Download this issue - Optometry Today

www.optometry.co.uk June 3 2011 vol 51:11 £4.95
optometrytoday
Eye contact in
consultations
Back to School
campaign
Tinted lenses
’offer relief
from migraines’
A place in the sun
New looks in sunglasses for the summer

Introducing
®
the natural defence against Dry Eye
Trehalose 3%
THEALOZ® contains trehalose:
•Trehalose protects and avoids
corneal cell damage from dryness
•Trehalose increases resistance to
dryness of epithelial corneal cells
•Trehalose protects cell life in
extremely dry conditions
THEALOZ® is a real alternative for
Dry Eye treatment.
We learn from
watching nature
To Order & Enquiries: 0845 521 1290 or www.spectrumthea.co.uk
Spectrum Thea, Fernbank House, Springwood Way, Macclesfield, Cheshire, SK10 2XA

Become our fan on Facebook’
http://twitter.com/OptometryToday
CONTENTS
June 3 2011 vol 51:11
Photo by Phil Weedon/BCLA
6 30
News
5 Glare opportunities
Global study shows practitioners could
benefit from tackling patients’ symptoms
6 Contact lenses ‘drive growth’
Sales of contact lenses rose last year but the
frames market dropped according to new
figures
7 Eye Health Week
Details of the annual focus on eye care
later this month
8 Comment
OT editor-in-chief David Challinor asks if a
‘maybe’ approach to pay rises in practices
might benefit business
10 Tints ‘give relief’
New research on precision tinted lenses
shows they can help migraine sufferers
12 New resource
A website has been launched which shows
how donations to the Central (LOC) Fund are
used for the benefit of the whole profession
14 GOC recruiting
The regulatory body is seeking a new lay
member
Cover story
30-31 Sunglasses
A look at the latest styles and trends
Events
6 BCLA 2011
Reaction from newcomers to the annual
conference
28 OT Live
An optometrist gives her verdict on the CET
programme
Products
20-21 Industry news
New launches from Silhouette, Charmant
and Bausch & Lomb plus a major boost for
Jai Kudo and new technology from Shamir
UK
Regulars
22 Spectator
A review on the future of the High Street seeks
to create diverse town centres
32 Crossword
This month’s prize competition
36 Diary dates
All the latest optical events for the summer
39 Student news
Celebrations for Glasgow Caledonian and
Anglia Ruskin plus an OSCE refresher course at
Bradford
Features/interviews
16-18 Improving communication
Part 2 on the importance of eye contact and
gaze in optometry consultations
24 Children’s eyecare
Why the profession’s campaign is vital for every
child
27 Compliance update
Advice from the AOP on the the latest
developments on contract compliance
inspections
Clinical
34-35 VRICS: Presbyopia
& Ageing Eyes
This covers the correction of presbyopia and
identification and management of ageing eye
conditions
40-44 CET: Optimising
glaucoma referral
Key advice on how to recognise possible
cases of glaucoma, for referral to specialist
practitioners, through presentation of case
studies
45-48 CET: Optometric
management of dry eye
This article outlines the role of the optometrist
in the conservative management of dry eye,
namely through treatment with artificial tear
substitutes and eyelid therapy
Classified
50-54 Jobs
All the latest vacancies. The Outside Clinic
continues to grow and is looking for employed
and locum opticians
55-58 Marketplace
CBS offering frame package deals from £1.25
Feature is online
Video is online
www.optometry.co.uk

TELEPHONE:
0151 426 3907
WWW.CONTINENTAL-
EYEWEAR.CO.UK
JUNIOR
MODELS FEATURED
HE WEARS 2064
SHE WEARS 2044

A NEW global study of people patients who experienced
using vision correction has
the symptoms found each
found that halos and glare
bothersome (84% and 89% for
remain commonplace.
halo and glare, respectively).
The Needs, Symptoms,
·
Spherical aberration, which can
Incidence, Global Eye Health contribute to irregularities in the
Trends (NSIGHT) study surveyed visual system, can create halos and
3,800 spectacles and contact glare. Spherical aberration is a type
lens-corrected wearers, from 15 of image blur caused by light rays
to 65 years of age, from seven striking the lens periphery where
different countries (the UK, as they are bent too much – over
well as China, Korea, Japan, refracted – compared with rays
France, Italy and the United coming through the centre of
States) to better understand the lens.
the eye-related symptoms
Loughborough-based
that vision-corrected patients optometrist, Nick Dash, said:
experience.
“It is important for eye care
The study found:
professionals to discuss vision
·
About half of the spectacle in low-light situations with their
and contact lens wearers
patients to ensure solutions
surveyed reported suffering from are identified for patients
the symptoms of halos (52% experiencing halos and glare.”
and 56%, respectively) and glare The study findings indicate
(47% and 50%, respectively) that the severity of symptoms
more than three times a week. associated with halos and glare
· More than four out of five is sufficient enough to impact on
NEWS
Glare study shows
‘opportunities’
Falls awareness
to focus on sight
THIS
YEAR’S Falls
Awareness
Week will
focus on the
link between
reduced
vision and
falls. Events highlighting
the annual week from June
20-24 will be held across
the country with the aim of
informing older people about
the simple steps they can take
to reduce their risk of falls,
such as having an eye test.
Helena Herklots, services
director at Age
UK, said: “There
are a number
of things that
professionals
can do to help
prevent falls;
simply ensuring
older people have regular
eye tests and are wearing the
right prescription glasses will
help with balance, making
them feel as confident as
possible.”
To find out how to host an
event visit www.ageuk.org.
uk/fallsweek.
patient satisfaction with prescribed
vision correction methods.
Coupled with how ‘bothersome’
patients tended to find the
symptoms, about 90% of these
patients (90% for halos, 91% for
glares) reported having either
no solution or one that was
unsatisfactory. Moreover, the same
rate of these patients (89% for
halos, 87% for glares) expressed
an interest in an intervention that
more adequately addressed the
symptoms.
Carla Mack, global medical
affairs director for Bausch & Lomb,
which commissioned the report,
said the company believes there
was opportunities for eye care
professionals to address these
common symptoms with their
patients. “Some spectacle designs
as well as aspheric contact lenses
may help patients achieve optimal
visual correction with no halos or
glare,” she claimed.
The study was conducted by
independent market research
firm, Market Probe: Europe.
Additional analyses from the data
obtained in NSIGHT is expected to
appear in optometry journals and
professional congresses later
this year.
BRIEFING
MIDO moves to
new days
Organisers of MIDO have
announced that next year’s show
will start on Sunday March 11 and
end on Tuesday March 13, moving
away from its traditional Friday to
Sunday scheduling.
The change comes following
feedback collected at this year’s
event, which showed that many
delegates and exhibitors would
prefer two weekdays, according
to MIDO vice president, Cirillo
Marcolin (pictured).
He added: “We came up with
what we think is a very good
answer – two of the three days of
(the 2012) MIDO are on consecutive
days when many Italian opticians
are not working. Sunday and then
Monday, a day on which stores are
closed in many regions of Italy and
in some other European countries.
We think that this will meet the
needs of our reference public and
will help in the decision to visit our
exhibition.
“We are confident that these
considerations will please many of
our stakeholders and fulfil our main
mission of organising an event at
the service of the sector.”
5
03/06/11 NEWS

NEWS
optometrytoday
JUNE 3 2011
VOLUME 51:11
ISSN 0268-5485
ABC CERTIFICATE OF CIRCULATION
January 1 2009 – December 31 2009
Average Net: 20,203
UK: 19,308 Other Countries: 895
Editor-in-Chief: David Challinor
T: 020 7202 8164
E: davidchallinor@optometry.co.uk
Deputy Editor:
Robina Moss
T: 020 7202 8163
E: robinamoss@optometry.co.uk
Web Editor:
Emily McCormick
T: 020 7202 8165
E: emilymccormick@optometry.co.uk
Reporter: Chris Donkin
T: 020 7202 8162
E: chrisdonkin@optometry.co.uk
OT Multimedia Editor: Laurence Derbyshire
T: 020 7401 5310
E: laurencederbyshire@optometry.co.uk
Clinical Editor: Dr Navneet Gupta
E: navneetgupta@optometry.co.uk
OT Manager: Louise Walpole
T: 020 7401 5330
E: louisewalpole@aop.org.uk
Editorial Office:
Optometry Today, 61 Southwark Street,
London SE1 0HL
Advertising: Vanya Palczewski
T: 020 7878 2347
E: vanya.palczewski@tenalps.com
Sponsorship: Sunil Singh
T: 020 7878 2327 E: sunil.singh@tenalps.com
Recruitment & Classified: Haley Willmott
T: 020 7878 2313 E: haley.willmott@tenalps.com
CET and bookshop enquiries: Charlotte Verity
E: charlotteverity@aop.org.uk
Production: Ten Alps Creative
T: 020 7878 2323 E: gemma.trevillion@tenalps.com
Membership Dept:
61 Southwark Street, London SE1 0HL
T: 020 7261 9661
W: www.aop.org.uk
Advertising and Production Office
Ten Alps Creative and Ten Alps Media,
Commonwealth House, One New Oxford Street,
High Holborn, London WC1A 1NU
Editorial Advisory Board
Duncan Counter, Leon Davies, Mark Draper,
Polly Dulley, Dan Ehrlich, Andy Hepworth, Niall
Hynes, David Ruston, David Shannon, David
Whitaker, Vincent Yong
W: www.optometry.co.uk
Published fortnightly for the Association of
Optometrists by Ten Alps Creative
Subscriptions
Alliance Media Limited, Bournehall House,
Bournehall Road, Bushey, Herts, WD23 3YG
T: 020 8950 9117
E: stelios.kontos@alliance-media.co.uk
UK £130, OVERSEAS £175 for 24 issues
Next generation praises
record-breaking BCLA
NEW DELEGATES given free
places to this year’s BCLA
clinical conference and
exhibition described the event
as “informative and excellent
for networking” and vowed to
recommend it to colleagues
for next year.
A record numbers of
delegates attended this
year’s event at the Manchester
Central conference centre, which
ran from Thursday to Sunday
last week. Final figures confirm
that there were a total of 1,186
delegates, of which 98 attended
just the free exhibition.
BCLA president Shelly Bansal
said he was delighted by both
the attendance and the feedback
from new delegates. He told OT:
“It (the conference) has been
excellent. The new delegates
say they are pleasantly surprised
to realise that the BCLA is not a
clique, it’s for every practitioner,
no matter what their skillset. They
seem to have really enjoyed it.
They’ve seen we’re just everyday
people and they can be a part of
this. We want them to be a part
of this.”
For the first time this year,
free spaces at the conference
and the Bollywood-themed gala
dinner were made available to
some new delegates, together
with a personal meet-and-greet
breakfast with Mr Bansal on
Sunday.
Addressing the newcomers,
Mr Bansal said: “The BCLA is not
a club for the best practitioners,
it’s not a club for the novices,
it’s a club for everyone. We want
to break the myth that we’re an
outdated organisation for contact
lens specialists.”
At the breakfast, new delegate
Sarabdip Ryatt, owner of Ryatt
Optometrists in Loughborough,
told OT he had been tempted to
attend because of the offer of a
free place: “I’ve been meaning
to come to the BCLA conference
for a long time,” he said. “The free
places are excellent, you get
to find out exactly what it’s like
being a member.”
Ravi Vaid, clinical support
colleague at Boots Opticians
in Greater London added: “It’s
been great. Really informative.
In the past we (myself and
colleagues) didn’t really know
what the conference offered,
but now we do, I’d definitely
recommend it.”
Another first-time delegate
Simon Lefever, CLO for
Specsavers, Barrow-in-Furness,
praised the community
spirit he found among other
new delegates – who were
identifiable by the yellow stripe
on their badges.
“It’s quite nice. Most of the new
delegates seem to be here on
their own so between lectures
and in the exhibition everyone’s
really friendly and wants to chat,”
he said.
Next year’s event will take
place away from a Bank Holiday
weekend, on May 24-27 at the
new Birmingham venue for the
association, the ICC.
• For more on this year’s BCLA see
www.optometry.co.uk.
Contact lenses ‘drive growth’
SALES OF contact lenses
and care products arose
almost 5% in value for the
last year according to GfK
Retail and Technology UK,
while the frames market
continued to fall.
Comparing figures for
the first quarter of 2011 to
those from the same period
in 2010, sales of contact
lenses were up 4.9%, adding
£6m, despite the number of
fittings being down 0.9%
Photo by Phil Weedon/BCLA
year-on-year.
The report shows frames
as being the only segment
of the UK optics market
down in both volume and
value. Volume dropped 3%
to 3.16 million units and in
value by 2%, which meant a
slight increase in the average
frames dispense to £68.10.
Women’s frames now make
up 44% of the market with
men’s sales contributing
35.2%.
The figures also show a
shift from lower price points
towards the mid and highend.
In the first quarter of
2010, glasses sales valued as
lower than £75 accounted for
45.1% of the market, whereas
current figures show this has
fallen to 42.1%. The luxury
segment of the market (above
£220) now accounts for nearly
5% of all sales in value.
For a detailed report visit
www.gfkrt.com/uk
Comment on the news via www.optometry.co.uk

DO complaint leads to
advert being banned
A COMPLAINT from a
dispensing optician has led
to a national press advert by
Specsavers being banned
by the ASA (the Advertising
Standards Authority).
The advert was headlined:
“Some opticians charge
extra for digital retinal
photography. At Specsavers,
we don’t”. Text underneath
stated: “Many opticians charge
for using the latest optical
technology. You pay once for
your ‘normal’ eye test, then
pay again for digital retinal
photography, a sophisticated
process that uses a digital
camera to take a picture of the
back of your eye and help your
optician monitor the health
of your eyes ... We also believe
that as many people as possible
should have access to this new
technology, so digital retinal
photography is now available in
590 of our stores”.
The DO challenged whether
the advert misleadingly implied
that digital retinal photography
was the latest technology,
because he understood “that it
had been superseded by Spectral
Domain Optical Coherence
Tomography”.
Specsavers told the ASA that
Digital Retinal Photography (DRP)
and Spectral Domain Optical
Coherence Tomography (SDOCT)
were completely separate
technologies.
Specsavers also explained that
the technology for OCT was first
introduced over more than 20
years ago and disagreed with
the complainant that it had been
recently introduced.
However, the ASA
decided the advert had
breached its ‘misleading
advertising’ and
‘substantiation’ rules, and
said it must not appear
again in its current form.
A Specsavers spokesman
told OT: “This was a
single complaint by one
dispensing optician,
based on an interpretation of
the word ‘latest’. It was upheld,
after some quibbling over the
dates when various technologies
were introduced, but that does
not take away from the fact
that Specsavers provides a
sophisticated, nationwide digital
imaging capability as part of the
standard eye test.
“At Specsavers if you are
over 40, or your optician
recommends it, then digital
retinal photography comes at no
extra cost. It not only provides an
in-depth eye examination, with a
detailed record, it also can – and
does – save lives.”
First woman president
THE WORLD Council of Optometry
(WCO) has welcomed its first
female president, Tone Garaas-
Maurdalen (pictured) at its latest
meeting in Puerto Rico. Ms Garaas-
Maurdalen takes over the role from
George Woo, who has recently
completed his two-year term. Ms
Garaas-Maurdalen said: “It is a real
honour to be the first female WCO
president and I look forward to continuing the
important work the WCO does for the profession
worldwide. WCO has always been an important
unifying voice and catalyst for international
projects and services. I am delighted to be able
to ensure that it continues to meet the future
needs of the optometric
profession and the public
around the globe.”
Her career highlights
include working as
professional affairs
manager at CIBA Vision
for Nordic countries,
working in private practice
and holding the position
of executive director of the Norwegian
Optometric Association. Other appointments
at the meeting include the UK’s Bob Chappell
becoming chair of the legislation, registration
and standards committee, and Canadian
Susan Cooper being made president elect.
BRIEFING
Eye Health Week -
final preparations
Last minute preparations are being
made for this month’s National Eye
Health Week (June 13-19).
Readers are being urged by
its organisers – a cross-sector
grouping which aims to raise public
awareness of the importance of eye
health and the need for regular eye
examinations – to get involved in
10 days’ time and tell their patients
and the wider community about
how vital eye care is.
To do this go to the campaign’s
website at www.visionmatters.
org.uk/
The event will be helped by two
eye care charities which are putting
their weight behind the promotion.
SeeAbility
is urging the
public to
have an eye
test during
National Eye
Health Week
with the help
of food writer and cook Clarissa
Dixon-Wright (pictured). She
said: “Having faced the terrifying
experience of sight loss with
cataracts, I know how important it
is to have regular eye tests. Without
early intervention, I could have
lost my sight. I am delighted to
support SeeAbility during National
Eye Health Week. I do hope it
will resonate with the public and
encourage people to look after
their eyes and have them tested
regularly.”
SeeAbility, formerly the Royal
School for the Blind, supports
people with a visual impairment
and multiple disabilities. Fight for
Sight has also joined National Eye
Health Week, as a lead sponsor.
The charity, whose mission is
to support research into the
prevention and treatment of
blindness and eye disease, will
use National Eye Health Week as
a platform to launch ‘Carrots’ – its
first fundraising nightwalk which
will take in London landmarks on
September 23.
7
03/06/11 NEWS
News updated regularly at www.optometry.co.uk

