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Antarctic
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January 28 2011 vol 51:2
optometrytoday
21
14
25
Comment
Eye care in England
AOP chief executive Bob Hughes gives his
views on the opportunities which the
Health and Social Care Bill will bring
News
High Court appeal decision
The AOP wins an appeal over a 2010
News
OT Live to run in April
Bookings to begin in February for the
education programme at Optrafair
Industry
New collections available
Our latest round-up on products
for the practice
8
7
20-21
Pre-reg Focus
Don’t overlook a hospital place
Optometrist Nadeem Rob extols the
benefits of hospital placements for
pre-regs
Feature
Our man in Antarctica
Andrew Gasson reports on eye
care at the bottom of the world
Geoff Shayler’s second article in
fitness to practise case 6 26-27 our Ageing Vision series 37-40
Profile
Garrey Haase
The Yorkshire optometrist takes our
20 Questions Q&A
News Extra
On the road with the LOCSU
We report on the first of LOCSU’s
roadshow seminars about the
future provision of eye care services
24
28
30
VRICS
Anterior Eye & Contact Lens
Assessment
Take our latest picture quiz 34-35
Free CET
Visual features of Parkinson’s
disease
Free CET
Sight saver, life changer
Dr Cameron Hudson writes about
the wider work of the role of an
eye care practitioner 41-45
Visit www.optometry.co.uk today

NEWS
Teamwork aims to steer
Health Bill in optics’ favour
THE TURBULANT debate over the
Government’s Health and Social
Care Bill shows no sign of abating
as it heads towards its second
reading in the House of Commons
on Monday (January 31).
Nevertheless, sources within and
outside optics believe the Bill can
bring the sector improvements,
such as further enhanced service
schemes within England.
The Bill has attracted controversy
with its aims of allowing GPs to
purchase patient care from 2013
after the abolition of Primary
Care Trusts in England, and the
establishment of a national
Commissioning Board. Although
ministers expect to save billions
of pounds later this decade, the
Bill’s critics have claimed it to be a
massive gamble at improving the
nation’s health care provision.
However, those closer to
optometry believe that the Bill
will provide optical practitioners
improved chances to get involved
in shared care schemes and
eventually win wider recognition.
Speaking at the first of a dozen
events for the LOCSU, specialist
optometric adviser from Primary
Care Commissioning – the
Department of Health group –
John Hearnshaw commented:
“Now is a good time to be
seeking those new, enhanced
optical services. The new GP
commissioning consortia may
have open minds, but empty
wallets – that’s not necessarily a
bad thing though, if we can show
them some savings.”
Minister visits Moorfields
HEALTH MINISTER Lord
Howe visited Moorfields Eye
Hospital NHS Foundation
Trust and spoke about the
new Health Bill.
He was at the hospital to
learn more about a new role
which provides practical
support to people with sight
loss, or their carers.
Moorfields’ new eye
clinic liaison officer (ECLO)
Caroline Beebee, pictured
with the minister, said: “My
job is to support patients
and their families in coming
to terms with their new
situation by offering guidance
on specialised equipment,
employment services and
support groups.”
Lord Howe held a
roundtable discussion at the
hospital with senior directors
Speaking on behalf of the
Optical Confederation, Bob
Hughes, AOP chief executive, said:
“The Health Bill brings a number of
opportunities for optometry and
optics. The outcome for Primary
Ophthalmic Services being with
the new National Commissioning
Board is carried through to the Bill,
and the Board has the powers to
set protocols and prices for what
are currently enhanced services.
“Of course, like all opportunities,
there are potential dangers. For
instance, the Board could decide
it won’t involve itself in enhanced
optometric services or we may
fail to persuade the Department
of the public health needs in eye
care.
“What is certain is that it is vital
for the profession that we are
working together nationally and
locally. LOCSU are working with
LOCs and the optical bodies have
formed a Bill team to work on the
detailed aspects of the Bill as it
goes through Parliament.”
from Moorfields and
representatives from optical
charities.
