Download this issue - Optometry Today

www.optometry.co.uk June 17 2011 vol 51:12 £4.95
optometrytoday
What a nerve!
Read our latest CET: optic nerve anomalies

A refreshing perspective
CooperVision TV has now launched
Available online and on mobile devices,
CooperVision TV is your destination for digital
learning and development. Watch seminars on some
of the most advanced areas of contact lens fitting,
get help and support, take tests and earn CET
points. It’s a flexible and informal way to increase
your knowledge and expertise - CooperVision style.
And it’s available when and wherever you want it.
CooperVision TV is live now.
To register and instantly view the latest content,
please go to coopervisiontv.com

Become our fan on Facebook’
http://twitter.com/OptometryToday
CONTENTS
June 17 2011 vol 51:12
20 22 44
News
5 Parental ignorance
A new poll has revealed just how many
parents are unaware of the importance of eye
examinations for the under-7’s
6 Consortia get guidance
New eye care commissioning guidance is
launched by NHS Alliance chief executive
Michael Sobanja
7 Trio honoured
Details of those who received recognition
in the optical sector in the Queen’s Birthday
Honours List
8 Comment
In the week that the Government annonced
revised plans for the Health Service in
England, AOP chief executive Bob Hughes
writes on the NHS Future Forum
10 Extra CET credits
Next month’s Independents Day will have
an eve-of-conference mini symposium with
CET points
12 Eye Health Week headlined
The profile of vision issues was raised this
week by the latest promotion week on the
importance of eye care
Events
27,29 Demystifying dyslexia
A review of last month’s ‘Managing Dyslexia in
your Practice’ course
30-33 BCLA shines in Manchester
Our review of the annual contact lens-focussed
conference and exhibition which took place
last month
Products
20-21 Industry
A major contact lens launch from Sauflon,
sunglasses from Stepper, dry eye solutions
from Bausch & Lomb; plus designer frames
and a new discount scheme from Dunelm
24 Accessories
Ideas to improve your profits Hilco, Dibble
Optical, Caseco and Optipak
Regulars
14 Pre-reg Focus
Nadeem Rob with important information on
OSCEs
18 Q&A
Nick Atkins takes our 20 questions
38 Diary dates
All the latest optical events
News Extras/Background
16-17 AOP secures victory in
field screeners challenge
Background details of the latest defence the
Association has provided
22 Fresh call to improve testing
drivers’ vision
European optical groups claim the UK has
fallen behind along with other EU member
states in its requirements for testing drivers’
eyesight
34 Millions too hard-up to book
New research has found many people are
not attending eye examinations because of
financial pressures
Clinical
36-37 VRICS: Presbyopia &
Ageing Eyes
The picture quiz covers the correction of
presbyopia and identification and management
of ageing eye conditions
40-43 CET: Optic nerve
anomalies
Key advice in the latest part of our referral
refinement course, written by Dr Marcela
Votruba
44-48 CET: Visual factors in
specific learning difficulties
This article, by Lindsay Bater, outlines the results
of a clinical study to determine whether there
were any predictive factors to indicate the
presence of Meares-Irlen syndrome
Classified
51-54 Jobs
All the latest vacancies. Sandwell and West
Birmingham Hospitals are inviting dispensing
optician/ senior optical dispensers for interview
or please see our Jobs section for NHS jobs
55-58 Marketplace
Ocuco has affordable software to suit
independent budget and requirements
Feature is online Video is online www.optometry.co.uk

WIN
an
iPad 2
When you experience the UK’s NEWEST, FASTEST and
most USER-FRIENDLY online LENS ORDERING service
The NEW JAI KUDO WEBSITE has been built from the ground up to provide
the most comprehensive and efficient online experience available, including:
ONLINE ORDERING
order from our entire product range in a fast & simple interface.
ONLINE ORDER TRACKING
with up-to-the-minute status updates on your orders.
ONLINE ACCOUNT HISTORY
check deliveries & invoices, online, anytime.
Simply register online with JAI KUDO and when you place
your first online order you’ll be automatically entered into our
FREE DRAW to win an iPad 2
www.jaikudo.com/lenses
No purchase necessary. Please see our Terms & Conditions for more information.
For further assistance or to register your account call 0208 732 9620.

NEWS
Parents’ ignorance of
kids eye care revealed
NEW EVIDENCE has revealed
that many UK parents are
unaware how important an
eye examination is for their
young child.
A new poll by the
influential Mumsnet forum
involving over one thousand
respondents found the
majority of parents are
concerned about their child’s
eye health, yet only half (49%)
have taken their child for an eye
test with a medical professional,
over and above a developmental
check-up.
Commissioned by the
Childhood Eye Cancer Trust
(CHECT), the survey – conducted
by Mumsnet with parents
of children aged up to six –
revealed most (79%) of those
questioned felt sure their child’s
eyes had been examined as
part of a routine developmental
check. Nevertheless 12% said
they didn’t know if they had
been checked, and a further 9%
were sure that they definitely
hadn’t been checked during
developmental checks.
A total of 49% of parents stated
they had proactively taken their
child for an eye check with either
‘an optician, GP, hospital doctor
or health visitor,’ outside of a
scheduled developmental check.
CHECT undertook the project
to mark the start of National
Eye Health Week and is urging
parents to become more aware of
their child’s eye health.
Online retention
gets thumbs up
FURTHER PROOF that
optometrists and others
professionals are happy to
register online has emerged
this week. And the GOC
has reported it is to expand
its electronic retention
procedure to businesses from
2012-2013.
Following the success of the
first year of online registration
reported by the GOC in
April, when almost 95% did
so, a survey conducted by
the optical regualtor has
found that practitioners are
happy with the new online
retention system. Of 885
practitioners replying to
its survey, 86% reported
completing their application
in under 10 minutes, with
80% describing the process
as ‘very easy’ or ‘easy’.
Online retention is also
now available for students,
who have until July 15 to
apply at its website, said
head of registration Philip
Hallam, who also confirmed
that the GOC intends to
introduce the online system
for business registrants
next year.
Of those parents surveyed,
most (61%) had heard of
retinoblastoma, but 89% of
those that were aware of it
(55% overall) didn’t know
much about it and few were
aware of all the signs and
symptoms. Almost two-in-five
(37%) were not aware of the
life-threatening disease at all.
More than three-quarters
(77%) correctly noted that a white
reflection in the pupil is likely to
be a symptom of childhood eye
cancer, while only 12% correctly
said a squint or lazy eye could be
a symptom. Less than half (48%)
correctly thought that a change
in the colour of the iris could
also be a warning sign. One-infive
(19%) incorrectly identified
a red reflection in the pupil as a
symptom of eye cancer.
“Parents appear to be relying
on the media to provide them
with vital information on what
to look out for,“ said a CHECT
spokeswoman, “with 46%
becoming aware of childhood
eye cancer through a national
newspaper or magazine article
and 37% through the internet. Just
4% had heard about it through a
medical professional.”
BRIEFING
Thank you to those
who ticked to raise
cash for charity
OPTICAL charity Optometry Giving
Sight has praised AOP members
who have collectively donated
more than £4,000 via those who
decided to add a donation to their
annual membership renewal.
Members who ticked ‘Yes’ to
fund Optometry Giving Sight
helped refractive error programmes
to support millions who are blind
or visually impaired simply because
they do not have access to an
eye examination and a pair of
spectacles.
“The amount raised was more
than last year which is fantastic”
said Donna Power, UK country
manager. “We are truly grateful
for this donation and would like
to thank all of the members for
supporting us, and the AOP for the
continuous support we receive as
their Charity of Choice.”
For every £1 raised, Optometry
Giving Sight can guarantee at
least 85p goes directly to those
in need. Last year, $US1.2m was
disbursed, which supporting 18
refractive error programmes in 16
countries, enabling 322,189 people
to receive an eye examination and
appropriate eye care in 2010.
Bob Hughes, chief executive of
the AOP, said: “Optometry Giving
Sight funded projects are making a
real and sustainable difference to
people who cannot afford glasses,
but cannot function without them,
and I would like to thank our
members for contributing to
this work.”
5
17/06/11 NEWS

NEWS
optometrytoday
JUNE 17 2011
VOLUME 51:12
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
Guidance is launched
for new GP consortia
YESTERDAY (June 16) NHS
Alliance chief executive Michael
Sobanja (pictured) launched
new eye care commissioning
guidance to help GP consortia in
commissioning ‘quality, costeffective
eye care services’ for
patients.
Speaking at the Vision UK
2011 conference he said: “It
is important to have patients
right at the heart of eye care
service commissioning. This
new guidance will assist
commissioners to improve
quality of provision in a
sustainable manner.”
The conference and guidance
are both initiatives of the UK
Vision Strategy, which held its
annual Vision UK event in
London yesterday.
The guidance has been
produced in collaboration with
GPs, ophthalmologists and other
clinicians, and is intended for those
taking a ‘hands-on approach’ to
local commissioning.
It recommends priority areas
and hopes to enable consortia
to: ‘assist in making considerable
cost savings in the short, medium
and longer term; deliver high
quality care through specific
improvements to the patient
journey; create innovative eye
care services tailored to the
needs of local populations; and
to develop sustainable services
through increased collaboration
between commissioners,
clinicians and local communities
The guidance is available as
an online resource at: www.
commissioningforeyecare.org.uk.
FMO briefs on new Bribery Act
LAVISH HOSPITALITY
and gifts should be guarded
against to avoid any
potential challenge under
the new Bribery Act, a
meeting of the Federation
of Manufacturing Opticians
(FMO) was told last week.
A briefing was given as
part of the FMO’s regional
meeting which took place in
Birmingham and discussed
the implications of the
Bribery Act 2010 which
comes into force on July 1.
An FMO spokeswoman
Glaucoma clarification
THE AUTHORS of our CET article
in June 3 OT (pages 40-44)
have clarified their statement
on prevalence of glaucoma
increasing with age, ‘from about
2% for a patient aged 40-50
years’. “The prevalence varies
according to each study and the
said: “Soon the Optical
Confederation will be
releasing guidance that will
stress the need for optical
practitioners to comply
with existing GOC Code of
Conduct and Professional
Guidelines to minimise risks
or accusations of influencing
clinical judgement.”
Mark Nevin, head of policy
and regulation at the FMO,
FODO, and the ACLM, told
the FMO’s Frames, Lenses
and Equipment Associations
that the Ministry of Justice
population studied,” they state.
“The figure of approximately
2% is used as an average
for glaucoma in the general
population, all ages averaged.
This increases to 5% for those
in their 80s. These figures are
applicable to Caucasians only.
“is not intending to prohibit
normal, honest, business
practice”, but that companies
need to be aware “of any risk
of bribery”.
He also updated FMO
members on the Optical
Confederation’s campaign for
better vision for safer driving
(see also page 22).
In addition, the meeting
discussed specific industry
challenges, with dedicated
optical training for all
levels of employees a major
talking point.
For black populations the figure
is higher with about 5% and
8% depending on studies and
age. This figure is taken as an
average of all populations ages
from several different studies
and is not meant to reference
one particular study.”
Comment on the news via www.optometry.co.uk

Trio are recognised in
Queen’s Honours List
INDIVIDUALS FROM optics were
recognised this week in the
Queen’s Birthday Honours List.
Frank Norville (pictured),
chairman of the Norville Group,
has been awarded an OBE for
services to manufacturing.
The ‘champion of
manufacturing’, Mr Norville
is well-known for supporting
the development of the UK
manufacturing industry and
also as a supporter of charitable
causes.
Mr Norville told OT: “It was quite
a surprise and a great honour to
receive the news on behalf of all
the colleagues and friends within
the profession, some of whom are
sadly no longer with us.
“Optics is a small but important
industry and it is a great honour
that manufacturing has been
recognised in this way.”
As a ‘third-generation’ optics
professional, he says the business
was one he was ‘born into’ and as
well as being chairman of Norville
Group, Mr Norville has held the
titles of chairman of the FMO
and master of the Worshipful
Company of Spectacle Makers.
He puts his own and his
company’s success down to
continuous attention to detail and
developing and embracing new
technology, but has no plans to
rest on his laurels.
“It’s a very exciting time in
manufacturing,” he added, “with
technology developing into
being more compact.”
Chief executive of the FMO,
Malcolm Polley, said the
award was richly deserved,
and added: “Frank’s dedication
and commitment not just to
manufacturing but across the
whole spectrum of optics is
unsurpassed. He continues to
be a fantastic champion of UK
manufacturing.”
Other recipients were Dick
Roberts and Rosie Auld who
both received CBEs for services
to optometry and services to
healthcare, respectively.
Mr Roberts, a self-employed
optometrist, is a fellow of the
College of Optometrists and the
American Academy of Optometry.
He was appointed consultant
optometric advisor to the National
Assembly of Wales in 2000, and
was awarded the OBE in the 1998
New Year’s Honours List.
Ms Auld spent six years as chair
of the British and Irish Orthoptic
Society and is currently head
orthoptist/lead clinical tutor at
the Birmingham and Midland
Eye Centre.
Book now for workshops
BOOKINGS are being
taken for practitioners
who are interested
in training to
become ’professional
ambassadors’ for
the Careers in Optics
scheme.
The initiative’s team,
which last month won a
prestigious award for innovation at the National
Recruiter Awards – pictured – aims to raise
awareness of optics as a career option amongst
secondary school and sixth-form pupils.
To ensure all ‘ambassadors’ are well-equipped
to deliver the workshops, the Working
Group running the scheme is offering optical
professionals the chance to attend free-to-
attend workshops
during this month
and next.
The workshops
will take place in
London at City
University (June
24), Birmingham
(July 4), and
Manchester
(July 5), with venues for the latter two to be
decided.
Each workshop lasts two hours and
refreshments will be available. However, there
is a limit of 20 places per session so those
who are interested should book now to avoid
disappointment.
• To register email charlotteverity@aop.org.uk
BRIEFING
GOC outlines plans
to ‘get tough’ on
illegal sales
The General Optical Council
has published a new protocol
explaining how it will deal with
breaches of the Opticians Act.
The protocol for the investigation
and prosecution of criminal
offences details how the GOC will
deal with individuals and firms it
suspects of breaking the law.
Offences that the Harley
Street-based Council may decide
to prosecute over, include
selling contact lenses without
the involvement of an optician
(including over the internet),
testing sight while unregistered,
falsely claiming to be a registered
optician and selling zero-powered
contact lenses illegally.
GOC director of regulatory
services David Howell said: “We
take breaches of the Opticians
Act extremely seriously and this
protocol sets out the action we
will take when we suspect the law
has been broken. This may involve
conducting investigations and
bringing criminal prosecutions in
appropriate cases.
“We have begun to apply
this policy, and in several cases
the alleged activity has ceased
following initial contact from us.”
The protocol is available on the
GOC’s website and sets out a faster
process by allowing the registrar
to decide to pursue a prosecution,
instead of a committee as
previously. GOC staff are to attend
the Trading Standards Institute
conference later this month, to
raise awareness of the Opticians Act
among trading standards officers.
Anyone who wishes to report a
suspected breach of the Opticians
Act should telephone the GOC on
020 7580 3898 and select option 2.
7
17/06/11 NEWS
News updated regularly at www.optometry.co.uk