NEWS
COMMENT
8
03/06/11 NEWS
Optometrist found
to be fit to practise
A GOC panel has decided
that an optometrist who
failed to immediately
refer a patient showing
symptoms of a potential
retinal detachment does
not have his fitness to
practise impaired.
The fitness to practise
committee, chaired by
Margaret Wall, found that,
although optometrist
Roger Staite was guilty of
misconduct it was a ‘quite
uncharacteristic lapse on
the part of a competent
and conscientious
practitioner who has
given great service to the public over many years.’
Mr Staite, who practised for 42 years, admitted
allegations that he: failed to perform a dilated
examination of the patient’s retina during an
examination in February 2009; did not refer
her as an emergency on the same day to an
ophthalmic unit or seek any advice on such a
referral; and in a further consultation – less than
a week later – he referred her to a GP rather than
an ophthalmic specialist.
The practitioner has now retired, but Ms Wall
confirmed that ‘had he remained in practise
the committee would not
have felt there was a risk of
repetition.’
During the case, Ms
Wall said the panel was
“impressed by the way he has
questioned himself rigorously
over these matters. He has
clearly agonised over the
lapses of judgement he has
made (and) co-operated fully
with the GOC’s investigation
and willingly came to the
hearing to give evidence.’”
Although not used by the
defendant to try and excuse
himself, there was found to
be an ‘administrative failing’
which meant the results of a visual field test
examination were not immediately available
during the first assessment.
Ms Wall added: “This failing helps to explain,
but not excuse, the misconduct that took place
in relation to this patient. It is important for
members of the profession to remember that
delegation of tests to unqualified staff does not
absolve them of professional responsibility.’’
The GOC concluded Mr Staite’s fitness to
practise is not impaired and has not issued a
warning for the misconduct charge.
Moorfields charity launched
FORMER CONSERVATIVE MP Ann
Widdecombe launched the new
Moorfields Eye Charity at the
hospital last week (pictured).
The charity is to help to provide
services and improvements that
cannot be achieved within the
limits of normal NHS funding. Its
aims include to support hospital
improvements, fund research,
purchase new equipment,
support ophthalmic teaching
and training, improve the ‘patient
environment’ and generally enhance
services to patients.
Cutting the ribbon Ms Widdecombe
said: “Moorfields strives to make
advances in the field of eye care
and, no matter what government
is in place, it
will never be possible to fund
them all.
“This new charity will help
support Moorfields in taking
this work forward and to keep
producing ground-breaking work.
It is an honour to be launching the
charity and I can only encourage
people to support it over the
coming years.”
For more information on the Moorfields
Eye Charity, visit: www.moorfields.nhs.uk
COULD A ‘MAYBE’ BE
THE BEST POLICY
RECENTLY I heard that a practice
employer was facing something of a
revolt by his receptionist and optical
assistant over their hopes to get a
bigger pay rise, and one which would
keep pace with inflation.
Before many of you fellow managers
out there cry ‘in the current economic
environment? They’d be lucky!’ I’d
ask is there room for something of a
negotiation?
One area which our sector constantly
debates is the necessity to get new
patients to grow an optical business.
Some practices produce a plethora of
leaflets etc, while others use special offer
boards outside their outlets to attract
new people in. But in this day and age,
isn’t it time to be somewhat more direct?
What I mean is that I’m constantly
approached by those representing
charitable causes – or ‘chuggers’ as
they’re also known – but I for one
would find it refreshing to find a
representative of an opticians asking
me directly whether I have had an eye
examination of late.
And who better to do this than the
very personable and ‘people friendly’
receptionists and other public-facing
staff that practices employ? If carried
out to some success surely wouldn’t
that be worth negotiating towards a
payrise, rather than a blanket ‘no’?
I do understand that business is very
difficult out there, and that this would
mean discussing an extension of an
employee’s role, which can be difficult
too. But in a month where we mark
National Eye Health Week isn’t more
proactive approaches like this worth
a try?
David Challinor, Editor-in-Chief OT
Comment on the news via www.optometry.co.uk

is
ACUVUE ® . SEE WHAT COULD BE .

NEWS
10
03/06/11 NEWS
OBITUARY
Decia Griffiths MCSP,
BSc(Hons), FCOptom
The death has been reported of
former practitioner Decia Griffiths
who graduated in Ophthalmic Optics
from City University. She was 83.
Her optometrist daughter and
Huddersfield practice owner, Stella
Griffiths, writes: “My mother and
my family are steeped in both optics
and politics. My father, Will Griffiths
FBOA, MP, came from Manchester, and
trained as an ophthalmic optician in
the 1930s, when he also joined the
Labour Party. He was elected as an
MP in his home city in 1945.
Passionate about health
provision for the public, he became
Parliamentary Private Secretary
to NHS founder Aneurin Bevan,
was closely involved with the
establishment of the Health Service
in 1948, and was also a founder of
the Opticians Act of 1958.
Decia Griffiths was raised
in Blackpool also with politics
in the blood. She trained as a
physiotherapist and married Will
Griffiths having met him at a Labour
Party dance. They moved to London
and encouraged by her husband,
Decia went to City University and
graduated in Ophthalmic Optics in
1970.
Will and Decia were in practice,
both in London and Manchester, and
Decia continued as an optometrist
until 1998.”
Lis Thomas
Wales-based optometrist and practice
owner Lis Thomas, 45, has died.
Optometry Wales said that she ran
her practice Thomas Opticians, in
Margaret Street, Ammanford,
for 15 years and died “suddenly
and unexpectedly during a recent
Bank Holiday and will be missed by
colleagues and family”.
Tints ‘give migraine relief’
NEW RESEARCH on precision
tinted lenses has claimed they
can offer relief to migraine
sufferers. The study, which
involved a UK-based team, may
provide a breakthrough for
patients hitherto considered
untreatable.
Precision tinted lenses have
been used to help poor readers,
and are used for migraine
sufferers, but the science behind
their effects has been unclear.
The study published in
Cephalalgia (May 26), uses
functional magnetic resonance
imaging (fMRI) for the first time
to suggest a neurological basis
for these visual remedies. It
shows how coloured glasses,
tuned to each migraine sufferer,
work by normalising activity in
the brain. The researchers saw
specific abnormal brain activity –
hyperactivation – when migraine
sufferers saw intense patterns.
The tinted lenses considerably
reduced the effect.
BRITISH EYEWEAR brand TD
Tom Davies has increased its
Chinese-based production
workforce by 22% to meet
a growing demand for its
ready-to-wear collection
and bespoke and couture
spectacles and sunglasses.
To celebrate progress,
the brand invited a team
of international opticians
to tour the facilities and
take part in an inaugural
four-day advanced training
programme inside the
workshop in Shenzhen.
A dozen opticians visited
the production departments
and newly renovated
The team, from Michigan State
University and the University of
Michigan, US, and the University
of Essex, homed in on specific
visual stimuli known to trigger
migraines and which may also
cause seizures in those with
photosensitive epilepsy.
Before the brain imaging
took place, participants were
tested and prescribed precision
ophthalmic tints (POTs) with an
Intuitive Colorimeter. Previous
studies have suggested that
some 42% of migraine with aura
sufferers saw their migraine
frequency halved on days when
they wore POTs.
The researchers used the
Colorimeter to illuminate text
with coloured light, manipulating
hue and saturation at constant
luminance. For each test
participant, this gave an optimal
hue and saturation (chromaticity)
of light that led to the greatest
comfort, reducing perceptual
distortion. The test subjects then
viewed stressful striped patterns
illuminated with their optimal
coloured light settings to screen
for efficacy. The researchers used
the readings to generate both
effective POTs for each migraine
sufferer and also two other pairs
of grey and coloured lenses
with slightly different properties
as controls. Eleven patients
who frequently suffered from
migraine enrolled in the fMRI
study. Each patient was paired
with a migraine-free control,
who was also tested with that
patient’s three sets of lenses.
Although patients reported
some relief using all of the lenses
(by around 40%), the POT lenses
had a significant effect when
viewing the stressful stripes
(70% discomfort reduction).
Both control and migraine
patients responded similarly to
the non-stressful stripe patterns,
and in these cases, all three
lenses made no difference to
the result.
Workforce increased
ground floor. They observed
the intricate production
processes developed by
Mr Davies, from the initial
design and engineering
process to the final quality
control procedures at the
end. They also took part in
workshops on key stages of
production, including rim
wire forming, sandblasting
and hand polishing, with
each visitor able to oversee
the production of frames
that they had ordered for
their own customers.

Manufaktur
Anything but standard.
Unusual requests need
unusual solutions. Therefore,
the Rodenstock Manufaktur
Team is your number one
contact partner for all special
lenses requirements.
01474 531113

NEWS
12
03/06/11 NEWS
IN BRIEF
Don’t miss AOP
Awards deadline
The deadline is fast approaching
for nominations for the AOP’s
new awards, with the winners
nominated and voted for by the
profession itself. The winners
will receive their accolade at a
prestigious and fun annual awards
ceremony in November.
We all know a group,
organisation, individual or students
(picture from the AOP student
conference) that deserve to be
recognised for their contribution
to optics, so here’s your chance to
thank them for their efforts, but
hurry as all nominations must be
received by June 30.
The entries will be whittled
down by an internal judging panel
to a shortlist of three finalists
per category. The finalists will be
published in OT and readers asked
to vote for the winners. Everyone
who is shortlisted will be invited
to attend the National Optometric
Conference on November 3, where
the winners will be announced.
The conference and ceremony
will be at Chesford Grange, a
luxurious hotel set in 17 acres of
private grounds in the Warwickshire
countryside.
Nominating is easy, just visit
www.optometry.co.uk/awards and
enter your nomination. Alternatively
post it to: AOP Awards, AOP, 61
Southwark Street, London, SE1 0HL.
You will need to provide
contact details for yourself and the
nominee/s, as well as between
200-500 words describing why you
feel this person or group should
be nominated. There should be
evidence of true effectiveness
related to the award criteria. Full
details are on the website.
Central Fund launches
new website resource
A NEW website has
been launched which
gives more details of
how the voluntary
levy from eye health
professionals supports
projects benefitting
the whole profession.
The new site, www.
centralfund.org.uk,
has been established
by the Central (LOC)
Fund, giving details of both
current and past projects, as well
as initiatives which have been set
up thanks to generous voluntary
contributions from optical
professionals.
Keith Chapple, a representative
of the Central (LOC) Fund said:
“We are very grateful for the
optical profession’s generosity
enabling us to regularly fund a
wealth of projects including eye
health campaigns and literature.
Although we are acutely aware
of the financial pressures faced
by LOCs, we hope some may
consider making a one-off
donation as they complete their
end of financial year accounts.”
Readers can contact the Central
Fund treasurer Roy Brackley via
the new website.
The Central (LOC) Fund collects
money by voluntary levy and
donations from optometrists
and LOCs. It distributes the
donations in the form of grants
to organisations and individual
applicants for “issues and projects
that will be of benefit to
the whole profession”.
Georgina Gordon,
head of the LOC
Support Unit, has left
the LOCSU to explore
opportunities outside
of the organisation. A
spokeswoman for the
Unit said: “Georgina was
the first head of LOCSU,
and brought to the role
a wealth of expertise in clinical
and general management gained
from board level positions in a
number of major organisations.
We thank her for her valued
contribution to the work of the
LOC Support Unit and we wish
her well in her future career.”
The acting head of LOCSU
is Richard Carswell at the AOP
(pictured at a LOCSU training
day) and the director of
operations and commissioning
is Katrina Venerus.
Independent duo expands
A STAFFORDSHIRE duo
is looking forward to
expanding their business
with the opening of a
second practice in the
county. Optometrist Jan
Goodwin and Sarah Edge,
dispensing optician, have
now bought the former
Gnosall Optometrists in Gnosall, following the
retirement of Peter Mincher-Lockett.
The duo bought Mr Mincher-Lockett’s Stafford
practice in 2006, and have made significant
changes, including extending into neighbouring
premises, and a total refurbishment, as well as
investing in some new kit. Both practices will
now be known as Mincher-Lockett Opticians.
“We are thrilled to be opening a second
practice,” said Ms Edge.
“When we started
out, we made it part
of our commitment to
continually improve
the quality of the eye
care we provide, and
we are already looking
at investing in new
equipment for the Gnosall practice.”
New services will include macular pigment
screening and NHS diabetic screening, and the
new owners are also planning to introduce a
wider range of frames and contact lenses, along
with new equipment.
“Using more modern equipment improves the
efficiency, quality and the range of the testing
we can do,” said Ms Goodwin.

GG Vivvi C2
INTERNATIONALeyewear
The Eschenbach Group Telephone: 0121 585 6565

NEWS
14
03/06/11 NEWS
IN BRIEF
Police presentation
Optometry Wales has delivered
a presentation to South Wales
police officers about vision and
driving. The presentation, which
has been delivered in England and
some European Countries, was
created by FODO’s head of policy
and regulation, Mark Nevin. A
spokeswoman for OW said that
feedback has been positive, and
that other stakeholders present
have asked OW to deliver the
presentation within their own
organisations.
New WCSM director
The Worshipful Company of
Spectacle Makers (WCSM) has
announced the appointment of
Adele Williams (pictured above)
as its qualifications director.
Responsible for the further
development and marketing of
WCSM qualifications, this will
include the expansion of its current
range of examination-based
qualifications and the introduction
of new ones with an emphasis
on work-based assessment. Ms
Williams has worked for a number
of years as a lecturer in education,
and for the last seven years, she has
been a senior manager in Awarding
Bodies, working with employers to
develop qualifications, particularly
in the health sector.
Smart multiple
Staff from Specsavers have a new
look from this week after two big
names in fashion – Gok Wan and
Jeff Banks – worked together to
help redesign the optical group’s
uniforms. The 20-piece capsule
collection, known as iWear, was
rolled out across the UK and Ireland
with all staff wearing it from this
month.
Ultralase ahead by 5%
LASER EYE surgery company
Ultralase has announced a
5% growth in revenue for
the last full year.
Revenue increased to
£42.3m in 2010, compared
to £40.3m in 2009, with its
core business of refractive
surgery showing a sales rise
of 8%.
Chief executive of
Ultralase, Tony Veverka
(pictured) said: “Whilst market
conditions remain challenging,
our latest figures are a clear
indication that the group
continues to increase market
share. Our performance yearon-year
and in the context
of our competitors, remains
strong and is testimony to our
growth strategy and continued
investment in our clinical
team and advanced
technology.
“This year sees us
celebrate our 20th year
and we are delighted that
the outlook is promising.
With 31 clinics in the UK
and Ireland and a series
of new clinic openings
planned this year, we are
well positioned to achieve
further gains in market
share within the industry.”
The company also said that
99.1% of its patients in 2010
achieved vision ‘of driving
standard or better’.
New lay member sought
THE GOC has launched its
search for a new lay member
through the Appointments
Commission.
In the advertisement on
the Commission’s website,
the Council says it is looking
for a candidate who can:
“demonstrate senior level
experience in patient safety
or advocacy, or public
involvement” and is “able
to articulate the interests
of service users who are
especially vulnerable, either
because of income or other
circumstance, or because
of their complex optical
requirements”.
Talking about the
importance of attracting a
forward-thinking member,
THE OPTOMETRIC adviser for
the College of Optometrists
has been appointed to the
National Association of
Primary Care’s council. The
council, of which Susan
Blakeney is now a member,
chair of the GOC, Anna
Bradley (pictured) said:
“Our vision is to lead the
way in professional health
regulation. There are going
to be some significant
challenges in healthcare
regulation over the next few
years and the Council and
staff are very focused on
identifying and addressing
is a national not-for-profit
body. Ms Blakeney said: “It is
a membership organisation
for those involved in, or with
an interest in, a primary
care led NHS. It has three
core aims – to promote the
these challenges proactively.
“We have made an
important start strengthening
the organisation and
modernising some of our
practices. We have been
laying the foundations, but
there is plenty more to do
and we are looking to
enhance our team for the next
phase of work.”
Applications must be
received by June 16 with
interviews taking place in
late July. Remuneration is
in the region of £12,000 per
annum for around three days
commitment each month.
Those interested can apply
through the website: www.
appointments.co.uk using
reference DH0251.
National role for adviser
highest possible quality in the
delivery of primary care services
for patients; to support the
effective introduction of GP
commissioning and to support
the development of clinical
leadership.”

