the measurements are the same centre distance are similar. Care must phoropter) as both are required to be then all is well; but often there can be also be taken to equalise the edge useful to the dispensing optician. Also a difference which can lead to an thicknesses in the vertical meridian. it is worth remembering that the effectivity error; ie, the effective vertex distance needs to be checked power of the lens will be different to Changing the position of the lens by on collection, as there is no point in that prescribed. If the lens power is altering its vertex distance, taking this measurement during the low and the difference in the vertex pantoscopic angle and faceform dispensing processes if it is not used distances small; then the effective angle all affect the as-worn later. power error will be too small to be performance of a lens. If these noticed by the patient. But with additional measurements are taken The vertex distance is the distance increasing power and larger as part of the dispensing process and from the back surface of the lens to differences in the two vertex passed on to the manufacturer, then the apex of the cornea and should distances; it can sometimes become complex computer algorithms can be measured along the line of sight necessary for the dispensing optician calculate the surface geometry and perpendicular to the spectacle to order a slightly different lens power required so that the back vertex front (Figure 4). to that prescribed. Of course any power is maintained across the lens. such action must be recorded on the Freeform surface generators (Figure 3) The reason for measuring the vertex patient’s records. The effect of can then create a complex lens distance on dispensing is to see if it changing the vertex distance is surface comprising around 40,000 differs from that of the trial frame or summarised in Figure 5. An example
Moving a plus lens further from the eye Moving a plus closer to the eye causes causes the lens to effectively be more the lens to effectively be less positive; positive; therefore the ordered power therefore the ordered power needs to needs to be decreased be increased b
Moving a minus lens further from the Moving a minus lens closer to the eye eye causes the lens to effectively be causes the lens to effectively be more a c less negative; therefore the ordered negative; therefore the ordered power power needs to be increased needs to be decreased
Figure 4: a shows a vertex gauge in use, along with b a conversion wheel, c shows the vertex Figure 5: The effect of changing the vertex distance on back vertex power distance measured with a clear ruler
Continued overleaf DO November 2012_1 19/10/2012 09:47 Page 6
6 dispensingoptics November 2012
Visual axis
a b c face form angle
Figure 6: a shows what the angle is, b the Rodenstock device, c a device from Zeiss +3.87/-0.50x90 to give Rx +4.00
optical axis
Figure 7: Formula to calculate the change in Figure 8: Face from angle Figure 9: The effect of applying face form angle effective power for a given pantoscopic angle to a prescription
of the effect a change to the vertex towards the face. This is shown closely match that of the trial frame distance is to consider a 7.00D lens. A diagrammatically in Figure 6, where lens position. movement of 5mm will result in a the angle formed is positive, as the change of 0.25DS in the effective frame’s lower rim is inclined However tilting a lens before the eye power of the lens. This is found by towards the face; which is usually the induces aberrational astigmatism using Fx = 1000/(f-x), where Fx is the case. If the angle was negative, then which is due to the pencil of light new effective power of the lens, f is it could be called a retroscopic passing obliquely through the lens. the original focal length and x is the angle2, which might be found with Here is an example, a -5.00DS lens change in vertex distance. If you snooker spectacles. Pantoscopic made in plastic of refractive index consider the difference in vertex angle and the vertical fitting position 1.5, is tilted from a pantoscopic angle distance achieved simply by are closely linked; remember that 2o of zero to 12.5o. The equation given in changing from a plastic frame to a of pantoscopic angle results in a Figure 7 can be used to calculate the metal, pad-on-arms frame, then on 1mm change in the vertical position resultant (as-worn) back vertex higher powers it becomes a very of the optical centre. If the power; the answer being that our important measurement to consider. pantoscopic angle is increased, then prescribed -5.00DS is now the optical centre should be lowered, -5.08DS/-0.25DC x 180 in the new ‘as- Pantoscopic angle and vice-versa for a decrease in worn’ position. The definition is that it is the angle pantoscopic angle. This change to between the optical axis of a lens the vertical centration results in the Faceform angle and the visual axis of the eye in the optical axis of the lens to pass (Figure 8) primary position, usually taken to be through the eye’s centre of rotation; Also called the frame wrap/bow or horizontal1. Put more simply it is the thus improving performance of the the dihedral angle (the British angle of the frame front inclined lens in the ‘as-worn’ position, to more Standard term is Faceform angle), this can be thought of as the horizontal version of pantoscopic angle. The effect is far more noticeable for sports eyewear as they are usually highly curved; but that is not to say that it does not have an effect for normal ophthalmic frames.
When increasing the angle, the induced errors can be compensated for by decentration using the same rule of thumb that we use for vertical centration and pantoscopic angle (ie, 1mm for every 2o). This will assist with the unwanted induced prism; although it does not help with the overall field of vision as the eye roams around the lens. With a personalised Figure 10: A selection of devices for measuring face form angle lens the manufacturers can use the provided monocular PDs along with the faceform angle to design a lens DO November 2012_1 19/10/2012 09:47 Page 7
Continuing Education and Training
a b c
Figure 11: Facial asymmetry, on the left is the original image, the centre is a Figure 12: Some examples of computerised dispensing terminals right mirror image and the right hand image is a left mirror image a Zeiss relaxed vision terminal, b Essilor Visioffice, c Anyview pro from BiB
to take into account the final sitting Final thought The content of this article gives a brief position of the lens. Before dispensing these lenses it is overview of the efforts taken by worth talking to your supplier to make manufacturers to design spectacle If we take a +4.00DS prescription sure you have an understanding of the lenses which give optimum clarity of taken from a trial frame with a zero lens and what the lab requires for vision to our patients. If anyone is face form angle and then dispense personalisation, as some interested in pursuing this subject the prescription into a frame with a manufacturers may only require one further they might consider face form angle of 20o, to achieve of the extra measurements discussed undertaking the Association of British the desired back vertex power of above; while a different manufacturer Dispensing Opticians’ Honours +4.00DS, we would need a lens with a will want all three. The advantage of qualification in spectacle lens design. compensated power of these personalised lenses is that they +3.87DS/-0.50DCx90. Luckily most aim to provide our patients with a References frames have smaller faceform angles, greater level of optical accuracy and 1. Jalie M. Ophthalmic Lenses and rd but the compensation is necessary as visual performance than conventional Dispensing 3 ed. London: Butterworth the visual axis of the eye is not the lenses. The effect of each Heinemann, 2008; chapters 2 & 3 same as the optical axis of the lens measurement on its own might be 2. Millodot M. Dictionary of Optometry and Visual Science 7th ed. London: (Figure 9). small, but when combined the overall Butterworth Heinemann, 2008 effect can have more impact on the 3. Jalie M. The Measurement of There is an array of devices available back vertex power in the ‘as-worn’ Spectacle Lens Power – Part One, for taking this measurement, some of position. All three of the measurements Dispensing Optics, July 2012, pp4-11 which are shown in Figure 10; but discussed are also inter-dependent practice is required to become e.g. changing the pantoscopic angle Further reading proficient. can also affect the vertex distance 1. BS EN ISO13666:1999. Ophthalmic since increasing the angle can cause Optics – Spectacle Lenses - Vocabulary. Verification the lenses to sit further from the eye. A London: British Standards Institution. When these lenses arrive at the final note on measuring is that we 2. Ophthalmic Lens Availability (2012) practice from the manufacturer it is cannot assume that patients are for listings of many freeform single normal to check that the prescription symmetrical (Figure 11) and taking vision lenses meets the appropriate BS EN these additional measurements is a 3. Brooks C.W. and Borish I.M. System Standards. But care needs to be taken way of optimising each lens, as well as for Ophthalmic Dispensing 3rd ed. St with personalised lenses. When showing off our skills and expertise. Louise Missouri, Butterworth checking using a focimeter the lens is Care must also be taken to refine our Heinemann, 2007; chapter 5 usually placed perpendicular to the measuring techniques as some lens holder so that there is no patients can find these close proximity Anthony Blackman is senior lecturer in pantoscopic angle and the optical measurements disconcerting; this is vision science at Canterbury Christ and visual axes are parallel. However where good communication skills are Church University and academic link this does not take into account the required. It is also worth remembering tutor to ABDO College. He also works ‘as-worn’ position of the lens, where that there are several computerised part-time in high street practice as a light will be entering the eye differently systems available which not only add dispensing optician and contact lens to the focimeter as the optical and some ‘show’ to the dispensing optician. For ABDO he is Area 3 visual axes are not parallel . The process, but can assist with taking the Secretary and CET Officer for Area 9 laboratory should provide the practice measurements (Figure 12). They can (South East) and sits on the ABDO CET with the “measured powers” for which be particularly useful if the patient has Committee. Anthony also finds time to to check against. It is also a trouble maintaining a natural head be a distance learning tutor for the recommendation that the details of position, particularly during the Worshipful Company of Spectacle the measured power are noted on the measurement of the pantoscopic Makers. To contact Anthony email patient’s record for future reference. angle. [email protected] n MCQs overleaf DO November 2012_1 19/10/2012 09:47 Page 8
8 dispensingoptics November 2012
Multiple choice questions (MCQs): Single vision lenses - now it’s personal
1. Which lens is not a personalised single vision lens? 4. What alteration needs to be made to the vertical position a. Kodak Digital SV of the optical centre of the lenses if the pantoscopic angle b. Essilor Stylis is increased by 5°? c. Zeiss Clarlet Individual a. It should be raised by 5mm d. Hoya Nulux EP b. It should be lowered by 5mm c. It should be raised by 2.5mm d. It should be lowered by 2.5mm 2. For a prescription of R +11.00DS L +11.00DS with a refraction vertex distance of 13mm, a frame is dispensed 5. What will be the cylindrical element of the new effective with a vertex distance of 9mm. What will be the required prescription if the lens -8.00, made of plastic refractive power supplied to ensure the correct effective power? index 1.5, is tilted 10° in front of the patient’s eye? a. +10.75 a. None – the cylindrical element will be insignificant b. +10.50 b. +0.25 c. +11.25 c. -0.25 d. +11.50 d. +0.50
6. If tolerance tables state that no more than 1Δ of 3. Which computerised system is not intended to measure unwanted prism can be tolerated by a patient, which mono and record the required measurements for a personalised centration error (horizontal) falls WITHIN this tolerance, and lens? is therefore acceptable? a. Relaxed Vision Terminal a. 3mm mono centration error on +4.25/-1.00 x90 a. Visioffice b. 2mm mono centration error on -4.50/-0.75 x 90 a. Accufit c. 4mm mono centration error on +2.75/+2.50 x 90 a. Anyview Pro d. 2mm mono centration error on +7.25/-1.75 X 90
The deadline for posted or faxed response is 19 December 2012 to the address on page 4. The module code is C-19503 Online completion - www.abdo.org.uk - after member log-in go to ‘CET online’ After the closing date, the answers can be viewed on the 'CET Online' page of www.abdo.org.uk. To download, print or save your results letter, go to 'View your CET record'. If you would prefer to receive a posted results letter, contact the CET Office 01206 734155 or email [email protected] Occasionally, printing errors are spotted after the journal has gone to print. Notifications can be viewed at www.abdo.org.uk on the CET Online page
CET points All points from ABDO-provided CET this Reminder for the end of CET period year will be uploaded to CEToptics by 21 December. Please check your Registered practitioners are reminded that the current CET CEToptics record as 20 December period ends on 31 December 2012. However, the GOC have approaches, and contact the CET requested that all points for the period must be confirmed by department if you are missing any 21 December. By that date, to ensure continued registration points from ABDO CET. Points from other CET Providers should be queried with the GOC, you must have accrued 36 points as a with that Provider, as the CET dispensing optician or an optometrist, or 54 (36 +18) points as department has no access to your a contact lens optician on the GOC’s CL Specialty list. The CEToptics record, and cannot answer points must be confirmed on your CEToptics record. Pending, queries about CET from other or unconfirmed points will not count towards your requirement. Providers. If you have any enquiries about your points record, contact CEToptics (0843 208 5487), or for other enquiries, contact the To contact the ABDO CET department ABDO CET Office (01206 734155 Tuesday - Friday). n telephone 01206 734155 or email [email protected] or [email protected] n DO November 2012_1 19/10/2012 09:47 Page 9 DO November 2012_1 19/10/2012 09:47 Page 10