NEWS
COMMENT
8
17/06/11 NEWS
Survey reveals public
attitude to eye health
ALMOST a third of people
who haven’t had a sight
test for the last two years
say they ‘don’t think it’s
necessary’ according to
new research. And 50%
state they haven’t visited
an optometrist because ‘I
haven’t experienced any
problems with my eyes’ .
Current public attitudes
to eye care have been
scrutinised as part of a
report released this week by the College of
Optometrists. The survey was undertaken by
independent research company FreshMinds,
which heard the views of 4,004 UK adults
aged below 60.
Other popular reasons for not attending an
eye examination among the 716 respondents
who stated they have not had a recent sight
test included: concern about the cost of a
test (20%); the cost of glasses (17%); lack of
free time (20%); ‘it’s just
too much hassle’ (14%);
‘I’m worried they’ll try
and sell me spectacles
even if I don’t need them’
(14%); and a proportion
of people worried about
problems the optometrist
might find (7%).
Further findings
revealed in the report
include that 65% of
people wear some sort
of corrective eyewear, with 62% owning
spectacles and 14% in contact lenses, 11%
had both. Explaining the reason for the
research, president of the College, Dr Cindy
Tromans (pictured), said: “Patients are at the
heart of our work and we commissioned this
research because, as a public benefit body,
it is important for us to develop a better
understanding of patient attitudes towards
their vision and eye health.”
Successful roadshow
event is now online
ONE of this year’s AOP
roadshow events which
helped explain the Making
Accurate Claims in Scotland
publication can now be
viewed online. The Inverness
meeting, filmed earlier this
year is now available – see
link below.
Kevin Wallace (pictured),
chairman of AOP Scotland,
spoke about claiming GOS fees in Scotland
and gave examples of illustrative cases, as
well as answering questions posed from the
practitioners attending.
Although almost a third of Scottish
practitioners were present at one of the
five roadshows which the AOP ran, there
were still many who were unable to attend
because the distances involved were
just too great. “So”, said
Mr Wallace, “we decided
that filming the event
and making it available
for free on the OT website
would mean that every
practitioner in Scotland was
able get the benefit.
“Furthermore, because
the subject matter is very
relevant to many nonprofessional
staff in practices as well, they
can also access the film.”
Scottish AOP members are reminded
that, if they have questions about GOS
they should contact the AOP office;
richardcarswell@aop.org.uk
The event can be viewed at http://
www.optometry.co.uk/multimedia/viewvideo?id=990437320001
NHS FUTURE – YOUR
FUTURE?
The NHS Future Forum has just reported
to the Government on the NHS reforms
in England and I am trying to wade
through the five separate documents
published on Monday.
As you would expect, we engaged
with the process and made the case for
optometry and optics. In this we are
grateful to Ash Soni, a member of the
Forum and a Croydon pharmacist, who
helped us ensure that our voice was
heard and that our views were taken on
board.
We have backed the Government’s
reforms from the beginning because
they offer real opportunities to improve
eye care provision and of course they
remove the Primary Care Trusts, so
many of which have failed to tackle
eye care issues and have acted so badly
towards practitioners.
There are two big opportunities for
the profession. Influencing the Council
Health and Well Being Boards, and
ensuring that commissioning consortia
see optometry as an essential partner
in reaching eye care commissioning
decisions. The profession is well set
up for this, and for once we don’t need
to play catch-up. We have lobbied
tirelessly using the combined resources
of the Optical Confederation, and we
have support for local action in place
through the LOC Support Unit. LOCs
have the opportunity to become an
essential part of health planning and
public health assessment and to make
the case for developing enhanced
services in the community.
In any longer term risk assessment it is
an inescapable conclusion that, if we fail
to take advantage of these opportunities,
we face the very real possibility that a
refusal to adapt will bit by bit impact on
the core business as others move in to
fill the gap.
Bob Hughes, AOP chief executive
bobhughes@aop.org.uk

Amazing things
can happen in
the blink of an eye.
Ben knows little about ASD technology in
1•DAY ACUVUE ® MOIST ® for ASTIGMATISM…
…but he loves his football on Saturdays.
Ben knows little about Accelerated Stabilisation
Design technology (ASD), and its unique
four-zone stabilisation system that ensures minimal
lens rotation irrespective of eye movements or
extreme gaze, but he relies on his clear vision
whenever he’s taking a penalty 1,2 .
1•DAY ACUVUE ® MOIST ® for ASTIGMATISM offers
patients visual acuity as good as when wearing
spectacles 3 .
What’s more, 1•DAY ACUVUE ® MOIST ® for
ASTIGMATISM provides the highest UV protection
of any daily disposable toric lens available. This
helps protect patients’ eyes from harmful UV rays
during outdoor activities 4 .
For patients like Ben, don’t think
astigmatism, think 1•DAY ACUVUE ® MOIST ®
for ASTIGMATISM.
SEE EVERY MOMENT, EVERY DAY
1. Chamberlain P et al. Fluctuation In Visual Acuity During Soft Toric Contact Lens Wear. Optom Vis Sci 2011; 88: E534-538. 2. Zikos G et al. Rotational Stability of Toric Soft Contact Lenses During Natural Viewing
Conditions. Optom Vis Sci 2007; 84(11): 1039-1045. 3. JJVC data on fi le 2011. Randomised, bilateral study for 1 month daily wear with 66 astigmatic spectacle wearers (lapsed wearers and neophytes). 4. JJVC
data on fi le 2010. Class II UV blocking; more than 85% UVA and 99% UVB. UV blocking contact lenses are not substitutes for UV blocking sunglasses as they do not completely cover the eye and surrounding area.
ACUVUE ® , 1•DAY ACUVUE ® MOIST ® , LACREON and SEE WHAT COULD BE are trademarks of Johnson & Johnson Medical Ltd. © Johnson & Johnson Medical Ltd 2011

NEWS
10
17/06/11 NEWS
IN BRIEF
Christie at
CooperVision
Well-known academic Caroline
Christie (pictured) has been
appointed clinical and professional
affairs manger for CooperVision.
She will be responsible for the
clinical and professional profile of
CooperVision in the UK and Ireland.
Sales and marketing director for
the UK and Ireland, Gabor Dozsa
said: “We are delighted to welcome
Caroline to the team and believe
she will be a great asset to the
company. As such a renowned figure
in our industry, her strong lecturing
experience, coupled with her
outstanding clinical and academic
background, will really enable us to
build on our clinical expertise and
training initiatives.”
Optom proud of
MoonWalk
An
optometrist
has walked
over 26 miles
for charity.
Meera Patel
(pictured),
who works at
Specsavers’
Walton on Thames practice, has
raised more than £500 for Walk
The Walk by completing the annual
MoonWalk in Hyde Park. Ms Patel
commented: “The MoonWalk
means so much to me as quite a
few members of my family have
sadly been affected by cancer. I was
joined by my two aunts and it took
us seven hours to complete the 26.2
mile walk. We started at 11.30pm
and didn’t finish until almost 7am
– by that point we were cold and
exhausted but still extremely proud.”
Early arrivals for ID’11
can get extra CET credits
PRACTITIONERS WHO attend a
free ‘mini symposium’ on the eve
of Independents Day can receive
two CET points.
The afternoon event, on
July 3 at the Windmill Village
Hotel, Coventry is open to all
practitioners, regardless of
whether they have booked to
attend Independents Day 24
hours later.
Business lectures include
independent practitioner Simon
Donne discussing his patient
communication tips in his
THE OPTICAL
CONFEDERATION will host
an introductory training and
apprenticeship workshop
which aims to inform
delegates about government
schemes available to help
support optical training next
month.
To be held at FODO’s
headquarters in London on
presentation entitled ‘Contact
Lenses… It’s the way I tell em!’
and Sandi Charlesworth from
Essilor discussing ‘Tuning-up
your business for maximum
performance’. General dispensing
and contact lens CET points will
be provided by Andy Hepworth
(pictured) – ‘Modern Day
Varifocals: Betamax to HD Vision’
and Jonathon Bench – ‘Striking
the right balance of material
properties’ respectively.
Essilor and Johnson & Johnson
Vision Care are sponsors of the
symposium, and in addition
to the presentations, there will
be a small exhibition of both
company’s latest products.
Confederation to hold info
day on support staff training
OPTICAL CHARITY Vision
Care for Homeless People has
received a boost from Topcon.
The instrument supplier has
donated consulting room
equipment for the good
cause’s new London centre in
Shepherd’s Bush, including a
Topcon fundus camera and
Volk lenses. Andrew Yorke
(pictured, with chair of the
charity Elaine Styles), medical
July 6, the one-day event
(10am-3pm) is free to attend
and will focus on training
for optical assistants and
support staff.
Attendees will have the
opportunity to meet training
providers, representatives
from companies already
using the schemes, and
the bodies awarding the
qualifications.
The event will also cover
how practices’ own workplace
training schemes could be
accredited towards nationally
approved modules which
would lead to an assessment
and a nationally recognised
qualification for staff.
To book a place email
karensparrow@aop.org.uk
New kit for homeless
director of Topcon GB, said:
“People are in need in this
country and, do excuse the
pun, we can’t turn a blind eye.
When we were asked to help
we were happy to do so,
especially as it is here, close
to home.”

TruEye
1 • DAY ACUVUE®
Brand Contact Lenses
is on TV
2.7 million
women * will see
our message
on
From March to November
we’ll be sponsoring the very
best US drama premieres.
Driving patients to your practice
www.jnjvisioncare.co.uk
BRAND CONTACT LENSES
ON
*Based on expected sponsorship coverage, ABC1 women, period March – November 2011 – all Johnson & Johnson Vision Care sponsored programs. Source: Techedge– predicted via the sponsorship module and actual via Advantedge Advantedge.
ACUVUE ® , 1•DAY ACUVUE ® TruEye and SEE WHAT COULD BE are trademarks of Johnson & Johnson Medical Ltd. © Johnson & Johnson Medical Ltd. 2011.

NEWS
12
17/06/11 NEWS
IN BRIEF
GOC joins Twitter
Practitioners who want the
up-to-date, inside knowledge on
events at the GOC can now follow
its statements on social networking
facility Twitter. The regulatory body,
which has the username
@GOC_UK joins OT, the Student
AOP, Eye Health Alliance, the College
of Optometrists and a number of
other optics groups who use the
website to inform ‘followers’ on the
latest news and developments.
Students get
smoking insight
Students in the Nottinghamshire
area have been told of the links of
smoking and sight loss – by seeing
themselves as smokers aged 70. The
RNIB’s ‘virtual ageing photo booth’
went to three colleges to coincide
with National Eye Health Week as
part of Nottingham’s Sight Matters
Week. Barbara McLaughlan, RNIB’s
eye health campaigns manager,
said: “Our focus is on younger
people because we want to show
them, in a very tangible way, how
their lifestyle choices may affect
their risk of developing eye disease
in later life.”
OGS donates £2k
Optical charity Optometry Giving
Sight has given a £2,000 grant
to enable five Cardiff-based
optometrists and 10 students
to take part in the Romania and
Moldova Vision Project later
this summer. The project, which
has been running for nine years
extended into Moldova last year,
and has already provided 10,000
people with vision care. While there,
the Cardiff University students
aim to provide vision care to over
2,000 impoverished people of all
ages; spending time in orphanages,
churches and schools.
Cardiff student Juliet Ashwell, said:
“It’s a very exciting challenge and
we’re grateful for the financial
contribution. It will help us
significantly improve quality of life
for thousands of people.”
Eye Week highlighted
THE EYECARE TRUST used this
week’s National Eye Health
Week to raise the profile
of vision issues, including
contributing to a vision
supplement in The Guardian
newspaper.
Published in the newspaper
on June 13, the vision and
hearing supplement featured
items on glaucoma, the
importance of regular sight
testing for children and also
covered advances in laser eye
surgery.
Other initiatives by the Trust
include the launch of ‘A guide
PRIVATELY-OWNED UK frame
and sunglasses company
Fabris Lane has announced it
is looking to expand – and is
actively seeking to purchase an
established optical distribution
business.
Managing director Tim
Downes explained that with a
strong growth in sales the time
is right for the firm to grow to
‘the next level’.
He said: “We believe the
most expedient path is through
to summer eye care’, attending
regional events and producing a
practitioner resource pack.
The resource pack for
optometrists has been produced
in association with one of the
lead sponsors of the Week,
Simplyhealth. It includes: A
poster, pocket guides and a
handbook highlighting ways
of caring for eyes when using
a computer, a door panel for
practices promoting the concept
of affordable eye care, template
press releases and a quiz for
patients.
Chair of the Eyecare Trust,
BOOTS OPTICIANS has launched a campaign to encourage parents
to make sure their children wear adequate sunglasses, and highlight
the dangers of UV. The initiative, launched by the multiple last week,
includes a video made with its celebrity ‘ambassador’ actress Patsy
Kensit (pictured with a child sunglasses wearer) outlining some of
the main issues parents appear unaware of according to a new survey.
The video theme centres on: 80% of UV damage happens by
the age of 18 and that only around half of parents put their children
in sunglasses in sunny weather, compared to 86% who will apply
sun cream in the same weather. It is available to parents on website
youtube, and the multiple also plans to market it to ‘mummy
bloggers’ in the hope they will promote the message in the coming
weeks.
Dharmesh Patel, said: “National
Eye Health Week is an important
event in the optical calendar and
the trust will be working hard
to help lift optics up the public
health agenda with a series of
high profile promotions and
more locally targeted events such
as our attendance at the Ryedale
Sight Support Open Day.”
Packs are currently being
sent out to supporters of the
Trust.For further information
about becoming a Friend of the
Trust contact Melissa Reeds on
0845 129 5001 or email info@
eyecaretrust.org.uk
Fabris now looks to acquire
acquisition and we are looking
to acquire a well respected
company with an established
sales structure, which may also
licence some strong consumer
brands. Being in a cash-positive
position we would fund
any purchase from existing
resources.
“Our customer service
facility, extensive quality
testing laboratories, and
fully integrated EDI and
bespoke stock management
warehousing, which ships
thousands of frames around
the world each day, supports
sales into 35 countries.
“We have the means,
and desire, to bring further
eyewear products to market.”
Actress helps multiple
Geoff Caddick/PA Wire

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.