Silhouette | valid until 12.2011
©
CRYSTALS.
A WOMAN’S
PASSION.
PRESENTED BY HELENA CHRISTENSEN
www.silhouette.com

RESEARCH
Eye contact and gaze in
optometry consultations
16 28
08/04/11 03/06/11 COVER COMMUNICATING
STORY
Researchers at the Department of Management Helena Webb and Dirk vom Lehn at King’s College
London report from a project about communication in optometry consultation. In this the second
part of their series – the first published by OT on April 8 – they describe the importance of eye
contact and gaze
IN OUR research we video-record optometry consultations
in order to observe and analyse the communication that
occurs between optometrists and patients. Using videorecordings
enables us to capture both verbal and nonverbal
forms of interaction and we can then develop an
advanced understanding of how communication takes
place in the consultation. In this article we highlight
the connections between talk and non-verbal
elements such as eye contact and body movement
and discuss their implications for practice.
Across healthcare fields, surveys of patient
satisfaction regularly highlight the importance
of eye contact. Patients often complain that their
practitioners spend much of the encounter looking
through medical records, at the computer screen
etc rather than making eye contact and that as a
consequence they do not feel properly listened to.
Communication skills’ guidance for practitioners
therefore frequently emphasises the importance of
maintaining eye contact in order to establish rapport,
demonstrate empathy and ultimately to enhance
patient satisfaction. We can add that as well as
affecting satisfaction; the presence or absence of
eye contact can influence the way in which
communication in the consultation unfolds.
Example 1 in our data shows a transcript
of a brief segment of history-taking in a
standard eye examination. The videostill
images illustrate the physical
positions of the optometrist and patient
throughout this segment. The patient
is looking towards the optometrist
and the optometrist is turned
towards her desk writing
on the record card.
We have added some extra
markings in the transcript
(used as standard in our
method, Conversation
Analysis) to highlight
something noticeable about
this interaction. Although
the optometrist elicits the
necessary information from
the patient, the conversation

etween them appears
Example 1
‘stilted’ rather than smoothflowing.
The frequent
silences - shown by the
numbers in brackets in
the transcript- contribute
to this stilted feel, in
particular those that seem
to delay a response, such
as in line 2 following the
optometrist’s question
about computers and
in line 8 before the
optometrist acknowledges
the patient’s comment
about television. There
is also an overlap of talk
and a mismatch of topics.
In line 5 the patient
begins speaking and the
optometrist also begins
to speak in overlap with
her (this is shown by the
square brackets in adjacent
lines of the transcript).
The patient stops shortly
after the optometrist begins
her question, answers the
question in line 7 and then goes back to her original comment
about television.
Delays, overlaps and topic mismatches can occur in
conversation for various reasons. In this instance we suggest
that they are connected to the absence of eye contact between
optometrist and patient. This is because eye contact, or more
generally looking at another person during conversation,
functions as an important resource to aid communication
during face-to-face encounters. Looking at someone whilst
he/she speaks to me displays that I am listening, allows
me to notice any gestures the speaker is making and which
may convey important information, and also enables me to
discern when that person is about to stop talking so that I can
take my ‘turn’. Meanwhile, by looking at me the speaker is
able to monitor my expression for signs that I may not have
understood, am in disagreement etc. Maintaining eye contact
“Eye contact and gaze are crucial
interactional resources that can
aid the flow of communication”
and gaze helps us to be actively involved in the interaction
and where this does not occur – as in example 1 – a stilted,
non-flowing conversation can result.
The resources provided by eye contact and gaze can be
particularly important in interactions where those involved
do not know each other well – such as in consultations
between a healthcare practitioner and patient. Ironically, these
are occasions in which eye contact is frequently withdrawn as
the practitioner turns towards the record form, examination
equipment etc. We
have already observed
that the absence of eye
contact can disrupt
the flow of interaction.
Additionally, patients
sometimes pursue
eye contact when the
practitioner’s gaze is
elsewhere. Example
2 occurs at the start
of the consultation.
The patient is
sitting next to the
optometrist’s desk
and the optometrist
is turned towards
her as she asks about
the existence of any
problems. The patient
replies ‘no’ in line 3
and then goes on to
describe how she does
not wear her glasses
all the time. During
this description the
optometrist turns to
her computer and
begins typing, withdrawing eye contact. There follows a 1.6
second silence during which the patient changes her body
position. As shown by the video-stills in the transcript, she
moves her entire body sideways towards the optometrist.
This makes her significantly closer, positions her within
the optometrist’s field of vision and makes it easier for the
optometrist to return the patient’s gaze. In fact it ‘requests’
that she does so by making it clear that patient is looking
at her. As the patient describes feeling sick in lines 6-8 the
optometrist does in fact look over to her.
The pursuit of a return of gaze through body movements
or other actions is a widely-observed phenomenon across
communication studies. This is not to suggest that people do
this in a pre-meditated way, but rather that this is another
‘seen but unnoticed’ interactional resource that all of us
deploy, often even without realising it. In our analysis we
notice that patients typically perform such actions when
they are about to reveal some information that can be
considered important. In example 2, the patient’s change
of body position comes just before she reveals that she
can’t wear her glasses without feeling sick, a potentially
significant symptom. In our final example the patient delays
revealing the exact nature of a problem until the optometrist
has turned around to face her.
The optometrist is sitting at his desk facing away from
the patient and preparing the record form. As with example
1, this physical position prevents eye contact and we can
observe that the conversation is slowed down with silences.
In line 1 the patient says that her eyes have got worse and
the optometrist invites further information by asking ‘what’s
been happening?’. The patient answers in line 6 with a
17
03/06/11 COMMUNICATING

RESEARCH
Example 2 Example 3
18 28
08/04/11 03/06/11 COVER COMMUNICATING
STORY
short, ambiguous response, ‘driving’. After ‘okay’ from the
optometrist she does not continue with her problem report
but asks a question of her own in line 10, ‘you know?’. The
optometrist does not answer but turns his head to look at her
for the first time in this sequence. In the silence at line 11 he
begins moving his chair round to face her with the record
form on his lap. It is at this point that the patient provides
a more complete description of her problem – that she can’t
see distances (line 12). This description has been delayed
until the optometrist is in a position where he can see as well
as hear her and eye contact is possible (although the patient
herself is looking down in line 12). The delay of talk provides
a different kind of resource to ensure important information
is delivered at a point when eye contact is possible.
These three examples illustrate patterns across our data
and display the close connection between talk in optometry
consultations and non-verbal elements such as gaze, eye
contact and body movements. These patterns have practical
implications that optometrists may wish to consider.
Firstly, whilst eye contact is often linked to patient
satisfaction this is not the only role it plays in the
consultation. Eye contact and gaze are crucial interactional
resources that can aid the flow of communication. The
withdrawal of eye contact by the optometrist can lead to
disruptions, and patients may perform actions that pursue
the return of the optometrist’s gaze or delay reporting certain
information until eye contact becomes possible. It is therefore
useful for optometrists to reflect on how far they maintain or
withdraw eye contact during their consultations.
Of course many practitioners will point out that
maintaining eye contact would be ideal but that time
limitations sometimes make it to necessary to withdraw
gaze in order to make notes or prepare equipment etc
whilst conversation is taking place. Given these practical
constraints it is also useful to reflect on which moments in
the consultation particularly benefit from the maintenance of
gaze. We have shown that eye contact is important when the
patient is delivering key information about his/her symptoms
so it is worthwhile avoiding other activities at this point, or
at least to combine them with frequent looks towards the
patient. For similar reasons maintaining eye contact is also
important when the optometrist is delivering key information
in the form of a diagnosis and management advice. A further
point to consider is that whilst withdrawing gaze to carry out
other activities appears to save time, it may well result in the
kind of delays seen in examples 1 and 3 and in fact slow the
consultation down rather than speed it up.
Finally, the layout of the consultation room can help or
hinder the maintenance of eye contact. Looking again at
example 1 we can see that when the optometrist faces her
desk she has no opportunity for eye contact and would
need to change her body position to a large extent to see
the patient’s face. This in fact happens during example 3,
in which the optometrist first looks over his shoulder at
the patient and then moves his chair round to face her. By
contrast, in example 2 the positioning of the optometrist’s
desk and patient’s chair next to each other means that the
optometrist can transfer gaze between the patient and the
computer via a much smaller movement. So the physical
layout of the room can have significant consequences for
communication in the consultation.
The connections between verbal and non-verbal elements of
interaction are integral to communication in the consultation.
Any consideration of ‘communication skills’ needs to include
attention to eye contact, gaze and body movement. This article
has illustrated some key points for such consideration.

BUSINESS BUILDING WEB SEMINAR SERIES
Live: June & July
Want to maximise your business?
Then join leading business consultants
and participate in an interactive
discussion, debate and live Q&A session
from the comfort of your home!
Ahead of the game: The benefits of professional
fees based pricing.
Shelly Bansal, 7pm, Monday, 20th June 2011
Make it happen: A step by step guide to
professional fees based pricing.
Martin Russ, 7pm, Monday, 11th July 2011
Open to Eyecare Professional throughout the UK and Ireland. Interested delegates are invited to visit
www.cibavisionacademy.co.uk
© CIBA VISION (UK) Ltd, a Novartis company, 2011. The Fit for Life logo, CIBA VISION and the CIBA VISION logo are trademarks of Novartis AG.

INDUSTRYNEWS
MEN’S FRAMES
20
03/06/11 INDUSTRY NEWS
The Charmant Group, the global specialist in
high-value titanium eyewear, has launched
a new collection for men, “ad lib” which
combines fashion and comfort.
Inspired by the word and attitude derived
from the Latin, “ad libitum”, which means
“be free” or “as you like”, young fashionconscious
spectacle wearers can choose and
wear the “ad lib” frame in a more casual and
individualistic manner, suiting their lifestyle
and circumstances.
With a touch of the latest trends for young
men, the new models are inspired by cars
and home interiors. Edges and slits have been
used in the frame structure with a threedimensional
approach.
Colours for “ad lib” men are vibrant and
individualistic. The dual colouring on the metal
or layered acetate, utilised using a carving
technique, provides a contrast of colours.
Frame AB3108U (pictured top) is an urban
inspired half rim style. The wearer’s personality
is reflected by the frame’s modern structure
of a milled titanium front, individualistic
temples with the three rhythmic bevel slits and
masculine dual colours. It is offered in black/
orange and black/green as well as brown, dark
grey and white.
The “ad lib” icon has been put on the end
tips. The unique hinge function ensures a
wearing comfort for this particular style,
despite the temple form.
Frame AB3112U (pictured middle) is a
modern remixing of vintage acetate frames
with the carving on the layered acetate and the
selection of colours giving it a fresh look. It is
offered in brown, green, orange and yellow.
Frame AB3110U (pictured above) has a
touch of oversized styling. It is offered in black,
brown, dark and light grey as well as silver.
020 8992 9911
Pack for travel
BAUSCH & LOMB’S Biotrue Flight Pack is now
available in the UK and Ireland, offering contact
lens wearers the benefits of the multi-purpose
solution in a convenient size in time for the main
summer holidays.
Each flight pack contains two 60ml bottles of
Biotrue, a clear plastic zip bag, two lens cases and
care instructions, making it easier for contact lens
wearers to keep their lenses clean and healthy
when travelling for work or pleasure.
The solution is bio-inspired to work like the
eyes to help contact lenses stay moist for up to 20
hours.
“The flight pack offers eye care practitioners
the opportunity to increase their sales by providing their customers with on-the-go lens care at
the busiest time of year for travel products,” said Nichola Menzel, professional relations manager,
Bausch & Lomb Northern Europe Vision Care.
“Bausch & Lomb recognises that when people are travelling they want to minimise the size and
number of bottles and liquids they are carrying, especially when flying.”
Biotrue was developed following intensive studies on how the eye naturally works. It is
formulated to work like the eyes with three bio-inspired innovations. It matches the PH of healthy
tears, utilises a lubricant found in eyes and keeps certain beneficial tear proteins active. The
solution also exceeds the FDA/ISO stand-alone procedure for disinfecting products.
0845 602 2350

Making
waves
SILHOUETTE, THE world’s leading rimless
brand, has joined the fashion trend for
a return to colour with its new ‘Colour
Waves’ eyewear collection, featuring zesty
colours and graphics.
The collection is up to 80% handmade
in Austria and comprises six frameless
models which extenuate the wearer’s
features, complemented by the arms
available in the colours, Sweet Honey,
Fresh Green, Power Red and Cool Blue.
For the more reserved are the colour
combinations of Trendy Grey and Young
Pink, which emphasise the graphics and
wave optics of the arms but look different,
depending on the perspective.
“Particularly when the light shines
from a certain angle on the ultra light
SPX temple arms and illuminates the
strong colours, Colour Waves comes alive
transforming from eyewear into a fashion
statement,” said Silhouette brand director
Andreas Aschauer Martinelli.
020 8987 8899
New market
unmasked
GET LENSES,
the UK’s
largest online
contact lenses
retailer, has
expanded into
the Italian
market with
the launch of
GetLenses.it.
The move is in response to rapidly
growing demand in Italy and builds on
the company’s success in the UK and
Ireland, where the business is growing at
around 20% per year. The London and
York-based company has sales of £6m
a year and 100,000 customers. Around
75-80% of sales come from repeat
customers.
“A less crowded marketplace, with
fewer competitors, made sense for our
first foray into mainland Europe,” MD
Michael Kraftman told OT.
Eyes on
exports
JAI KUDO designer eyewear company
has been recognised as one of Britain’s
best performing exporters, with an annual
international growth in sales of 62.51%.
In this year’s International Track 100
published in The Sunday Times, Jai Kudo/
Pure Technology ranked at number 71.
The league table ranks Britain’s private
companies with the fastest-growing
international sales over the last two years.
“We are delighted to feature in the
list,” said Jai Kudo’s executive managing director, Jamie Holoran. “Given the ever increasing
competitiveness of the UK optical market, we have opted in recent years to concentrate on
developing market share further afield. I’m pleased to say that the reaction to our products
has been extremely encouraging.”
Jai Kudo is based in Hertfordshire and represented in more than 30 countries, with sales
from North America and Europe contributing to around half of last year’s turnover. Large
deals with overseas clients in America have further boosted international sales from £1.9m in
2007 to £4.9m in 2009.
“Although, like everybody, we are hopeful of an improving economy domestically, I would
envisage us continuing to drive sales forward in the European territories where we have
made the greatest gain,” said Mr Holoran.
020 8732 9600
As-Worn Technology
SHAMIR UK this week launched the upgrade of Smart Single Vision, with As-Worn
Technology. It is aimed at providing single vision patients with the personal fit they need “to
experience crisp, clear uncompromised vision”.
The technology is an innovation in the personalisation process, which fine-tunes a
patient’s prescription by calculating three distinct measurements – back vertex distance (the
distance between the lens and the eye), pantoscopic tilt (the angle at which the frame sits on
the patient’s face) and panoramic angle (the angle of the frame itself).
Submitting the three measurements, along with the patient’s Rx, allows Shamir’s Presciptor
software to adjust the prescribed Rx to “better suit the patient as they wear the frame on
their face”.
The upgrade also offers an advantage to patients due to its aspheric/atoric rear surface
which means the lens can be lighter, due to decreased centre thickness, and for high plus
patients, an aspheric/atoric lens means better clarity because of minimised off-centre errors.
The design is produced consistently in all materials, which means single vision patients can
have multiple pairs of Smart Single Vision
As Worn in various materials, switching
from pair to pair without adjustment time.
“We offer the most superior progressive
lens solutions on the market and we
wanted to extend this commitment to
superiority to the single vision market as
well,” said Shamir UK general manager,
Phil Bareham.
01954 785100
21
03/06/11 INDUSTRY NEWS

SPECTATOR
Mary to the retail rescue
for diverse town centres
22
03/06/11 SPECTATOR
THE PRIME Minister has announced that Mary Portas
(pictured) has been appointed to lead a “no nonsense”
review into the future of the High Street to “help us to
create vibrant and diverse town centres.” A couple of the
items in the shopping list contained in the objectives of
the review are for her to advise on how to: ‘prevent the
proliferation of “clone towns”’, and, ‘to increase the number
of small and independent retailers’. One could speculate
whether, with the relatively fresh memory of riots in Bristol
against the presence of the leading supermarket brand, this
latest initiative is politically motivated.
However, the aim is clearly laudable as variety, choice
and the regular refreshing of our town and city centres
benefits us all. But before we all become dewy-eyed with
nostalgia, we must be realistic – support for variety does
not mean defending mediocrity. Tired and weak businesses,
no matter how quaint or once loved, will go – they simply
have no future on the modern High Street. Equally certain
is that strong innovative businesses, including optometrists
and opticians, will survive. But as in Bristol, where the
Cheltenham Road Tesco Express store re-opened last week
(May 24) there should be no doubt that the supermarkets
will continue to grow and over time will come to dominate
all the markets in which they are active – including optics.
Towards the end of last year, the Department of Health
was indicating that by April 2014, GPs would have to
have reduced unscheduled admissions to hospital (by
patients with long term conditions) by 20%. But GPs aren’t
being allowed to take their time working towards this target,
with an article in last week’s Pulse magazine revealing
that PCTs and healthboards have set their own target of an
average of a 15% reduction by the end of this financial year
alone.
That’s not all – average reductions of over 30% in A&E
attendance are also being targeted. Against this background,
Stephen Dorrell, chairman of the Commons health select
committee, has spoken out with his view that the solution
to achieving the unprecedented levels of savings required,
lies not in simply more competition, but in proper
integration. GP magazine reported his comments to an
audience at the King’s Fund last week, where he argued
that better service integration across the health sector
rather than simply delivering services in ‘silos’ was the
answer: “If we are going to rise to the challenge we face,
we now have the urgent, drop-dead requirement to deliver
a degree of integration that we have talked about but never
succeeded in delivering.” Which is why, as the primary care
practitioner group for community eye care, our profession
must form part of this solution.
Review to advise on how to
‘increase the number of small
and independent retailers’
According to a report published in last week’s Barrister
Magazine, medical negligence claims against GPs increased
by 20% in 2010 when compared to the previous year.
Although delayed or incorrect diagnosis formed the basis of
the majority of the claims, the second most common category
was ‘failure to refer.’ While there is no suggestion that
pressure to reduce referral rates has had an influence (rather
it is suggested that the increasing availability of ‘no win no
fee’ arrangements may play a part), there is no doubt that this
has potential to create a friction between the need to control
budgets and the need to ensure that all those who require
onward referral are so directed. With the prevalence of ocular
problems on the average GP patient appointment list, there
is much that primary care optometry can do to support their
local GPs with both sides of this difficult equation.
For more comment visit www.optometry.co.uk