10 dispensingoptics November 2012
Antonia Chitty explains how to boost your bottom line via practice pricing
Practice pricing: what you need to know
nderstanding practice profitability When to increase prices market share by keeping prices low Uis important for every practice Has it been a while since you then now might be the time to raise owner or manager, and putting prices increased your prices? When was the prices by a small amount to increase up can be the most obvious way to last time you evaluated your prices to profit margins.” If you are nervous of make more profit, but there’s more to check they are still relevant? It is a increasing prices, remember that this than meets the eye. Over the last good idea to review your prices patients value other parts of what you two articles we have looked at how to periodically. Award winning business offer, and do not just choose to buy make your practice more profitable expert and author Erica Douglas of based on price. People’s choices are by cutting costs, and how to ACEInspire advises: “Quarterly or bi- influenced by the relationship they understand pricing strategy. In this final annual reviews should be sufficient.” have with you and your staff, the article on boosting your bottom line, When you evaluate your business services they receive both in the learn about putting prices up, the best progress, there are a number of signs testing room and during the dispense. way to introduce price increases, and that you could put your prices up. when decreasing prices is the right Douglas explains: “You should increase Implementing a price increase and necessary thing to do. your prices if you’re experiencing Once you’ve decided to increase excess demand, such as full testing prices you need to decide how to do rooms and a long wait for an it. Price increases without thought to appointment. You can influence strategy and communication can put demand through increasing prices. If people off. Particularly in times of you have too much demand make economic hardship, this can be incremental price increases until enough to deter business owners from supply meets demand.” any price increase at all. With thought and planning, though, price increases Another reason to increase prices is if can help to develop your practice customer value is higher than price. reputation and attract patients who Douglas explains: “If your customers do still have money to invest in quality place a high value on your products eyecare and eyewear. and services then you can afford to charge a little more and demand Erica Douglas outlines a few ways you should be mostly unaffected. If your can implement price increases: “A costs have risen, it is prudent to price jump is the most straightforward increase your prices to maintain your method; simply increase prices by the profit margin. And if you have good whole amount. Doing this may lose Erica Douglas market share and want to maximise you some customers who will reject a profit margins, you might also want to price rise. Of course if you’re trying to increase prices. If you have built good influence supply and demand then this Continued overleaf DO November 2012_1 19/10/2012 09:47 Page 11 DO November 2012_1 19/10/2012 09:47 Page 12
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is the point. You will lose the customers “Increased product choice and the promotions. You can also be more who are the most price sensitive, and economy are just two factors that can open to being negotiated down on retain those who are willing to pay influence this. There are times when price. more. Do some calculations about business is slow and sales drop off. In how much profit will increase with a this situation you may deliberately 4. Product bundling: you can bundle price jump and how many customers increase excess supply as a way to products together to create ‘value’ you could afford to lose. If you want boost sales. In this situation you can packages that are cheaper than your price rise to go under the radar either implement a permanently lower buying products separately. then you could make a few smaller price or try a sales promotion. Use price increases over time. However, sales and discounts with caution; if you Looking at the whole picture, develop this strategy may appear to patients are perpetually offering discounts you a plan for sales promotions. You could as if your prices are constantly rising. will attract only those who are after have quarterly sales on certain ranges something free or cheap. On the other or just sales in January and July across “Instead of a direct price increase you hand, a sales promotion can your products. And think smart; you can stop sales promotions and be encourage existing patients to try don't just need to offer money off but firmer in negotiating situations. This will something new, extra or different. It you could make a sales promotion to increase revenue without the can draw in new customers and, at encourage people to buy more. Many requirement of direct price increases. the same time, allow you to shift stock practices offer some sort of discount Evaluate what promotions you have that isn't moving as fast as you want.” on a second pair or prescription running throughout the year, how sunglasses. Tie sales promotions and many people come in to the practice You may decide that some products price cuts in with your overall because of them, and how many are permanently off limits for price- marketing plan for maximum effect. people then go on to take up the cutting. If you place a high value on promotion. Understand how much professional services, you may want to Keeping up with the competition each promotion costs you, and which ensure that your eye examination fee Beyond planning your own practice ones are key for increasing sales and is never discounted. You may offer pricing, what you do may be patient numbers. You will then be in a some exclusive ranges of designer influenced by the competition. position to decide which discounts to frames and feel that it is inappropriate Realistically, while some people abolish and which to retain. Finally, if to ever offer these at a discount. reliably purchase spectacles from your you have lots of ‘value’ packages you practice after their eye examination, can unbundle these packages and Once you have evaluated the others like to shop around. Your sell products at the original and benefits of price cuts, here are four business will benefit if you think through individual prices. This has the effect of ways that Erica Douglas suggests to strategies about how to respond if a raising prices without actually being cut prices: competitor cuts their prices, and what seen as raising them.” to do if they increase them too. 1. Price fall: the most straightforward Price cuts tactic is to simply reduce the price. First, think about situations where your Do you have frames that have been You will want to include this exciting competitor has put their prices up. This hanging around gathering dust? Or development in your marketing but can give you the chance to increase are you keen to find a way to increase you should consider how this comes your own prices. You can justify raising market share of sight tests or contact across as you don’t want loyal your prices in response to a lens wearers in your town? There are customers thinking that the quality of competitor’s rise if your own costs lots of reasons why cutting prices can your products has gone down. An have risen. If there have been industry benefit your business, sometimes in alternative is smaller reductions to wide rises in the cost of raw materials, combination with price increases for price over time. services or products leading to the other products and services. competition increasing prices, then it 2. Introduce a ‘fighter’ brand. This is a makes sense to raise your prices to Erica Douglas outlines the strategy used by larger supermarkets. maintain profit margins too. It will be circumstances when making a price The current products maintain current relatively acceptable to customers for reduction may be the correct choice: prices but cut price ‘value’ you to raise your prices if they see your “Price cuts can help you to build alternatives are introduced to competitors have done so. If you have market share. If you are a new compete with cheaper competitors’ more demand than you can business or you’re entering a new products. If you feel that some people reasonably supply then it is market or launching a new product are attending your practice but not advantageous to dampen demand you may consider keeping prices purchasing because your current by increasing your prices. Doing this at artificially low to encourage people to frame range is outside their budget, it a time when competitors’ prices are buy from you instead of the might be time to introduce some rising too reduces the risk of too many competition. If the value of your ‘value’ frames. people going elsewhere. product has fallen then you may need to drop prices in order to bring price 3. Higher discounts: instead of a direct Some markets are very price sensitive, and value back into line. price reduction you can increase sales others less so. Consider how price DO November 2012_1 19/10/2012 09:47 Page 13
Patient and practice management
sensitive your customers are. If raising prices will have a minimal effect on Frequently asked questions demand then it makes sense to follow a competitor’s price rise and maximise your profit margins. If you have Answered by Kim Devlin FBDO (Hons) CL positioned yourself at the upper end of the market, customers will expect to And another thing . . . pay a premium. When your competitor puts their prices up, raise your prices to You may remember a couple of months ago I answered a question about dispensing maintain the perception of being at plano lenses without a prescription. That brought more queries on a similar theme I the luxury end of the market. thought I could answer here.
If your competitor raises their price The original question was specifically about supplying a single plano lens, without a and you do not need to, this can give prescription, after cataract surgery. My argument was that as a temporary measure with full explanations given to the patient it was both legal and professional. The theory has you some advantages, as Erica never been tested in court or at an FtP hearing but I felt it was a professional course of Douglas explains: “You can choose to action. The further query raised the problem of dispensing a pair of plano lenses to a ignore the raise and maintain your patient without a prescription; was that too legal? current prices. Do this if your costs have remained the same or are The law does not class plano lenses as an optical appliance and, as such, they are not falling, if you have excess capacity, covered by the legislation that governs the sale and supply of spectacles; but is it and if customers are very sensitive to professional? price increases. You may attract some of your competitors’ business. This A customer walking in to your practice has every right to buy a frame and have it works well if you have a ‘value’ brand glazed with plano lenses, without a prescription, and you have every right to sell them to him. It becomes a little greyer when you ask the question: why would they want to image; if your brand is positioned as do that? It might be an actor wishing to look the part or someone wishing to be ‘affordable’ or a cheaper alternative fashionable or look more intellectual, all good reasons. But what if it was a vulnerable then you may consider keeping prices adult or young teenager? Would that still be professional? low to fit with your brand. It also works if you are new to the market or if I would take the view that such patients have the right to spend their money on you’re trying to grow your customer whatever they wish, unless there is some legal restriction on their finances. Stiletto base.” shoes with four inch heels? Tattoos? Body piercings? It is all a question of personal choice. Great tact is needed to suggest that they may like someone else to come in and Finally, what if your competitor is look at the frames with them, giving a carer the chance to say: “That’s a lot of money to having a big sale or even a spend, are you sure it’s what you want?” permanent price cut? If your If your records can show that you took all reasonable steps to ensure the customer was competitors drop their prices what do not coerced in any way to make an expensive purchase, there is nothing unprofessional you do? Do you follow suit or stand in such an action. firm? Douglas advises: “Consider dropping your own prices if your costs Another possible scenario is when a sight impaired or severely sight impaired patient have fallen, you have spare capacity wishes to have spectacles when there is no improvement to their sight with or without and your customers would respond to the appliance; the lenses could be plano or any other power. May you dispense that a price cut by buying more. This could patient? Most definitely yes; only a registered practitioner may dispense to SI or SSI further help you to grow your customer patients by law. Together with any family or carers, a discussion can be had, sensitively base. Remember that a drop in price explaining that spectacles may be worn or not; there is no visual improvement with or without them. will affect your brand image, though, and avoid it if your practice positions This is where it is so useful when the eye examination has been conducted in house; itself at the premium or luxury end of you have the benefit of seeing the records and understand the limits of the acuity. Of the market.” course, what often happens is that a Hospital Eye Department will simply say, glasses are no use to you, you don’t have to wear them. Read more If you want to read more about A patient who has been a spectacle wearer all their lives will feel naked and vulnerable pricing, study ‘Principles and Practice without their specs, they may feel their eyes look unsightly and wish to hide them, or a of Marketing’ by D. Jobber. filter may not give them useable sight but may well give some relief from glare.