PRE-REGFOCUS
Sponsored by
I have some important firsthand
advice on your OSCEs
14
17/06/11 PRE-REG FOCUS
AND SO the end begins; it’s almost
time to take those last steps to
become fully qualifed, writes
optometrist Nadeem Rob (pictured)
as he reflects on taking his OSCE.
You may not choose to believe me
but the hardest part was over when
you passed your Stage 2. The only
obstacle left that stands in your way
now are 60 minutes of practical
exams.
Here are my tips to making it
through the OSCEs.
Obvious
Be obvious. Try not to over
complicate things and keep things
simple. This is not always as easy as
it sounds, but complicating things
will only get you in a muddle and
confuse the examiner beyond their
tolerance. This tip comes in handy with
stations like data interpretation. To start off,
just say what you see or hear. If it’s a field
plot, describe through the data logically
as you normally would. If you’ve taken
everything in over your pre-registration
period, while describing through the data
you will get that ‘light bulb’ moment.
Smart
Be smart. It’s an exam with clinical cases.
The potential for the type of patient is
endless but being smart in your revision
can make all the difference. Know your
more common disorders inside out as
more often than not it will be one of these.
Remember, the exams are in place to see if
you are competent in everyday practice.
Ideally you should be able to diagnosis
everything, but realistically that’s
impossible. If you haven’t a clue, make
an intuitive suggestion. Any answer is
better than no answer.
Confident
Be confident. By oozing this you will
instil confidence in your patient and
conseqently your examiner. No patient
wants a bumbling, sweaty palmed
practitioner looking after their eyes.
Naturally nerves will kick in, but have a
certain degree of confidence in yourself
and your training. The past year has
effectively been a dress rehearsal for
these individual stations. Now it’s time
to step up.
Efficient
Be efficient. This allows you to look
and sound like you know what you’re
talking about. Remember you have
five minutes for each station and this
time will race by. When you’re running
through data or doing a history and
symptoms, be ready to be flexible
and adapt to whatever gets thrown
at you. Practice explaining different
disorders in simple everyday terms to
your non-optometry related friends.
This is much more difficult than it
sounds and I would advise everyone
to have a rough script ready for each
problem as your patient actors will
ask you about anything that is even a
little technical.
Success lies in the preparation.
Revising for the OSCE can be difficult.
My last piece of advice is to make up
a group of case studies of your own.
Choose certain disorders and write
down what you think a patient would
say in their history and symptoms. Then
come up with signs that you would see
in patients with these disorders. Follow
that up with possible investigations
which are relevant to the disease and
a list of differential diagnoses. Finally,
finish with your possible management
decisions which should include the
correct referral if required or a recall date.
By logically breaking down each disorder
you can efficiently recall them during a
station.
But remember; be Obvious, Smart,
Confident, and Efficient – my version of
the OSCEs.
Good Luck.
• Keep up-to-date with all things prereg
related on the new student AOP
website at www.studentaop.org.uk/
pre-registration/

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

NEWS EXTRA
16
17/06/11 BACKGROUND
AOP secures
victory in field
screeners
challenge
THE AOP initiated a Judicial
Review over a decision by a
number of PCTs in the south
west to refuse a contract to an
optometrist who did not have a
portable electronic visual field
screener to use on domiciliary
visits.
However, since the legal
challenge, the PCTs involved have
withdrawn their requirement and
the AOP has therefore withdrawn
the Judicial Review proceedings.
Devon-based optometrist and
AOP member, James Faverty,
was refused a domiciliary contract by Devon PCT because
he did not possess a mobile electronic visual field screener
(eVFS). Mr Faverty approached the AOP for advice and
the Association immediately protested to the PCT, on the
grounds that there was no contractual requirement for a
domiciliary provider to possess or use an eVFS.
Three-month deadline
Devon PCT acted on behalf of several other PCTs in the area
– Cornwall and the Isles of Scilly, Somerset, Bristol, Dorset,
North Somerset, Torbay and Plymouth – in the matter of the
contract application and, with the exception of Bristol, then
acted together to write
to all practitioners on
their lists, requiring
those who carry out
domiciliary visits to
ensure they had eVFSs,
giving them a threemonth
deadline to
acquire one if they did
not possess one. This
was despite the fact
they knew that Devon
PCT was in discussion
with the AOP over the
legality of its actions
with respect to Mr
Faverty.
AOP director of
legal services, Gerda Goldinger (pictured) stated: “This was a
hugely inflammatory course of action for the PCTs to take. The
AOP’s legal challenge had been made, yet they tried to force a
large number of practitioners to purchase portable electronic
visual field screeners by a deadline that would fall before any
judicial proceedings could be heard, let alone decided. They
knew full well that, if the legality of their decision was not
upheld, those practitioners would have spent their money on
unnecessary equipment; yet they went ahead regardless.”
The AOP carried out a poll of practitioners in the south west
“This is clear evidence that peer
practice… is that eVFSs are not
used routinely”
and was able to confirm that few practitioners had portable
eVFSs – just over 10% – and less than 3% actually used one
while carrying out a domiciliary visit. Ms Goldinger reasoned:
“This is clear evidence that peer practice – which is the
standard by which optometrists will be judged – is that eVFSs
are not used routinely.”
Consequently, the AOP launched a Judicial Review of
the decision by the PCTs to make this unreasonable
requirement of practitioners. In order to further build its
case, the AOP consulted its members across England and
Wales. In a survey reported in OT (March 25 pages 42-43),
practitioners stated they did not have such equipment and
that the vast majority of their patients would be unable to
undertake the test.
To nominate for the AOP Awards go to www.optometry.co.uk/awards

667
practitioners
responded
In total, 667
practitioners
responded to the
survey saying
they carried out
domiciliary visits;
and only 18% of
them said that they
had access to an
eVFS. Of those,
77% stated they
“rarely or never”
take it with them
to a domiciliary
visit. Of those
who take the eVFS
with them, only 6% said they use it “always or frequently”,
with 94% using it “rarely or never”. In other words, of 667
domiciliary practitioners, only five take an eVFS with them
and use it frequently – less than 1% of those who undertake
domiciliary visits.
“This was the AOP doing what
it does best – battling for its
members”
Additionally, half of the practitioners felt that just 10% or
fewer of their patients were capable of completing such a test
meaningfully.
Furthermore, the action taken by the PCTs was likely to
lower the level of patient care. Only 3.4% of practitioners
said they would be prepared to buy an eVFS, whilst 58%
said they would stop doing domiciliary visits altogether if
one was required. As Trevor Warburton (pictured left), the
AOP legal department’s clinical adviser and a practice owner
based in Stockport, pointed out: “Taking action that could
result in almost 60% of domiciliary test providers giving up
visits was hardly likely to improve the eye care provided to a
vulnerable sector of the community.”
Expressing his gratitude to the practitioners who
responded to the survey, David Craig, AOP director
of operations, (pictured above) said: “The number of
optometrists who responded was fantastic and played a
really big part in enabling us to establish that the peer view
backed up our position. So we are really grateful to all those
who helped – their contribution has had a genuine role
in protecting the profession from creeping regulation and
legislation.
“All of us at the AOP were moved also by the expressions
of support that we received from practitioners all over the
country – some of whom did not do visits themselves but
recognised and supported our fight to protect their colleagues
from unjust and foolish regulation.
“This was the AOP doing what it does best – battling
for its members.”
Reflecting on the situation, Mr Faverty commented:
“It would have been much less stressful to just purchase
the eVFS, but after much soul searching I felt it was an
unreasonable requirement. I also wanted to fight the potential
precedent of local guidelines superseding those established
nationally.”
In the meantime, the PCTs involved have stated they
intend to consult about eVFSs and said their “guidance”
continues to advise the use of eVFSs. The AOP notes that this
guidance quotes extensively from the College guidance for
the routine eye examination and not at all from the guidance
on domiciliary eye examinations.
The Association is happy to have guidance issued for
domiciliary eye exams and indeed, the Domiciliary Eyecare
Committee have done so. However, eVFSs are “gold
standard” and not a mandatory requirement. Mr Warburton
added that the AOP looks forward to seeing the PCTs’
consultation process – and even hopes that the AOP can
contribute.
The AOP is currently considering whether practitioners
who have bought equipment unnecessarily, as a result of the
requirement issued by the PCTs, may have legal grounds to
request compensation from the PCT.
Mr Faverty added: “I would encourage any practitioner
who feels its PCT or optometric advisor is imposing
unreasonable regulations or guidelines to contact their LOC
and the AOP for advice.
“The support I received from the AOP was fantastic and I
wish to thank them again for all their help.”
• This article appeared on our website, www.optometry.
co.uk earlier this month.
17
17/06/11 BACKGROUND
To nominate for the AOP Awards go to www.optometry.co.uk/awards

PROFILE
20 Questions – Nick Atkins
The Independents Day organiser Nick Atkins is the latest to take our Q&A
18
17/06/11 20 QUESTIONS
How are you?
Well and busy. Trying to keep up with my
various business interests, in particular
preparations for Independents Day.
What can delegates expect
from Independents Day?
This year David (Goad) and I have
introduced some new initiatives including
a free-to-attend Title Sponsor Mini-
Symposium on the Sunday before ID, that
is open to all independents regardless of
ID attendance. There are new interactive
Skills Workshops on how to practice
PR, better merchandise, increase sales
through more effective communication.
How is business generally?
I must say that my businesses are very
buoyant. Positive Impact, the contract
sales company I set-up with Maxine
Green continues to bring in new clients.
And following success using the model
sending professional colleagues to deliver
over 4,000 in-practice training sessions on
behalf of a couple of clients, we launched
our own service for independent practices
at Optrafair.
What do you like about
working in optics?
The people I have met and friends I’ve
made in the last 30 years.
What’s the best thing that’s
happened in the optics during
your time working in it?
Scrapping of the free eye exam for all. It
made everyone focus on what we offer
and working harder to promote
it through the delivery of even better
eye care.
Who do you admire in the
sector?
Whilst perhaps not the most popular
choice, I’m sure, I have to say Specsavers.
Whether you like what they do or not it
is impossible to argue that the general
public is far more aware of the need for
our profession as a result of what they
have done in the last 20 years. Who
would have thought that an optician’s
advertising strap-line would become
such common parlance.
Where are your favourite
places in the world that optics
has taken you?
Kula Lumpa as an ABDO Contact Lens
Practical Examiner.
Are you superstitious?
No. I never buy a lottery ticket as I believe
the only way to wealth is to earn it!
If you were granted one wish
for the profession what would
you wish for?
That we continue to work together as
one ‘optical’ profession to make people
truly value the excellent service we
provide. And that starts with every
individual practitioner acting as an
ambassador for our profession every day
Do you have a favourite film?
I’ve always loved sci-fi films and so it
must be Independence Day.
What are your hobbies?
Watching Portsmouth FC, mountain
biking, music gigging and, rarely these
days, trying to improve my drumming.
Sum up your feelings for the
next 12 months in five words.
The future is bright – that’s only four!
Where do you go on holiday?
I love the UK as its beauty is right on the
door-step.
What are your favourite
products in the optical sector?
Multi-purpose contact lens solutions.
Their formulations are more complex
than many drugs and the importance
of their role in safe contact lens wear
should never be underestimated.
If you weren’t in optics what
would you be doing?
Not sure, as with a father who was a DO, I
think it was prewritten. But when I retire I
want to be a volunteer forest ranger!
What’s your favourite singer
or musical group?
I’m an old punk rocker and I’m looking
forward to Kings of Leon, Foo Fighters
and Kasabian at the Isle of Wight Festival.
What do you put down your
success down to?
Nothing but a bit of imagination and
good old fashioned hard work.
Favourite time of year?
Autumn – a gloriously beautiful and
uniquely English time of year.
Your perfect day?
Probably out on my bike in the heart of
the countryside.
Any final thoughts?
Real difficulties can be overcome,
it’s only imaginary ones that are
unconquerable.

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
BUSINESS LINK
20
17/06/11 INDUSTRY NEWS
Partners in signs
Optimed celebrated an industry partnership
with Topcon GB, one of the UK’s leading
manufacturers and suppliers of ophthalmic
instruments, OCTs, fundus cameras, practice
management software and accessories at the
BCLA clinical conference and exhibition in
Manchester.
Topcon will provide Optimed’s i-Vue waiting
area display signage (pictured above) primarily
for all 3D OCT purchases within the UK and
Ireland and CAPTIV8 chair-side education and
marketing software (pictured below) will be
offered fully integrated as part of Topcon’s new
I-Clarity practice management software.
Topcon’s medical director, Andy Yorke, said:
“The added value to our after sales customer
support package will be very much enhanced
by the i-Vue software package and will provide
a fantastic patient information platform when
introducing OCT for the first time into clinical
practice.
“The option to add CAPTIV8 to our new
PMS software, I-Clarity, will add an extremely
unique and dynamic additive software platform
to our package, which will enhance practice
development and profitability.”
CAPTIV8 is a marketing and communications
tool, which gives the practitioner the ability to
draw over film during chair-side consultations.
All the animations can be shared and viewed by
the patient at home.
Optimed director, Dr Trusit Dave said:“I
believe that the combination of Topcon’s
amazing technology and our state-of-theart
communication software will mean that
practitioners now have the ability to successfully
promote devices like OCT to their patients and
fully underscores Topcon’s commitment to
offering ‘not just OCT’ but the ability to make OCT
a worthwhile investment in practice”.
02476 444118
• Interview on www.optometry.co.uk
Targeted dry eyes
relief
BAUSCH & LOMB launched three new
innovative formulations of its Artelac
range of dry eye solutions at the BCLA
conference in Manchester, targeting
patients’ specific needs and age ranges.
Artelac Splash, Artelac Rebalance and
Artelac Nighttime Gel are designed to
manage the symptoms for dry eye by stabilising the tear film to break the dry eye cycle.
Instant relief for environmentally dry eyes is offered by Artelac Splash, (pictured) a preservativefree
eye drop containing the natural lubricant hyaluronic acid (HA). It is designed for those with
dry eyes caused by computer use, lifestyle, air-controlled environments, a lack of blinking and dry,
windy outdoor environments. It is available in single-dose units for convenience and in packs of
30 or 60. Artelac Rebalance is a combination of tear film stabilising agents to help older patients
with chronic tear dysfunction and is said to offer long-lasting relief with no blurring effect. The
inclusion of mineral nutrients naturally found in healthy tears and vitamin B12 supplement
the tear film to promote a healthy ocular environment where epithelial cells can begin to heal
themselves. For patients with lipid deficiency, an inability to close their eyelids, or those with
more severe chronic dry eye symptoms, Artelac Nighttime Gel seals in moisture for additional
protection, and it is designed for those needing a little more relief.
0845 602 2350

Stepping
into the sun
FRAMES COMPANY Stepper has launched
its first sunglasses collection at the BCLA
clinical conference and exhibition.
The new sunglass range is fully
glazeable and is designed to give
prescription spectacles wearers the
look of fashion sunglasses but with the
fit, comfort and style that Stepper is
known for.
There are 10 sunglasses in the new
range, each available in two colours,
some with intricate jewels and diamante
detailing on the arms.
01732 375975
Software offer
extended
ORASIS, which launched its new
contact lens and clinical modules at
Optrafair, has extended its special offers
until the end of this month, including
free data transfer and the buy-one-getone-free
module.
Director Linus Mason, felt that, after
talking to one practice owner who hadn’t
even opened his ‘bags’ from Optrafair,
decision makers needed a bit more time
“to gather all their information on the
numerous systems available for the
optical market”.
The Midlands-based company believes
that the Orasis system is very easy to use
due to its ‘uncluttered’ screen. “Using
the latest technology, this non Web-based
system will make a real difference to the
independent practice,” said Mr Mason.
Anyone interested in the Optrafair
offers, or a demonstration, can email
sales@orasisnet.co.uk or view the
website www.orasisnet.co.uk.
01527 834740
World-first in torics
BRITISH contact lens and solutions
manufacturer Sauflon has launched
Clariti 1day toric – the world’s first
silicone hydrogel daily disposable
toric contact lens. It will be available
exclusively to eye care professionals
to encourage patient loyalty.
The launch at the BCLA clinical
conference and exhibition follows the launch in 2009 of the award-winning silicone hydrogel
daily disposable lens, Clariti 1day. It has been very successful, enabling practitioners to upgrade
their patients from older technology, allowing them to wear their lenses for longer, whilst
improving ocular health. Sauflon has positioned Clariti 1day toric as a premium product which
patients can be upgraded into for little, or no, extra cost. “We are very proud to be launching
the world’s first silicone hydrogel daily disposable toric lens,” said Sauflon’s UK sales director,
Bradley Wells. “This unique lens will enable eye care professionals to fit their astigmatic patients
with the safest modality and the healthiest material and improve end of day comfort. The
product’s positioning allows for an easy upgrade from the older conventional hydrogel lenses
into Clariti 1day toric, leading to improved end of day comfort and greater patient retention.”
As with Clariti 1day, the new toric lens uses Sauflon’s patented manufacturing process,
AquaGen, for a highly wettable lens surface combined with low modulus and high water
content for added comfort. Clariti 1day toric is available in all minus powers, plano to -6.00
(0.25 steps) and -6.50 to -8.00 (0.50 steps) with 2 cylinders, -0.75 and -1.25 at axis of 90 and 180,
and 20 degrees either side.
020 8322 4222
Feminine touch added
DUNELM OPTICAL has launched a new collection from top designer John Rocha which
steers away from his usual unisex style, instead focusing on embellishment inspired by his
jewellery collections. The new feminine range has six styles with detailed sides and temples,
made up of floral, diamante and cut out patterns on classic brown, white and black frames.
The styles range from delicate minimal frames to bold retro designs.
Alongside the launch, Dunelm has also introduced a John Rocha gold membership
scheme, which runs until August 31 and works on a volume discount basis. Customers who
purchase 10 or more John Rocha frames will receive a 10% discount, and those who buy 30
or more will receive a 20% discount. They will also automatically become
gold members and be in with the chance of winning four tickets to
visit London Fashion Week next year.
Dunelm director, Peter Beaumont, said:
“It’s fantastic to see a female-focused
collection from John Rocha this
season. We’ve seen jewellery
inspired designs really
take off over the
past year, and
these latest
styles put
the Rocha
optical
range
at the
forefront of
that.”
01388 420420
21
17/06/11 INDUSTRY NEWS