Humphrey HFA II-i
The Gold Standard in Perimetry
Be part of a winning team
Not all visual field instruments are equal,
the Humphrey Field Analyzer is by far the
number 1 in the world.
Its also number one in the UK with over
95% of NHS hospitals trusting its accuracy.
Carl Zeiss Ltd
Medical Division
www.zeiss.co.uk
PO Box 78, Woodfi eld Road
Welwyn Garden City Herts AL7 1LU
Tel: 01707 871237 Fax: 01707 871363
E-mail: medical@zeiss.co.uk

CAMPAIGN
A clear vision for every child
24
03/06/11 CAMPAIGN
IN SEPTEMBER, almost 500,000
five-year-olds will start school.
Their ability to learn will
certainly be affected by their
ability to see, and for many,
no-one will know how well they
can see. Just 53% of children in
the UK have had any form of eye
examination and in September,
it is estimated that one million
children will return to school
with an undiagnosed vision
problem.
The UK is way behind the
rest of Europe in the number of children who have regular
eye examinations and the proportion of children who wear
vision correction. In France, it is part of the summer back to
school routine to book children in for an eye exam. In the US
state of Kentucky, it is the law that every child must have a
comprehensive eye examination before they are allowed to
start school.
The UK Government has recommended that all four-yearolds
should have orthoptist-led vision screening. However,
with less than 1,000 orthoptists in the UK, it is an impossible
task. Add to the lack of man-power the fact that it’s entirely at
the discretion of individual PCTs whether they commission
any form of vision screening or not, and it’s easy to see why
vision screening does not work effectively.
However, most parents still assume that their child will
have their vision checked at school, regardless of whether this
actually happens or not. Vision screening, when it is done, is
designed to pick up amblyopia. It probably won’t pick up low
to moderate refractive error or binocular vision anomalies and
certainly does not assess the health of the eyes.
Optometrists in community practice are qualified to
examine the eyes of all children, paid for by the NHS. Isn’t
it time that our profession started to blow its own trumpet
and let parents know that we are here to provide that very
important service? Children’s eyes change over time and so
it is important to examine children’s eyes regularly over the
years, as they grow. This, in
turn, can be a great practice
builder. One child’s vision
problems solved by you can
lead to an entire family of new,
loyal patients for your practice.
Back to School
The Children’s Eyecare
Initiative aims to improve
awareness of the need for eye
examinations for all children
among parents, teachers and
healthcare workers in schools.
The 2011 campaign has a ‘Back to School’ theme, including
a new poster which we would like to see displayed, not only
in schools, but also in High Streets up and down the country.
The AOP will be sending out a resource pack this month,
including the campaign poster to download, a template press
release and tips for generating local media coverage. The
association will be also sending out the poster, along with
other downloadable resources, to primary schools throughout
the UK via school nurse managers.
Get talking
The AOP will be compiling a list of all interested
optometrists and dispensing opticians who would be
prepared to visit schools to give talks in assemblies,
to children in class, or to members of staff or parents.
Commenting on school talks, Polly Dulley, chair of the
Children’s Eyecare Initiative, said: “I’ve been doing this
myself for many years and can testify just how good this is
for your profile in the community. It never ceases to amaze
me how receptive both children and staff can be when I visit
the school with a member of my team to talk about eyes.
We’ve had a stall at Health Week in one school, had a ‘drop
in for a chat’ session at an evening for new parents, as well as
giving talks to individual classes to help them with their Key
Stage 1 and 2 curriculum.”
The Children’s Eyecare Initiative aims to support
colleagues to get up to speed in seeing children. A range
of resources have been produced, from a top tips guide, to
myth-busting in children’s eye care and practice leaflets for
parents. In addition, many of the larger CET providers are
currently offering courses as well as distance learning on
children’s eye care.
An information pack will be sent out this month with
everything you need to get involved with this year’s ‘Back
to School’ campaign. If you would like to volunteer to visit
schools in your area, and to be included on the national
register, please send your details (including your practice
address) to childrenseyecare@aop.org.uk
For more information, visit the website: www.aop.org.uk/
childrenseyehealth or email childrenseyecare@aop.org.uk

First choice ocular supplement
of UK ophthalmologists
Once-daily with extra lutein
For further information please call Alcon Freephone 0800 092 4567 or visit
If in any doubt, consult a medical practitioner before starting to take ICAPS.
Available in the UK only.
ICAPS:OT:05/11:LHC
www.icapsinfo.co.uk

Face Facts
Approximately 19 million adults say they would like some form of cosmetic surgery
Between 2005 and 2009, the cosmetic surgery market in the UK grew by 174.9%
Since 2005, 50% more men are reaching out for cosmetic surgery procedures
3
2
1
Uplift is a national network of independent
optometry practices and leading
oculoplastic and refractive surgeons.
We provide:
cosmetic eyelid and upper face surgery
eyelid surgery
cataract surgery
laser eye surgery
Join the team
Demand for the procedures we offer continues
to increase rapidly.
Become part of the team and benefit from:
significant additional income opportunity
added value for existing business
increase in services offered to patients
national promotional campaigns
clinical, aesthetics, sales and referral training
Discover more at:
www.upliftnetwork.com
cosmetic eyelid &
upper face surgery
Request an Information Pack at:
0800 0148 321
info@upliftnetwork.com
www.upliftnetwork.com
1. Mintel Oxygen, June 2010. 2 and 3. Key Note Cosmetic Surgery Market Report 2010

ADVICE
Update on
compliance
Trevor Warburton reports on the latest
developments regarding PCC
IT IS now two years
since the pro-forma was
introduced with a list of
relevant inspection points
and questions to assist PCTs
and optometric advisors
on contract compliance
inspections and so Primary
Care Commissioning
has been revising it, in
consultation with the
National Optometric
Advisors’ Association and
the Optical Confederation.
In some cases, the changes
reflect variations in the
contract, such as the requirement to offer a choice of
practitioner where possible, whilst others relate to changes in
guidance, such as the College Guidelines on Infection Control.
On record keeping, final visual acuity has been separated
from unaided VA, or VA in current spectacles. C:D ratio is
mentioned in ophthalmoscopy, along with a question to
note whether any further comments have been made under
the heading of ophthalmoscopy. There is a specific note that
electronic records should be backed up regularly and the
backup kept separately and securely, though this has been
advice within Quality in Optometry (QiO) from the start.
Contract compliance is about ensuring a basic and safe
standard of practice that complies with the contract and the
law. It isn’t about requiring best practice, or even typical
practice, but ensuring patient safety. The practitioner may
endanger themselves if their record keeping is poor, but the
contractual concern is whether it endangers the patient.
Improving standards beyond this is a matter of education and
peer practice, not contract inspections.
Other new items include a check on whether it is possible
for the optometrist to make a confidential telephone call to,
or regarding, a patient, for instance to refer urgently, and
whether computer terminals in public places are safe and
secure – access restricted when no member of staff is present
and the screen not observable by passing patients.
For any practice which is already fully compliant with
Level 1 of QiO, these changes will be minor. Nevertheless,
work to update QiO and its accompanying audit tools to
match the new pro-forma has already commenced. Any
questions relating to contract compliance should be directed
to Richard Carswell at the AOP.
• Full article can be read on www.optometry.co.uk
27
03/06/11 ADVICE

EVENTS
‘Thrilling and valuable’
Optometrist Vicky O’Connor describes the OT Live CET offering at Optrafair
28
03/06/11 OT LIVE 2011
THIS YEAR’S Optrafair
highlight for many clinicians
was the OT Live CET
programme. The format of an
open-air main lecture arena
provided a fantastic setting
for some thrilling lectures,
allowing all participants to
soak up the atmosphere of
the surrounding exhibition
while gaining some valuable
education. The variety of age
and specialities amongst the
delegates in the audience at any
one moment highlighted the
wide range of people the setting enabled speakers to reach.
Saturday’s lectures in the main arena included an
emotive talk by ophthalmologist Brendan Moriarty, and
optometrist and independent prescriber Peter Frampton on
the importance of the provision of eye care in both the UK
and developing countries. They compelled us to get on board
with such projects, even within our own local communities.
Optometrists Dan Rosser and Dr John Wild opened
our eyes to the latest updates on glaucoma diagnosis and
management. Meanwhile, in the satellite arena, optometrist
Peter Charlesworth (pictured) advised on the most important
aspects of children’s eye care for community practitioners,
including the somewhat trickier aspects of paediatric
dispensing.
Karen Sparrow, educational adviser to the AOP, shared
a few tricks of the trade with employed optometrists,
mentoring on how best to communicate with our employers,
colleagues and even our patients, key skills to a good working
environment.
Sunday offered a packed schedule, with an emphasis
on the new toy in town, OCT. Simon Browning and David
Samuel shed some light on the fear that can be the peripheral
retina, its imaging and the value of the latest version of the
Optomap when doing
so. Mike Potts and Craig
McArthur tackled the
hot topic of macular
pigment and the use of
dietary supplements in
daily practice. Andrew
Blaikie and Cliff Williams
rounded up the session
with a perfect example
of how the use of OCT
in everyday practice
can not only offer a
more comprehensive
eye examination,
but is a key factor
in the consolidation
of accurate clinical
decision-making
with sound business
development.
Ophthalmologists
Paulo Stanga and
Praveen Patel and
optometrists Nick
Rumney and Brian
Tompkins (never one
to disappoint) captured
the audience with an enthusiastic, hugely engaging and
practical approach to optimising our HES referrals, optimal
patient selection when playing with our new toys and
considering the greater use and value of these in our daily
practice. It was a truly engaging session and hugely popular
among the attendees.
“Many made the journey
especially for this session”
On Monday the main arena opened its doors to preregistration
optometrists. Optometrists Professor Steve
Parrish and Dr Anna Kwartz from Innovative Optical
Training dispelled the myths surrounding the OSCE exams,
combined with a round-up of the most important aspects of
ocular pathology. This feature has become a favourite among
pre-registration students with many making the journey
especially for this session. However, it wasn’t just student
optometrists who were catered for. The satellite arena was
a hub of activity as the Worshipful Company of Spectacle
Makers’ Education Trust provided a revision course for the
level four optical technician’s qualification.
For those of us who spend the majority of our day sitting in
a darkened testing room, the OT Live poster quiz provided a
great opportunity to gain some well needed exercise as well
as some extra CET points.
OT Live provided a full and comprehensive programme of
CET that was both inspiring and reflective of our professional
abilities. The take home message was undoubtedly one of
encouragement, pride and confidence in the services that
we as a profession can provide for the public, the potential
for growth and development despite the current climate and
excitement for the possibilities that lie before us. This is one
optometrist who is already on countdown for what the next
OT Live offering will bring.
For more events see www.optometry.co.uk

GIVE YOUR PATIENTS
THE VISION THEY NEED
Results from a global survey show that the majority of vision-corrected patients are still looking for more when it comes
to their vision. 1 Bausch + Lomb PureVision ® 2 contact lenses with High Definition Optics offer a solution. The High
Definition Optics design helps to reduce halos and glare by reducing spherical aberration across the entire power
range – offering crisp, clear vision, especially in low light conditions. And because they are amongst the thinnest on the
market today 2 , PureVision ® 2 HD contact lenses allow exceptional breathability and comfort, keeping your patients’ eyes
bright and healthy all day long.
GIVE THEM HIGH DEFINITION OPTICS
Introducing Bausch + Lomb PureVision ® 2 contact lenses with High Definition Optics.
To find out more, speak to your Bausch + Lomb sales Territory Manager today or call
customer services on UK: 0845 602 2350 Republic of Ireland: 1800 409 077
1. Results from a global survey across 7 countries, 3,800 vision-corrected consumers aged 15-65. Consumers provided incidence of symptoms (dryness, sensitivity, etc), how impactful,
when experienced, and benefits of product features most likely to motivate consumers when it comes to eye health/vision correction products. 2. Data on file. Bausch & Lomb Incorporated.
© 2011 Bausch & Lomb Incorporated. ®/ denote trademarks of Bausch & Lomb Incorporated. Other product names/brand names are trademarks of their respective owners.

COVER STORY
Hot styles for
the summer
30
03/06/11 SUNGLASSES
International
Eyewear
This year’s signature ladies piece from
International Eyewear in its Ocean Blue
collection is the style 9086 (pictured).
While still retaining the trendy
oversized eye shape, it has been
designed not to be too large to avoid
dominating the face and also to be
‘dispenser friendly’ due to its suitability
for prescription lenses.
0121 585 6529
From big and bold to rimless and retro, the latest sunglasses
can add to any look your patients want to go for this
summer. OT looks at some of the new designs on offer.
Rodenstock
Rodenstock has increased the number of designs in its
Wimbledon collection for 2011. Using the success of the classic
English summer tournament as a marketing platform, the new
designs are backed and modelled by former champion Boris
Becker (pictured wearing model 9938).
The whole collection is available with a choice of plastic
plano, single vision, bifocal, and varifocal lens options.
01474 325 555
Brulimar
Bringing some rock and roll to summer 2011
is the new collection from the ‘godfather of
tattoos’ Ed Hardy, distributed by Brulimar.
The brand will be well known to younger
patients through its clothing range, which
has featured on popular TV shows Jersey
Shore and The Real Orange County.
The high-end range is available in male and
female designs. Pictured is the EHS044 Live to
Ride frame.
0845 130 1415
Dunelm
Retro is the buzz-word for many
fashionistas again this year.
With this in mind, Dunelm’s latest
sunglass looks back to the trends
of yesteryear with the Lennon
inspired Retro Sun 65, available in
classic tortoiseshell. The rounded
lens shape is marketed as being
‘the favoured shape of the year
for the in-crowd’.
01388 420 420

Caseco
Aimed at the brand-aware customer the Levi’s
Eyewear’s new sunglass collection, distributed by
Caseco, plays on the recognisable features of the
fashion label.
Technical details incorporated in the designs
include rivets and denim-inspired finishes, as
well as the Levi brand name and logo. Pictured is
the LS5039, which is available in four colours.
01580 890 111
Luxottica
Released this month, Ray-Ban –
distributed by Luxottica – presents
a new take on its classic aviator and
caravan styles with Light Ray RB 3460
and RB 3461 (pictured). Both designs can
be sold with a kit of three interchangeable
lenses so wearers can change their ‘look’
each day to suit their mood or outfit.
0845 034 8843
Maui Jim
New for the summer, the Lani from Maui
Jim is a feminine, mid-size square frame
which merges Maui Jim’s exclusive lens
technology with a stylish, beach-side look
The design is available in several colour
combinations including Tokyo Tortoise
and black (pictured).
0800 980 1770
31
03/06/11 SUNGLASSES
Silhouette
The sunglass designs of the Silhouette’s Crystal
Collection (modelled by Helena Christiansen) feature
tints for a ‘cosmopolitan look’. As well as being
fashionable, they are designed to provide ‘clear vision
and glare-free sight in every situation to facilitate
the highest level of relaxation and intelligent sun
protection for the eyes.’
020 8987 8899
Inspecs
The Layback design (pictured) is part of the Animal Sun 2011 range,
distributed by Inspecs, which has a heavy retro influence with 70s
eyeshapes, double-bridge aviators and ‘preppy-geek’ acetate.
Surf-flavours also feature in the wide-ranging collection for 2011 with
hot pink, aqua and fresh lime coloured frames all available.
01225 717 000

COMPETITIONS
32
03/06/11 CROSSWORD
June crossword
This issue we continue our monthly crossword
series. So why not enter our competition
before the closure date, July 1. The winner will
receive £50 in Marks & Spencer vouchers.
ACROSS
1. Take a ‘Cooks Tour’! (3.3.6)
7. Girl’s name (5)
8. Neutralising agent (7)
11. Transfers to a large computer
system (7)
12. Staff manning an aircraft (3-4)
13. ----- Previn, musician and
conductor (5)
14. Upset over the barrow-boys
turnover! (9)
16. Away from the main stream
(9)
19. Surplus to requirements (5)
21. Melancholy verse (7)
23. Chris -------, former athlete and
sports journalist (7)
24. Condiment (7)
25. Racket (5)
26. Good looking, colloquially
(4,2,3,3)
DOWN
1. Prepared a horse for riding (7)
2. Give out (7)
3. Given unfair advantage in the
race (4-5)
4. Organisation for Soldiers, Sailors
and Air Force members (5) (init.)
5. James ------- (well known for his
work with Pink Floyd) (7)
6. Interval for a ‘commercial’ (7,5)
9. ----- Bruni, former model and
First Lady of France (5)
10. Money wasted, colloquially
(4,3,5)
15. Country seat for a Judge! (4,5)
17. Cockeyed way to teach a
twister! (5) (anag.)
18. Heavy (7)
19. Where the ‘bucket and spade’
brigade prefer to be beside! (7)
20. One who exhibits physical
prowess (7)
22. Castrated chicken (5)
Name:
Address:
Send entries to OT, June Crossword, 61 Southwark Street, London
SE1 0HL to arrive by July 1, 2011. You can now enter the crossword
competition online at www.optometry.co.uk.