Former optometrist Antonia Chitty now All of the above are good clinical reasons to dispense plano lenses but only a registered writes on business topics. Her latest professional would have the knowledge and skill to be of help to such patients. A book is Blogging: The Essential Guide, registered DO is in an ideal position to help in such situations. You have the knowledge and she has also written A guide to and training to ensure that all spectacles dispensed are correct for the individual, whatever their situation. Promoting Your Business and Marketing: The Essential Guide which Kim Devlin is chair of ABDO's Advice and Guidelines Working Group will help you if you need effective n ways to promote your practice. n DO November 2012_1 23/10/2012 12:44 Page 14
14 dispensingoptics November 2012
Ophthalmic lens - tint teaser
By Frank Norville OBE
Question 1: What ophthalmic lens has this unique transmission? (Chart1)
Clue 1: Look far right to the infrared end of its spectral transmission.
Clue 2: It is available to Rx
Now this second group of connected charts (C2-C3) are basically the same lens as C1 - but with an added element.
Question 2: What is that element?
Clue: The element is 1.4mm thick Chart 1
Chart 2: Unexposed transmission Chart 3: Darkened transmission
Answer Q1: Chart 1. This is the ‘signature’ transmission chart Both the above lens forms are available in surfaced single for Blue Glass ACE-2 Amethyst contrast enhancement vision (limited power range +3.00DS/-4.00DS), and some (replaces Rose Didymium) sometimes known as Blue years ago as a flat top bifocal but no longer. However, Didymium - a unique lens for furnace work, glass or freeform digital production now enables high definition jewellery hot flame working. With an average transmission single vision and progressive designs in this glass material, of 38% LTF, it is less satisfactory for sun protection when used greatly widening its attraction to users, many of whom will be outdoors. older craft persons who will welcome a progressive solution. Alternatively of course plano lenses glazed into an overspec. Answer Q2: This is the same ACE-2 lens but with a bonded thin glass photochromic wafer (photo grey thin and dark) For further information contact the Norville Group or go to which dramatically changes the reach and scope of this www.norville.co.uk and download a copy of the October lens. Transmission range is now 38% 13% dark. 2012 Companion publication.
Acknowledgements: Schott Glass/Dr Colin Fowler DO November 2012_1 19/10/2012 09:47 Page 15 DO November 2012_1 19/10/2012 09:47 Page 16
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The ABDO Board: Fiona Anderson, Keith Cavaye, Peter Black, Kevin Milsom, Jennifer Brower, Kevin Gutsell, Tony Garrett, Angela McNamee, Ashton Galloway and Ted Moffatt Much ado about conference
aking place on 29 and 30 honest I was not expecting people to TSeptember at the Holiday Inn, flock in as they did,” said Elaine 3D vision was the theme of Stratford-upon-Avon, this year’s Grisdale, ABDO head of professional the 2012 ABDO conference, conference had an underlying theme services and international gravitating around three Ds pertinent development. held at the end of to everyone in practice. Through a complementary medley of CET Kicking off proceedings on Friday 28 September in the heart of lectures, business presentations, September was the annual pre- Shakespeare country practical workshops and special conference golf tournament held at discussions, delegates learnt how they Stratford on Avon Golf Course and could – diversify, develop and sponsored by Shamir Optical, differentiate. The venue proved a Marchon and Transitions Optical. There conveniently central location for the were 32 golfers competing this year, great many delegates from across the and fortuitously the weather held up country who turned up for a busy few on what was a nostalgic day, as days of learning, practical tuition, Samuel Ryder was once the club’s networking, product browsing and captain and on the same day Teams partying. “I knew we had a great USA and Europe commenced the location and I knew we had a great battle for the Ryder Cup in Chicago. programme, but if I’m being totally “It was without doubt a great day of DO November 2012_1 19/10/2012 09:47 Page 17
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Paul Shimmel receiving his green jacket from Barry Paul Shimmel receiving the Frank Clipson Pavan announces the Association’s accounts for Duncan Memorial trophy from Richard Clipson, son of 2011 at the AGM Frank fun, laughter and lots of great Alicia Thomson, and a look at where opportunities to socialise and meet practices stand after PCTs disappear new friends,” said Barry Duncan, ABDO with Mike Cody and Barry Duncan. A members’ support manager. Paul trip to the exhibition, which was open Shimmel won the Frank Clipson from 1-5pm on the Saturday, Memorial Trophy and the coveted presented delegates with more than green jacket with a score of 42 points. 40 stands to choose from with the “It was very fitting that Richard Clipson industry’s leaders out in force as well presented the trophy to Paul,” added as smaller niche companies, charities Barry, “and ABDO would like to and, of course, ABDO, ABDO College sincerely thank all those who and ABDO College Bookshop. participated and the industry partners Voting at the AGM who very kindly donated prizes.” Chris Beal, managing director, Menrad Optics, said after the event: “We were Tournament player and conference extremely impressed at the overall speaker, Frank Munro of Optometry turnout, as well as the amount of Scotland, said: “It was a great people who took the time to come pleasure to attend and speak at this and meet with us. There was a real mix year’s ABDO conference. The venue of new and old customers from was excellent with a large exhibition independent practices, which was and the educational programme was great to see. Those we met with were varied and interesting. To top it all I very complimentary about our had the chance to play at the golf customer service, which is always course that Samuel Ryder was captain good to hear. What was most of during a momentous Ryder Cup encouraging was the positive reception weekend.” the new product launches received. I have no doubt that we will be back “Priceless” opportunities exhibiting at ABDO in the future.” On Saturday afternoon delegates made the most of an afternoon of Having the opportunity to speak to parallel presentations, including Sally such a large number of delegates was Ian Hempseed, Tony Garrett and Jennifer Brower Bates presenting whether spectacles “priceless” for exhibitor Rodenstock. “It at the AGM cause basal cell carcinoma, two enabled us to offer one-on-one examination revision sessions with demonstrations of both the new high Photos below: members at the AGM
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The President, Jennifer Brower and Vice President, Peter Black visit the exhibiton on Saturday afternoon
tech consulting and 3D video centering system, ImpressionIST 3, and our new anti-fog cloth, FogFree,” said Ian Harrison, Rodenstock UK’s national sales manager. Continental Eyewear debuted new frames ahead of its cross-Channel hop to Silmo in Paris the following weekend. “Our new styles were very well received, particularly in the X-eyes collection,” said Neal Grimason, the company’s sales director.
Paul Walden, director of the Norville Group, said it was one of the best events he had attended since the recession kicked in. “Both suppliers and delegates were feeding off each other’s enthusiasm for all things new and reacquainting themselves with really exciting and colourful products released over the last few years, which may have slipped off our mutual radars during the intervening grey DO November 2012_1 19/10/2012 09:47 Page 19
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years,” Paul told Dispensing Optics. “Hopefully everyone left re-energised with the additional tools and information that will help to kick start the recovery.”
First-time exhibitor, Charmant, left the conference extremely impressed. “It was well organised, and the venues for both the conference and dinner were well chosen,” said Louise Brunton, Charmant UK general manager. “It was a useful opportunity to discuss our eyewear products with dispensing opticians and to receive valuable feedback as to how we can continue to improve and to support those at the frontline. We hope to work closely with ABDO in the future and thank the Association for its interest and support in our group.”
Ballots and boogying At the Association’s AGM later on Saturday afternoon, the results of the votes on two important resolutions were announced – one concerning a name change for the Association and the other on proposed new Articles of Association. A special resolution that the name of the Association be changed from ‘The Association of British Dispensing Opticians’ to ‘The British Association of Opticians’ was defeated – with 364 members voting for the motion, and 406 members
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voting against it. A total of 5,633 members were eligible to vote, so just under 14 per cent exercised their right to do so. The new Articles of Association were successfully adopted, allowing ABDO to now fully comply with the 2006 Companies Act.
After reporting on events and achievements during 2011-12, ABDO President Jennifer Brower said it would be the last time that an annual report would be given so long after the end of the year. She told members that during that time, full membership had risen by nearly 200, accompanied by another strong financial performance, which resulted in a surplus of £268k. Following the AGM, the President updated members on the ABDO Benevolent Fund. She said that income had dropped slightly over the previous year, but grants to dependants fell significantly so that the Fund had ended the year around 12 per cent up on its reserves.