DEVELOPMENTS
22
17/06/11 DRIVERS’ VISION
Fresh call for
UK to improve
testing drivers’
eyesight
A NEW REPORT has found that the UK
lags behind other European countries
in its requirements for testing drivers’
eyesight.
The report, by optical sector groups
ECOO, EUROM I and EUROMCONTACT,
highlights substantial variation in the
assessment of drivers’ vision across
Europe, and recommends that member
states – including the UK – act to better
assess drivers’ vision.
While many European countries have
good systems in place to assess all drivers’
vision, the report notes that the UK and a
small number of other countries continue
to rely on what many consider to be
an outdated assessment of vision – the
‘Licence Plate Test’ – which is thought
not to be consistent with the underlying
standards.
Among the proposals put forward by
the UK government in its consultation
response, is to retain the Licence Plate
Test for car and motorcycle drivers and
to lower the current eyesight standard
by reducing the distance at which the
licence plate is read. In addition, the UK,
along with France, Germany and four
other countries, has no requirement
for ongoing assessment of vision for
these drivers, which is seen as a missed
opportunity to improve road safety.
The report also recommends that the
European Commission press the member
states that are dragging their feet to
implement better screening of drivers’
vision before issuing a first licence, and
when renewing a driving licence.
With the EU committed to halving
road deaths across the European Union
by 2020, the aim is to achieve this by
legislative means that changes driver
behaviour, as well as raising the technical
standards of vehicles and improving road
designs. The visual requirements to drive
safely in European law are currently being
implemented by EU members states,
including the UK, which lately launched a
consultation on the matter.
On behalf of the Optical Confederation
Jayne Rawlinson said: “The UK is at the
bottom of the league when it comes to
assessing drivers’ eyesight. We have been
working to achieve better vision for safer
driving in the UK and greatly value the
support we have received from other
road safety groups. We hope the UK
Government will use this opportunity to
ensure everyone drives with good vision.”
Mark Nevin, spokesman for ECOO
said: “The European Commission should
be alert to those member states that
are dragging their feet and refusing to
implement appropriate assessments of
vision, before issuing a first licence and
during the driving career. Given that
90% of sensory information when driving
comes from vision, and poor vision
impacts on driving performance, this
must be an area with potential to deliver
improvements in road safety.”
• The Report can be found online at:
www.epolitix.com/members/memberpage/sites/abdo/pages/key-statistics-1/

Zeiss - World Leader in OCT
Zeiss Cirrus 400
Affordable Quality
Sub £40K!
The Cirrus 400 is one of the easiest
OCTs to operate, with a small footprint
and a unique 90 degree patient to
operator position. It is the complete
diagnostic tool with 2 FDA approved
normative data bases for nerve fibre
layer and macula thickness.
Cirrus OCT affordable quality.
Carl Zeiss Ltd
Medical Division
www.zeiss.co.uk
PO Box 78, Woodfi eld Road
Welwyn Garden City Herts AL7 1LU
Tel: 01707 871369 Fax: 01707 871363
E-mail: medical@zeiss.co.uk

PRODUCTS
Accessorising
your profits
24
17/06/11 ACCESSOSRIES
From novelty contact lens and spectacle cases to prescription goggles
and much more, offering useful accessories in your practice can help
boost add on sales and increase profits. OT looks at what’s on offer
Optipak
Optipak is offering the child and young at heart adult contact lens wearers
amongst your patients a ‘fun and practical’ way to keep their contact
lenses safe – the 3D contact lens case (pictured).
Ideal for storing and carrying lenses around in when on the
go, the case comes with an accompanying keyring attachment,
whilst its 3D design makes it easy to identify between the right and
left contacts. The case is available in a number of quirky animal characters
including a Duck, Fish, Turtle, Ladybird and Dolphin, as well as an Eye Ball.
0208 322 4210
Dibble Optical
Having launched its latest accessories catalogue just last
month, Dibble Optical has a wide variety of new and useful
products on offer.
As the largest supplier of prescription swimming goggles
and diving masks in the UK ,the company has launched
several new models to supplement its Optiswim and Tusa
View collections. Pictured is the 945901 children’s swimming
goggle, which have a power range of +6.0 to -7.0D and come
with a multi-purpose case that spectacle
wearers can use to store their
frames whilst swimming as
standard.
01634
880885
Hilco
It’s very important for independent practices to build a long-lasting relationship
with their patients in order to retain them and increasing brand awareness is one
way this can be achieved. Offering practice owners a simple way to do this is
Hilco with its personalised spectacle cases and lens cleaners.
Practice information, such as the name, address and telephone number, can
now be printed on several of the company’s popular case styles. Personalisation
is offered free of charge, with the information available to be printed in black or
white text, on the inside or outside of the case – silver or gold text can be printed
on the outside also. A minimum order of 100 applies.
In addition to being able to offer customisation on Hilco’s lens cleaning sprays,
a new bottle design with a focus on colour has been introduced. The compact
35ml bottles come in blue, green, yellow and clear.
01453 761 900
Caseco
Casco has introduced a wide variety of new spectacle cases,
from the larger hard top to the small more feminine
cases and soft wallets.
The ECURVEMAX-sparcle (pictured) is a
large case suitable for bigger frames and
sunglasses and has a ‘sparkly’ finish.
Whilst the J5-spot is a soft touch
‘fun, tactile and sophisticated’
case featuring polka dots.
Casco also supplies a
colourful, soft wallet case
which comes with a microfibre
cloth and is available in six colours.
01580 890111

This independent optician grew
his practices by 18% last year
– you can do the same with this
FREE practice marketing book
Claim your FREE paperback copy of a
new book on opticians marketing
A
new book that was officially launched at Optrafair
earlier this year reveals how any independent
optician can achieve double digit growth in
their practice over the next 12 months.
“It’s Time to Fight Back” has been written
by Richard Pakey FBDO, and looks at the
need to focus on 12 key practice growth and
marketing areas.
Richard is the successful owner of two independent
practices in Essex and Hertfordshire.
He is also behind an exciting business
called Independent Practice Growth UK.
Together with an experienced team of
writers, web experts and marketers, he’s
working closely with a number of optoms,
helping them grow their business.
Richard said: “It’s been an unbelievably
tough couple of years to be an independent
optician.
“The multiples are successfully using a
mix of marketing methods that are becoming increasingly
aggressive. In most cases they are targeting each
other but of course independents are being caught in
the crossfire, affecting revenues.
“The economy continues to be depressed with no upturn
in sight, meaning people are continuing to put off
eye tests.
“And to top it all off, the glasses websites have added
further pressure and continued to speed up the commoditisation
of the market, by encouraging the dreaded
‘prescription-only’ client.”
SUCCESS: Richard
Pakey FBDO says it’s
time to fight back
against the recession
and the multiples
Despite these crippling challenges, Richard is surprisingly
upbeat about the opportunities for the independent
sector.
He said: “I’ve seen my two practices grow by 18%
over the last year.
“I’m no better an optician than most, but
I do know how to run my business for easy
growth and profit.”
Richard’s belief is that any independent
in any area can quickly and significantly
grow their practice if they focus on improving
their marketing.
And it’s why he has agreed to give 200
paperback copies of his book away to OT
readers.
In Richard’s book, you will quickly discover:
• How to achieve double digit growth in
your practice
• The right way to combat the multiples
• How to get rid of prescription-only clients
in a way which doesn’t offend them
• Why you must create a practice that doesn’t rely on
you (the great news is, it’s a practice that delights
your clients)
Richard added: “There are only three ways to grow
your practice - get more clients; get them to ethically
return more often; and get them to spend more when
they do return, This book looks at all three methods in
detail and with plenty of practical examples.”
200 paperback copies of the book have been reserved
to be posted - totally free of charge - to OT readers.
GET YOUR FREE OPTICIANS MARKETING
BOOK POSTED TO YOU TODAY
To claim your FREE copy of this new paperback (worth £4.99),
visit this special web page and fill in your details:
www.opticians-marketing.com

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.

EVENTS
Demystifying
dyslexia
Optometrist Kate McMahon writes about last
month’s course aimed to help demystify dyslexia
LAST MONTH’S
latest course on
‘Managing Dyslexia
in Your Practice’ was
well-attended by
practitioners.
The Watford-based
event, which took
place at the town’s
Ramada Jarvis Hotel,
followed the success of a similar day-long event at the Hilton
Hotel, Birmingham in February. A total of seven CET points
were available at the day-long event, which again included
C3Rs training for participants.
C3Rs is a new company using The Versatile Trackograph
system, a patented, easy-to-use, system to benefit those with
reading difficulties.
27
17/06/11 DYSLEXIA DAY
Dyspraxia used to be called the
‘clumsy child syndrome’
Its holistic approach is user friendly and ‘practice building’,
and the aim of the system to make reading fun, enjoyable and
to remove the stress.
The day was divided up into lectures in the morning, based
on ‘Recognition, Research & Resolution’, and a workshop in
the afternoon.
The lectures covered an introduction to dyslexia, visual
stress and associated conditions, some of which, like
dyspraxia, are closely linked to dyslexia.
Dyspraxia used to be called the ‘clumsy child syndrome’
and indicates co-ordination difficulties. Helping to overcome
these difficulties forms the basis of associated sports vision
exercises.
Continued on page 29

S m a r t T e c h n o l o g y f r o m
i C a r e
T o n o m e t e r - IOP Made Simple
• Proven Reliable Technology
• Easy IOP without Anaesthetic or uncomfortable Air Puff
• Quick & Efficient
• Ideal for Practice , Clinic or Home Visit Use
• Portable and Simple To use
• Child Friendly
Pro Version
now available for
Supine use
Tel : 0121 458 6800
Fax : 0121 458 6844
www.main-line.co.uk
sales@main-line.co.uk Mainline Instruments Ltd
6 Prince Road
Kings Norton Business Centre
Birmingham
B30 3HB
Get smart with our Auto Lensmeters, Auto Refractors, Image Capture Systems, Auto Phoropters,
Topographers, Video Dispensing Systems, LCD Charts, Visual Fields, Refraction Units and furniture.
Call for more information or for a demonstration, on: 0121 458 6800

EVENTS
Continued from page 27
Computer Vision Syndrome
(CVS) was also covered and
included how the Vistamesh
lens has had a dramatic effect
for a number of patients
suffering visual stress.
This was followed by an indepth
look at anatomy, effects
of light, facts and figures,
solutions and getting started. It
included up-to-date research,
and the facts and figures to
empower practitioners enabling
them to answer questions
and have a greater understanding of their dyslexic
patients and their concerned families.
Case histories were also reviewed, giving an insight into
how we can work with colleagues and make a difference to
young lives. For instance, one family was said to be grateful
for ‘getting their son back’, and, with regards to another
patient, a mother said she was ‘over the moon’ that her
daughter was now out of special needs.
The morning session concluded with a presentation by
Raglan Sanders, an education expert, on the best ways
to approach schools. A schools pack was provided to all
delegates to aid their introduction to headteachers, teachers
and SENCOs (Special Educational Needs Coordinators).
The day’s workshop session began with an overview
about prescribing and various binocular vision techniques
and exercises followed by an
introduction to Sports Vision and
Colour Vision.
A DVD which demonstrated
how to use the C3Rs system,
before a ‘hands-on’ session using
the Versatile Trackograph system.
Vision screening
C3Rs also provides a Business
Model, and appointment times
and all charges are merely
suggestions and entirely at the
discretion of the practitioner,
but form a helpful guide to the
possibilities. A register of practitioners on the C3Rs web site
is being complied and there is a follow-up programme in
place.
The demise of the children’s vision screening programme
in schools has left a vacuum that the optical profession is
ideally placed to fill.
Both the optical and national press have noted with
concern children’s vision and literacy levels. This new
approach of C3Rs can benefit patient and practice alike by
raising practice profile, providing increased job satisfaction,
offering a new career path – especially for dispensing
opticians – and at the same time providing a much needed
service in the community.
• For further information go to the C3Rs website
www.c3rs.co.uk/default.aspx
29
17/06/11 DYSLEXIA DAY