Do your astigmatic patients
experience fluctuating vision?
Toric contact lens wearers rub their eyes on average 6 times a day with
89% subsequently experiencing visual disruptions. 1
Over 90% of astigmatic patients would be interested in a solution to the
problem of blurred or hazy vision. 2
Bausch + Lomb’s Toric contact lenses feature the unique Quick Alignment
System which is designed to ensure faster rotational recovery to help
your patients maintain consistently clear vision throughout their day. 3
To find out more, contact your Bausch + Lomb Territory Manager
or call customer services on:
UK: 0845 602 2350 Republic of Ireland: 1800 409 077.
1. Rub Your Eyes Consumer Research Report, Decision Analyst. March 2010. Participants totalled 502 soft contact lens wearers of which 250 were toric wearers. 2. Symptom, Incidence and Needs Survey, Market Probe. December 2009. Participants
totalled 1,642 claimed astigmats. 3. Cairns, G et al. Diff erences in Toric lens performance: Lens Orientation and Orientation Recovery. Presented at American Academy of Optometry, Orlando. November 2009. Two clinical studies were conducted to
evaluate the rotational recovery abilities of two toric lens designs: Quick Alignment System (Bausch & Lomb, Rochester, NY) and Accelerated Stabilization design (AS) (Vistakon, Jacksonville, FL). In Study 1, the Quick Alignment System of PureVision®
Toric (PVT) (Bausch & Lomb) was compared with the AS design of Acuvue Advance for Astigmatism (AAA). In Study 2, the Quick Alignment System of PVT (Bausch & Lomb) was compared with the AS design of Acuvue Oasys for Astigmatism (AOA).
Image represents the eff ect of a 2.25D cylinder mis-rotated by 45° on an eye with 2.25D of astigmatism.
© 2011 Bausch & Lomb Incorporated. ®/ denote trademarks of Bausch & Lomb Incorporated. Other product names/brand names are trademarks of their respective owners.

VRICS
VISUAL RECOGNITION
AND IDENTIFICATION
OF CLINICAL SIGNS
Sponsored by
This FREE VRICS test should be completed online by clicking on the “VRICS Test” button at http://www.otcet.co.uk/
and answering the Multiple Choice Questions (MCQs) using the associated images. Please note that there is only
one correct answer for each MCQ. The associated reading list provides useful help for completing the MCQS.
Successful completion will result in two CET points. VRICS regularly appears in Optometry Today.
Presbyopia & Ageing Eyes
COURSE CODE: C-16279 O/D/CL
Dr Navneet Gupta BSc (Hons) PhD MCOptom FBCLA
Acknowledgements
The author would like to thank the International Association of Contact Lens Educators, Dr Chris
Purslow (Cardiff University), Mohammed Muhtaseb (Singleton Hospital, Swansea) and Louise
O’Toole (Mater Private Hospital, Dublin) for providing images for this VRICS.
34
1. Which of the following statements about the measurement shown in Image
A is FALSE?
a) It can be better visualised by instillation of sodium fluorescein and illuminating with a cobalt
blue filter
b) A value of 0.1mm at the temporal aspect and 0.35mm at the centre is considered normal
c) The regularity of the measurement can be affected by blepharitis
d) It can be affected by environmental factors such as air conditioning and humidity
03/06/11 VRICS
A
2. Considering the measurement shown in Image A alone, which of the
following statements is LEAST appropriate when fitting contact lenses for a
60-year-old patient?
a) “Comfort enhancing” contact lenses ought to be selected if the measurement is low
b) Rigid gas permeable contact lenses are the lens of choice if the measurement is low
c) Contact lens re-wetting drops can be prescribed if the patient is symptomatic
d) The patient should be advised to minimise their wearing time if they are symptomatic
3. A 58-year-old patient with the condition shown in Image B is interested in
wearing contact lenses. Which of the following considerations is TRUE?
a) This condition will disrupt the tear film making them unsuitable for contact lens wear
b) This condition will disrupt their vision making them unsuitable for contact lens wear
c) This condition indicates a soft contact lens with a thin edge should be selected
d) This condition precludes the fitting of alternating design bifocal contact lenses
B
C
4. For the patient in Question 3 and with the condition shown in Image B,
which of the following statements is FALSE?
a) A soft contact lens with ultraviolet (UV) filter should be fitted
b) A soft photochromic contact lens should be fitted
c) The use of wrap-around sunglasses should be recommended
d) The use of ocular lubricants should be recommended if needed
5. A 54-year-old patient has the spectacle refraction shown in Image C.
Which of the following contact lens options would be the MOST
appropriate to select initially?
a) PureVision Multifocal, High Add for both eyes
b) Air Optix Multifocal, High Add for the right eye, Medium Add for the left eye
c) Proclear Multifocal, Add of +1.50DS, D lens in the right eye, N lens in the left eye
d) Acuvue Oasys Multifocal, with an Add of +1.25DS for both eyes
6. If the patient in Question 5 and with the spectacle refraction shown in Image
C decides to opt for monovision correction, which of the following would be the
MOST appropriate lens powers to select initially?
a) +2.25DS for the right eye, +1.25DS for the left eye
b) +2.25DS for the right eye, +2.75DS for the left eye
c) +3.75DS for the right eye, +1.25DS for the left eye
d) +3.75DS for the right eye, +2.75DS for the left eye

Sponsored by
CONFUSED ABOUT CET REQUIREMENTS? www.cetoptics.com/cetusers/faqs/
IMPORTANT INFORMATION: Under the new Vantage rules, all OT CET points awarded will be uploaded to its website by us.
All participants must confirm these results on www.cetoptics.com so that they can move their points from the “Pending Points
record” into their “Final CET points record”. Full instructions on how to do this are available on their website.
The closing date for this examination is July 29 2011. CET points for this exam will be uploaded to Vantage on August 1 2011.
2 FREE CET POINTS
Approved for Optometrists Approved for DOs Approved for CLPs
About the author
Dr Navneet Gupta is an optometrist with special interest in presbyopia, an
Assessor for the College of Optometrists Scheme for Registration and is the
Clinical Editor for Optometry Today. He completed his PhD investigating
“Functional Near Vision Assessment in Presbyopia” from Aston University.
Associated reading:
1. Gasson & Morris (2010) The Contact Lens Manual
(4th Ed), Butterworth-Heinemann
2. Efron, N (2010) Contact Lens Practice,
Butterworth-Heinemann
3. O’Toole, L (2010) Management & Investigation of Retinal
Conditions, Optometry Today, May 7 2010
4. Goes, FJ (2009) Multifocal IOLs, McGraw-Hill
7. Which of the following statements about the intraocular lens (IOL)
shown in Image D is TRUE?
a) This IOL uses diffractive zones to create simultaneous vision
b) This IOL uses adopization to create simultaneous vision
c) This IOL uses alternating refractive zones to create simultaneous vision
d) This IOL combines diffractive and refractive zones to create simultaneous vision
35
D
8. When assessing the visual function of a patient implanted bilaterally with the
intraocular lenses (IOL) shown in Image D, which of the following is FALSE?
a) High contrast VA will be reduced by a greater degree than low contrast VA
b) Measurement of binocular VA is more informative than the individual VA of each eye
c) A near spectacle addition can be prescribed for those patients who require it
d) Patient satisfaction with their VA is more important than acheiving a VA of 6/5
9. Which of the following is NOT thought to be a risk factor for the condition
shown in Image E?
a) Hypertension
b) Female gender
c) Obesity
d) African-Caribbean race
03/06/11 VRICS
E
F
10. If a person presents with the condition shown in Image E and has a visual
acuity (VA) of 6/18, which of the following is the MOST appropriate course of
action to take?
a) Routine review in 1 year with advice on ocular nutrition / supplements and UV protection
b) Routine referral to be seen at the hospital eye service within 2 months
c) “Soon” referral to be seen at the hospital eye service within 4 weeks
d) Urgent referral to be seen at the hospital eye service within 1-2 days
11. What is the vertical differential prism that a person with the spectacle
refraction and lenses shown in Image F is likely to experience, at the near vision
point (NVP)?
a) 2.25∆ Base Down RE
b) 2.25∆ Base Up RE
c) 3.75∆ Base Down RE
d) 3.75∆ Base Up RE
12. For the patient in Question 11 and Image F, which of the following would be the
LEAST appropriate method of vision correction?
a) Executive style bifocal lenses
b) Prism controlled bifocal lenses
c) Round segment bifocal lenses with different segment sizes
d) Fresnel lenses

DIARYDATES
36
03/06/11 DIARY DATES
Explore new AMD approaches
Next month practitioners have the opportunity to gain a greater
The famous setting of Aintree racecourse plays host to this year’s
College understanding of Optometrists of the latest conference, diagnostic, see below therapeutic and preventative
heathcare approaches to treating AMD – all in the historic
surroundings of Cambridge.
AMD for Optometrists 2011, held on July 12, has been awarded
eight CET points and will take place at the picturesque Downing
College at the city’s famous university. Lecture topics include:
‘Diagnosis on AMD and different types’, ‘Epidemiology and the
risk factors of AMD’, ‘Role of nutrition in AMD’, ‘Trials of macular
carotenoids’ and ‘Should optometrists always refer patients to an
ophthalmologists?’ The day will conclude with a question and
answer session with experts.
For more information on the event and to book, visit the website:
www.amdforoptometrists.org
JUNE
6 NES, Macdonald Rusacks Hotel, Pilmour
Links, St Andrews, Fife, Developing
optometric skills (www.nes.replaylearning.
com/clinical-skills)
7 North London AOP, Moorfields Eye
Hospital, London, EC1V, CET meeting
(stevedross10@hotmail.com)
8 FMO, Birmingham NEC, West Midlands,
summer meeting including discussions
on the economic situation and industry
training (sfisher@fmo.co.uk)
13, 14, 15, 16, 17 J&J, The Vision Care
Institute, Pinewood, Wokingham, OSCE
preparation one-day courses (www.
thevisioncareinstitute.co.uk)
14 Hampshire LOC, Chilworth Manor,
Chilworth, Southampton, demonstration
of OCT, AGM and CET lecture (www.
hampshireloc.org.uk)
15 UltraVision, Head Office, Leighton
Buzzard, Bedfordshire, ‘KeraSoft IC
Workshop’ workshop and fitting techniques
(workshop@ultravision.co.uk)
16 RNIB, Queen Elizabeth II Conference
Centre, Westminster, London, SW1P, Vision
UK 2011 featuring Techshare (www.rnib.
org.uk)
20-21 J&J, The Vision Care Institute,
Pinewood, Wokingham, ‘Returning to work
confident and refreshed’ two-day course
SEE ABOVE
21-22 SBK Healthcare Events, Maple House,
Birmingham, 2011 ophthalmology series
(bookings@sbk-healthcare.co.uk)
28 The Scottish Optical Golfing Society,
Glenbervie, Falkirk, second annual outing
(haddington@montgomeryoptometrists.
co.uk)
NEW… 29 East Sussex LOC, Venue TBC,
Halland, Annual contact lens day, RSVP
(jackie.oxley@googlemail.com)
30-1 (July) Innovatove Sclerals Ltd, 73
Railway Street, Hertford, Introduction to
scleral lens practice (www.sclerals.com)
JULY
4 Independents Day, National Motorcycle
Museum, Birmingham (www.
independentsday.co.uk)
12 NES, The Beardmore Hotel, Clydebank,
Glasgow, Developing optometric skills
SEE ABOVE
9 NES, The Marriott Hotel, 500 Argyle
Street, Glasgow, Developing optometric
skills SEE ABOVE
12 Downing College, University
of Cambridge, Cambridge, AMD
for optometrists 2011 (www.
amdforoptometrists.org)
20 UltraVision, Head Office, Leighton
Buzzard, Bedfordshire, ‘KeraSoft IC
Workshop’ workshop and fitting
techniques SEE ABOVE
AUGUST
17 UltraVision, Head Office, Leighton
Buzzard, Bedfordshire, ‘KeraSoft IC
Workshop’ workshop and fitting
techniques SEE ABOVE
22, 23, 24, 25 J&J, The Vision Care
Institute, Pinewood, Wokingham,
OSCE preparation one-day courses
SEE ABOVE
SEPTEMBER
NEW… 1 NES, Ettrick Riverside, Dunsdale
Road, Selkirk, Developing optometric skills
SEE ABOVE
7 The Scottish Optical Golfing Society,
Ladybank, Fife, final annual outing
SEE ABOVE
NEW… 12 NES, Kingsmills Hotel,
Culcabock Road, Inverness, Developing
optometric skills SEE ABOVE
See more events at www.optometry.co.uk/events

ADVERTISEMENT FEATURE
DAILIES ® AQUACOMFORT PLUS
SUPERIOR TEAR FILM STABILITY – PROVEN
1 DAY ACUVUE ® MOIST ®
Embedded moisturising agent
SofLens ® - Moisturiser
added to saline solution
DAILIES ® PLUS - Enhanced timed
moisture release through blink
activation
A recent study assessed the clinical performance of ‘comfortenhanced’
daily disposable contact lenses over a 16-hour day. 1
20s.
Pre-lens Non-invasive
Tear Breakup Time (seconds)
15s.
10s.
New
Clinical
Data
5s.
0s.
18.3 ** 16.3 ** 15.5 **
15.4
14.1
13.4
13.1
12.4
11.5
8h.
12h. 16h.
Time since lens insertion (hours)
It was observed that the pre-lens non-invasive tear breakup
time was longer in wearers of DAILIES PLUS * contact
lenses than with other comfort-enhanced daily disposable
contact lenses.
DAILIES PLUS * , with its blink-activated technology
releases moisturising agents throughout the day to help
maintain a stable tear film.
HELPING YOUR CONTACT LENS WEARERS
ENJOY WHATEVER THE DAY BRINGS
THE NATURAL EYE
The pre-corneal tear film comprises three layers: the mucin layer,
produced by the conjunctival goblet cells, which binds mucin to
the corneal surface, making it more ‘wettable’; the aqueous layer
which provides nutrition and flushes and cleanses the eye; and
the lipid (oily) layer which impedes tear film evaporation. All three
are essential to maintain tear film stability. When contact lenses
are applied to the eye they separate the tear film producing
a pre lens tear film and a post lens tear film. This disruption
results in a thinner pre lens tear film compared to the normal
tear film. As a result tear film break up time occurs faster with a
conventional contact lens in place.
BLINK-ACTIVATED RELEASE TECHNOLOGY
Unlike traditional contact lenses, DAILIES PLUS *
contact lenses mimic the biology of the natural
eye. Just as the natural eye stabilises the tear film
through mucins that constantly renew themselves
during blinking, DAILIES PLUS * contact lenses use blinkactivated
technology with moisturising agents
gradually released during the day. DAILIES PLUS*
have demonstrated outstanding tear film stability 1 in a
recent published study by Wolffsohn et. al.
Stable Tear Film
Tear film break up
Tear film stability is essential for good visual acuity,
comfort and contact lens-wearing success.
OUTSTANDING COMFORT TO ENJOY THE DAY
Proven cushioning lubricant hydroxy-propyl methylcellulose
(HPMC) provides superior comfort upon insertion 2 . Hydrophilic
wetting agent polyethylene glycol (PEG) coats the lens and binds
with polyvinyl alcohol (PVA) supporting its moisture release
throughout the day to provide improved wettability to the end
of the day.
Enhanced Timed Release Moisture Technology
Through Blink Activation
*DAILIES® PLUSTM is the abbreviated name for DAILIES® AquaComfort PlusTM 1. Wolffsohn J., Hunt O., Chowdhury A., Objective clinical performance of ‘comfort-enhanced’ daily disposable
soft contact lenses. Contact Lens & Anterior Eye, 2010. 2. CIBA VISION data on file, 2007. Focus, DAILIES, AquaComfort Plus, PLUS, CIBA VISION, the DAILIES logo and the CIBA VISION logo are
trademarks of Novartis AG. ACUVUE and MOIST are trademarks of Johnson & Johnson Vision Care, Inc. Soflens is a trademark of Bausch & Lomb, Inc. ©2011 CIBA VISION AG, a Novartis AG Company
2011-077-52766

THERE’S MORE TO EYE
HEALTH THAN CARROTS.
Original Visionace ® Tablets
Your eyes may be in need of some nutritional support.
Carrots contain the carotenoid betacarotene, an antioxidant important to eye health, but many other
nutrients may also play a vital role in maintaining healthy eyes. Visionace ® is a premium quality,
comprehensive, research based formula † of 23 nutrients including lutein esters, zinc, natural carotenoids,
bilberry and other powerful antioxidants to help maintain healthy eyes and good vision as you get older.
For extra support, Visionace ® Plus dual pack combines the original formula with pharmaceutical quality
omega-3 capsules, plus extra lutein and zeaxanthin.
For further information visit www.visionace.com
Dual Pack with Omega-3
Recommended & approved
by leading UK optometrists
Britain’s leading
supplements
for specific life stages
From Boots, Superdrug, chemists, Tesco, Holland & Barrett, Lloydspharmacy, GNC, health stores & www.vitabiotics.com
Supplements may benefit those with nutritionally inadequate diets. †Tested formula, found in a placebo controlled trial to help maintain normal eye moisture and conjunctival health.