He said: “Our Health
and Social Care Bill is
about improving patient
care and tailoring services
locally so that they meet
individual needs. This is
a great example of how
NHS care is more than just
providing medical treatment
by helping people who need
emotional and practical
support so they can return
to living the lives they
want to lead.”
BRIEFING
J&J and others
back at Optrafair
CONTACT LENS companies are
returning to Optrafair within a
dedicated pavilion. It is understood
that attendees at the NEC show in
April will hear news of a major new
lens launch.
Large companies such as
Johnson & Johnson and Bausch &
Lomb are being joined by suppliers
specialising in solutions and dry eye
treatments. The specific area has
been warmly welcomed by optical
companies in this sector –
Shirley Bovonsombat, senior
product manager for Johnson &
Johnson Vision Care in UK and
Ireland said: “We are delighted to
be returning to Optrafair for the
first time in five years. The new
Contact Lens Pavilion is a welcome
addition for the industry and will
provide us with a fantastic platform
to launch a brand new lens,
showcase our entire Acuvue range
and discuss the latest innovations,
trends and developments with the
entire optical community.”
Eye Logic, one of the first
companies to secure space within
the Contact Lens Pavilion, will
be promoting its liposomal spray
for dry eyes, available only to
independents.
“We are aiming this particularly
at contact lens wearers and
computer users,” said David
Gunning, marketing manager for
Eye Logic UK.
Alcon vision care business unit
manager, Chris Miller, who is
also bringing his company to the
contact lens pavilion, said: “We are
delighted to be part of Optrafair
and are looking forward to using
the event as a launch platform to
share information with customers
on exciting new products.”
5
28/01/11 NEWS

optometrytoday
JANUARY 28 2011
VOLUME 51:2
ISSN 0268-5485
ABC CERTIFICATE OF CIRCULATION
January 1 2009 – December 31 2009
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Editor-in-Chief: David Challinor
T: 020 7202 8164
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T: 020 7202 8163
E: robinamoss@optometry.co.uk
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THE AOP has won an appeal
in the High Court against the
decision of a GOC fitness to
practise committee which
found an optometrist guilty
of misconduct and deficient
professional performance.
In January last year a fitness
to practise panel found AOP
member Janine Vali’s fitness to
practise to be impaired after
it was alleged that she failed
to take appropriate action on
discovering a patient had raised
intraocular pressures.
The case arose when a
complaint was lodged in 2007
relating to a sight test conducted
in 2005 when Ms Vali was newly
qualified.
When announcing its decision
in 2010, the fitness to practise
committee issued Ms Vali with
a series of conditions to adhere
to whilst practising for a period
of two years, which have now
been overturned. They included:
remaining under the supervision
of a supervisor who would
NEWS
AOP wins High Court
appeal over FTP case
monitor her compliance with the
decision and report back to the
GOC’s registrar every six months;
not performing examinations on
patients over 40-years-old unless
supervised; not undertaking
any locum work without prior
agreement with their supervisor
and the GOC registrar; and
attending a specialist glaucoma
clinic in a hospital eye department
as an observer for 12 sessions.
On Friday (January 14) Appeal
Court Judge Ounsley allowed the
appeal, and quashed the decision
and the conditions stipulated by
the fitness to practise committee,
upholding the lesser charge of
misconduct and awarding costs
against the GOC. The Judge did
not accept that Ms Vali’s fitness
to practise was impaired in 2010,
but that there had been a one off
oversight.
Commenting on the successful
appeal, Bob Hughes, AOP chief
executive, said: “Fighting for our
members is what the AOP is for
and what our staff are engaged
in day to day – protecting our
members. Congratulations to our
legal director, Gerda Goldinger,
and all her team on a significant
victory for the profession.”
Web success for CIBA Vision
TWO HUNDRED eye care
practitioners from the UK and
Ireland participated in CIBA
Vision’s optical business live
web seminar from their own
homes. A further 30 were in the
London-based studios where
the event was beamed live, with
more following on Twitter.