Another year of achievements were marked that evening with some surprises in store. Held at the unique venue of the Heritage Motor Centre in Gaydon, this year’s gala dinner gave delegates the chance to relax and enjoy a private viewing of the centre’s impressive vintage car collection. “The gala dinner was in a fantastic location DO November 2012_1 19/10/2012 09:47 Page 21
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at the Heritage Motor Centre and the have been asked to help out. The CET food and entertainment was top presentations were well attended and notch,” said Elaine. “It’s always a the exhibition looked busy and good sign to see the dance floor full vibrant.” John Hardman added: from the beginning to the end of the “Personally it was an honour to present evening. We even caught a glimpse the Hamblin Memorial Prize to such a of ABDO secretary general, Tony worthy recipient as Mike Cody. All in all Garrett, on the dance floor this year – it was a very enjoyable and a rare sight indeed!” The evening memorable weekend. Well done to all exemplified how truly international the those involved in organising and Association is by welcoming guests running the event.” from not just all four corners of the UK, but from Dubai, Romania, Malaysia, Proud recognition Canada, Eire, France, Austria, plus a Jennifer Brower presented Honorary few more! ABDO Fellowships to two industry stalwarts – Frank Norville OBE and A Special Recognition Award was Malcolm Polley. The Honorary presented to Matt Dorling of Transitions Fellowship is a special accolade Optical for their recognition of the awarded to individuals who have worth of qualified staff in dispensing made an outstanding contribution to and for actively supporting ABDO and both the profession of dispensing its members. The Area Prize was optics and the Association. Since it presented by Jo Holmes to Debbie was founded in 1986, ABDO has Anderson (Area 7). The Dispensing previously only awarded Honorary Optics Readership Prize was presented Fellowships to nine individuals, by Sheila Hope to Duncan Counter for Malcolm and Frank Norville now being his article, ‘Free and easy’. The the 10th and 11th respectively. Hamblin Memorial Prize was presented by John Hardman to Mike Cody (Area Delighted to receive the coveted 5) for his outstanding contribution to award Malcolm, chief executive of the profession. Mike told Dispensing the Federation of Manufacturing Optics: “Receiving the Hamblin Opticians (FMO), said: “To be Memorial Prize was a huge honour honoured by one’s peers is the best and totally unexpected. We at Area 5 accolade of all. It was so unexpected felt the conference was a great and I am deeply touched as I have success and we feel very privileged to received so many wonderful
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Malcolm Polley receives his Honorary Fellowship Frank Norville receives his Honorary Fellowship Matt Dorling receives his Special Recognition from Jennifer Brower from Jennifer Brower Award from Tony Garrett The Gala dinner at the Heritage Motor Museum in Gaydon
comments. This not only demonstrates the close collaboration between ABDO and the FMO, but also my involvement over the years with dispensing and how we have supported this side of the profession – long may the bond continue.”
For Frank Norville, receiving an Honorary ABDO Fellowship had particular poignancy. Frank told Kevin Siew President of the Malaysian Association Dispensing Optics: “The ABDO gala of Practising Opticians dinner, already a fantastic occasion,
Debbie Gigg Tony Garrett, Paul Surridge and Gordon Jones was made all the more so by the great surprise of a Honorary Fellowship presentation which I was delighted and honoured to receive especially in the presence of so many of my optical friends. Even more so, as I can now catch up with my late father and perhaps become one of the few optical families across two generations of father and son to hold ABDO Honorary Fellowships, a proud recognition of the Norville family’s 115 years of ophthalmic activities.” DO November 2012_1 19/10/2012 09:47 Page 23
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Debbie Anderson receives her Area Prize from Jo Duncan Counter receives his Dispensing Optics Mike Cody receives his Hamblin Memorial Prize Holmes Readership Prize from Sheila Hope from John Hardman
Buzzing all round On the Sunday morning of the conference, three special discussion presentations enabled delegates to find out more about vision screening in schools from Michael Gilsenan, primary school talks from Jo Holmes and Christopher Heap and the benefits of becoming and a Careers in Optics ambassador from Peter Black. Michael Gilsenan said: “The conference was superb from start to Chris Hunt President of the AOP, Catherine Elaine Grisdale finish. It was refreshing to see Hempseed and Robert Dalton executive director confidence and buzz from all the from the Opticians Association of Canada delegates. Stratford-upon-Avon was the ideal venue for the conference.”
Sunday’s CET and non-CET presentations covered everything from making the most of the resources you have, eg. product, people, expertise (Julian Wiles) and how to become a ‘styling practice’ by building a bespoke business around eyewear (Stuart Jones) to the DO’s role in developing a lifestyle/healthy vision practice (Frank Munro). All of the workshops held on Sunday were full to capacity – such that an extra low vision workshop was hastily organised with two extra volunteers drafted in at the last minute. A waiting list quickly developed for the refraction workshop sessions, hence ABDO is now
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Well attended lectures, workshops and special discussion sessions
considering running these as a regional event as an ABDO Area activity.
“The buzz for this year’s conference was amazing,” said Elaine. “From the kick off at the exhibition on the Saturday, through to the lectures being well attended, people were engaged with the conference throughout the weekend. Numerous people told me it was the best conference they have attended in years, which is very gratifying and testament to all the hard work that the conference team put in.”
In agreement was one of the presenters, Paul Surridge, chief executive of Sight Care, who said afterwards: “ABDO has come a long way in the past five years, and it’s plain to see it is at the forefront of representing the dispensing profession in a highly professional and innovative way. Its marketing collaterals are clean, crisp, well presented and ably communicate the many and varied DO November 2012_1 19/10/2012 09:48 Page 25
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membership benefits available. Members should be proud of their Association, and non-members should be eager to join. The 2012 conference was a great success in disseminating vital information to members via a wide range of presentations and workshops. There was a very noticeable buzz about the event. I met some lovely people, eager to do a great job for the public. I was honoured to speak at the conference. Well done ABDO.”
Elaine concluded: “The enthusiasm shown by everyone throughout the weekend – and the fact that they turned out and participated and had fun – is a firm statement to our own members and to the wider world of optics that we are here, we are progressive and we mean business.”
This was the last time that the ABDO conference will be held in the autumn. Next year, the Association’s AGM and CET event will take place during Optrafair in April and then in 2014, the conference will return in a new springtime slot. If you have any suggestions on how ABDO could further develop its conferences for the future, then please feel free to email your ideas to [email protected]
Report: Nicky Collinson Photographs: Williams Photo Agency n DO November 2012_1 19/10/2012 09:48 Page 26
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In-car conditions are an important consideration Dr Michael Pritchard, director general of the for contact lens wearers Royal Photographic Society Life in the fast lane
Contact lens practitioners heard how they could help their patients to see - and drive - better at the recent 2012 BCLA Presidential Address
ith her background in which would also tighten Group 2 She explained that the functional field W occupational vision research, driver regulations. Catharine admitted of view improved with increased VA, using driving simulators to monitor eye there was a weak correlation between CS and driving experience but movements, Dr Catharine Chisholm’s VA and accident rates, mostly decreased the more complex the British Contact Lens Association (BCLA) because of the inherent limitations of scene and with distractions such as Presidential Address, held at the Royal driving research, but stated that VA mobile phones. Eye movement Society of Medicine in London in was critical when reading road signs tracking provided an insight into September, was entitled ‘Contact and was a proxy for other measures of drivers’ vision. Looking in the rear view lenses and driving: life in the fast lane’ visual performance such as CS and mirror required a 30-40˚eye (approved for one contact lens CET dynamic acuity. Research showed movement, with the amount of point, OO, DOs and CLOs). Giving that as many as 20 per cent of people vertical movement depending on the BCLA members and their guests a could be driving with eyesight below driver’s height. unique insight into the subject, the legal minimum. Catharine underlined its importance Better vision with contact lenses given that the majority of UK contact “Contact lens wearers should have Wearing contact lenses could lens wearers were drivers. After better vision than spectacle wearers definitely help drivers. For example, reviewing the visual benefits of contact because they have regular check- spherical lenses generally resulted in lenses, such as the ability to neutralise ups,” said Catharine, but commercial little or no degradation of visual corneal irregularities and an factors were a hindrance. “One cause performance with eye movements. unrestricted field of vision, Catharine of substandard vision with contact “When assessing lens fit, consider the reiterated that modern contact lens lenses is the failure to correct small degree and speed of horizontal lag in materials provided visual quality astigmatic errors,” she said. “We have this context, and modify the fit to comparable to spectacles. no excuse for leaving contact lens minimise the lag if vision is likely to be patients with anything but the smallest impaired,” Catharine advised. New vision standards degree of uncorrected astigmatism.” New vision standards for drivers, due in This could affect driving reaction times Modern soft torics had fewer issues January 2013, would see the to hazards such as pedestrians with stabilisation, which should be numberplate viewing distance stepping out. “The greater cost of toric assessed in all positions of gaze, reduced to 20m – possibly even 17.5m lenses, the perceived difficulty of fitting particularly the obliques. Night driving – for Group 1 drivers. Drivers would be them and, until recently, their was a much more complex visual task, required to see 6/12+ binocularly and unavailability in particular materials and and glare problems were reported by pass the numberplate test, but neither modalities, means that a few contact 53 per cent of drivers (Eyecare Trust). test accounted for contrast sensitivity lens wearers will still have sub-optimal “Multifocal contact lenses are (CS) or glare. Contact lenses were not VA when driving,” said Catharine. generally fine for driving at night but mentioned in the new standards, be wary of suggesting them to DO November 2012_1 19/10/2012 09:48 Page 27
BCLA news
9th BCLA Pioneers Lecturer, Professor Fiona Free CET, conference and exhibition available for BCLA members this month Stapleton
patients who already have reduced event for full BCLA members, who may and Professor James Wolffsohn on ‘The CS or slow glare recovery due to bring one non-member guest each to future of contact lens practice in the ageing and/or disease,” said the evening CET lecture. Student and UK’, the BCLA president Dr Catharine Catharine, who then looked at pre-registration BCLA members can Chisholm, ABDO president Jennifer aspects of mesopic conditions that attend free of charge and affiliate Brower, AOP chairman David affect visual performance – and the (online) BCLA members may attend Shannon, Optical Confederation types of lenses that may help (or by simply upgrading to full BCLA chairman Don Grocott, and Dr hinder). membership. This year, the event takes Kamlesh Chauhan, president of the place on Wednesday 22 November, College of Optometrists, will answer In-car conditions affected the tear starting at 12.30pm. vital questions about the future of film, compounded by a slower blink contact lens practice. Delegates will rate whilst driving. Diverting the blow The first session of the afternoon will be be asked to vote on ‘How safe is the heater could help, as could the use of an illustrated talk by Dr Michael future of contact lens practice in our silicone hydrogel materials in those Pritchard, director general of the Royal leaders’ hands?’ at the start and end with marginal dry eye. Photographic Society, on the of the session, declaring whether they development of the camera and are ‘unsatisfied’, ‘neutral’, ‘satisfied’, or Lastly, multifocal lenses had many image making - from the ‘very satisfied’. advantages for drivers such as ability daguerreotype camera in 1839 to to see the dashboard and reduced today’s digital cameras. Andrew Following a Pioneers Update from Tim visual distortion on head turning when Gasson will then ask: ‘Do you need a Bowden, Professor Stapleton will reversing, and were preferred over slit lamp to take useful corneal present the 9th Pioneers Lecture at monovision for real-life tasks including photographs?’; while Professor James 6.30pm, entitled ‘Understanding how night driving (Woods et al 2009). Wolffsohn will take delegates on a to eliminate contact lens related However, the aberrations could be journey through the options and microbial keratitis’. For the first time, disturbing for some wearers and breadth of anterior eye optical this lecture has been approved for practitioners could help by ensuring coherence tomography (OCT). The one therapeutics CET point as well as that patients were well adapted use of confocal microscopy will be one contact lens CET point. As always before driving in multifocals at night. investigated by Dr Clare O’Donnell, there will be an accompanying Driving over-spectacles were useful for after which Glenn Carp of the London exhibition with, among others, monovision patients, Catharine Vision Clinic will present, ‘The conference sponsors Alcon, Bausch + added. usefulness of complex instrumentation Lomb, CooperVision, David Thomas to weed out patients unsuitable for Contact Lenses, Johnson & Johnson In conclusion, Catharine reiterated refractive surgery’ – highlighting the Vision Care, Sauflon, Spectrum Théa that most contact lens wearers were latest advances assisting the clinician and Topcon. drivers, so practitioners should consider to increase the sensitivity of the pre- if they would pass current (and future) operative screening process. 9th BCLA president, Dr Catharine driving standards with lenses and Pioneers Lecturer, Professor Fiona Chisholm, said: “This year’s spectacles. Patients should be advised Stapleton, will also present in the programme features a fantastic line- to always keep a spare pair of afternoon on ‘Best practice, up of speakers and topics, brought to spectacles in their car, as a point of practitioner compliance and patient you as a result of the hard work and safety. advice: are we following the rules?’ dedication of honorary Pioneers Conference organiser, Nigel Burnett Grill the profession’s leaders In a twist on the usual panel discussion, Hodd, and the BCLA staff. Held each autumn at the Royal Society delegates will witness ‘Our leaders in of Medicine, London, the BCLA Pioneers the dock’. In a special panel BCLA members may register for a free Conference is an exclusive and free discussion led by Dr Shehzad Naroo place online at www.bcla.org.uk’ n DO November 2012_1 19/10/2012 09:48 Page 28
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Youngsters compete at athletics day Inspiring a Anyone for generation golf?