FOURTH YEAR
optometry
undergraduates
from Glasgow
Caledonian
University
celebrated their
forthcoming
graduation with
an end of year ball late last month.
A total of 88 students and staff gathered at
the Macdonald Forest Hills hotel in Aberfoyle
to mark the end of their degree studies before
they go on to prepare for their pre-reg period.
Organised by student Laura Telford with the
help of some fellow coursemates, the evening
began with a three-course sit down meal
followed by lively Ceilidh dancing.
STUDENTNEWS
Graduation celebrations
Whilst the optometry boys embraced their
Scottish roots and donned kilts, the girls
OPTOMETRY AND dispensing
students at Anglia Ruskin
University have raised more
than £700 for Cambridge
charity Camsight and also
Vision Aid Overseas.
The money was raised
through the school’s annual
charity ball which was
organised by Anglia Ruskin
Optics Society and this year
had a masquerade theme.
Over 100 undergraduates attended the
event which was held at the Doubletree by
Hilton Hotel in Cambridge. Entertainment
included a harp player, a drumming solo
performance and a magician.
During the evening, organisers also hosted
a raffle, with prizes such as a Nintendo Wii, a
embraced the
opportunity
to dress up
(pictured).
Optometry
lecturer Mhairi
Day, who
attended the
event and has
taught the students over the last four years,
told OT: “It was a fantastic night in a beautiful
location with an intelligent and lovely group
of our fourth year students.
“As a new lecturer a few years ago,
they were the first years that I taught and
I feel extremely proud (and a little old!)
seeing them flourish into aspiring pre-reg
optometrists.”
The students’ graduation ceremony will be
held at Glasgow Concert Hall on June 29.
Having a ball for charities
garra rufa fish pedicure
and massage, and a volk
lens from Keeler up for
grabs.
A spokesperson for the
society said: “We would
like to thank Specsavers
and Boots Opticians
for their extremely
generous donation to
the society and to all
the other companies that helped with raffle
contributions.”
Pictured left to right are Optics Society
members: Karan Sharma (vice president), Hafsa
Okhai (events organiser), Fatema Ebrahimji
(secretary), Pretesh Patel (events organiser),
Priya Katira (treasurer), and Samnika Kalsi
(president).
Sponsored by
Hoya supports
Ethiopian DOs
HOYA LENS UK has provided a group of
dispensing optician students in Ethiopia with
their first “tools of the trade”.
Supported by Vision Aid Overseas (VAO), the
second year students are studying at
Hawassa University Hospital, 200 miles south of
Addis Ababa. Hoya contributed PD rulers, lens
cleaning products and other support materials.
Dispensing optician David Hollander, who
practises in Surrey and is part of the VAO team,
said: “This is the first group of students to
be trained at this university in the southern
part of the country. Serving some 60 million
people, which is around three quarters of
the population, it is very rewarding as we are
helping them to build a basis so that they
become self-sufficient in eye care.”
Bradford hosts
OSCE refresher
THE SCHOOL of Optometry and Vision
Science at the University of Bradford
will host an OSCE refresher course for
pre-registration students this month.
The course, which is scheduled to
run from 10am-4.30pm on June 14,
aims to give pre-registration students
the opportunity to experience a
variety of OSCE situations under exam
conditions and receive feedback on their
performance.
A group session outlining how to
prepare for the OSCE format of the Final
Assessment will also be held.
The course costs £200. For more
information email Catherine Viner on
c.l.viner@bradford.ac.uk.
39
03/06/11 STUDENT NEWS

CET CONTINUING
EDUCATION
& TRAINING
1 FREE CET POINT
Approved for: Optometrists
Dispensing Opticians
OT CET content supports Optometry Giving Sight
Having trouble signing in to take an exam?
View CET FAQ Go to www.optometry.co.uk
Optimising
glaucoma referral
40
REFERRAL REFINEMENT PART 5 COURSE CODE: C-16277 O/D
03/06/11 CET
Lisa Cowan BSc (Hons) MCOptom, Sikander S Sidiki, BSc, MBChB,
FRCOphth
The first Independent Prescribing (IP) optometrists have now qualified, enabling
an expanded role for practitioners in the care of patients with glaucoma.
However, glaucoma is a difficult disease to detect in the first place, and yet is
one that requires early detection for improved prognosis. This article therefore
aims to provide key advice on how to recognise possible cases of glaucoma,
for referral to specialist practitioners, through presentation of case studies.
In the area of glaucoma and ocular
hypertension (OHT), evidence-based
guidelines such as those produced by
NICE 1 and the College of Optometrists 2
provide a valuable framework upon
which to base diagnosis and management
decisions. Some patients fall easily into
pre-defined categories, and the decision
Figure 1
Inferior notching of the neuro-retinal rim
to treat is relatively straightforward
eg, patients with IOP of 35mmHg. In
other patients, it is apparent that no
treatment is required, and the patient
can either be discharged, or monitored
without treatment eg, low risk OHT
with IOP of 23mmHg, healthy discs,
full visual fields, and central corneal
thickness (CCT) greater than 590µm. 1
There are a significant number of cases
however, which do not fit into distinct
categories, and these are perhaps the
cases that test our diagnostic skills most.
The development of prostaglandin
analogues has introduced a very safe,
effective treatment to reduce IOP. This
may suggest that the best policy in these
equivocal cases is to “err on the side of
caution” when managing such patients.
However, many patients find using eye
drops, even if only once a day, to be
disruptive to their everyday life, stressful
and physically demanding. Long-term
use of glaucoma medications, particularly
those containing preservatives, may have
an impact on the health of the ocular
surface and cause symptoms such as
discomfort and dryness. 3,4 Patients are
Figure 2
Nasal cupping with nasalisation of blood vessels
sometimes anxious about remembering to
instil their drops, or about whether they
can physically manage to do so. Many
patients are elderly and have physical or
mental disabilities such as arthritis and
dementia. Glaucoma treatment, which is
usually life-long, also has a significant
financial impact on the patient and/
or the NHS in terms of prescription
charges. So treatment for glaucoma,
whilst generally well tolerated, safe and
effective, is not without its problems.
Primary Open Angle Glaucoma
(POAG)
POAG, and particularly normal tension
glaucoma (NTG), are generally slowly
progressive diseases, and a diagnosis is
often made on the basis of detecting a
change in one or other parameter. By this
definition, more than one visit would
be required to make a diagnosis. In
practice, it is often possible to diagnose
glaucoma on a single visit, as there has
been sufficient change already to clearly
differentiate the eye from normal. Signs
that may indicate a pathological process
include: (i) focal changes in the neuroretinal
rim eg, notching or focal thinning
(Figure 1) (ii) acquired pits of the optic
nerve (iii) blood vessel signs such as
baring and nasalisation of vessels (Figure

and parameters such as mean deviation
patient’s lifetime”. 8 It has been shown
(MD) and pattern standard deviation
that a significant proportion of cases of
(PSD) can be analysed sequentially using
NTG do not progress significantly, even
sophisticated software to determine
without treatment. 9 It seems reasonable
rates of progression; 5,6 a simple plot
then to suggest that slowly progressive
of MD against time and the age of the
glaucoma in elderly patients does not
patient provides a useful insight into
the rate of progression for an individual
always require treatment. Of course,
this does not imply discriminating
41
patient, and can lead to a change in
against patients based on age, but
patient management in some cases.
rather recommends taking a holistic
The prevalence of glaucoma increases
view, considering all the available
with age, from about 2% for a patient
information, and involving the patient
Figure 3
Peri-papillary atrophy
2), and (iv) peri-papillary atrophy
(Figure 3); if these signs are associated
with corresponding visual field defects,
the likelihood of glaucoma increases.
In many cases though, it is not
immediately clear whether an optic
disc is physiologically unusual, or if it
is pathologically damaged. In addition,
it is not possible to assess the rate of
progression on the basis of a single
visit – even if the optic disc appearance
and visual field plots are typical of
glaucoma, isolated results form only a
snapshot of the disease process at one
point in time. IOP may give a clue as to
the likely rate of change but part of the
diagnostic process involves watching
carefully for any evidence of change
aged 40-50 years, to 5% for a patient over
70 years, in a Caucasian population. 7 The
European Glaucoma Society suggests
that the aim of glaucoma treatment
is to “maintain the patient’s visual
function and related quality of life, at
a sustainable cost”. 8 It also states that
“the aim of treatment need not be no
progression at all, but a reduction of rate
of progression to such a level that quality
of vision is not endangered during the
in the decision making process. This
takes account of many factors, in
addition to the patient’s age, including
severity of glaucoma at presentation,
family history (including severity,
progression and age of onset for family
members with glaucoma), ethnic origin,
CCT, and other risk factors for NTG such
as migraine and disc haemorrhage. 9
Of course, deciding not to treat a
patient at the first visit does not mean
that they will never be treated; the
decision to treat or not depends on
monitoring the rate of progression
for each patient individually. It can
be something that evolves over time,
and not treating does not equate to
doing nothing. The patient should be
monitored at regular intervals, and the
management plan changed accordingly.
03/06/11 CET
over time, which indicates an active
disease process. When looking for these
changes, there are a variety of techniques
available. Serial photography of the
optic disc (ideally stereoscopic images)
can show changes in the neuro-retinal
rim and position of blood vessels on
the disc, as well as revealing retinal
nerve fibre layer defects that are often
Case Study A
A 91-year-old female patient was
diagnosed with early to moderate NTG
in her right eye and early NTG in her
left eye. IOP was 18mmHg in the
right eye and 16mmHg in the left eye.
Phasing revealed no significant diurnal
variation in IOP. Due to her advanced
more apparent on photographs than
age, normal IOP and likelihood of slow
on slit lamp examination. Imaging
techniques such as OCT can allow
sequential analysis of the nerve fibre
layer, and measures changes in retinal
nerve fibre layer thickness, which can
indicate progression. Visual field plots
Figure 4
Progression of visual field defects in Patient A. Top
panels were measured at diagnosis, bottom panels
were measured 6 months after diagnosis, with no
treatment conducted during this time
progression, as well as her personal
preference to avoid using eye drops, it
was decided not to treat the patient but
to monitor her on a 6-monthly basis. If
there were any evidence of progression
in optic disc appearance and/or visual

CET CONTINUING
EDUCATION
& TRAINING
1 FREE CET POINT
Approved for: Optometrists
Dispensing Opticians
OT CET content supports Optometry Giving Sight
Having trouble signing in to take an exam?
View CET FAQ Go to www.optometry.co.uk
42
03/06/11 CET
Figure 5
Deep glaucomatous cupping and thinning of the
inferior neuro-retinal rim in Patient B
fields, this management plan would be
reconsidered. At the first 6-monthly
review, the optic discs appeared similar
but visual fields showed an increasing
glaucomatous defect in both eyes (Figure
4) and IOP, while still normal, was higher
than at the initial visit (RE=20mmHg
LE=19mmHg). Based on this change
in clinical picture, the decision was
made to commence treatment and
the patient was happy with this.
Case Study B
An 81-year-old female patient was
diagnosed with early NTG with IOP of
16mmHg in the right eye and 15mmHg
in the left eye. The appearance of the
left optic disc is shown in Figure 5;
glaucomatous cupping is present with
a very thin inferior neuro-retinal rim.
After some discussion, it was agreed
that she would be monitored, without
treatment, but this management plan
would be re-assessed if there were a
change in the clinical findings. To date,
this patient has been monitored for 4
years, with no evidence of progression
of the visual field defect (Figure 6).
Referral
In the cases of patients A and B, NTG
Figure 6
Stable visual field defects for Patient B, measured in April 2010
was diagnosed and the decision not to
treat was made by, or in conjunction
with, a consultant ophthalmologist.
NICE guidelines state that practitioners
should “refer people with suspected
optic nerve damage or repeatable visual
field defect(s), or both, to a consultant
ophthalmologist for consideration of a
definitive diagnosis and formulation
of a management plan”. 1 As such,
appropriate management in primary
optometric care would be to refer
these patients to ophthalmology,
even if it was felt that they might not
require treatment. Indeed, in some
cases of NTG, it may be necessary
to arrange neurological imaging
to rule out more sinister causes of
optic neuropathy, and this would
require an ophthalmological opinion.
Once the diagnosis has been
confirmed, there may be instances
where it is possible to refer the patient
back to their own optometrist for
follow-up care, with the option to
refer back to ophthalmology available
to the practitioner if there is a change.
The NICE guidelines state that people
with a diagnosis of OHT, chronic open
angle glaucoma (COAG) or suspected
COAG should be monitored and treated
by a trained healthcare professional
who has all of the following: 1
• a specialist qualification (when not
working under the supervision of a
consultant ophthalmologist)
• relevant experience
• ability to detect a change in clinical
status.
Monitoring and treatment of people
with OHT, suspected COAG and
established COAG should be carried out
by healthcare professionals trained to
make relevant management decisions.
Monitoring (but not treatment) of
people with a confirmed diagnosis
of OHT or suspected COAG who
have an established management
plan can be carried out by a suitably
trained healthcare professional with
the relevant skills and ability to
detect a change in clinical status.
Much of the above is open to
interpretation though, and the
definition of “supervision” in this
context has recently been clarified
by the Joint Group on NICE
Glaucoma Guidelines. 10 Advice on the
interpretation and implementation
of NICE guidelines by optometrists

has also been issued by the AOP, and
the LOC Support Unit (LOCSU). 11
Referral refinement
Of course, not all patients need to be
referred to ophthalmology, and the
community optometrist has the oftendifficult
task of deciding which patients
to refer. Some cases are clear and referral
is obviously indicated (eg, clearly
glaucomatous optic nerve head with
definite thinning or absence of neuroretinal
rim (Figure 7). There are other
cases where observation is all that is
required (eg, large physiological cupping
with healthy neuro-retinal rims and no
additional risk factors for glaucoma). As
ever, the difficulty is the patient who falls
somewhere in between these two groups.
An audit of the authors’ hospital
glaucoma clinic in 2006 revealed the
outcomes of referrals received; 37%
had some form of glaucoma (including
POAG, narrow angle glaucoma, NTG,
and secondary glaucoma eg, pigment
dispersion glaucoma), 16% had OHT, 28%
had no evidence of glaucoma or OHT and
19% were diagnosed as glaucoma suspect.
A diagnosis of glaucoma suspect was
perceived risk include IOP, CD ratio,
disc size, CCT, family history, myopia,
ethnicity and vascular risk factors
such as diabetes. Risk calculators are
available but are limited by the number
of factors that they can account for and
by the studies on which they are based.
As such, while they may be useful, they
should not be considered a substitute
for clinical judgement and experience.
It is important to note that low CCT
is a risk factor independent of IOP and
corrected IOP. Although correction
factors for IOP taking into account
CCT have been suggested, opinion as
to the validity of these varies as other
corneal biomechanical factors such as
corneal hysteresis have been suggested
to influence IOP measurement much
more than CCT. 12,13 The OHT treatment
study identified CCT as the single most
important risk factor for conversion to
glaucoma, but did not make any attempt
to “correct” IOP. 14 Other reasons for
the association between low CCT and
glaucoma have been hypothesized, but
not proven e.g. low CCT may indicate
a difference in structural properties of
the eye, which could pre-dispose to
glaucoma, such as a thinner retinal nerve
fibre layer, or lamina cribrosa. 15 These
are interesting areas of research, which
may shed further light on the diagnosis
of glaucoma and OHT in the future.
If a glaucoma suspect is reviewed
after 6 months or one year, there are
essentially two possible outcomes:
1. Progression of the optic disc cupping
and/or visual field defect – referral
to the HES can then be made, ideally
with disc images and visual fields to
illustrate progression. This gives the
HES clinician a great deal of information
upon which to base their diagnosis,
management and treatment plan.
2. No progression of the optic disc
cupping and/or visual field defect is
identified – the practitioner and patient
can be reassured that there is still no
evidence of glaucoma, and if there is
any glaucomatous progression, it is
proceeding at such a slow rate that it
would be likely to be picked up by regular
6-monthly or annual reviews. Referral to
the HES could then be made for treatment
if necessary. Once again, if the patient
does need to be referred for treatment,
both the patient and the clinician
43
03/06/11 CET
made if it was not possible on the first
visit to diagnose the patient as either
normal or glaucomatous, so further
follow-up was arranged. Examples of
suspect disc appearances include cup
to disc (CD) ratio >0.5, disc-cupping
asymmetry between the eyes, ISNT
negative discs, and baring of blood
vessels. Discs may also be considered
suspicious if they are difficult to
interpret, with shallow cupping, sloping
neuro-retinal rims or if they are tilted.
Community optometrists with
appropriate skills and equipment could
follow-up some glaucoma suspects
who are considered at low risk of
developing glaucoma, without the need
for referral to the hospital eye service
(HES). Factors that will influence this
Figure 7
Clear glaucomatous disc with absent inferior
neuro-retinal rim
Figure 8
Suspicious optic disc cupping