REVIEW
BCLA’s variety on
show in Manchester
OT Clinical Editor Dr Navneet Gupta and AOP Education Advisor Karen Sparrow report on this
year’s clinical conference and exhibition
30 28
Photo by Elliott Franks/BCLA
Photo by Phil Weedon/BCLA
08/04/11 17/06/11 COVER BCLA 2011 STORY
Photo by Elliott Franks/BCLA
WHILE THE red half of Manchester had its attention fixed
firmly on Wembley Stadium for the European Champions
League final, the focus of the contact lens world was on the
city’s Central Convention Complex as it played host to the
35th BCLA annual clinical conference and exhibition.
Recent years have seen a gradual increase in the variety
of topics on offer and this year’s event crossed borders into
optometric and therapeutic areas to capture a wider audience.
So, for example, for the first-time, a selection of lectures
also carried COPE accreditation for international delegates.
With sponsor showcases, hands-on clinical workshops, a
motivational presentation from Dr Frank Dick OBE (pictured
top left), and a Bollywood-themed gala dinner to boot, this
year’s meeting certainly offered something for everyone.
Oxygen
The importance of oxygen for successful contact lens wear
has taken centre stage at many BCLA meetings, and this
year’s event proved to be no exception. Professors Desmond
Fonn, Nathan Efron, Noel Brennan, James Wolffsohn and
Brien Holden debated on a very confusing issue, each in turn
presenting compelling and varied arguments as to whether
the problem of oxygen has been solved.
Having re-analysed the original Holden-Mertz data,
Professor Fonn suggested that a Dk/t in excess of 350 may
be required for 0% corneal swelling with extended wear
(EW) contact lenses. In contrast, Professor Efron suggested
that a Dk/t as low as 50 is sufficient, based on assessment of
oxygen flux ie, how much oxygen is actually consumed by
the cornea. Indeed, the law of diminishing returns indicates
that there is an upper limit as to how much oxygen the cornea
can actually use, such that any further increase in oxygen
availability has little benefit; Professor Efron suggested that
this plateau is reached at a Dk/t of 50.
Professor Brennan (pictured, page 32) suggested that Dk/t is
of little use now, since this metric does not allow comparison
between different contact lenses and, more importantly, to the
no lens situation. Furthermore, he alluded to the possibility
that a minimum Dk/t of infinity may be required, since the
original Holden-Mertz data follows an asymptotic curve.
Professor Brennan also endorsed measurement of the cornea’s
oxygen consumption as a more useful metric, but pointed out
that current assessments are based on inaccurate models that
require many assumptions. Despite the development of new
methods to assess corneal oxygen consumption, presented by
Professor Wolffsohn, the panel’s views were well summarised

y Professor Holden, who explained that the advent of
silicone hydrogel lenses has in many ways solved the problem
of oxygen but that other complications have arisen, with
attention now deviating towards areas such as maximising
comfort and enhancing the efficacy of cleaning regimens.
Comfort
Professor Brennan continued the theme of contact lens
comfort in his next presentation. It was surprising to learn
that 49% of patients who drop out of contact lens wear do
so due to poor comfort, whilst 9% do so due to dry eye. Poor
comfort is multi-factorial but a key contributor is friction
between the lens surface and the upper palpebral conjunctiva
(on blinking), as hilariously illustrated by the US political
video Dick Cheney vs. Nancy Pelosi: The Blink-Off, from the
TV show David Letterman (a must-see on YouTube); basic
calculations reveal that when blinking, the eyelids travel
approximately 42km in a single year and this can lead to
lid wiper epitheliopathy, which can contribute to reduced
comfort during contact lens wear. Research presented by
Professor Brennan confirmed that there are subjective
differences in comfort between different types of contact
lenses, and that this is not due to the material or Dk/t, but
due to the modulus and coefficient of friction. This confirms
the importance of lens surface interactions in the eye, and the
need to manage conditions that may affect this eg, meibomian
gland dysfunction.
New technologies such as iPhone
apps or contact lens cases with
date displays need to be embraced
Daniela Nosch (pictured below) took a patient-orientated
approach to the topic of comfort, looking at whether
patient compliance could be an issue. Many patients fail to
adhere to manufacturers’ and practitioners’ instructions for
cleaning lenses and cases and for replacing lenses, and it
was proposed that new technologies such as iPhone apps or
contact lens cases with date displays need to be embraced to
improve compliance and comfort. Ms Nosch also discussed
the importance of improving the quality of the tear film by
recommending artificial tears / re-wetting drops, avoidance of
preservatives, avoiding environmental triggers (eg, smoke and
air conditioning), and even taking nutritional supplements
(eg, omega-3 fatty acids), which can help to reduce ocular
inflammation and increase tear production. Ms Nosch
also emphasised the practitioner’s role in ensuring patient
compliance, by providing information in writing, discussing
the benefits of compliance, and managing expectations.
including motion after-effects, the Zollner illusion, the Ponzo
illusion, and size constancy, and although well-explained
some audience participation and less busy slides would have
helped to bring some real fun to the occasion.
Glaucoma and the anterior segment
Although unusual for a contact lens conference, a half-day
session on glaucoma was very informative and very well
presented by Professor John Flanagan. He began by describing
the risk factors for glaucoma and how each of these forms
stressors that are thought to cause glaucoma. The effects
of these on the structure/function relationship were then
discussed, before Professor Flanagan described how diagnosis
of glaucoma could be improved by considering gonioscopy,
central corneal thickness (CCT) measurements, phasing IOP
measurements, and ocular perfusion pressure; it is known that
IOP increases at night whilst a good sleeper will have a greater
dip in blood pressure, leading to nocturnal hypotension, both
of which increase the risk for glaucoma – if these could be
measured for an individual, the risk of glaucoma can then
be better evaluated. A new contact lens device has been
developed for this purpose but in order to obtain accurate
measurements, the lens must stick to the cornea and not
move – not the most ideal situation for overnight contact lens
wear! As expected, the device is not suitable for use but an
alternative scleral device is currently being investigated.
Anterior segment pathogens
If the audience was slightly bewildered by a glaucoma lecture
during a contact lens conference, they were in for a further
twist when the session was “gate-crashed” by a lecture on
anterior segment pathogens by Dr Lisa Keay. Concentrating
on microbial keratitis, Dr Keay looked at the consequences of
this devastating corneal condition, most commonly associated
with EW contact lenses, before embarking on a detailed tour
of the variants, including differential diagnosis of: (i) fungal
keratitis, particularly relevant due to the contact lens solutionrelated
outbreak of Fusarium Keratitis in 2005-2006; (ii)
acanthamoeba keratitis, which causes pain out of proportion
with the symptoms and is particularly relevant due to its
association with a contact lens solution; and (iii) other types
31
17/06/11 BCLA 2011
Visual illusions
The Albion lecture delivered by Professor Will Ayliffe
promised much with the title of “Fun with Visual Illusions”.
He began with a brief look at how visual illusions come to
be, discussing how the brain makes errors in interpretation
by filling in gaps within the visual scene through “topdown”
cortical processing. Professor Ayliffe then took the
audience through a variety of different visual illusions,
Photo by Phil Weedon/BCLA

REVIEW
32 28
08/04/11 17/06/11 COVER BCLA 2011 STORY
of keratitis including
those caused by Herpes
Simplex, Pseudomonas,
and Noccardia (rare in
the UK).
Visual fields
analysis
The session went back
on track when Professor
Flanagan took to the
stage again to deliver a
presentation on visual
fields analysis, in which
he offered six key pearls:
(i) do the right test –
fast strategies look for
normality so if you suspect a defect then conduct a standard
strategy to detect it; (ii) the patient is not automated so
remember to keep them attentive with continual reassurance;
(iii) assess the reliability – false positive errors are more
important than false negative and even fixation errors,
particularly since the latter can arise if the camera is not
working properly; (iv) assess the statistical indices – focal,
hemifield and general defects can be ascertained from these
whilst progression over time can also be monitored; (v)
beware learning effects – it is not wise to refer on the first
or second field test result, as the defect may not be real;
remember that a normal field plot can never be faked; (vi)
use the right equipment – standard automated perimetry
detects functional loss after a significant amount of structural
damage has occurred, so consider methods that could lead
to earlier detection, such as Frequency Doubling Technology
(FDT), Short Wavelength Automated Perimetry (SWAP), the
Heidelberg Retinal Tomograph (HRT) and the new Heidelberg
Edge Perimeter, the latter two of which provide structural and
functional data.
Photo by Elliott Franks/BCLA
Photo by Phil Weedon/BCLA
Corneal
dystrophies
Professor Ayliffe’s
discussion of corneal
dystrophies followed a
similar format to his take
on visual illusions. It
was interesting to learn
more about commonly
encountered dystrophies
such as Meesman’s,
Recurrent Erosion, Reiss-
Buckler, Granular, Fuch’s
and Lattice dystrophies,
although less time spent
on rarer dystrophies,
including some that have
only been reported in 4 or 5 families in the world, would have
been preferred, especially since Professor Ayliffe proclaimed
“you will never see this in your career!”
Scientific round-up
Amongst the many scientific research sessions was a
section dedicated to presbyopia, updating delegates on
current contact lens practice. Contact lens prescribing has
changed very little over the past 20 years, with distance
contact lenses and reading spectacles still being the most
popular choice (60%), whereas the previously popular
monovision correction is now losing out to modern
multifocal contact lenses, with a direct swap in popularity
(30%). Multifocal contact lenses such as the Proclear EP
have positive effects in reducing asthenopia in emerging
and pre-presbyopes, without significantly affecting visual
clarity. Indeed, subjective satisfaction with multifocal lenses
appears to out-weigh corresponding poorer objective visual
performance, but it is still advisable to trial all available
options to find one that works best for the individual. It was
also fascinating to learn about the latest progress in surgical
presbyopia correction, including the use of liquid crystals
and biocompatible materials that could replace the natural
crystalline lens.
There is a possible application for
silver-infused contact lenses, which
do not affect the natural biota
Another scientific research session concentrated on contact
lens care systems. Many lens/solution combinations can lead
to corneal staining (SICS) and it was shown that peroxidebased
systems minimise this whilst certain lens surface
treatments (such as that used on the Acuvue Advance lenses)
are also associated with reduced staining. Lens cleaning
could be enhanced by dual disinfection solutions eg, those
containing Polyquad and Aloxidine, whilst there is a possible
application for silver-infused contact lenses, which do not
affect the natural biota of the eye. In addition to lens cleaning,

case cleaning considerations are equally important and it
was shown that although vibrating contact lens cases do not
reduce cholesterol deposition, the most effective current
method of cleaning a case and reducing biofilm production is
to rinse and rub with a finger, then wipe with a tissue before
air-drying face down.
Save the best ‘til last
The BCLA certainly saved the best ‘til last. Just when
delegates were flagging after four days of lectures and
networking, the BCLA brought attendees an X-Factor-style
finale entitled ‘The Great Debate: Ten Top Tips for Clinical
and Practice Success’. Of course, the Simon Cowell seat
on the judging panel was taken by Professor Brien Holden,
flanked by BCLA vice president Dr Catharine Chisholm and
BCLA president Shelley Bansal. The stage was set with ten
empty seats. First up was Jayne Schofield, who gamely set the
ball rolling in the few minutes allocated to each presenter.
She faced the judges bravely before Dr Phil Morgan took
to the stage. Dr Morgan’s power-point shimmered with
Mac special effects but that didn’t save him from Professor
Holden’s sharp comments. Professor Desmond Fonn received
a kinder response from the judges, although his 1970’s dress
sense was called into question, as was Professor Efron’s
bow-tie. Dr Craig Woods forgot his microphone and then
put on spectacles for his contact lens presentation … which
unsurprisingly lost him favour and marks with the judges!
One of the highlights was Dr Kathy Dumbleton breaking
into song, with acknowledgements to Paul McCartney
Photo by Elliott Franks/BCLA
for ‘Yesterday’, as she urged patients to change their
lenses regularly. Professor Lyndon Jones recommended a
compliance sheet for patients, before giving the floor to
Professor Charles McMonnies who recommended a blink
instruction guide. Jonathan Walker was the penultimate
presenter and managed to get in a jibe about the cricket
before the stage was taken over by ‘The Edutainer’ Brian
Tompkins who prescribed fun with helium balloons and a
gold jacket, the latter of which he later discarded to reveal his
take home message across his t-shirt. The judges held their
nerve and marked in the manner of Strictly Come Dancing,
out of 10, with Professor Jones and Professor Efron (pictured
above) trying to share the ‘trophy’ to a round of applause.
33
17/06/11 BCLA 2011

RESEARCH
Millions are too hard-up
to book an appointment
National Eye Health Week has provided some revealing new figures
34
17/06/11 NEW DATA
THIS WEEK’S National Eye Health Week emphasised that
financial pressures are having a real impact on the nation’s
eye health.
New YouGov research released to mark the start of the
Week estimates that millions of adults in Britain currently
do not attend regular eye examinations – at least once every
two years – because they believe they cannot afford to. A
total of 13% of those questioned for the research, 2,042
adults during May 11-13, said they were too hard-up to
make an appointment.
With the UK economy still in difficulty, the survey
found that people are economising on this type of essential
purchase, and not just treats and luxuries. More than fourout-of-ten
(43%) of the population are currently risking
their sight and their health by not attending regular sight
tests. Although more than nine-out-of-ten people know
about the wider health benefits of eye examinations,
this knowledge does not result in people visiting their
optometrist.
The research also revealed that for women, cost is even
more of a barrier to good eye health, as over a third of women
(34%) have put off buying new spectacles or contact lenses
because they thought they could not afford it.
David Scott-Ralphs, chairman of National Eye Health Week,
said: “This is a massive public health issue.
“Many people do understand the importance of a sight test,
but there is great concern that they are still avoiding having
one, often citing cost grounds. Many people qualify for a free
NHS sight test and may also qualify for help with the cost of
spectacles or contact lenses.”
Supporters and sponsors of the Week agreed that eye
examination is vital for the nation’s health.
Anna Turvey, superintendent optician at Tesco Opticians,
said: “We perform free eye examinations for customers, many
of whom decide on a whim to have an eye check because they
happen to be in a store for another reason.
“Some customers have turned out to have a significant
condition such as high blood pressure – and in some cases
tumours – that would otherwise not have been diagnosed.”
Michele Acton, chief executive of Fight for Sight, said:
“Regular eye tests are so important not only for picking up
early signs of eye disease but also for identifying other health
conditions. Many people wait until they experience problems
with their vision before they go for sight tests but sadly this
can be too late. With conditions such as glaucoma, by the
time symptoms become apparent, permanent damage to the
eye has already occurred.”
National Eye Health Week started on June 13 with events
around the country.
The YouGov survey was carried out online, and its figures
are weighted and are representative of all British adults aged
18 or over.

A one-day CET conference for optometrists on
Age-related Macular Degeneration (AMD)
July 12th 2011, Downing College, University of Cambridge, Cambridge, UK
1 day on AMD
8 CET Points
July 12th 2011
Help reduce the risk of people developing this debilitating condition by learning about the diagnosis and
monitoring of AMD. This one-day update from leading specialists aims to give you the tools you need in
order to recognise cases that warrant onward referral.
Speakers:
Professor Stephen Beatty, Dr John Nolan, Professor David Thurnham, Dr James Loughman
Diagnosis of AMD and the
different types
Epidemiology and risk factors of
AMD
Role of nutrition in AMD
Measuring macular pigment in
patients with and without AMD
Trials of macular carotenoids in
patients with and without AMD
What to do following detection of
AMD signs and symptoms: should
optometrists always refer patients
to an ophthalmologist?
Registration fee: £200 per delegate
Course fee is inclusive of lunch and refreshments
For more information, contact us on:
info@amdforoptometrists.org or call 01223 234193