“The Paralympic Games the day – all members of many don’t get to It’s been a year of made me want to do Actionnaires clubs for blind participate in sport at all highlights for the ABDO Golf sport,” said 10-year-old and partially sighted outside of their local Society, which is always on Lydia Wrightson from children, run by Action for Actionnaires clubs. It was an the lookout for new Pocklington after taking part Blind People. Representing opportunity to sample a players. in the Boots Opticians towns and cities from across range of sports for the first Actionnaires Athletics Day, the North of England and time, helping them to Annually, the society plays run by Action for Blind the Midlands, the children understand that sight loss for two prestigious trophies, People in Sheffield. “I was at took part in a variety of isn’t a barrier to fun, the ABDO Challenge Cup the stadium in London when track and field activities, competitions and social and the Stercks Martin Oscar Pistorius won his gold including long jump, javelin activities.” Silver Salver. medal and I met the and sprint events, at the captain of Team GB’s blind English Institute of Sport in Richard Edwards, director of In May this year the football team. Now I’m Sheffield. professional services, Boots Challenge Cup was played competing at a major Opticians, said: “We were for at Moseley Golf Club, event too,” Lydia added. Lesley Inganni, delighted to be sponsoring Birmingham, and was won development manager at this event again and our by Paul Cross, with David Around 120 visually impaired Action for Blind People, said: colleagues were extremely Kirk the runner-up. youngsters, aged between “The children were so excited about sharing in the four and 16, competed on excited about the event, as fantastic day.” n In September the Salver was played for at Henley on Thames Golf Club and was won by Julian Gunn, with David Kirk runner-up Billions to be saved from restoring sight again.
The society is indebted to Restoring sight would save the global establish the eyecare services to provide LensTec and Continental economy US$202bn each year, says new good vision to people with uncorrected Eyewear for their generous health economics research from Australia. refractive error, enabling greater sponsorshp. workplace output and increasing gross Governments could add billions of dollars domestic product. As reported in this issue, the to their economies annually by funding the pre-conference golf provision of an eye examination and a “Spending US$28 billion to train eyecare competition for the Frank pair of glasses to the estimated 703 million personnel, establish infrastructure and Clipson Memorial Trophy people globally that needed them in 2010, provide spectacles, is a drop in the ocean was won by Paul Shimell at according to a health economics study in compared with the annual cost to the Stratford-upon-Avon Golf the Bulletin of the World Health global economy,” said co-author of the Club on Friday 28 Organisation October edition. study Professor Brien Holden, CEO of the September. Brien Holden Vision Institute. “By restoring It calculates that there would be a saving people’s vision, we’re generating massive Any dispensing optician of US$202bn annually to the global economic benefits for society – it’s as who is interested in joining economy through a one-off investment of simple as that.” the society and getting US$28bn in human resource development involved with 2013 events and establishing and providing vision care Read more about the study at should email Mike Stokes at for five years. The investment would www.brienholdenvision.org n [email protected] n DO November 2012_1 19/10/2012 09:48 Page 29
Newsbrief
Jennifer Brower
Area 5 (Midlands): New programme The President’s diary
Area 5 held a committee A few weeks ago I had the outstanding role model who seems that low vision meeting on Tuesday 25 pleasure of being invited to demonstrated how far talent services are still the poor September at Fradley Arms, witness the unveiling of a and determination can take relation of the NHS. nr Lichfield. The main blue wall plaque on a house you, and the house where purpose of the meeting in London to commemorate she lived now has a fitting This situation is not because was to finalise its the pioneering and permanent reminder of dispensing opticians have involvement at the 2012 ophthalmologist Dame Ida this inspirational lady. no inclination towards low ABDO Conference. The Mann. Dame Ida was a vision work. There is a group also discussed the remarkable woman at a During September I visited growing band of specialist Area’s next CET day, which time when so many doors Areas 1 and 4, and was very LVOs and I regularly receive will be held at the usual were shut to women. impressed to see the calls from other members north Midlands venue, the Among her many continuing enthusiasm and wanting to know how they Riverside Centre, Derby, on achievements, her book sheer hard work put in by can improve their skills and Monday 4 March 2013. ‘The Development of the the Area committees. Next become involved, and at Human Eye’ published in year the opportunities to the ABDO conference in As always, the cost is £20 1928 and ‘Congenital obtain CET points through Stratford-upon-Avon the low per ABDO member Defects of the Eye’ in 1937 Area activities will increase vision workshops were, (including students) and became standard texts; she and I hope you will all once again, filled to £45 for non-members. A established the first contact support your own Areas and capacity. The conference completely new lens clinic in London, and perhaps visit some others. itself was splendid, with well programme of speakers will became the first female attended lectures and a be put together taking into Honorary Consultant to the I am continually concerned busy exhibition. The weather consideration the new Royal London Ophthalmic at the patchiness of NHS low was kind, and the gala GOC rulings on CET Hospital. She was appointed vision services in some dinner, set in the stunning competences. All bookings Professor of Ophthalmology areas of the UK despite surroundings of the Gaydon will be taken on a first at Oxford University, many attempts by myself Heritage Motor Centre, was come, first served basis and becoming the first woman and others to remedy the a huge success (see capped at 80 delegates. To Professor at Oxford in any situation with recommended conference report page 16). reserve your place please field. During this time she pathways, and exhaustive Many congratulations to the email [email protected] was also the first to use explanation of the role of team behind the scenes. gehome.co.uk or penicillin to treat eye dispensing opticians to telephone 07814 558343 n infections. service commissioners. I Finally, my thanks to recently gave a talk members who showed their In 1949 Dame Ida moved to entitled, ‘Your low vision support for the ABDO Board Australia and in 1957 assessment’, at the Macular by sanctioning the adoption became a consultant Disease Society conference of the new Articles at the ophthalmic surgeon at the in London. There were AGM. The Articles are ABDO CET Royal Perth Hospital. She several hundred people in designed to reflect a more 5 Kingsford Business Centre also researched the the audience, most of modern and forward- Layer Road, Kingsford incidence of trachoma in whom were blind or partially looking membership Colchester CO2 0HT the indigenous population sighted, and afterwards I organisation and will email [email protected] and developed mass was approached by many continue to protect telephone 01206 734155 treatment programmes. She people asking where they members’ interests to the fax 01206 734156 died in Australia in 1983. could have a low vision highest level. Although Dame Ida lived so assessment because it had long ago I think she is still an never been offered. It Jennifer Brower DO November 2012_1 19/10/2012 09:48 Page 30
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Helping the homeless Joanne Benfield Games reach homeless Taking up the Members’ email patients challenge addresses
The Third Annual Homeless bifocals and three pairs of Dispensing optician, Please ensure we have Games, held in Liverpool ready readers. Joanne Benfield of your correct email address during September, brought a Edmonds & Slatter new opportunity for Vision Shaneela Chana, VCHP Opticians in Lutterworth, ABDO Membership Services Care for Homeless People organiser, said: “The majority joined in last month’s World department would greatly (VCHP) to reach those who who took part in the games Sight Day Challenge when appreciate it if all ABDO need help with vision. were under 25 and living in the practice asked for members could ensure that hostels which really brought donations from all their their personal details are The two-day event was to light their vulnerability. It patients after correct by logging into the supported by Optoplast with was very worthwhile complimentary adjustments Members’ area of the a donation of frames and attending and to be able to and repairs. ABDO website (www.abdo. ready readers, glazing by highlight the charity in this org.uk) and checking all Hoya and mobile equipment part of the country.” “We have supported their existing details are still loaned by the Outside Clinic. Optometry Giving Sight for up to date, especially their In conjunction with Crisis Our photograph shows three years now and I am email address. Merseyside, the VCHP team optical assistant, Amanda proud to donate to such a dispensed 21 pairs of single Grewal, who volunteered at worthwhile cause,” said Members can also update vision lenses, five pairs or the event. n Joanne. “The World Sight their details contacting Day Challenge is a great Membership Services by way to help support the email at If you have a job vacancy in your practice, please millions of people who [email protected]; remember that the Situations Vacant section in the Bulletin don’t have access to the or by calling them on 01227 Board area of the ABDO website provides you with a quick and easy facility to advertise completely free-of-charge. n basic eyecare that we can 733902, 01227 733912 or take for granted.” n 01227 733922. n Science of nystagmus explained
The first scientific book dedicated been made in understanding and solely to nystagmus was launched diagnosing nystagmus in the past 20 during National Eye Health Week years. (NEHW) in September. NN chairman, Richard Wilson, said: ‘The Challenge of Nystagmus: “This is an important publication that Proceedings of the Nystagmus brings together the world's leading Network Research Workshop, experts on this complex eye Abingdon, UK, 2-5 September 2009’, condition. We are raising money to Nystaagmus book launch produced by the Nystagmus Network bring the experts together again in (NN), has 25 chapters written by some 2013 so that we continue to make the of the world’s leading experts on most of their work to support people Matt Dunn form the PHD Research Unit nystagmus. It contains current with nystagmus.” for Nystagmus; Chris Purdon, the nystagmus research, treatment and book’s production editor; Tom Margrain management options, showing that The book costs £60 and can be from Cardiff University’s Research Unit early onset nystagmus is a obtained at www.nystagmusnet.org for Nystagmus; Ceri Jackson, chair of developmental condition. It also the NEHW steering group in Wales; and shows that considerable progress has Our photograph shows (from left): John Sanders of NN. n DO November 2012_1 19/10/2012 09:48 Page 31 DO November 2012_1 19/10/2012 09:48 Page 32
32 dispensingoptics November 2012
Gemma Craven presents MDS award The late Liz Danielewicz National award for Obituary: Moorfields team Elzbieta Danielewicz