CET CONTINUING
EDUCATION
& TRAINING
1 FREE CET POINT
Approved for: Optometrists
Dispensing Opticians
OT CET content supports Optometry Giving Sight
Having trouble signing in to take an exam?
View CET FAQ Go to www.optometry.co.uk
44
03/06/11 CET
who examines them will be greatly
helped by the additional information
available from the referring optometrist.
Of course, the level of skill and
training in glaucoma will vary between
optometrists, and some will be more
confident in assessing glaucomatous
changes in patients than others. If the
optometrist does not feel comfortable
observing the patient over time,
then they should refer to the HES.
Case Study C
A 49-year-old man was diagnosed as a
glaucoma suspect due to a suspicious
optic disc appearance, which was not
clearly glaucomatous, but neither was it
clearly normal. CD ratio was 0.8 in both
eyes (Figure 8) with no focal thinning,
disc height was 2.2mm in both eyes, and
IOP was consistently normal in both eyes
(RE=15mmHg and LE=14mmHg). He has
now been reviewed for four years with no
evidence of any change in the optic disc
appearance. Visual fields remain full,
and his IOP has remained within normal
limits throughout this time. It is likely
that he will be discharged back to the care
of his own optometrist in the near future.
Scotland
In Scotland, community optometrists
have the equipment and resources to
examine glaucoma suspects fully under
General Ophthalmic Services (GOS),
and some have additional equipment
and skills to perform techniques such as
gonioscopy and pachymetry. In addition
the GOS contract allows community
optometrists to be funded to perform
additional tests such as contact tonometry,
repeat visual field tests, and facilitates
early recalls, which may be required in
the management of glaucoma suspects.
It also ensures that when patients are
referred on to the HES, the clinician
receiving the referral should have a
wealth of useful additional information,
such as repeat threshold visual fields
and contact tonometry, which helps the
diagnostic process and to prioritise the
urgency of the out-patient appointment.
Summary
Optometrists, both in hospital practice
and in the community, have an
important role to play in the detection,
diagnosis and follow-up of glaucoma.
The advent of IP status is likely to allow
us to develop this role further over the
coming years, as we move further away
from a “detection of abnormality” role,
and continue to develop our skills in
diagnosis and management of disease.
About the authors
Lisa Cowan is a specialist optometrist
at the Southern General Hospital and
New Victoria Hospital, Glasgow, and
lead glaucoma practitioner in the
shared care glaucoma service. Sikander
Sidiki is a consultant ophthalmologist
at Southern General Hospital and
Gartnavel General Hospital, Glasgow.
References
See http://www.optometry.co.uk
clinical/index. Click on the article title
and then download "references".
Module questions
PLEASE NOTE There is only one correct answer. All CET is now FREE. Enter online. Please complete online by midnight
on July 1 2011 - You will be unable to submit exams after this date – answers to the module will be published on
www.optometry.co.uk. CET points for these exams will be uploaded to Vantage on July 11 2011.
Course code: C-16277 O/D
1. Which of the following is NOT a risk factor for primary
open angle glaucoma?
a) Increasing patient age
b) Hypermetropia
c) Low CCT
d) Family history of glaucoma
2. Prevalence of glaucoma in patients aged 40-50 years is
approximately:
a) 0.1%
b) 2.0%
c) 5.0%
d) 8.0%
3. Which of the following is NOT a requirement for
healthcare professionals monitoring patients with OHT,
COAG, or suspected COAG, according to NICE guidance?
a) A specialist qualification if working independently
b) Relevant experience
c) Independent prescriber status
d) Ability to detect a change in clinical status
4. Which of the following was identified by the Ocular Hypertension
Treatment Study as the single most important risk factor for conversion
to glaucoma?
a) Low CCT
b) Myopia
c) Family history
d) Peri-papillary atrophy
5. For a myopic patient with optic disc cupping of RE: 0.6 ISNT obeyed,
LE: 0.4 ISNT obeyed, IOP of 21mmHg in both eyes, and no visual field
defect, what is the most appropriate course of action?
a) Refer to HES routinely
b) Refer to HES urgently
c) Repeat the visual fields test
d) Monitor annually
6. In the author’s 2006 audit of glaucoma referrals, what percentage of
patients was diagnosed with some form of glaucoma?
a)12%
b) 28%
c) 37%
d) 74%

CET CONTINUING
EDUCATION
& TRAINING
1 FREE CET POINT
Approved for: Optometrists
Dispensing opticians
OT CET content supports Optometry Giving Sight
Having trouble signing in to take an exam?
View CET FAQ Go to www.optometry.co.uk
Optometric
management of dry eye
COURSE CODE C-16461 O/D
Samantha McGinnigle BSc (Hons), MCOptom, Dr Frank Eperjesi BSc
(Hons), PhD, MCOptom, Dip Orth, FAAO, MHEA, PGCertHE, MBA Dr
Shehzad Naroo BSc (Hons), MSc, PhD, MCOptom, FIACLE, FAAO, FBCLA
Dry eye has been defined by The Dry Eye Workshop (DEWS) as ‘a multifactorial
disease of the tears and ocular surface that results in symptoms of discomfort,
visual disturbance and tear film instability, with potential damage to the
ocular surface. It is accompanied by increased osmolarity of the tear film
and inflammation of the ocular surface’. 1 This article outlines the role of
the optometrist in the conservative management of dry eye, namely
through treatment with artificial tear substitutes and eyelid therapy.
There are three steps towards
treating dry eye, according to a recent
European Ocular Surface Workshop: 2
1. Patient education, monitoring the
eyelid environment, use of artificial
tear substitutes and eyelid therapy.
2. Addition of temporary antiinflammatory
agents, temporary punctual
occlusion, secretagogue administration.
3. Use of autologous serum
and amniotic membranes.
This article concentrates on the first
step of this treatment paradigm, but
first considers the risk factors that lead
to a patient suffering from dry eye.
Risk factors for dry eye
The ocular surface functions as a
complex unit which includes the surface
tissues, secretory glands, eyelids and
nasolacrimal outflow channels, all
linked via the neural reflex arcs which
collectively form the lacrimal function
unit. This interdependent unit is further
supported by an intact nervous system
and hormones, particularly systemic
androgen. There is constant feedback from
neural receptors to maintain the finely
balanced homeostasis and if any aspect
of this complex system is compromised
then the structure and function is
affected. 3 Regardless of which element
causes the ocular signs or symptoms, all
dry eye conditions share the common
features. These include an unstable tear
film between blinks, increased osmolarity
and inflammation. 4 Ocular irritation and
visual disturbance can pose significant
problems for patients with dry eye 5 and
the debilitating effects of dry eye have
been rated as similar to those of moderate
angina in quality-of life surveys. 6
Researchers have found that 52% of
contact lens wearers, 23% of spectacle
wearers and 7% of clinical emmetropes
self-report dry eye in optometric
practice. 7 Increased age, female gender,
medication, connective tissue disease,
radiation therapy and LASIK/refractive
excimer laser surgery are proven factors
for dry eye. 1 Environmental stresses at
the workplace (particularly prolonged
VDU use) or during recreational
activities can also initiate or exacerbate
dry eye. 8 Allergic and inflammatory
ocular surface conditions can have a
destabilising effect on the tear film 9 and
smoking interferes with the lipid layer. 10
Meibomian gland dysfunction (MGD)
is a major cause of evaporative dry
eye 11 and in a prospective study of
patients seeking an eye examination
because of ‘ocular discomfort’ or
‘irritation,’ there was a diagnosis of
posterior blepharitis in 24% of cases and
anterior blepharitis in 12% of cases. 12
45
03/06/11 CET
Figure 1
Different causes of ocular irritation
Presentation of dry eye
The patient may complain of ocular
irritation, grittiness, burning, foreign
body sensation, blurred vision,
photophobia or possibly just general

CET CONTINUING
EDUCATION
& TRAINING
1 FREE CET POINT
Approved for: Optometrists
Dispensing opticians
OT CET content supports Optometry Giving Sight
Having trouble signing in to take an exam?
View CET FAQ Go to www.optometry.co.uk
46
03/06/11 CET
“A fluid is defined as a substance that undergoes continuous deformation when
subjected to shear stress. The resistance of the fluid to this deformation is
measured in terms of the fluid property called viscosity.
Newtonian fluids have a constant viscosity at a given temperature and the viscosity
is independent of changes in shear stress.
Non-Newtonian fluids have a variable viscosity at a constant temperature and the
viscosity also varies with the rate of shear of the liquid, ie, with increased stress the
viscosity decreases.”
Figure 2
Definition of a fluid
discomfort, particularly in the evening. 13
There is, however, a lack of association
between symptoms and the severity of dry
eye, although validated questionnaires,
such as The Ocular Surface Disease
Index can be helpful in consolidating
evidence towards a correct diagnosis. 13-16
Indeed, there are many different
causes of ocular irritation (Figure 1),
several of which can cause similar
symptoms, making differentiation of the
underlying cause all the more difficult.
The patient may exhibit signs of
arthritis (poor mobility, joint deformity),
acne rosacea, red eyes, lid problems,
abnormal blink patterns, incomplete
blinking and reflex epiphora. Signs
may include reduced inferior tear prism
height, a reduced tear break up time,
staining of the cornea with fluorescein
and conjunctiva with lissamine green,
lid parallel and conjunctival folds
(LIPCOF) and reduced corneal sensitivity
(standardised grading scales for
parameters are available in the Diagnostic
Methodology Subcommittee Report 1 ).
In terms of anterior blepharitis there
may be crusts or flakes on the eyelashes,
the lids may be stuck together in the
morning and be accompanied by red eyes
or eyelids; with posterior blepharitis there
may be a change in meibomian gland
secretions, meibomian gland plugs, lid
telangiectasias, a frothy tear film, aqueous
tear deficiency and excess lipid deposits. 17
Composition and role of the
tear film
The tear film provides a smooth optical
surface and protects the corneal surface
by flushing away debris, bacteriostasis,
maintaining epithelial hydration and
acting as a lubricant to prevent the
eyelid rubbing the surface on blinking.
Studies have shown the tear film to
be made up of a lipid layer overlying
a mucoaqueous layer containing
both gel-forming and transmembrane
mucins. The lipid layer is secreted by
the meibomian glands and is thought
to reduce evaporation and maintain
the smooth surface by interacting with
lipid-binding proteins such as lipocalin
in the aqueous phase. The stability of
the tear film relies on adequate lipids
being present to carry in water, lower the
surface tension and combine with other
tear components to create a highly non-
Newtonian viscous liquid (Figure 2). 18
Within the aqueous layer, the soluble
mucins secreted by goblet cells and
lacrimal gland acini are thought to serve
a variety of purposes. They are moved
through the aqueous during the forces
of blinking and protect the surface of
the eye via debris removal and the
harbouring of defence molecules secreted
by the lacrimal glands. The membrane
associated mucins expressed by the
stratified surface epithelia also protect the
eye, forming a dense barrier to prevent the
entry of pathogens. They allow the lids to
glide over the surface due to the anionic
character of all mucins, so when the
soluble mucins pass over the membrane
bound mucins their charges force the
molecules apart, preventing adherence. 19
Composition of tear
supplements
Aqueous artificial tears
Cellulose derivatives are water soluble,
viscoelastic polysaccharides with a low
molecular weight, which exhibit emollient,
cohesive (film-forming) properties. They
do not generally blur vision (with the
exception of methylcellulose) and are
useful for mild or transient symptoms.
The solutions are absorbed by the corneal
epithelium, so there is a short ‘bathing
‘period and only temporary relief. They
can be formulated with electrolytes as a
hypotonic solution. Hypromellose can
cause crusting of lids and so care must be
taken not to confuse this with blepharitis. 20
Polyvinyl alcohols are water soluble
synthetic polymers. Their viscolysing and
surfactant action is helpful in patients with
mucin deficiencies and at a concentration
of 1.4% have the same surface tension as
normal tears. They do not blur vision but
have a short ocular surface retention time.
They do not mix well with other products.
Lipids
Phospholipids occur naturally in the tear
film and have surfactant properties as well
as a role in surface monolayer formation.
Commercial products are now available
to deliver phosphatidylcholine (the major
phospholipid) via a stable liposome,
which can be sprayed onto the closed
lid and migrate from there to combine
with the tear film. Improvements in the
lid margins have also been found with
these products making them especially
useful in the management of blepharitis. 21
Viscoelastics
Sodium hyaluronate is a

mucopolysaccharide
with
high viscosity, good ocular
surface retention time and is
beneficial to wound healing.
Studies have shown an
improvement in damaged
ocular surface epithelium
after using this product. 22
Carbomers are synthetic
polymers with high viscosity
and good ocular surface
retention time, but they tend
to sting and blur vision.
Carbomer 980 is a gel with
thixotropic
(reversible)
properties; during blinking
it liquefies, then reforms
to a gel rather than being
eliminated. 23,24 This means
that fewer instillations are
required and the eye has less
exposure to benzalkonium
chloride, which reduces the
risk of developing allergies
for the patient. These types
of therapies benefit patients
who have lipid, mucin and
aqueous tear deficiencies.
Povidones
(polyvinyl
pyrrolidones) are synthetic
polymers of differing chain
lengths and molecular weights.
They act as surfactants and
in higher concentrations
increase the viscosity of solutions. They
are useful for mucin deficiencies and
can be co-formulated with electrolytes. 25
Hydroxypropyl guar (guar gum)
is a mucomimetic agent which has
been shown to be more effective than
carboxymethylcellulose in reducing
the signs and symptoms of dry eye. 26
Ointments
Aqueous
artificial tears
Paraffin ointments have a long retention
time and should only be used at night
before sleep due to their detrimental
effect on vision. They should be used
as an adjunct to daytime artificial
Active ingredient
Hypromellose
Carboxymethylcellulose
Poyvinyl alcohol
Polvinyl alcohol with povidone
Product brand name
Tears Naturale
Isopto Plain
Artelac SDU
Optive
Sno Tears
Liquifilm Tears
Hypotears
Liquifilm
Refresh
Clinitas Ultra
Ocutect (povidone)
Liposomes Liposome spray Tears Again
Optrex Actimist Eye Spray
Viscoelastics Sodium hyaluronate Optrex Dry Eye Drops
Blink Revitalising Drops
Sainsburys Dry Eye Drops
Clinitas Soothe, Clinitas Soothe
Ocular
lubricants
Carbomer 940
Carbomer 980
Hydroxypropyl guar
Tamarind seed polysaccharide
and hyaluronic acid
Liquid paraffin
White soft paraffin
Yellow soft paraffin
Geltears*
Viscotears*
Liposic*
Clinitas Hydrate
Viscotears
Systane
Rohto Dry Eye Relief
Rohto daily dose
Lacri-Lube
Lubri-Tears
Simple Eye Ointment
Lubrifilm
Table 1
Artificial tear availability. All solutions are preserved with Benzalkonium
chloride with the exception of those highlighted with an asterisk (*), which use
Cetrimide. Italics indicate single dose, unpreserved preparations
tears and are particularly useful in the
treatment of recurrent epithelial erosion.
Table 1 summaries the various artificial
tear supplements that are available and
also provides examples of products
that can be recommended to patients.
Management strategies
It is important to manage blepharitis; both
anterior and posterior blepharitis need
to be treated, as if left untreated it can
progress, causing significant discomfort
and possibly scarring. Conservative
management of anterior blepharitis
includes lid hygiene; lid scrubs using
dilute baby shampoo (10:1)
or commercial products eg,
Ocusoft Lid Scrub Eyelid
Cleanser (Cynacon/ Ocusoft),
TheraTears Sterilid (Advanced
Vision Research), in addition
to aqueous artificial tears.
This has been shown to be
an effective combination and
should mitigate the need
for additional antibiotic
therapy if adhered to. 27
Posterior
blepharitis
requires heat above body
temperature to melt the
inspissated secretions. A wash
cloth soaked with warm water
(40-45°C) for 3-10 minutes
has been shown to increase
the tear film lipid layer
and improve tear quality. 28
Lid massage should be
performed immediately after
to help the flow of meibum.
Artificial tears or liposomal
sprays are also beneficial.
With mild, transient dry
eye, the logical progression
regarding artificial tears
is to try the least viscous
formulations first, as these
cause the least symptoms ie,
stinging and blurred vision,
so the patient is more likely
to be compliant. The recommended dose
for most artificial tears is one to two
drops applied three to four times a day.
For patients who have difficulty inserting
drops, devices are available to help and for
those who don’t like putting drops in their
eye, the spray offers a useful alternative.
With more moderate cases of dry eye,
patients may be more willing to accept
the slight stinging on insertion and initial
blurring of more viscous formulations
to gain relief from their symptoms.
The most widely used preservative in
artificial tears is benzalkonium chloride
47
03/06/11 CET

CET CONTINUING
EDUCATION
& TRAINING
1 FREE CET POINT
Approved for: Optometrists
Dispensing opticians
OT CET content supports Optometry Giving Sight
Having trouble signing in to take an exam?
View CET FAQ Go to www.optometry.co.uk
48
0.01% which can destabilise the tear film
and have cytotoxic effects. 29 Patients
requiring the application of tear substitutes
more than four times a day should
therefore be advised to use unpreserved
formulations. There is, however, an
increased cost and also compliance issues,
due to the fact that the patient has to
carry sufficient vials when not at home. 30
Conclusion
There are many products available to
lubricate the eye for patients who suffer
from symptoms indicative of dry eye.
However, due to the significant variation
in both formulation and viscosity of these
products, it can be very difficult for the
patient to choose the most appropriate
preparation. The optometrist can
provide useful guidance to help with
these choices, as some may involve
considerable expense. It is interesting,
however, that the DEWS report has
found a ‘prominent apparent placebo
effect’ in most clinical trials evaluating
topical therapy for dry eye disease, 1
so perhaps the key to management is
as simple as encouraging compliance!
About the authors
Samantha McGinnigle is an
optometrist, post-graduate and
Clinical Demonstrator at Aston
University. Frank Eperjesi is
Head of Optometry at Aston
University. Shehzad Naroo is a
Senior Lecturer at Aston University.
References
See http://www.optometry.co.uk
clinical/index. Click on the article
title and then download “references”.
03/06/11 CET
Module questions
Course code: C-16461 O/D
1. According to the Dry Eye Workshop, which of the following is a
sign of dry eye?
a) Decreased osmolarity of the tear film
b) Inflammation of the ocular surface
c) Punctal occlusion
d) Increased corneal sensitivity
PLEASE NOTE There is only one correct answer. All CET is now FREE. Enter online. Please complete online by midnight
on July 1 2011 - You will be unable to submit exams after this date – answers to the module will be published on
www.optometry.co.uk. CET points for these exams will be uploaded to Vantage on July 11 2011.
4. Which product is MOST helpful in patients with evaporative
dry eye?
a) Hypromellose
b) Geltears
c) Liquifilm
d) Tears Again
2. In the tear film, which of the following is a function of soluble
mucins?
a) They produce defence molecules against bacteria
b) They form the optically smooth surface of the tears
c) They reduce the stability of the tear film
d) They allow the lids to glide over the ocular surface
3. Which of the following components of tear supplements has the
highest viscosity?
a) Methylcellulose
b) Polyvinyl alcohol
c) Carboxymethylcellulose
d) Carbomer 980
5. What is the BEST option for a patient with dry eyes and surface
staining, who needs to administer artificial tears more than four
times a day?
a) Liposome spray
b) Hypromellose
c) Unpreserved saline
d) Unpreserved Clinitas Soothe
6. Which of the following statements about blepharitis is FALSE?
a) Warm compress requires heat in excess of 50°C
b) Liposomal sprays can improve tear quality
c) Antibiotic therapy may be required in severe cases
d) If left untreated, it can possibly lead to scarring