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.
36
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
17/06/11 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
37
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
17/06/11 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
12 NES, The Beardmore Hotel, Clydebank,
Glasgow, Developing optometric skills (www.
nes.replaylearning.com/clinical-skills)
22-24 International Conference on
Ophthalmic Photography, Venue TBC, Oxford
(www.icopmeeting.org)
38
17/06/11 DIARY DATES
Optics hits the bright lights
With the UK optics conference season almost ended practitioners
The famous setting of Aintree racecourse plays host to this year’s
College can start of Optometrists considering the conference, possibility see of below visiting one of the many
overseas exhibitions in the autumn.
One of the biggest and brightest conferences and exhibitions, just
crying out for a holiday-education combination, is Vision Expo West
in Las Vegas on September 21-24.
Last year’s event featured lectures on the revelation of exclusive
research as well as a high profile exhibition – where you were sure to
bump into the occasional celebrity, at the many launches.
Full speaker details are still to be confirmed, more details will be
revealed as they are available at www.visionexpowest.com
JUNE
20-21 J&J, The Vision Care Institute,
Pinewood, Wokingham, ‘Returning to work
confident and refreshed’ two-day course
(www.thevisioncareinstitute.co.uk)
21-22 SBK Healthcare Events, Maple House,
Birmingham, 2011 ophthalmology series
(bookings@sbk-healthcare.co.uk)
28 The Scottish Optical Golfing Society,
Falkirk, second annual outing (haddington@
montgomeryoptometrists.co.uk)
29 East Sussex LOC, Venue TBC, Halland,
Annual contact lens day, RSVP to (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 Downing College, University of Cambridge,
Cambridge, AMD for optometrists 2011 (www.
amdforoptometrists.org)
20 UltraVision, Head Office, Leighton
Buzzard, Bedfordshire, KeraSoft IC Workshop
(workshop@ultravision.co.uk)
AUGUST
17 UltraVision, Head Office, Leighton Buzzard,
Bedfordshire, KeraSoft IC 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
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
14 BCLA, Royal Society of Medicine, London,
presidential address (events@bcla.org.uk)
21 UltraVision, Head Office, Leighton Buzzard,
Bedfordshire, KeraSoft IC workshop and fitting
techniques SEE ABOVE
NEW… 25-26 BABO, Oxford University,
college TBC, Oxfordshire, Annual conference
and 20th anniversary celebration (www.
babo.co.uk)
NEW… 29-2 (October) Silmo, Paris Nord
Villepinte exhibition center, Paris, France
(www.silmoparis.com)
OCTOBER
NEW… 19 UltraVision, Head Office,
Leighton Buzzard, Bedfordshire, KeraSoft IC
workshop and fitting techniques
SEE ABOVE
NEW… 22 Nystagmus Network, Harrow,
north-west London, open day (0845 634
2630)
NOVEMBER
NEW… 3-4 National Optometric
Conference, Chesford Grange Hotel,
Kenilworth, Warwickshire (www.aop.org.uk)
NEW… 5-6 Hospital Optometrists 37th
Annual Conference, Chesford Grange Hotel,
Kenilworth, Warwickshire SEE ABOVE
NEW… 16 UltraVision, Head Office,
Leighton Buzzard, Bedfordshire, ‘KeraSoft IC
Workshop’ workshop and fitting techniques
SEE ABOVE
NEW… 25-27 AOP Student Eye Opener
Conference, Center Parcs Longleat Forest,
Warminster, Wiltshire SEE ABOVE
See more events at www.optometry.co.uk/events

BACKGROUND
Assistants get improved
training within Scotland
AS THE Worshipful Company of Spectacle
Makers (WCSM) announces the first set of
results for its Certificate in Optical Care,
the chief optometrist at NHS Education
for Scotland (NES) has said that the new
examination marks a “change in attitude”
in Scotland.
“Optical assistants are a key part
of healthcare delivery,” said Donald
Cameron (pictured), the programme
director for optometry at NES, the
education and training body of NHS
Scotland. “This new course encourages
everyone within the profession to think
more carefully about these roles.
“It’s a change in attitude, it’s gearing
up for the future. Ultimately, we want to put in place an
educational structure that enables optical assistants with
few or no academic qualifications to develop themselves,
and for some of them to go on and study for a professional
qualification.”
The Certificate in Optical Care, which was launched by the
WCSM in 2010, is designed for optical assistants working
under the General Ophthalmic Service in Scotland. Full
funding is provided by NES, and the qualification is approved
at Level 5 by the Scottish Qualifications Authority. The next
course begins in August 2011.
The five-month programme combines distance learning with
three one-day workshops held at Stirling Management Centre,
part of the University of Stirling.
Debbie Gigg, the WCSM’s training
director, said: “The blended learning
approach makes a big difference to the
students’ understanding of the topics
and their retention. The workshops are
hands-on, a chance for optical assistants to
get together, use relevant equipment, ask
questions and prepare for the examination.
“In terms of professional development,
it gives students the opportunity to obtain
confidence and recognition for the role
that they are performing. It has been the
case that once one person in a practice
started the course – and could see the
benefits – their colleagues showed
interest in doing it too.”
A total of 27 candidates passed the inaugural examination,
which was held in March. A further 10 candidates who failed
a small number of units were due to resit those individual
sections in June. An official WCSM award ceremony will be
held on September 14 at the Royal College of Surgeons in
Edinburgh, where successful candidates will be presented with
their certificates by Michael Barton, the master of the WCSM.
Enrolment is now underway for the 2011/12 course.
The one-day workshops will be held in August, October
and January, and the examination, which can be taken by
e-assessment or as a written paper, will be held at the end of
February 2012. Further information – including details of the
full funding support available from NES – can be obtained
from the WCSM at training@spectaclemakers.com.
39
17/06/11 QUALIFICATIONS

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
40
Optic nerve
anomalies
REFERRAL REFINEMENT PART 6 COURSE CODE: C-16562 O/D
17/06/11 CET
Dr Marcela Votruba, BM, BCh, MA, FRCOphth, PhD
Optic nerve anomalies are commonly seen in optometric practice and
practitioners must be able to differentiate acquired anomalies from those that are
characteristically congenital in origin. Indeed, acquired optic nerve anomalies are
likely to require fast and effective referral to the hospital eye service (HES), whereas
anomalies of congenital origin simply require detection and monitoring. This article
aims to help practitioners to distinguish between acquired and congenital optic
nerve anomalies, in order to improve appropriate detection and referral of cases.
Clinical features
The normal anatomy of the optic nerve sets
the parameters for the clinical appearance
of optic nerve anomalies, and the following
features are specifically pertinent. The
normal optic disc is approximately
1.5mm in diameter, and is located 10-
15° from fixation, nasally, slightly above
the horizontal meridian. It carries 1.2
million nerve fibres from retinal ganglion
cells (RGCs). There is a rigid scleral
opening and a collagenous cribriform
plate. Myelination is normal beyond
the cribriform plate. The sub-arachnoid
space begins as the nerve exits the eye.
The post-laminar optic nerve is 3-4mm in
diameter. The normal blood supply is via
Figure 1
Normal optic disc appearance
the two posterior ciliary arteries from the
ophthalmic artery, which divide into 15-20
short posterior ciliary arteries. The central
retinal artery penetrates the optic nerve
12mm posterior to the cribriform plate.
Clinical investigations
The importance of being able to distinguish
the normal optic disc and its associated
cup (Figure 1) from physiological cupping
(Figure 2) on one hand, and frank pathology
on the other, should be emphasised. This
article does not intend to delve into the
detection of glaucomatous optic discs, as
this has been dealt with elsewhere in this
series (see Optometry Today, June 3 2011).
The clinical features of optic
nerve disease generally are relatively
circumscribed. Firstly, the symptoms
depend on the underlying condition, but
generally there is poor vision. There is
rarely, if ever, any pain. The signs of optic
nerve dysfunction are reflected in reduced
visual acuity (VA), both for near and
distance and there may also be diminished
sensitivity to light brightness and colour
vision anomaly (or dyschromatopsia),
which may be red-green or blue-yellow
in nature. Testing of the pupil reactions
Figure 2
Appearance of physiological cupping
may reveal a relative afferent pupillary
defect (RAPD) whilst visual field
defects may be documented, including
(typically) central scotoma, centrocaecal
scotoma, altitudinal defects or nerve fibre
bundle defects. Special investigations,
such as imaging of the visual pathways
by computerised tomography (CT)
scan or by magnetic resonance
imaging (MRI) scan are invaluable
to exclude additional underlying
pathology. Electrophysiology, including
visually evoked potentials (VEPs), is
diagnostically useful in revealing which
part of the visual pathway is affected.
Acquired nerve anomalies
Acquired disorders of the optic nerve
include anterior ischaemic optic
neuropathy (AION), optic neuritis,
papilloedema (swelling of the optic
nerve head secondary to raised
intracranial pressure), toxic optic
neuropathies, tumours of the optic
nerve, and genetic optic neuropathies
(such as Leber’s hereditary optic
neuropathy and autosomal dominant
optic atrophy), and, of course, glaucoma.
Disc swelling (whether unilateral or
bilateral) and optic atrophy will not be
dealt with here in detail. The commonest
causes for disc swelling are papilloedema
itself, papillitis and neuro-retinitis and
AION, as well as infiltration of the optic
nerve. A unilateral or bilateral swollen
disc should always be referred urgently

to the HES, as this may have a potentially
life-threatening cause. Ultimately, optic
atrophy or disc pallor results from these
conditions. However, the detection of a
pale disc or optic atrophy may also suggest
a range of other diagnoses, such as postoptic
neuritis, compressive optic atrophy
(due to tumours affecting the optic nerve
or visual pathway), and hereditary optic
atrophies (eg, Leber’s hereditary optic
neuropathy and dominant optic atrophy).
Optic nerve anomalies are important to
clinical practice because it is vital for the
practitioner to be confident in distinguishing
between congenital structural anomalies
from acquired and potentially treatable
conditions, such as papilloedema. Whilst
the conditions discussed here are generally
rare, they may result in visual symptoms
Congenital optic nerve
anomalies
These may be divided into those
without systemic associations and those
with associated systemic features. 1
Congenital optic nerve anomalies
without systemic associations include
tilted disc, disc drusen, optic disc pit
and myelinated nerve fibres. Those with
systemic associations include optic
disc coloboma (including the morning
glory anomaly), optic disc hypoplasia,
megalopapilla,
peripapillary
staphyloma, and optic disc dysplasia.
Tilted disc
The VA is typically normal in this
common, bilateral condition, which is
frequently associated with myopia and
distinguishes it from a visual field defect
that is due to chiasmal compression.
Disc drusen
Disc drusen are calcified deposits
within the optic nerve head. Disc
drusen are not common (less than 2%
of the population) and when they do
occur they are generally bilateral (75%).
Familial cases have been reported.
Rare associations include retinitis
pigmentosa (RP) and angioid streaks.
The VA is typically normal, unless
complications occur, such as choroidal
neovascularization or peripapillary
haemorrhage. The clinical features
include an absent cup and the appearance
of pink/yellow or waxy, pearl-like,
indistinct lumps on the disc margin
41
17/06/11 CET
or even poor vision, and thus are of
high astigmatism. The appearance is
(Figure 4). Disc drusen may be under the
importance to the practising optometrist.
that of a small disc, which is commonly
disc surface (Figure 5) or penetrating it.
It is desirable to emphasise here the
oval, and is due to the oblique angle
They frequently start out in childhood
importance of accurate and educated
at which the optic nerve enters the
deep in the optic nerve and later emerge
history-taking in the assessment of these
globe. This gives rise to an appearance
to be more superficial. There is no dilation
individuals. In the conditions described
which is easily confused with disc
of the veins or obscuration of the vessels.
here there may be a family history in a
swelling (Figure 3). Most commonly
Disc drusen display autofluoresce,
good proportion of cases and it is important
a nasal defect of the optic disc may
but there is no leakage on fluorescein
to include this in the assessment. In
be seen, with hypopigmentation
angiography. They are also seen on CT
addition, and even of greater importance,
of the inferonasal retina, and these
scans because they contain calcium. They
there are systemic features in some of
individuals may have a supero-
may be easily visualised on an ultrasound
the conditions, and patients may not be
temporal visual field defect 2 that does
of the eye. This allows them to be
aware of their relevance or significance.
not observe the vertical midline, which
distinguished from papilloedema, which
Figure 3
Tilted disc appearance
Figure 4
Pink/yellow or waxy, pearl-like, indistinct lumps on
the disc margin in optic nerve head drusen
Figure 5
Optic nerve head drusen under the surface

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
been advocated as alternative surgical
management for such complications.
Myelinated nerve fibres
Normal myelination in the human
visual pathways is completed by nine
42
17/06/11 CET
Figure 6
Optic disc pit (courtesy of Professor JE Morgan)
is a very important distinction to make. 3
Optic disc pit
Optic disc pits are uncommon and generally
unilateral. 4 The disc is often larger than in
an unaffected eye, and it contains an oval
or round pit. The pit is usually inferotemporal
in position (Figure 6). The VA is
typically normal. However, complications
are sometimes seen in cases with optic
disc pits. Pits have been associated with
glaucoma, 5 whilst other complications
include macular detachment, especially if
the pit is centred on the maculo-papullar
bundle. This occurs in approximately
50% of eyes with pits and this may then
eventually give rise to oedema or a central
serous retinopathy-like appearance, which
will reduce the central VA. However,
there may be spontaneous resolution of
this state. Argon laser photocoagulation
or photodynamic therapy (PDT) may
have some potential benefit if treatment
is needed for such cases, although largescale
clinical trials are currently clearly
lacking in the evidence base. Vitrectomy
and internal membrane peeling has
months of gestation. It starts at the lateral
geniculate body and moves towards the
lamina cribrosa. However, sometimes the
myelination spreads onto the surface of
the retina, starting from the optic disc and
spreading variably onto the retina. Thus the
appearance of myelinated nerve fibres may
follow one of three patterns: 6 isolated in the
periphery, or peripapillary, or extensively
around the disc (Figure 7). Recently,
retinal vascular abnormalities have been
reported with myelinated nerve fibres. 7
Occasionally a visual field defect may be
documented in patients with myelinated
nerve fibres (specifically an enlarged blind
spot), but it is usually inconsequential and
asymptomatic. The VA is typically normal.
Optic disc coloboma
Optic disc coloboma is rare and may
be unilateral or bilateral. It is usually
sporadic, but may occasionally be
inherited. In almost all cases, the VA
is decreased. The optic disc has a large
excavated area (Figure 8) and there
is often a superior visual field defect.
A coloboma is a defect resulting
from malclosure of the foetal cleft.
The foetal fissure of optic cup usually
lies inferiorly and normally it closes
between five to seven weeks of gestation.
Defects in this process cause coloboma.
Systemic associations of optic disc
coloboma include central nervous system
(CNS) malformations, cysts, chromosomal
abnormalities (Trisomy 13 and Trisomy
22 (cat-eye syndrome)) and CHARGE
(coloboma, heart defects, choanal
atresia, retarded mental development,
Figure 8
Coloboma of the optic nerve head
actually a variant of coloboma. 9 This is
very rare and usually unilateral. The
VA is typically decreased and the optic
disc appears very large with a funnel
shaped excavation; there may also be
glial tissue in the base (Figure 9). The
characteristic appearance results from
spoke-like emerging blood vessels from
the optic disc. There may be a surrounding
chorioretinal pigmentary disturbance
pattern too. 10 Serous detachment of the
retina may be seen in approximately
30% of cases. The morning glory disc
anomaly may be associated with midfacial
anomalies, such as hypertelorism,
nasal malformations and cleft palate. 11
Optic nerve hypoplasia
Optic nerve hypoplasia is rare and may
be unilateral or bilateral. 12 The VA is
variably reduced, and in severe cases
is devastatingly affected. Visual field
examination reveals a range of potential
defects including arcuate defects,
altitudinal defects, centrocaecal scotomas,
or bitemporal or binasal defects. The
appearance of the optic disc is small and
Figure 7
Myelinated nerve fibres
genital and ear abnormalities). 8
Other rare syndromes include the
morning glory disc anomaly, which is
Figure 9
Morning glory disc anomaly