A team of specialists from The honour, part of the West End optometrist, recently at Vision Care and Moorfields Eye Hospital Society’s 25th Anniversary Elzbieta Danielewicz, saldy Chiltern Street Opticians. have picked up a national Awards for Excellence, passed away on 21 August award. recognised the team’s at her home in London, “Liz was very professional exceptionally good aged 62, as a result of and had a great ability to Staff from the hospital’s practice in the care of pneumonia. get on with people from all Macular Clinic collected people with macular walks of life; she was the Clinical Service of the disease. They were Having grown up in North vivacious with a passion for Year Award at the Macular presented with their Wales, Liz moved to London Chanel, and had a very Disease Society’s annual award by charity patron to study at City University distinctive style. As London conference. They Gemma Craven, best and in the words of her mentioned at her memorial are Raja Das-Bhaumik, known for her role in the TV sister, Marta “never left the service, Liz was never Adam Mapani, Eric Ezra series Pennies From City”. happier than when outside and Simona Degli Esposti. Heaven. n a top London restaurant Roger Pope, for whom she with a glass of champagne worked, spoke fondly of Liz: in one hand and a “I knew Liz for 35 years cigarette in the other. She ABDO Benevolent Fund when she started at Keelers enjoyed West End life to the and our paths kept crossing full and had a long list of If you know of a dispensing optician, or a dependant over the years and she famous patients.” of a dispensing optician, who might benefit from the came to work for me in ABDO Benevolent Fund please get in touch with Jane New Cavendish Street 15 A memorial service was Burnand on 020 7298 5102 or write to her at ABDO, years ago. Prior to that, she held for Liz on 15 199 Gloucester Terrace, London W2 6LD. n had worked at Theodore September at St James’ Hamblin in Wigmore Street, Church, Spanish Place, at Harrods and more London W1. n
Sight test length surveyed
The Optical Confederation and the Department uses in fee negotiations, Richard Carswell OFRC Secretary Optometric Fees Review Committee has not been updated since 2000. explained: “We have discussed our (OFRC) recently surveyed one in 10 methodology and survey forms with optometrists to help measure the Since then anecdotal evidence is that the Department of Health and are average length of time a sight test the time taken to perform a sight test also being advised by a former now takes. has lengthened, particularly given the Department of Health statistician. This ageing profile of the population. will ensure that the data are of the The survey used to be funded by the highest possible quality and that the Department of Health but was Claire Slade, OFRC chair, said: time sequence is maintained.” abandoned when this responsibility “Despite repeated requests, the NHS transferred to the NHS and Social and Social Care Information Centre The survey will also calculate the Care Information Centre in Leeds. As has been loath to repeat the sight test private/NHS split of the number of sight a result information on the average survey so we have no option but to tests performed, data which again has time to perform a sight test, which the do it ourselves.” not been collected since 2004. n DO November 2012_1 19/10/2012 09:48 Page 33
Newsbrief
Battle of Britain celebrations Period drama at Stonehouse opticians
Staff at Norville Opticians in DO manager, Maria Kellett, said, “It almost as much as we enjoyed Stonehouse, Gloucestershire, recently was great to be involved in an event getting in costume for the day.” dressed up in period costume for like this. Opticians can be very Battle of Britain day celebrations in important in a small town like this and Our photograph shows from left: the town. I think it’s essential, especially with Daniel Read, DO Thornbury branch people’s worries about the economy, manager; Maria Kellett, DO The whole town was involved and to show that we as a business are Stonehouse manager; Julie Swain, there was music, face painting, and a part of the community. We did a free support staff; and optometrist Steve competition sponsored by Norvilles. prize draw which people enjoyed Tilley. n Job prospects in focus
Employers will be out in force at Optrafair next year to discuss job opportunities with attendees.
Daniel Grinsted, Boots Opticians’ franchise business development director, said: “Many in optics reach a point when they ask – what can we do next: we have forthcoming event promises locumed, we have been to be even bigger and employed and we at Boots better than last time. It will are exhibiting to show how provide us with the perfect we offer autonomy within platform to showcase our our franchise scheme as a diverse portfolio of services, natural career progression,” ranging from the recruitment he said. of optometrists, dispensing opticians, practice Specsavers, also exhibiting managers and contact lens at Optrafair 2013, will offer opticians. We also have an visitors the chance to interest within laser explore business ownership optometry, optical opportunities, or joint manufacturing, joint ventures, in Australia, New ventures and practice Zealand, Spain and the UK. sales.” Menwhile, Flame Health, which has supported Prospect Health will be Optrafair for the past 12 exhibiting for the first time, years, is looking forward to while the Outside Clinic will April’s show. Matthew be back with its recruitment Spicer, Flame Health and professional services divisional partner, said: “The team. n DO November 2012_1 19/10/2012 09:48 Page 34
34 dispensingoptics November 2012
Donations for repairs Caroline Lukehurst Proud Promotion at Tablets to supporter CVT claim
Norville Opticians asked for Caroline Lukehurst has been Shamir UK is offering an provides exceptional vision a donation whenever they promoted to the new post of Acer Tablet to customers in every viewing zone carried out an adjustment or international sales manager who purchase 35 pairs of owing to new technological a minor repair to someone’s at Cerium Visual Autograph InTouch lenses developments by Shamir, spectacles last month, to Technologies (CVT) a year before 30 November. said the company. support the World Sight Day after joining the company as Challenge. an assistant manager. The promotion is to Contact a Shamir sales celebrate the release of representative for more Norville Opticians director, CVT managing director, Autograph InTouch information or telephone Adrian Street, said: “We Clive Sangster, said: “I am progressive lens for on-the- 01954 785100. Full terms have supported Optometry delighted to confirm go users of digital devices and conditions can be Giving Sight for many years Caroline in this new and computers. The lens found at and we are proud to appointment. It signals the suits every wearer and www.shamirlens.co.uk n support such a worthwhile continuing youth and growth cause. It’s easy to take our of Cerium in this, the group’s Autumn price list out eyesight for granted here in 40th anniversary year. Her the UK, so taking the World new appointment underlines Norville’s new autumn Rx price list is now available. This Sight Day Challenge is a our commitment to the year’s edition covers 576 separate lens entries with an great way to raise funds to international development amazing 76 new since the 2011 edition. As previously, give sight to people who of Colorimetry, proving its Norville’s compact listings format enables product, don’t have access to the growing importance to available range and pricing to be quickly assessed via a excellent vision care our optometric practice logical sequence of lens material indices. For a copy call patients do. n diversification worldwide”. n 01452 510332 or email [email protected] n
Love campaign scoops award
Sight Care’s Eye Love My Local Independent Optician complaining of having flashing in his eyes. Joshua was campaign has won a gold award for Winchester based prescribed the use of different coloured lenses and advised Remarkable Group, the marketing agency behind the to complete a series of eye exercises, which improved his campaign. life dramatically.
Its Back to School initiative won the ‘Best Campaign’ More than seven million people had an opportunity to hear category at the PRide Awards, held in Southampton in and read about the initiative. September. The initiative addressed the statistic announced by the Association of Optometrists in 2011 that up to one Paul Surridge, chief executive at Sight Care Group, said: million children in Britain had an undiagnosed eye condition, “Remarkable, with their original and creative thinking, and conducted its own survey, which revealed that one in 10 achieved our aims entirely. We were pleased with the parents had never had their child’s eyes tested. coverage and would like to congratulate the team on their award. We are very proud that our campaign continues to Supporting the results was a case study of 10-year-old grow in strength and get important health messages across Joshua Hamwell from Essex, who was found to have macular to the public as well as promoting the value independent degeneration when he visited his local practice after opticians provide in local communities.” n DO November 2012_1 19/10/2012 09:48 Page 35
Newsbrief
Kate Walsh Ophthalmic Lenses Availability Former Apprentice 2012 edition now available joins Menrad
The new 2012 Ophthalmic Lenses Availability collates Kate Walsh of BBC’s The the UK. She said: “I’m information from leading lens manufacturers enabling you Apprentice fame has been thrilled to be joining the to rapidly locate the most suitable lenses for your patients. appointed as brand Menrad Optics team at ambassador for Menrad such an exciting time for A valuable dispensing aid, the guide includes: Optics. the business.” • Manufacturers’ data • Lens date files The appointment marks a Chris Beal commented: • An availability index new direction for Menrad “Kate is going to be Optics as it enters the world another vital part of our • PPL corridor length and fitting heights of high fashion with the operations and we are • Materials, tints and coatings launch of L’Wren Scott delighted to have her on • Lens engravings list eyewear at Silmo in Paris board. She has the last month. experience and ambition The new 2012 edition of Ophthalmic Lenses Availability is to take our future available now from the ABDO College Bookshop for only As sales and marketing portfolio into new fashion £45.00 plus p&p. director, Kate will support channels where you the company’s managing may not traditionally To place your order contact Justin Hall at the ABDO director, Chris Beal in expect to see the Menrad College Bookshop on 01227 733904. n promoting the range across name.” n
‘People-based’ progressive lens launched “It contains all the features that are characteristic of the Hoyalux iD LifeStyle design, such as a fixed Hoya has announced the launch of ordering behaviour and data input via curvature and uniform addition of Hoyalux iD LifeStyle V+, its new the MyStyle iDentifier we have +3.00D on the front surface, iD freeform progressive lens. The new received a wealth of valuable FreeForm Design Technology and lens forms part of the Hoyalux iD information. Wearer analysis, direct Balanced View Control,” added family of customised, freeform customer feedback, clinical trials and Eskola. progressive lenses and replaces consumer research have also The lens has two design variations: Hoyalux iD LifeStyle. contributed to new insights into the Hoyalux iD LifeStyle V+ Harmony – an visual needs of modern presbyopes. all-round progressive lens with the “Hoyalux iD LifeStyle V+ is our new Along with a new freeform most comfortable progressive progressive lens design based on aspherisation process and design distribution over the main vision areas; feedback received from your calculation technology, we can easily and Hoyalux iD LifeStyle V+ Clarity – patients,” said Petri Eskola, Hoya state that Hoyalux iD LifeStyle V+ is the with a primary focus on distance product specialist. “Through their result of people-based innovation. vision ideal for young, active presbyopes.