The event supported the
launch of a new book from
the company, ‘Maximise your
practice success with contact
lenses’. Developed by using
insights from global best
practices, the publication shows
practitioners how increasing
contact lens sales leads to
better customer satisfaction
and loyalty.
Business consultant Patrick
Myers and CIBA’s head of
professional affairs, Mark
Draper led discussions with the
audience on three key areas
of the book, key performance
indicators, marketing your
practice and staffing.
Mr Draper said: “These
are tough times for eye care
professionals. Practitioners
told us they wanted more
help in attracting new contact
lens wearers. The volume of
your contact lens business has
a direct impact on practice
profitability and so this is a
strategy that is very important
to ensure growth.”
For a complimentary copy
of the book visit http://www.
cibavisionacademy.co.uk/
business_academy.shtml

Book for OT Live at NEC
FOLLOWING the success of the
inaugural OT Live lectures in 2009,
the AOP-organised education
forum will be back at Optrafair
in 2011. Booking for OT Live
will open at the beginning of
February, offering delegates the
chance to experience an exciting
programme of education and
attend the exhibition. Optrafair
takes place April 9-11 at the NEC,
Birmingham.
With two lecture theatres
located in the main exhibition
hall delegates will be spoiled
for choice when it comes to
accessible and relevant CET.
Places at the lectures are free
but must be booked in advance.
Readers can book online at
www.otlive.co.uk or by calling
0845 1801 318. You can also
register for the exhibition at
www.optrafair.co.uk
Larry J Alexander, OD FAAO, one
of the International speakers at OT
Live 2009, said of the event: ”What
an exciting and fun meeting. It was
a great format and tremendous
interaction. A truly remarkable
learning and teaching experience
with wonderful hosts.”
Platinum sponsors for the event
have been confirmed as Johnson
& Johnson and Topcon. Other
sponsors include Zeiss, Optos,
Optegra, Grafton and Transitions.
Education Advisor for the
AOP Karen Sparrow said: “We’re
delighted to have Topcon back
as a sponsor for OT Live as their
‘Lunch & Learn’ session in 2009 was
sold out. In addition Johnson &
Johnson are already well-known
for their high quality CET lectures
so it’s great to have them on
board for 2011.” For more details
readers can email Ms Sparrow at
karensparrow@aop.org.uk.
Westminster reception
promotes eye care’s role
IN BRIEF
Membership offer
R A Valuations, the property
advice company whose expertise
is part of the AOP’s membership
benefit package, has announced
a 10% discount for the provision
of a business valuation to the
Association’s members. The offer
runs until February 28 2011. Read
Mark Ridout’s – who is a director of
R A – account of how the downturn
has affected practice values on
pages 32-33 of this week’s issue.
Facebook focus
The latest group to use the social
networking craze is the BCLA. From
this week viewers of Facebook can
learn more about this year’s clinical
conference and exhibition on the
new page ‘BCLA 2011’. “We hope our
new Facebook page will help create
a real buzz around this year’s event,”
said BCLA marketing manager,
Caroline Seville. “Over the coming
months we will be posting regular
updates, photos and messages and
we invite all members and others
within the profession and industry,
including BCLA 2011 exhibitors and
sponsors, to join us for a chat and to
share their views on what we have
planned for BCLA 2011.”
7
28/01/11 NEWS
THE EYE HEALTH
ALLIANCE Parliamentary
reception attracted highpowered
support last week,
with 15 MPs and 18 peers
attending to hear passionate
speeches on the millions
at risk from unnecessary
blindness.
Hosted by John Baron
MP (pictured), co-chair of
the All-Party Parliamentary
Group on Eye Health and
Visual Impairment, the event
included a speech from
Professor Nick Bosanquet
who presented an overview
of his paper Liberating the
NHS: Eye Care.
Mr Baron (pictured)
warned attendees: “We need
to act now to stop more
people needlessly going
blind due to undetected
eye conditions. Eye health
is often overlooked and
we must work together to
change this. This important
public health message
must be taken seriously
by national and local
government, commissioners,
and health and social care
professionals.”