often grey-pink and of variable size (Figure
10). There may be small optic nerve canals
and in severe cases loss of the foveal reflex,
due to loss of perifoveal retinal tissue. 13
The causes of optic nerve hypoplasia are
still largely unknown in most patients, but
may include the use of drugs (for example,
anti-epileptics or even LSD) and alcohol
in pregnancy and maternal diabetes.
Optic nerve hypoplasia is associated with
septo-optic dysplasia, in which there is an
absence of the midline septum pellucidum
and agenesis of the corpus callosum. These
patients may have endocrine anomalies,
which lead to low height and growth
retardation, unless they are diagnosed
early and receive growth hormone
or other endocrine supplementation.
Mutations in the genes HESX1, SOX2,
SOX3 and OTX2 have been implicated. 14
Megalopapilla
This condition presents with an unusually
huge optic disc, with horizontal or
vertical disc diameters of over 2mm. It
is a rare condition and may merge with
the diagnosis of coloboma or morning
glory disc anomaly in some cases.
Peripapillary staphyloma
This anomaly appears as a normal
disc with peripapillary excavation
and is associated with high myopia.
Summary
Congenital anomalies of the optic disc are
either confined to the ocular structures
alone or associated with systemic features.
Those without systemic associations
include tilted disc, disc drusen, optic
disc pit and myelinated nerve fibres.
Those with systemic associations are
optic disc coloboma and the morning
glory disc anomaly, optic disc hypoplasia,
megalopapilla, peripapillary staphyloma
and optic disc dysplasia or hypoplasia.
Conclusion
Accurate history taking and examination
readily reveal the key clinical features
required for the diagnosis of the
conditions discussed in this article.
Referral in the absence of previous
investigation is important, due to the
presence of systemic associations, which
require additional medical investigation
and may require intervention.
By and large, supportive measures,
including refraction and low vision
services, may be required for most
patients whose visual function is affected.
However, as a number of the conditions
Figure 10
Optic disc hypoplasia
affect children and have an impact on
visual function during education, there
is a need for a high level of awareness
and referral to the appropriate hospital
eye service and social services.
About the author
Marcela Votruba is an honorary consultant
at the University Hospital of Wales Eye
Department, Cardiff, and a senior lecturer
at Cardiff University’s School of Optometry
& Vision Sciences. Her specialist interests
are in genetic eye disease and optic
neuropathy. She is currently programme
secretary of the European Association
for Vision & Eye Research (EVER).
References
See http://www.optometry.co.uk
clinical/index. Click on the article title
and then download "references".
43
17/06/11 CET
Module questions
Course code: C-16562 O/D
1. Which of the following is associated with tilted discs?
a) Reduced vision
b) Papilloeadema
c) Visual field defect observing the midline
d) Astigmatism
2. Which of the following statements about optic disc
drusen is TRUE?
a) They are common, being found in 75% of the population
b) They display leakage on fluorescein angiography
c) They are visible on a CT scan as calcification
d) They are mostly unilateral
PLEASE NOTE There is only one correct answer. All CET is now FREE. Enter online. Please complete online by
midnight on July 15 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 25 2011.
4. Which of the following statements about colobomas of the optic
nerve is TRUE?
a) They require OCT for their clinical diagnosis
b) They arise from the mal-closure of the foetal fissure
c) They are not associated with systemic conditions
d) They always occur alongside iris coloboma
5. Which of the following statements about optic nerve hypoplasia is TRUE?
a) It has been associated with maternal alcohol ingestion
b) It rarely leads to poor vision
c) It is associated with hand anomalies
d) It has not been found to have a genetic cause
3. Which of the following statements about optic disc
pits is TRUE?
a) VA is always reduced
b) They must be treated by PDT
c) They have been associated with glaucoma
d) They are usually supero-nasal
6. Which of the following statements about optic nerve anomalies is FALSE?
a) They may have systemic associations
b) There may be positive family history
c) Acquired anomalies ultimately lead to optic atrophy
d) They all require emergency referral to the HES

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
17/06/11 CET
Visual factors in specific
learning difficulties
COURSE CODE C-16499 O/D
Lindsay Bater, BSc, MPhil, FCOptom, DipCL
This article reports the results of a clinical study that aimed to determine
whether there were any predictive factors to indicate the presence
of Meares-Irlen syndrome (also known as visual stress or MISViS)
and therefore whether such factors can help to identify which
patients would benefit from receiving precision tinted lenses (PTLs).
A secondary goal was to investigate whether PTLs bring about a
greater improvement in reading performance than coloured overlays.
The effect of using coloured overlays
or PTLs to help patients with specific
learning difficulties (SpLD) or MISViS
is already well-documented. 1 The
mechanism as to how the tint works is
not fully understood but it is theorised
to be related to hyper-excitability of
the visual cortex. 2,3 A clinical sign of
this is a sensitivity to striped patterns 4
(pattern glare - PG) and such tests may
have potential in helping to diagnose
the condition. 5-9 Certain patterns
can provoke some degree of visual
discomfort, 10 and this discomfort can
be associated with headaches. 11,12
Some people, however, are affected
more severely resulting in migraines or
difficulties with reading. 13 One study
found that a significant degree of MISViS
affects about 12.5% of the general
population and 31% of those people with
dyslexia. 14 As such, it would be useful
to predict the likelihood of MISViS and
the effects of treatment with coloured
overlays and/or PTLs. Particular factors
considered in this study were age, sex,
visual acuity (VA), ocular dominance,
binocular vision, stereoacuity,
accommodation,
convergence,
refraction, and fixation disparity.
Method
The clinical records of 244 patients
were retrospectively studied. All
patients had been referred to and were
examined at the same optometric
practice to investigate the possibility
of reading difficulties due to MISViS.
Referrals were received from a variety
of professionals including school
special needs teachers, disability
officers from tertiary colleges,
optometric colleagues, orthoptic
colleagues, or through self-referral.
The clinical protocol followed for
visual assessment was that described by
Lightstone and Evans 15 and as suggested
following an extensive clinical audit by
Evans et al. 16 The clinical protocol has
recently been elaborated upon in a book
by Allen et al. 17 Typically, patients had
a full optometric examination, which
included retinoscopy and subjective
refraction. The eyes were examined
to exclude any pathology that would
require referral. The binocular vision
status was assessed by a variety of
tests; the ocular motor balance was
determined with a cover test, motility
was performed, accommodation and
near point of convergence (NPC) were
Figure 1
Using the Intuitive coloured overlays
determined using a RAF push-up
rule, stereoacuity was measured using
the Lang Stereo test card and fixation
disparity was measured using the
near Mallett Unit. 18 Fixation disparity
assessment particularly included a
report of whether the patient observed
any movement of the nonius markers;
the presence of movement but no
misalignment indicated binocular
instability. Ocular dominance was
determined by the sighting/pointing
method and colour vision was
assessed using the Isihara plates.
PG was assessed using the Institute
of Optometry (IoO) PG Test. 8 The test
involves presentation of three cards,
each with a horizontal grating of either
0.5, 3 or 12 cycles per degree (cpd).
Patients who are prone to visual stress
find the 3cpd grating uncomfortable
and report distortions of the grating;
such patients were recorded as positive
for PG. Positive PG was also recorded if
the difference between the results of the
3cpd and 12cpd cards was greater than 1.
All patients then had an overlay
assessment using the intuitive overlays

Vision Assessment
MISViS
(n = 82)
(Figure 1). 1 Patients’ preference for
overlays was noted and their rate of
reading with and without the overlay
was determined using the Wilkins rate
of reading test; 19 an improvement in
the rate of reading by 5% or more, or
if the patient felt “more comfortable”,
were indications to prescribe the
coloured overlay. Thereafter, patients
who felt an improvement with the
coloured overlay were then assessed for
PTLs using the Intuitive Colorimeter;
patients who felt no improvement with
the use of the overlay did not have
follow-up colorimetry assessment. The
procedure for colorimetry followed
that described by Wilkins. 21 Once
the subject has determined the most
suitable hue and saturation for the
lenses, they are ordered either in plano
form or, if required, with the patient’s
refractive correction; if there was a
clinically significant refractive error,
Non-MISViS
(n = 144)
Significance
NPC (cm) 7.8 ± 3.0 7.1 ± 2.9 t=0.05
p=0.40
Stereoacuity (seconds of arc) 538 ± 67 544 ± 129 U=5904
p=0.50
Amplitude of Accommodation
(D)
7.4 ± 2.5 9.8 ± 3.0 t=7.75
p

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
Filter
Colour
Proportion
Preferring this
Colour (%)
Mean Rate of
Reading Without
Filter (wpm)
Mean Rate of
Reading With
Filter (wpm)
Change in
Rate of
Reading (%)
Significance
t
p
Yellow 18.8 65.6 73.3 11.7 4.15

There was no significant difference
in NPC, stereoacuity, binocular vision,
ocular dominance and fixation disparity
between patients with MISViS and those
without. These findings, which are
all assessments of binocular function,
suggest that binocularity is not a major
factor in predicting reading difficulties.
Indeed, a large proportion of people
without MISViS had a fixation disparity,
which suggests that this may be a
correlate of MISViS but not necessarily
causal of it. Furthermore, patients
remarked that the nonius markers on
the Mallett Unit were moving or were
intermittently suppressed, which may
be a consequence of the perceptual
instability that results from MISViS,
rather than a binocular vision anomaly
per se, since these participants
did not typically have other signs
of binocular vision anomalies.
Accommodation
It was found in this study that patients
with MISViS had significantly lower
levels of accommodation than those
without MISViS. This supports previous
reports that poor accommodation is
a factor in reading difficulties. 23-25
However, it is suggested that reduced
accommodation is a correlate of MISViS
and not necessarily causal of it. 23-25
The levels of accommodation
observed in this study were below
the norms expected. According to
Hofstetter, 26 accommodation ranges
from 17.0D in 4-year-olds to 4.0D
in 50-year-olds. However, when
comparing a control group with
a group of patients with dyslexia,
Buzelli 27 found accommodation was
slightly higher in those with dyslexia
compared to those without, a finding
at odds with the present study.
Allen et al., 28 in their controlled
study, have shown that in patients
with MISViS the use of coloured
overlays improves their rate of reading.
In addition, using a remote eccentric
photorefractor and viewing a cross on a
background, they also showed that when
the chromaticity of the background
matched the overlay, the accommodative
lag was reduced in the study group
compared to the control group.
Pattern glare test
It has been shown that people with PG
display hyper-excitability of the visual
cortex 12 and this is the strongest visual
correlate of MISViS. 29,30 The results of the
present study confirm this finding, since
PG was significantly more prevalent
in patients with MISViS compared to
those without. The results of this study
also revealed, however, that a large
proportion of people without MISViS
also experienced PG (n=64/244). This
would seem to indicate that whilst the
presence of PG is associated with the
supply of PTLs, it may not necessarily
confirm that PTLs are required.
Certainly a negative response on the
PG test suggests that it is less likely that
patients will benefit from PTLs, which
can be a useful indicator to the clinician.
Coloured overlays
The use of overlays resulted in an
improvement in the rate of reading
compared to without the overlays, and
this was significant in all cases apart
from purple and grey. This matches the
findings of previous studies. 31-34 The
majority of subjects chose a colour in
the yellow-blue part of the spectrum,
with yellow being the most popular; this
is likely to reflect the fact that the eye is
more receptive to images along the blue/
yellow axis of the chromaticity graph. 35
However, the greatest improvement
in rate of reading was achieved with
the rose overlay. This finding is in
keeping with Wilkins et al. 36 Indeed,
in their study using coloured light
as opposed to coloured filters, the
majority of subjects preferred blue or
green light, but there was considerable
variability and the optimal colour was
highly specific to each individual. 36
In the present study, the lowest
improvements in rate of reading
were achieved with the purple and
grey overlays. Patients who selected
these colours also had the fastest
rate of reading without an overlay,
which suggests that the degree of
difficulty was lower in the first place.
It is interesting to speculate whether,
in a classroom situation, using coloured
paper (not white) would benefit poorer
readers. With the increased use of white
boards in schools, undiagnosed visual
stress may cause reading problems.
Indeed, although the present study
was a retrospective clinical analysis,
previous prospective double-masked
randomised controlled trials 1,37 indicate
that the benefit from coloured filters
cannot be solely due to a placebo effect.
Rate of reading
Using the criteria that PTLs would
only be supplied if patients showed a
long-term benefit to overlays, 39.3%
of patients seen in this study received
PTLs. The rate of reading with PTLs
was significantly improved compared
with coloured overlays, spectacles
(refractive correction only) and with
no refractive correction or filter.
Previous studies 1,16,38 have shown that
PTLs provide benefit to patients with
MISViS, with Wilkins et al. 39 reporting
a 25% increase in the rate of reading
in 5% of children given overlays.
Correction of refractive error
alone did not produce a significant
improvement in the rate of reading
and therefore, in the absence of any
clinically significant refractive error,
each patient should be assessed
individually to determine whether
47
17/06/11 CET

CET CONTINUING
EDUCATION
& TRAINING
1 FREE CET POINT 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
there is any benefit in the supply
of spectacles to help with reading.
Conclusion
This study has identified that age, sex,
accommodation and the presence of
pattern glare are significant factors
to consider for MISViS. The absence
of pattern glare suggests that it is
less likely that a patient will need
precision tinted lenses. Binocularity
did not appear to be a major factor.
Coloured overlays can help to improve
rates of reading, but the greatest
improvement is achieved with PTLs.
About the author
Lindsay Bater graduated in 1978
from City University, London. He
was awarded an MPhil in 1982 and
DipCL in 1986. After qualifying he
spent two years at the Department of
Ophthalmology, University of Otago,
Dunedin in New Zealand. On returning
to the UK he moved to Swansea where
he and his wife run three practices. The
author would like to thank Professor
Bruce Evans for his encouragement
and guidance in producing this
article and Dr Alan Dobbins for his
assistance in the statistical analysis.
References
See http://www.optometry.co.uk
clinical/index. Click on the article title
and then download “references”.
17/06/11 CET
Module questions
Course code: C-16499 O/D
1. What proportion of the general population can be affected
by MISViS (Meares/Irlen syndrome or Visual stress)?
a) 10.5% of the general population
b) 12.5% of the general population
c) 15% of the general population
d) 17.5% of the general population
PLEASE NOTE There is only one correct answer. All CET is now FREE. Enter online. Please complete online by midnight
on July 15 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 25 2011.
4. Which coloured overlay produced the greatest improvement
in the rate of reading?
a) Aqua
b) Pink
c) Lime green
d) Rose
2. The presence of pattern glare is reported as positive if:
a) The number of distortions on the mid frequency grating is less than 3
b) The number of distortions on the mid frequency grating is 3 or more
c) The number of distortions on the high frequency grating is less than 3
d) There is no difference in number of distortions between plate 2 & 3
3. Which of the following statements about accommodation in
learning difficulties is TRUE?
a) Poor accommodation is usually associated with reading difficulties
b) The amplitude is generally lower than normal
c) It is a correlate of MISViS, not necessarily causal
d) All of the above
5. Which of the following statements about pattern glare is TRUE?
a) It is always present in MISViS
b) It is never present in MISViS
c) It is a cause of MISViS
d) It is correlated to MISViS but is not causal of it
6. What was the improvement in the mean rate of reading with PTLs
compared with no correction or filter, in this study?
a) 10%
b) 25%
c) 43%
d) 75%