Stylish additions Until 30 November, every pair of Hoyalux iD LifeStyle V+ lenses Rodenstock has added stylish new models for men and women to its purchased will qualify for Love2shop Contemporary collection. The latest additions to the eyewear portfolio vouchers. Promotion details are combine quality with trendy design and striking modern colours. available from Hoya customer services on 0845 9900984 and at For more information call Rodenstock on 01474 325555. n www.hoyanet.co.uk/promotions n DO November 2012_1 19/10/2012 09:48 Page 36
36 dispensingoptics November 2012
Michael Wilkinson Frances Mecoy New operating Frances bids region farewell
CooperVision has established a new operating region Well-known lecturer Frances retirement would not see encompassing India, Pakistan, the Middle East, Turkey, Mecoy has taken early her leaving optics, but Russia and Africa. retirement from City & would leave her free to Islington college after 37 pursue her other optical “We want to capitalise on the strong support we see for our years of service. interests such as examining, branded products in these markets and continue to refine practice visits and tutoring - our commercial approach to both vision care professionals Frances started as a Science once she had finished and consumers,” said Dennis Murphy, executive vice Technician in 1975 when the catching up with her friends, president of global sales and marketing for CooperVision. college was located at she added. Michael Wilkinson, former vice president of marketing for Bunhill Row and over the Europe, the Middle East and Africa, is now general years became chief Head of department, Trevor manager for the new region. He joined CooperVision in technician. Whilst in this role, Hunter, paid tribute to 2006 as general manager for the UK and Ireland, and she qualified as a dispensing Frances saying: “She has previously held roles with Parfums Givenchy and Gillette. n optician going on to been an amazing source of become a very popular help and support, not only lecturer at the College. to the other members of staff and the college, but to Marketing skills to Speaking at her retirement all the students who have party, Frances said that she passed through over the be judged had enjoyed a wonderful years. Her leaving is going time and counted herself to be a great loss to us all.” Independent practices marketing initiative and very lucky to have worked that excel in their offline marketing initiative. with so many great friends Frances can still be marketing efforts, over the years. She was contacted through City including best window Dietmar Rathbauer, keen to point out that early College. n displays, will be managing director of celebrated in the 2012 Rodenstock UK, said: “Our Rodenstock Club Awards. prestigious annual awards Optician Index - August 2012 summary give us a chance to The awards reward reward our loyal customers independents for their and thank them for their • Total practice turnover increased by 1% from July to loyalty and support, support. For the first time 163 Index points but this is 7 per cent lower than culminating with a trip to we are also celebrating August 2011 Prague for the winners. those opticians who prove Practices from across the to be the best in the • Total eye examinations increased by 2% from July to UK are competing in a business when it comes to 102 Index points but this is also lower than August 2011 number of product their all-important • Turnover per eye examination falls from last month by specific categories, marketing skills.” £2 to £150 including Impression • Sample average total dispensing increases by 4% on Lenses, Lifestyle Lenses, The competition period last month to 90 Index points ColorMatic IQ Lenses, runs until 30 November, • New contact lens fits up 2% from July to 122 Index Dunhill, Porsche Design and the winning practices and Rodenstock eyewear. will be announced at a points lunch and awards The full August 2012 Optician Index report was published in the New categories focus on ceremony at The 28 September 2012 issue of Optician marketing, including best Landmark, London, on 18 window display, online December. n DO November 2012_1 19/10/2012 09:48 Page 37 DO November 2012_1 19/10/2012 09:48 Page 38
38 dispensingoptics November 2012
Rosemary Bailey outlines the route to becoming a practising contact lens optician The route to practising as a CLO
(Including how to be successful in the exams)
Since 1989, those dispensing opticians performance criteria and indicators, have gained GOC approval and wishing to practise as a contact lens are available on the GOC website, have met the Ofqual Level 6 standard. optician (CLO) in the UK must be on www.optical.org Contact lens practice requires the General Optical Council (GOC) combining the theory knowledge of specialty register. To gain entry to the There are three theory preparation anatomy, physiology and applied register, the DO must hold a GOC courses: ABDO College Distance pathology, the application of contact approved qualification and that is the Learning Course; Bradford College lens visual optics and of the theory ABDO Certificate in CL Practice (or the Day Release Course; and two types of knowledge of contact lens practice Diploma in Advanced Contact Lens courses at City & Islington College – a with the ability to perform the Practice). Only those who hold those first-year day release with an optional practical skills involved. qualifications may use the suffix CL or second year focused more on the (Hons) CL respectively. There is no practical elements. However, the Success in Theory suffix for those who are practising now information imparted in a formal Analysis of successful candidates in because they were in practice prior to course alone is unlikely to be sufficient the theory examinations indicates that 1989 when a qualification was not to prepare for the various assessments, to achieve the pass mark of 60 per required, and met the GOC and it is necessary to be aware of cent the following should be noted: requirements at that time so were current developments in contact lens • Four questions must be completed certified to continue to practise. practice by following research and of the five on offer in the Anatomy clinical experience reported in the and Visual Optics papers and of the Background professional journals and, of course, six options in the CL Practice paper. The examinations assess the GOC through regular supervised practical It is unwise to spend excessive time Contact Lens Competencies and experience. Students must be qualified on one question and risk not being involve: three theory papers to assess and registered as dispensing opticians able to complete the other the background knowledge and deal before practical experience with questions. It is very difficult to with some of the ‘an understanding patients may begin and for entry to achieve the pass mark if less than of’ competencies (Anatomy, the theory and practical examinations. four questions are answered. physiology and associated pathology, • The questions asked must be Contact Lens Visual Optics, Contact Joining the GOC specialty register as a answered – not the one the Lens Practice); and two practical qualified CLO results in the option to candidate might have liked the assessments of the ‘ability to do’ practise without supervision using an in examiner to ask. So the question competencies – one in practice date spectacle prescription, discussing should be read carefully. It will be a during the training period, contact lens options with the patient, waste of valuable writing time and demonstrating the teaching of assessing their suitability for contact effort to provide information that is handling, wear and care of contact lens wear and proceeding to fit, issue irrelevant to the question, and it will lenses, and the second to assess the and carry out aftercare on the lenses. not receive any extra marks. remaining competencies at a choice The responsibilities involved require a • Candidates should remember that of Birmingham or London venues. Full level of competency and expertise markers have to be able to read details of the competencies, including that cannot be considered lightly, so and understand the answer to be the breakdown of elements, the assessments must be stringent, able to allocate marks, so care DO November 2012_1 19/10/2012 09:48 Page 39
Contact lens practice
should be taken to use the correct • Rigid lens fitting: product (including hayfever as patients do terminology and perhaps clarify any knowledge, lens choice and order, not always consider that an allergy). short forms or acronyms used. assessment. • If applicable, a contact lens history • Anatomy and Physiology and Visual • Other types of contact lenses: including length of wear in total, Optics are areas that trainee CLOs knowledge of choices, product and types of lenses worn, age of current have already studied and since appropriate application of lenses and the what, how and when 2009, contact lens knowledge has astigmatic and presbyopic of any care products used. also been included in the Fellowship correction; also special case lenses • External assessment and assessments. However, in all subject (for cosmesis and therapeutic use). measurements. areas, a greater depth of • Aftercare: a consultation with a • Assessment of the lid positions/lid knowledge is required and contact lens wearer who is provided tension; measurement of especially so in CL Practice. by ABDO, discussion of a selection HVID/VPA/Pupil measurements • Examinations revision must include of the 10 case records presented (normal and low illumination) not only any course notes but also before the exam (by 31 May/30 • Keratometry: radii/meridians/mire other relevant reading and November) and a viva on quality/non-invasive tear break-up information learnt during practical management of contact lens time. It can be useful to note experience. Often the reason for aftercare issues, solutions, and legal dioptric powers too. lower marks is insufficient depth of matters. • Full slit lamp routine including knowledge in the answer. Remember, • Verification: analysis of an RGP lens assessment of tear quantity/tear this is a postgraduate qualification and recognition of the design quality/conjunctiva/sclera/corneal so is extending knowledge beyond features of several other RGP status at all levels /lids/lashes/ the Fellowship qualification. lenses. palpebral conjunctiva (all without and with fluorescein). It is recommended that to prepare for Success in the practical examination is the theory examination, candidates achieved by those who demonstrate A full aftercare consultation should should begin by writing down as much practical skill and background include: as possible on a commonly occurring knowledge in the areas which are part • Confirmation that the history is subject on the paper. This should then of the journey of a contact lens unchanged or the addition of any be reviewed and rewritten to fine-tune patient. Trainees should be allocated changes (details of the patient’s the content to essential facts at the more time than a qualified member of history, including last eye appropriate level. The next stage staff so that they are able to begin examination information and should be to re-write, timing the with a full routine and then become contact lens specifications are process and to continue reducing until more efficient and speedier; the provided to the candidate at the the text can be written within the examiner will expect the candidate to beginning of that section of the examination timescale. The paper is demonstrate the driving test version. examination). Then the questioning prepared to allow 30 minutes per The following examples are suggested. should continue as normal for an question so ideally the answer should aftercare consultation. take a few minutes less to write, to A full initial assessment routine should • General progress since last allow for checking the script for errors. include: appointment (any new problems, Training courses usually include revision • Consideration of the prescription visual and comfort status). in preparation for the various and its implications for contact lens • Wearing information (today, usual assessments and some provide pre- fitting (if no VA is included with the number of hours and number of examination courses after the course prescription from the optometrist or days). has finished, for their and other ophthalmologist, this should be • Care products used (what, how and students. assessed with spectacles and noted). when). • A full and detailed history and • Visual results: distance and near Success in Practical symptoms (for example, not just ‘Do (right, left and binocularly, including The major areas of practice for a you have any family history?’ but over-refraction and refractive competent CLO form the six main ‘Does your family history include verification such as duochrome, etc). elements of the ABDO Contact Lens such diabetes, epilepsy, etc?’). • Lens fitting assessment, movement Certificate practical examination: • Date of birth (in practice you should and position/centration, and • Initial assessment: contraindications also note contact details and the condition (millimetrically measured to contact lens fitting and legal patient’s GP). movement in some form is a better issues. History taking, routine • Occupation and environment/ record). observations and measurements. Slit computer use/driving/hobbies • Detailed status of the cornea, tears lamp techniques. Keratometry. including any sports (in practice, the and lids (including palpebral • Soft lens fitting: product knowledge, intended use of contact lenses conjunctiva and lid margins). lens choice and order, assessment. would also be noted). • Keratometry information. Also included at the end of this • Details of general health/family • VA with spectacles. session is an over-refraction to best general health/medication/ocular • Plan of action for the patient and/or vision sphere. health/family ocular health/allergies the practitioner. Continued overleaf DO November 2012_1 19/10/2012 09:48 Page 40