Professor Bosanquet
added: “By 2050 the number
of people living with sight
loss is set to increase by
115% to almost four million
people, unless urgent action is
taken now. The NHS urgently
needs to free up capacity in
hospital eye care services. Reengineering
services as I have
proposed in my recent report
is the only way of meeting this
challenge. This opportunity
has been missed twice in the
last decade. It is vital not to
miss it again.”
The MPs and peers in
attendance included several
members of the House of
Commons Health Committee
and Dr John Pugh, the cochair
of the Liberal Democrat
Parliamentary Policy
Committee on Health and
Social Care.
Murder plot case
starts
The trial of laser eye surgery boss
Dr Michael Mockovak has started in
Seattle, US. Dr Mockovak, who cofounded
the Clearly Lasik business,
is accused of hatching a murderfor-hire
plot against his former
business partner, and the company’s
president, reported the Seattle Times
(January 18).
Lansley visit
In the run-up to presenting his bill to
Parliament, health minister Andrew
Lansley visited Cardiff University’s
optometric postgraduate centre.
The centre was chosen by Welsh
Assembly minister for health Edwina
Hart as an example of how Wales
is ‘leading the way in eye care and
reducing the burden of the NHS’.

NEWS
COMMENT
Parents are warned
over new 3D gadget
8
28/01/11 NEWS
THE AOP’s education advisor Karen Sparrow
(pictured) has spoken out warning parents to
be aware of the potential harm overuse of the
new Nintendo 3DS portable games system
could cause to children’s eyesight.
Both the Daily Telegraph (January 21) and
the Guardian online (January 20) featured
the story last week. In the issued statement,
Ms Sparrow warned: “As with anything else –
children should not use the 3DS to excess. As
3D technology has only recently hit the High
Street there is little scientific research available
yet but Nintendo is right to warn the public of
the potential harm of excessive use.
“This [potential risk] is not unique to the
Nintendo 3DS as watching 3D images through
other means, such as at the cinema or on
a 3D television could give rise to the same
concerns, however there are two additional
factors when using the 3DS. The close
proximity of the device could place more
stress on eyesight than looking at a television
set, meaning that eyes have to focus harder,
and it is more likely to be used by children for
longer periods.
“Children need a clear, sharp image in
each eye in order for their vision to develop
properly. If anything upsets that balance
(natural or artificial) it could affect the visual
development resulting in amblyopia or a
squint.
“This can be a problem when viewing 3D
if you have a weaker eye. If a child spends
excessive time using a device such as the 3DS
it could effectively act as a negative exercise,
as opposed to strengthening the eye, and it
can leave it underdeveloped, causing a ‘lazy
eye’.”
More concern for eyesight and 3D
technology – see page 12.
Has the NICE Glaucoma
Guideline affected you?
A RESEARCHER at
London’s South Bank
University is seeking
your views on how
the introduction of
the NICE Glaucoma
Guideline has
impacted optometric
practice.
Peter Campbell is
asking practitioners
across England and Wales to fill in a short
questionnaire on how the glaucoma/ocular
hypertension NICE Guideline has affected
them since its
introduction in 2009.
The survey, which
is anonymous
and takes just a
few minutes to
complete, can be
found at https://
www.surveymonkey.
com/s/JWVWFGP
The survey closes
on February 28, 2011.
For more information contact
glaucomasurvey@yahoo.com
EYE CARE IN ENGLAND
The Health and Social Care Bill will
revolutionise the NHS. Support it or not,
it represents a considerable opportunities
for optometry.
To start with, PCTs are going and
most AOP members will be delighted.
Many PCTs act with a carefully crafted
combination of arrogance, ignorance and
bullying towards the profession. You
have to ask: “Has all their over-zealous
checking and judging been of benefit to
patients?” The answer would be no.
Primary Ophthalmic Services will
become the responsibility of the new
National Commissioning Board in line
with what we had asked, and they
will oversee the recognition of LOCs.
Nationally and locally this provides
opportunities for England to learn from
the measurably improved eye health in
Wales and Scotland.