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
Traditional
Rayner is now in it’s 101st year and has its eyes firmly focussed on the future.
Few wholly UK owned optical groups have been around as long as us – and there
isn’t much about optics we don’t know.
On our retail optics side, we hold an enviable collection of strong and respected
regional names, giving us an almost unique position in the market.
Join us and you’ll be working as part of a dynamic organisation which has diverse
interests in optics across the globe.
If you’d like to join us as we start our second century, please contact us by letter
or email us at the address below.
Established 1910. Join in 2011.
51
Contact Lens Opticians
All Areas Locum or Employed
Optometrists
West Wales
Wiltshire/Berkshire
Cumbria Coast
Lincolnshire
Locum Optometrists
Essex/Suffolk
Dispensing Managers
Grantham
Yorkshire
Chester/Wrexham
Cumbria
Denbighshire
Pembrokeshire
All positions come with exceptional salaries,
private medical care and pension.
Lowndes House, The Bury,
Church Street, Chesham,
Bucks HP5 1DJ
Email: working@rayner.com
17/06/11 JOBS
Sandwell & West Birmingham Hospitals NHS Trust is one of the
largest teaching Trusts in the UK. With a reputation for excellence
we provide high quality care from 3 hospitals, and are working
towards Foundation Trust Status.
Dispensing Optician/Senior
Optical Dispenser
Band 5
Ref: 381-SB-0164
An exciting opportunity has arisen to work in the Optometry Department
at the Birmingham & Midland Eye Centre.
As a qualified Dispensing Optician/Senior Optical Dispenser working
in the Department, you will be solely in charge of the day-to-day
management of the newly refurbished Optical Dispensary, reporting to
the Head of Optometry. This position requires the demonstration of strong
organisational skills and the ability to work on your own, initiative as well
as interacting with the rest of the Optometry Department. You will be
expected to perform both routine and complex dispenses, arrange their
own appointments, place orders, manage stock control, and maintain the
general good order of the Dispensary.
Previous hospital dispensing experience will be very useful although not
essential. You will need to have a positive disposition and be an excellent
communicator, with a genuine enthusiasm for Dispensing to provide a full
and comprehensive Dispensing service for the Birmingham & Eye Centre.
All informal enquiries to Dr Waheeda Illahi, Head of Optometry on
0121 507 6727.
Closing date: 3rd July 2011. Interview date: 20th July 2011.
Please apply on-line at our website www.swbh.nhs.uk
INVITATION FOR INTERVIEW WILL BE VIA E-MAIL.
Please note that we are unable to contact all applicants after the
shortlisting stage due to cost implications. Therefore, if you have not
heard from us within three weeks of the closing date, please assume
that you have not been successful on this occasion.
The Trust is committed to equality of opportunity and is a no
smoking organisation.
www.swbh.nhs.uk
Optometrist - Cardiff
(1 permanent post; also some locum cover required)
DO/Trainee DO; Optical Assistants
Required for new independent practice in Cardiff. This will
be the new branch of an existing, established practice that
sets high standards for clinical excellence, great product
range and excellent customer service.
Flexible working hours can be considered.
Please apply in confidence by email to
cardiffoptician@hotmail.co.uk
optometrytoday
Boost your
chances of
finding the ideal
candidate for
your vacancy online by
advertising on
optometry.co.uk
and reach up to
18,000 users a
month. Call 020
7878 2313
Expanding Independant
seeks newly/one year
live
bookshop
CET
qualified Optometrist to
join our team
A relaxed working environment with working hours
of 9 to 5 Monday to Friday, very occasional Saturday
enewsletter
mornings and the odd Thursday evening will appeal to
VRICS
those who have a “work to live” outlook on life.
29 days hols per annum and a salary dependant on
experience. Who could ask for more?
Iain Campbell on 0131-661-7024 or
07977-470389
tv

JOBS
To place an advertisement call 020 7878 2313
or email haley.willmott@tenalps.com
For more details contact Jim
on 01793 648607 or visit
www.outsideclinic.com
SuPEr OPTOm
Cornwall, Sussex
Norfolk, Kent
OPTICAL ASSISTANTS &
DISPENSING OPTICIANS
Nationwide including
Manchester and Sheffield
52 50
Excellent opportunities to work in expanding practise - East London
We require:
• F/T or P/T Optometrist • Lab tech for
surfacing lab • Store manager
R12 OT Strip.indd 1 10/6/11 11:45:51
Be part of our team and put your ideas into action.Negotiable pay, flexible hours plus
benefits Please call 02084781631 or send CV’s to eyecare45@yahoo.co.uk
optometrytoday
More jobs visit
www.optometry.co.uk/jobs
live
bookshop
17/09/10 17/06/11 RECRUITMENT
JOBS
Specsavers Opticians
Portadown Northern Ireland • Permanent
position for Optometrist • 3-4 days per
week• Salary dependent on experience
Contact Michael or John on 028 3835 0400
CAMBRIDGE
Full/Part Time – Experienced, Locum Dispensing Optician
Enthusiastic,friendly,committed fully qualified DO 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
Banbury, Oxfordshire
D.O. Assistant Manager
Harrold Opticians is a family run group
of practices. We value choice and care.
We are seeking a D.O or nearly qualified
dispensing optician with enthusiasm and
drive looking to progress.
Contact Helen 07855094342 0r 01295 266326
email helskitch2006@yahoo.co.uk
Sign up to OT
Job Alerts and
hear about
the latest job
vacancies first
optometrytoday
Research Fellow
Faculty of Science and Technology
Cambridge Ref: 000046
Fixed-term contract for 6 months (with possibility of extension)
Hours negotiable (full-time/part-time)
£29,972 - £34,745 p.a. pro rata
Our vibrant, modern University has ambitious plans for its future.
Our two main campuses in Cambridge and Chelmsford are being
transformed with major capital investments. With an annual income
of £145m, 31,000 students and 2,100 staff, we are a major force for
higher education in the East of England.
An excellent opportunity has arisen for a Post-Doctoral Research Fellow
to join the Vision and Eye Research Unit (VERU) at our Cambridge
campus. VERU is part of the Postgraduate Medical Institute and it fosters
interdisciplinary research environment across different departments and
faculties. In the last Research Assessment Exercise, RAE2008, we
attained excellence in 55% of our research with 5% graded as world
class. We have a number of successful partnerships with the NHS,
especially Hinchingbrooke and Addenbrookes hospitals.
The successful candidate will work on a collaborative project with
Hinchingbrooke hospital investigating the effects of peripheral visual
field loss in patients with glaucoma and how these affect everyday
tasks such as step/stair descent and reach and grasp movements. You
will be expected to evaluate the level of glaucoma loss, collect data
on movement performance, analyse data and report findings to the
research team. You will also be encouraged to write papers and apply
for additional funding. You should have relevant experience or are willing
to learn how to carry out motion analysis and working with patients.
A relevant PhD in optometry or gait analysis is required.
Closing date: 01 July 2011.
For further details and to apply please visit our website
www.anglia.ac.uk. If you have any queries please
contact our recruitment team on 0845 196 4927
or email jobs@anglia.ac.uk
We value diversity at
Anglia Ruskin University
and welcome applications
from all sections of the
community.
bookshop
live
online enewsletter VRICS
CET

JOBS calling
To place an advertisement call 020 7878 2313
or email haley.willmott@tenalps.com
locums
chauffeur driven!
LOCUMS - OPTOMS
Norwich
28th June - optometrist required - £ Premium rate
SuSSex
27th June - optometrist required - £250 + 5% Sales
6th July - optometrist required - £250 + 5% Sales
53
cambridge
23rd June - optometrist required - £250 + 5% Sales
iPSwich
5th July - optometrist required - £ Premium rate
11th July - optometrist required - £ Premium rate
LoNdoN
30th June - optometrist required - £250 + 5% Sales
4th July - optometrist required - £250 + 5% Sales
caNterbury
6th July - optometrist required - £ Premium rate
17/06/11 JOBS
All locums overseen and transported to and from clinics by one of
our Super Optom National Trainers
For all the latest locum vacancies please visit
www.outsideclinic.com/careerslocum.html
and download the locum registration form
call for late June availability
Contact Jim or Stephanie for more details: - tel: 01793 648607
email: jim@outsideclinic.com or stephanie@outsideclinic.ednet.co.uk
Follow us on Facebook, Twitter, and Linked-In

JOBS
To place an advertisement call 020 7878 2313
or email haley.willmott@tenalps.com
See better. Feel better. Work better.
54 50
17/09/10 17/06/11 RECRUITMENT
JOBS
Joint Venture Partners (Established Business Opportunities – Nationwide)
The hard work and commercial acumen of our Joint Venture Partners, along with our state-of-the-art equipment and
impressive collection of designer products, has produced one of the most successful High Street Opticians. This is your
chance to join some of the best talent in the industry and take on the challenge of an established business with the
support of a fully trained team.
Naturally you’ll be commercially aware, with strong business experience within optics and a high level of professional
competence to build a profitable and thriving business. Developing talent within your store, motivating your team and
ensuring a successful patient base of returning customers will be high on your agenda.
We’ll provide you with partner development programmes, support from a regional manager, regional accounts team
and continued staff training and development. You’ll be the director of your own business and it’s you who’ll reap the
rewards. Vision Express is a brand name to be proud of ... and you can be part of it. If that’s what you’d like to see,
we’d like to see you.
We currently have opportunities available in the following locations:
l Bangor l Beverley l Braintree l Douglas - IOM l Eastleigh l Morpeth
All of the above offer excellent remuneration packages and relocation assistance if required.
To find out more please contact Chris Braddock on 0115 988 2139 or email chris.braddock@visionexpress.com.

MARKETPLACE
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
O p h t h a l m i c
a c c O u n t a n t s
a n d a d v i s O r s
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
Goldline Cases
Islington Large Leather Cases
was 55p
now Only 49p
now Only 35p
Min Order Qty 250
Cases
Tel +44(0)121 236 4549 CBS
Computer Systems
MORRIS & CO
MO
C O
MORRIS C H A R T E R E D A C C O U& N T A N TCO
S
C H A R T E R E D A C C O U N T A N T S
Min Order Qty 400
now Only 29p
MF Cloths
from
optometrytoday
Min Order Qty 400
MO
C O
Computer systems
Over 1000 independent UK opticians
use Ocuco software
Affordable software to suit Independent’s
budget and requirements:
Reception, Retail, Optometry
Imaging, Workshop
In-store or hosted remotely
Purchase, lease or rent
We have the solution, now is the time
PH: 0800 912 1004 info@ocuco.co.uk
*
Indicative, based on typical 5 year lease costs
S O F T W A R E W I T H V I S I O N
From
only £55
per month *
100701_OT Ad_Orange_Purple.indd 1
Optix
04/08/2010 15:04:11
www.optix.co.uk
live
software
Business Management System
bookshop
CET
Tel: 01904 606611
55
17/06/11 MARKETPLACE
For more Marketplace visit
www.optometry.co.uk/marketplace
online
Software made tv Simple
enewsletter VRICS
From £50 per month
optometrytoday
live
bookshop
CET
online
enewsletter
VRICS
tv
www.optisoft.co.uk 0845 2301230
optometrytoday
Looking to sell anything from a second-hand piece of
equipment to your practice. Advertise in OT and reach
19,842 potential buyers. Please call 020 7878 2313
live
bookshop
CET

& Advice on ...
Finance
Informed MARKETPLACE
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
TM
See20/20
Practice Perfection
Computer systems
Instant marketing
The world’s first web-based, ophthalmic
practice management software
Appointment Booking
Patient Management
Clinical Notes
Dispensing & Ordering
Sales: 0845 6120 141
Payments & Sales
Direct Debit Payment Manager
Text & Email Messaging
Business Intelligence Reporting
www.see2020.co.uk
Contact Lenses
Finance
VAT = 20%
VAT = 20%
Annual Investment Allowance
Set to change
“VAT De-Minimis Under
Pressure”
Informed Finance
& Advice on ...
Equipment
Imaging
Computers
Cars
Refit
PROFESSIONAL FINANCIAL SERVICES
Frames
56
Call : 0845 644 7778
E-mail : info@pfsleasing.co.uk
Web: www.pfsleasing.co.uk
optometrytoday
live
bookshop
CET
Frames
online
enewsletter
VRICS
tv
17/06/11 MARKETPLACE
Min Order Qty 400
now Only 29p
Min Order Qty 400
Bag
+
Case
+
Cloth
Bag 250 gsm Full Colour Coverage
8p
MF Cloths from
Equipment
100
95
75
Dispensing video display system
Touch Screen: No Wire,Keyboard or Mouse reqd.
From £1300 ex vat
36 Months Software Support
Dell Touch ScreenComputer
www.foreview.co.uk
sales@foreview.co.uk
Tel 01865 600161
Manufacturer of LogMar,
Slimline and Domiciliary
Test Types, Low Vision
Aids and many other
optometric products.
General ophthalmic and
optometric equipment
also supplied.
Order now online at
www.sussexvision.co.uk
Come and see………..
optometrytoday
Finance
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
live
bookshop
optometrytoday
For more Marketplace visit
www.optometry.co.uk/marketplace
CET
live
caseco
optometry_today_SS11
Tel 01580 890111 Fax 01580 890118 11 March 2011 15:02:37
optometrytoday
sales@caseco.co.uk www.caseco.co.uk
Eyebag 12/1/09 11:44 Page 1
Hot Compress
Whenever you recommend hot wet flannels -
Sell them an EyeBag instead.
For Dry Eye Syndromes, Blepharitis, Chalazion,
Styes.
Designed by Consultant Ophthalmologist Mr Teifi
James, this convenient re-useable warm compress
really works because patients actually use it. Heat in
the microwave for 40 seconds. Relax with EyeBag in
place for 10 minutes. Massage lids and repeat as
necessary.
Comprehensive colour instruction leaflet included.
Each EyeBag can be re-heated up to 200 times.
Trade £10 – RRP £20. To buy direct from The
EyeBag Co. order by phone on 0844 800 0159 or
email yebags@mac.com
bookshop
online enewsletter VRICS
More information at www.eyebagcompany.com
live
25
5
0
book
online enewsletter VR
online
enewsletter
VRICS
tv

MARKETPLACE
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
Instruments
Instruments
Practice fittings
Lens cleaning cloths
Grafton Optical
Practice fittings
57
Optovue OCT, DGH Pachmate
Reichert Non Contact Tonometers
LCD ClearChart
Frastema Combi units
Eyescape / Retinal imaging
Shin Nippon Slit Lamps & Tonometers
Oasis Punctum Plugs
Pre-owned equipment
Reliable competitive servicing
Visit graftonoptical.com
for more details on all our products and services.
Grafton Optical Company Limited
Crown Hall, The Crescent
T: 01923 233980
Watford, Hertfordshire
E-mail: sales@graftonoptical.com
WD18 OQW
optometrytoday
online
live
Practice fittings
enewsletter
bookshop
VRICS
100
95
75
CET
tv
17/06/11 MARKETPLACE
25
5
0
optometrytoday live
bookshop
CET
For more Marketplace visit
online
enewsletter VRICS
www.optometry.co.uk/marketplace
tv
optometrytoday
Practice for sale
SW Sheffield
Well established practice for sale due
to retirement of owner.
Turnover £85,000 approx
Leasehold premises
Offers invited for an early sale
Tel: 07549 812851
Repairs
live
bookshop
email : terminaleyes@hotmail.co.ukCET
optometrytoday
live

MARKETPLACE
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
Practice fitting
58
17/06/11 MARKETPLACE
Invest in a sales driven Store Graphics interior
with our exclusive low cost finance package.
Sales Driven
interiors
One-stop service
I N T E R I O R S I N O P T I C S
Contact us now for your free practice appraisal
01454 413 000 www.storegraphics.co.uk sales@storegraphics.co.uk
The UK’s Leading Practice Designers and Manufactures
“Nice People to deal
with and we found their
quote to be the
most competitive”
Designed Interiors and Bespoke Furniture
To discuss your options with one of our designers or
for a copy of our “Directory of Practice Design” phone: 01594 546385
The Style Design Company - www.style-design.com

Contact your Flexon representative
to view the latest additions to the Flexon family
0800 72 20 20