40 dispensingoptics November 2012
• Next appointment. also the Dk and Dk/t of the material; record is chosen for discussion. Check not just the power but also the back the ocular issues connected if a A detailed slit lamp examination surface curves and design, the front patient has a condition or is taking a routine should involve: surface design, centre thickness for specific medication. • Tear prism height assessment (using given powers such as -3.00 and +3.00. either a narrow slit or a small round • Care products: candidates will be It will be expected that the candidate spot of known size). expected to know not just the major will be able to discuss signs, symptoms, • General scan of the lids, lashes, preservative but other ingredients cause/s and management of sclera, conjunctiva, cornea and and their purposes. aftercare complications which should tears (using either diffuse illumination include: and a wide slit width or maximum Research the lenses and conditions • Detailed information including heat and light protection filters and discussed in Section 4: differential diagnosis - of the signs, a medium/narrow width – plus • Soft toric lenses are frequently fitted symptoms, causes (including likely sclerotic scatter). in current practice. In the pathogens) and management of • Detailed scan of the cornea examination, the candidate will be common aftercare complications. including the limbus (using a range expected to discuss the application (For example, anatomical of illuminations including focal direct of both RGP and soft toric designs. background to condition/why does and indirect, retro direct and • Presbyopia is corrected in a number condition arise/what are the signs indirect, optic section, parallelepiped of ways in current practice including and symptoms/all options of and specular reflection). multifocals, of which there is a range management.) • Slit lamp examination after the of both RGP and soft lenses in • Differential diagnosis of infections. instillation of fluorescein (with and current use. • Ingredients of contact lens solutions without cobalt filter). • Special lenses for cosmesis and and their purpose. • Observation of the palpebral therapeutic/bandage use are not conjunctiva (lid eversion at the slit seen regularly in general practice Candidates will be expected to be lamp). but the theory of their use is aware and able to discuss the legal discussed in articles and text books - implications of contact lens practice, All findings, even if quite normal, so candidates have access to as these will arise as appropriate in should be fully recorded in the notes. It revision information. (The examiners various sections. is difficult to prove that a specific will wish to be told which lenses check has been made if there are no might work best, in which situations Success in the section involving comments. (A’ tick’ simply means they and why.) verification and recognition of rigid have one and ‘NAD’ now translates as lenses requires the candidate to be ‘not actually done’.) Grading scales The candidates are required to able: encourage consistency and may take present case records developed • To analyse an RGP lens and to write up less space. during their personal clinical down all measurable parameters experience and to acknowledge and all information specific to that A routine assessment for over- ownership of the cases during lens so that it may be replicated. refraction, to achieve a best sphere discussion with the examiners, The lens is one the candidate might result, should include: confirming the rationale behind notes meet in general practice and is not • Achievement of the best sphere and the actions taken. Successful complex (the peripheral radii and power candidates: the lens material will not be • Assessment of distance visual acuity • Produce clear and concise case expected). • One or more confirmation tests used records examiners which meet the • To recognise the designs of four or in refraction (eg, duochrome, +1.00 mix and timing requirements. (The five other lenses. These have blur) case record mix requirements are complex lens design features. It is designed to ensure that candidates recommended that the instruments It is suggested that candidates: have experience with a range of are used to help with the decisions. Gain experience with a variety of prescriptions, lens materials and Although the actual measurements instruments, as it is unlikely that there designs before taking the are not required in the recognition will be an opportunity for a choice of examination - and are capable of element, maximum information slit lamp or keratometer in the managing the ongoing care of about the design should be stated. examination: contact lens patients. Full details are • Acquire full product knowledge, listed in the syllabus and in the Some final advice including full details of all lenses and training dairy issued to all students • Prepare fully. solutions used in the examination during their courses.) • Gain as much personal practical and of others, which may be useful experience as possible but ensuring in the contact lens practice (that Do some preparation before the the full procedures are employed. could relate to products outside the practical examination, such as revise a • And - good luck. range in particular practices). design of lens or the contents/actions • Lenses: candidates will be expected of solution if it is not in the practice’s Rosemary Bailey is ABDO chief to know not just water content but usual product range in case that examiner in Contact Lens Practice n DO November 2012_1 19/10/2012 09:48 Page 41 DO November 2012_1 23/10/2012 12:44 Page 42
42 dispensingoptics November 2012 Diary of events
dispensingoptics 4 November 4 March 2013 Area 11 (London) - CET day, Area 5 (Midlands) - CET day, £20 per The Professional Journal of the Association programme to be announced, there ABDO member or student, £45 for non- of British Dispensing Opticians will be at least 7 CET points, £25 to members, bookings will be taken on a first-come first-served basis, The Volume 27 Number 11 of 12 secure a place and provide a three- course lunch, Holiday Inn Bloomsbury. Riveside Centre, Derby. To reserve your EDITORIAL STAFF For details contact Membership place email [email protected] Editor Sir Anthony Garrett CBE Services on 01227 733902, 01227 home.co.uk or phone 07814 558343 Assistant Editor Jane Burnand Production Editor Sheila Hope 733912, 01227 733922, or email Email [email protected] [email protected] to book places. 13-15 April 2013 Features and News Editor Nicky Collinson Optrafair 2013 - FMO’s industry show, Email [email protected] NEC, Birmingham. For details visit Administration Manager Deanne Gray 14 November Email [email protected] President’s Consultation Day - All www.optrafair.co.uk members are invited and welcome to ADVERTISEMENT SALES attend at the Medical Society of 6-9 June 2013 Telephone 01892 667626 Email [email protected] London, Lettsom House, 11 Chandos BCLA - 37th BCLA Clinical Conference Street, London W1G 9EB. To confirm and Exhibition. Details www.bcla.org.uk SUBSCRIPTIONS your attendance email Jane Burnand UK £100 Overseas £110, including postage 8 July 2013 Apply to Tom Veti at [email protected], or ABDO, Godmersham Park, Godmersham call her on 020 7298 5102. Independents Day 2013 - ‘Close Kent CT4 7DT encounters of the patient kind: the Telephone 01227 733922 21 November sequel’. For details visit Email [email protected] I Area 10 (Kent) - AGM/CET evening, www.independentsday.co.uk ABDO CET Hoya - 'The digital switchover - not just CET Coordinator Paula Stevens MA ODE BSc for your tv', Charmant - 'Titanium in the (Hons) MCOptom FBDO CL(Hons)AD SMC(Tech) ABDO CET, 5 Kingsford Business Centre, Layer optical market', plus a visual recognition Road, Kingsford, Colchester CO2 0HT test 'A low vision aid(e)-mémoire', 4 ABDO College winter Telephone 01206 734155 CET points, buffet at 6.30pm, ABDO, revision courses Email [email protected] Godmersham Park, CT4 7DT. For details Email [email protected] ABDO College will once again be contact [email protected] CONTINUING EDUCATION REVIEW PANEL offering its popular revision courses FBDO (Hons) CL FBCLA to help students prepare for the Keith Cavaye 22 November Andrew Cripps FBDO (Hons) PG Cert HE FHEA forthcoming ABDO winter BCLA - 9th BCLA Pioneers Conference Kim Devlin FBDO (Hons) CL examinations. Stephen Freeman BSc (Hons) MCOptom FBDO (Hons) Cert Ed and evening lecture, Royal Society of Abilene Macdonald Grute FBDO (Hons) SLD (Hons) LVA Medicine, London. For details visit Monday 26 November Dip Dist Ed Cert Ed www.bcla.org.uk 9am-12noon: Year 2 Advanced Richard Harsant FBDO (Hons) CL (Hons) LVA Andrew Keirl BOptom (Hons) MCOptom FBDO Ophthalmic Lenses/Contact Lens Paul McCarthy FBDO PG Cert HE FHEA 25 November Anatomy Angela McNamee BSc (Hons) MCOptom Eyecare 3000 - London, The Queen 1pm-4pm: Year 2 Professional FBDO (Hons) CL FBCLA Cert Ed Edwin Moffatt FBDO Elizabeth II Conference Centre, London. Conduct/Contact Lens Visual Linda Rapley BSc FCOptom For details visit www.eyecare3000 Optics london.com or telephone 01848 332020 JOURNAL ADVISORY COMMITTEE Tuesday 27 November Richard Crook FBDO 9am-12noon: Year 3 Refractive 28 November Kim Devlin FBDO (Hons) CL Managemement/Contact Lens Kevin Gutsell FBDO ABDO Graduation and Prize Giving Practice/PQE Practical Ros Kirk FBDO Ceremony - Canterbury Cathedral. BSc (Hons) MCOptom 1pm-4pm: Year 3 Low Vision/PQE Angela McNamee Registration opens at 3.30pm and FBDO (Hons) CL FBCLA Cert Ed Practical closes at 5.30pm. Graduands should Dispensing Optics is published by assemble in the Chapter House no Monday 10 December ABDO, 199 Gloucester Terrace, London W2 6LD later than 6pm and the Cathedral 9am-4pm: CL practical/FQE Dispensing Optics is printed by doors will open for guests at 6.30pm. practical sections B, C & F Lavenham Press, Lavenham, Suffolk CO10 9RN For details visit www.abdo.org.uk © ABDO No part of this publication may be Tuesday 11 December reproduced, stored in a retrieval system, or transmitted 9am-4pm: FQE practical sections A, December in any form or by any means whatever without the D & E written prior permission of the publishers Identity Optical Training - FQE mock Dispensing Optics welcomes contributions for practical exams for sections B, C and All revision courses are subject to possible editorial publication. However, F, £75 per day, London. For details minimum numbers and will be held contributors warrant to the publishers that they contact Sally Bates on 020 8504 0967 at ABDO College, Godmersham, own all rights to illustrations, artwork or or email [email protected] Kent. Overnight accommodation photographs submitted and also to copy which is factually accurate and does not infringe any can be provided if required. 2 and 3 December other party’s rights For further information or to book a Identity Optical Training - FQE nd place, contact the ABDO College ISSN 0954 3201 practical exam revision courses, 2 rd Courses Team on 01227 733911 or Average circulation 2011: 8854 per issue - ABDO Section C and F, 3 Section B, D and email [email protected] n Board certification E, £75 per day, London. For details see Identity Optical Training above
ABDO members are welcome to attend Area meetings in any area they wish www.abdo.org.uk DO November 2012_1 19/10/2012 09:48 Page 43 DO November 2012_1 19/10/2012 09:48 Page 44