OT CET Video
C-14091 O/D: An Introduction
to Domiciliary Eye Care
Written and presented by Dawn Roberts (Joint Chair, Domiciliary Eye care
Committee), this video aims to provide a two-part introduction to domiciliary
Eye care for optometrists and dispensing opticians who are considering
working in this rewarding area of practice. Topics covered include: the need
for a domiciliary service, patient eligibility, regulations and recommended
equipment.
Part 1 details the changing age demographics of the UK, regulations and
eligibility for domiciliary services and questions whether the needs of all
patients unable to leave their homes are currently being met.
Part 2 offers advice about modifications to the typical sight test routine,
record keeping, domiciliary working environments and aftercare services.
This video is sponsored by Healthcall Optical.
This video features 12 MCQs that have been accredited with 2 CET points and
are GOC approved for Optometrists and Dispensing Opticians.
You must be logged in to the website before you can watch this video
and take the exam.
A hint button is now available for each question and will take you
to the section of the video that relates to the question.
The closing date for MCQ submissions
will be June 30, 2011 and the points
will be uploaded to CET optics 10
days later.
SPONSORED BY
www.optometry.co.uk

Creating a Brighter Outlook
A New Decade for Independent Success
Economic storm clouds clearing
With all the negative media coverage about the economy, business owners might be forgiven for falling into a deep
depression about their future. Independents Day 2011 intends to blow away all the doom and gloom. Top business
people will offer their best advice to help break out of the current doldrums to create a brighter outlook.
Brighter, clearer spells in July
Independents Day continues to shine as a top-class
business programme and so much more:
• Independents Night networking dinner (3rd July)
• Optical Assistants Programme
• Sponsors CET Lectures
• Over 40 supplier strong exhibition
NEW
• Skills Workshops
• Title Sponsors Mini-Symposium (Sunday PM, free entry for all)
TITLE SPONSORS
HEADLINE SPONSORS
FOUNDATION SPONSORS
Continental Eyewear Seiko Topcon
Bausch + Lomb AEL Partners
MEDIA PARTNER
Optometry Today
Long-term high’s expected
Come to Birmingham in the summer where this year’s
programme is forecast to deliver perfect conditions for
you and your practice team, with seasonal highs that
are predicted to last well into the autumn and winter.
For more information and to book
Visit: www.independentsday.co.uk

JOBS
To place an advertisement call 020 7878 2313
or email haley.willmott@tenalps.com
OPTOMETRISTS
DISPENSING OPTICIANS
required to work for a minimum of
one (1) year in the Island of
TRINIDAD AND TOBAGO, WEST INDIES
Interested candidates please forward
an updated Curriculum Vitae, to:-
Ferreira Optical Limited, P.O. Box 894,
Port of Spain, Trinidad, W.I.
Tel: (868) 623-3472
Fax: (868) 623-3473
E-mail: hro@ferreiraoptical.com
Website: www.ferreiraoptical.com
www.cardiff.ac.uk/jobs
Lecturer (Part-time)
Wales Optometry Postgraduate Education Centre
(WOPEC)
Cardiff School of Optometry and Vision Sciences
The purpose of this post will be to develop and deliver high-quality taught courses
at postgraduate level and to enhance the international reach of the School
through postgraduate teaching.
You will require registration with the General Optical Council and you will be
expected to have post-qualifying clinical experience.
Through Wales Optometry Postgraduate Education Centre (WOPEC), the
School of Optometry and Vision Sciences has been working with the Welsh
Assembly Government, Primary Care Trusts (PCTs), Local Health Boards (LHBs)
and Optometry Bodies to provide postgraduate training and accreditation to
optometrists in Wales and England. You will work with the highly motivated team
in WOPEC to help develop and deliver a flexible portfolio of taught postgraduate
courses for UK and overseas optometrists. This post is fixed-term for 2 years.
Hours: 22.5 per week
Salary: £29972 - £35788 per annum, pro-rata for hours worked.
Informal enquiries can be made to Barbara Ryan or Nik Sheen on
+ 44 (0) 29 2087 0794.
For an application pack and details of all our vacancies, visit
www.cardiff.ac.uk/jobs. Alternatively email vacancies@cardiff.ac.uk
or telephone + 44 (0) 29 2087 4017 quoting vacancy number 270.
Closing date: Friday, 24 June 2011.
51
03/06/11 JOBS
Glaucoma Optometrist
Opportunities
Hillingdon, Kingston, Midlands, North-West
& Nationwide
Newmedica is a dynamic, innovative UK healthcare company
delivering a network of high quality, optometrist-led glaucoma
monitoring units across the UK. We partner with the NHS to safely
and effectively deliver specialist clinical eye care services to our
patients, both in fixed and mobile settings.
We currently require optometrists to work in our clinics in
Hillingdon, Kingston, the Midlands and the North-West. However,
we are also interested in hearing frm Optometrists nationwide and
from those with experience in other sub-specialties.
If you enjoy leading a small team to deliver high quality patient
care smoothly and efficiently, we would be delighted to hear from
you. Clinical experience is preferred, however full training will be
provided. We will consider applicants who wish to work on either a
permanent or a locum basis.
Salaries are competitive, and are commensurate with skills and
experience.
To apply, please send your CV to Ben Gaehl at
ben.gaehl@newmedica.co.uk
www.newmedica.info
Currently recruiting a Regional
Account Manager for Essilor UK Ltd
in the south central area.
You will be responsible for managing
existing accounts together with new
business sales in the independent
optical market.
Previous Area Sales experience or a
D.O qualification is essential.
Excellent salary and package (including
Company car and pension) on offer.
For more details call John Williams
on 0121 4550774.
Email – john@jonesoptical.co.uk
www.jonesoptical.co.uk
URN 880866

JOBS
To place an advertisement call 020 7878 2313
or email haley.willmott@tenalps.com
Shared Care Department, Bristol Eye Hospital
Optometrist/Shared Care Practitioner
Band 7, plus 17% recruitment and retention premium
(£30,460 - £40,157 plus 17% RRP) Ref: 387-S-118
Two new positions for full time Optometrists have become available in the Shared Care
Department at Bristol Eye Hospital. The main initial responsibility of these posts is
provision of ongoing care for patients with glaucoma, with subsequent participation in
retinal and/or anterior segment clinics.
Optometrist
Ely and surrounding areas
Independent, modern and friendly practice
1 – 5 days per week (to suit)
Newly qualified welcome
Please contact:
shona@spectacularopticians.co.uk
Telephone: 01638 561 972
52 50
You will be GOC registered and have substantial post-registration experience. Evidence of
extended role practice or a strong background knowledge appropriate to glaucoma care
would be advantageous, although neither are pre-requisites for the position.
17/09/10 03/06/11 RECRUITMENT
JOBS
Bristol Eye Hospital is a teaching hospital providing a wide range of ophthalmic care to
people in the Bristol area and across the south west of England. The Optometric Shared
Care Department is well established and integrated into the multidisciplinary environment
of the hospital, providing clinical management of patients with glaucoma, retinal disease
and patients presenting acutely to eye casualty.
Informal enquiries regarding this position are encouraged. For further information please
contact Dr Paul GD Spry, Optometrist Consultant, Bristol Eye Hospital, Lower Maudlin
Street, Bristol BS1 2LX, Tel 0117 342 4652 (direct) or 0117 342 3812 (messages) or
email paul.spry@uhbristol.nhs.uk
For further details, or to apply please visit www.uhbristol.nhs.uk/working-at-the-trust.html
Closing date for applications: Thursday June 30th 2011.
Interview date: Tuesday July 19th 2011.
An equal
opportunities
employer, actively
working towards
a diverse workforce.
optometrytoday
Boost your chances of
finding the ideal candidate
for your vacancy by
advertising on optometry.
co.uk and reach up to
20,000 users a month.
Call 020 7878 2313
online
- CAMBRIDGE -
Full/Part Time – Experienced, Qualified Dispensing
Optician/Optical Assistant/Manager
Enthusiastic, friendly, committed fully
qualified DO/OA required for prestigious, busy,
independent practice in Cambridge.
Benefits include:
• Good Salary (according to qualifications & experience)
• Friendly working environment
• Full support staff
• Full or part time considered
• Hours 9-5.30 1 hour for lunch
Please contact Martin on: 07788 772334 or
Email: HR_Optician@yahoo.co.uk
optometrytoday
More jobs visit
www.optometry.
co.uk/jobs
online
Vision Care for Homeless
People (Charity no: 1118076)
Vision Care for Homeless People is a charity setup
to provide eye-care services to homeless and
other vulnerable people in an accessible and friendly
environment in which they feel safe, welcome and
comfortable.
We have recently expanded our services in the London
area and are subsequently looking for a Clinic Manager
who will manage 3 Vision Care for Homeless People
clinics in the London area, ensuring all VCHP policies and
live
bookshop
procedures are being adhered to, that all stock levels CET
are maintained and equipment is working correctly, to
administer all clinic paperwork including mail and to assist
with volunteer management and communication.
The position is on a part-time basis, 2 days per month.
For a full job-description and application details please
email: info@visioncarecharity.org
enewsletter VRICS
tv

JOBS
To place an advertisement call 020 7878 2313
or email haley.willmott@tenalps.com
OPTOMS
Norfolk, Suffolk, Kent, Cornwall, Sussex
DISPENSING OPTICIANS
All areas & Offi ce Based M4 corridor
53
TRAINERS
Greater Manchester, Cheshire, West Yorkshire,
Nottinghamshire, Derbyshire
SUPPORT DISPENSING OPTICIAN
Head Offi ce, Swindon
EXPERIENCED MOBILE OPTICAL
ASSISTANTS
Nationwide
LOCUM OPTOMS
Nationwide
Days still available to book, please visit
www.outsideclinic.com/careerslocum.html
or contact Jim Gilbert for more details.
03/06/11 JOBS
For all the latest vacancies please visit
Contact Jim Gilbert for more details:
tel: 01793 648607 - email: jim@outsideclinic.com
follow us on
facebook

JOBS
To place an advertisement call 020 7878 2313
or email haley.willmott@tenalps.com
Super
Optom
Cornwall, Sussex,
Norfolk, Kent
Technical Advisor /
Support Dispensing
Optician
Head Office, Wiltshire
Optical Assistant &
Dispensing Optician
Opportunities Nationwide
Call Jim on 01793 648607 or visit www.outsideclinic.com
54 50
17/09/10 03/06/11 RECRUITMENT
JOBS
R01 OT Strip.indd 1 27/5/11 13:32:53
Ninewells Hospital, Dundee
Surgical Directorate
Ophthalmology Department
Optometrist Specialist Band 7
Salary Scale £30,460 - £40,157 per annum
The main duties for this job are paediatric, post-op cataract, vitreous, low visual
aid and macular (including using an OCT) clinics. There will also be opportunities
for teaching and research.
You must hold General Optical Council registration and have post-registration
experience. As you may be required to work anywhere throughout Tayside and
NE Fife, the ability to travel is essential.
Informal enquiries and visits are welcomed. Please contact Dr Kathryn Weed,
Optometrist Consultant on 01382 632348.
22.5 hours per week.
To request an application pack please email: recruitment.tayside@nhs.net
(quoting Ref – D/JM/61 in the subject box).
Short-listed applicants will be contacted by email. Please check your emails regularly.
Closing date for receipt of completed application forms: Friday 24th June 2011.
Interviews are scheduled for Friday 8th July 2011 (Afternoon).
NHS Tayside is committed to equality and diversity and welcomes applicants from all sections
of the community.
Advertise your job vacancy in OT magazine
and reach 25,794 optical professionals and
online at www.optometry.co.uk and reach
an average of 14,506 unique
visitors per month.*
*Google analytics March 2011
For more details contact Haley Willmott on
0207 878 2313 or email
haley.willmott@optometry.co.uk
Optometrist
Full time/part time
position available
with competitive
salary for right
candidate to work in
Fife and Perthshire
Email CV to
Keith@eyecentre
scotland.co.uk
optometrytoday
Sign up to OT Job
Alerts and hear
about the latest job
vacancies online first at
www.optometry.
co.uk/jobs
en
optometrytoday
live
bookshop
CET
online
enewsletter
VRICS
tv

MARKETPLACE
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
O PHTHALMIC
A CCO UNTANTS
AND A DVISO RS
Accountants
Vat (Including Partial Exemption)
Business & Taxation Planning
Locum and Practice Accounts
Valuations Payroll Bureau
For A Free Consultation Contact Desirie Lea ACA on: 0151 348 8400
Email: specs@moco.co.uk Web: www.moco.co.uk
optometrytoday
online
Cases
MORRIS & CO
MORRIS CHARTERED ACCOUNTANTS & CO
CHARTERED ACCOUNTANTS
For more Marketplace visit
www.optometry.co.uk/marketplace
live
bookshop
CET
Chairs
enewsletter
VRICS
tv
Computer Systems
MO
C O
MO
C O
Computer systems
SOFTWARE WITH VISION
Optix
www.optix.co.uk
software
Business Management System
55
03/06/11 MARKETPLACE
Tel: 01904 606611
Computer Systems
optometrytoday
Looking to sell anything from a secondhand
piece of equipment to your practice.
Advertise in OT and reach 19,842 potential
buyers. Please call 020 7878 bookshop 2313
live
CET

MARKETPLACE
Computer systems
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
Instruments
optometrytoday
Finance
online
live
enewsletter
bookshop
VRICS
CET
tv
=%
56
Contact Lenses
optometrytoday
=%
live
PROFESSIONAL FINANCIAL SERVICES
Call : 0845 644 7778
E-mail : info@pfsleasing.co.uk
Web: www.pfsleasing.co.uk
books
03/06/11 MARKETPLACE
Frames
online enewsletter VRIC
Equipment
100
95
75
optometrytoday
live
25
5
bookshop
C
Finance
Equipment
0
optometrytoday
EQUIPMENT FINANCE
SHOPFIT FINANCE
I.T. FINANCE
TAX BILL FINANCE
CAR FINANCE
t: 01536 52 96 96
e: info@performancefinance.co.uk
w: www.performancefinance.co.uk
For more Marketplace visit
www.optometry.co.uk/marketplace
live
bookshop
CET
online
Hot Compress
optometry_today_SS11
11 March 2011 15:02:37
enewsletter
VRICS
tv

Frames
MARKETPLACE
Instruments
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
Lens cleaning cloths
optometrytoday
live
bookshop
For more Marketplace visit
www.optometry.co.uk/marketplace
online
enewsletter VRICS
CET
tv
caseco
Tel 01580 890111 Fax 01580 890118
sales@caseco.co.uk www.caseco.co.uk
Practice fittings
57
optometrytoday
live
bookshop
For more Marketplace visit
www.optometry.co.uk/marketplace
online
enewsletter VRICS
Instruments
CET
tv
Practice fittings
03/06/11 MARKETPLACE
Repairs
Practice fittings
100
95
75
25
5
0
Practice for sale
PRACTICE
FOR SALE
GLASGOW
SOUTHSIDE
APPROX T/O £60,000
ON 2-3 DAYS PER WEEK
EMAIL: drjo@talktalk.net

MARKETPLACE
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
Practice fitting
58
03/06/11 MARKETPLACE

Could you take
a 66% pay cut?
AOP
Members
receive 20% off
your first 3 years’
contributions!
“Nine out of 10 Britons who become too sick
to work will see their income slashed by up to
two thirds because Britain has some of the
lowest levels of State and private protection
against ill health in the developed world.”
Telegraph Money 19th March 2011
A PG Income Protection Plan can cover
you from the first day of incapacity.
Thanks to all those who visited us on the AOP stand at Optrafair
Pharmaceutical & General Provident Society (PG) are dedicated to serving the needs of
pharmacy professionals. Our Income Protection Plan has several options allowing you to
tailor it to suit your individual requirements whatever stage of your career you are in.
If you need to make a claim we won’t penalise you by putting your premiums up, and we will
continue to pay out until you’re able to return to your existing occupation or reach age 65.
For more details visit our website or give us a call today.
Freephone: 0800 146307
www.pgprotects.co.uk/aop
Pharmaceutical & General Provident Society Ltd, trading as PG
Registered Office: 11 Parkway, Porters Wood, St. Albans, Hertfordshire AL3 6PA. Tel: 01727 840095 www.pgprotects.co.uk Incorporated in the United
Kingdom under the Friendly Societies Act 1992. Authorised and regulated by the Financial Services Authority, Registered Number 110023.
* Please note that this offer is subject to PG’s terms and conditions, cannot be used in conjunction with another offer and applies to new applicants only.