We have put a Bill team in place, led
by our head of public affairs Heather
Marshall. They are charting progress
through Parliament and ensure MPs
are briefed. We are working with the
BMA and other contractors on areas of
common interest; and with the Royal
Colleges of GPs and Ophthalmologists,
the UK Vision Strategy and of course
the College of Optometrists to give
professional substance to our arguments.
This is complemented by LOCSU. Their
current training courses are specifically
aimed at equipping LOC leaders for the
new NHS world, and we are hosting an
informal meeting of experienced LOC
leaders to ensure we take into account
their experience on the ground.
The devil is in the detail. These
changes could transform eye care, or it
could amount to little or nothing. Our
future is largely up to us, and we are
engaged in giving optometry a say in
shaping a better future. There is little that
could be more important, and it is an
opportunity we cannot afford to miss.
Bob Hughes, AOP chief executive
bobhughes@aop.org.uk

If they’re comfortable here,
1,2
they’re comfortable anywhere.
ACUVUE ® OASYS ® contact lenses give that “no lens feeling” 1 ,
even when using a computer.
When working at a computer we blink five times less 3 , leading to dryer eyes and discomfort.
ACUVUE ® OASYS ® delivers a unique combination of smoothness, breathability,
flexibility and wettability to ensure patients experience a lens so comfortable they’ll
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Eyes are also shielded by the highest level of UV protection 4,5 of any reusable lens.
Talk to your patients today about why ACUVUE ® OASYS ® is the best choice for
computer use.
www.jnjvisioncare.co.uk
1. JJVC Data on File 2006. 84% of patients using the computer more than 25 hours a week agreed strongly/somewhat that ACUVUE ® OASYS ® made them forget they were wearing lenses. N=174. 2. Young G, Riley CM, Chalmers RL, Hunt C. Hydrogel lens comfort in
challenging environments and the effect of refitting with SiH lenses. OVS 2007; 84; 4: 302-308. 3. Patel S, Henderson R, Bradley L et.al. Effect of visual display unit use on blink rate and tear stability. Optom Vis Sci, 1991;68:11 888-92. 4. UV absorbing contact lens are
not substitute for UV-blocking sunglasses as they do not completely cover the eye and the surrounding area. 5. JJVC Data on File, 2010. ACUVUE ® , ACUVUE ® OASYS ® , HYDRACLEAR ® and SEE WHAT COULD BE are trademarks of Johnson & Johnson Medical Ltd.
© Johnson & Johnson Medical Ltd. 2010. Johnson & Johnson Vision Care is part of Johnson & Johnson Medical Ltd.

NEWS
10
28/01/11 NEWS
IN BRIEF
Let them buy
cakes…
Students and staff at the University
of Ulster’s optometry department
raised £965 for last year’s World Sight
Day Challenge – with nearly a third
of that total coming from sales of
buns made by the department. A
total of almost £300 came from the
sale of cakes on campus, with nearly
£300 from a night out organised by
second-year optometry students,
with the rest raised from a raffle.
Brandreth speaks
Gyles Brandreth will be guest speaker
at Oulton Hall, Leeds at the Optix
user group annual meeting in March.
With sponsorship from Nikon, Hoya,
Rodenstock, Essilor and Birmingham
Optical Group, an attendance of
160 delegates is expected for the
meeting, which is scheduled to take
place on March 22-23.
Hobson is choice
International Eyewear has appointed
Mark Hobson as joint managing
director to work alongside Julie Abel.
He has spent several years in the
optical sector, and was latterly at
Silhouette for two years as MD.
ABDO 25th lunch
ABDO will host a luncheon to
celebrate its 25th year at the
Plaisters’ Hall, London, on May 6.
The event will acknowledge some of
those who have played a part in the
Association’s development since its
foundation in 1986.
Eyeplan bucks an uncertain
market and hits million mark
EYEPLAN, THE provider of
monthly payment eye care
schemes, has reported it is
collecting in excess of £1m
in eye care fees per month.
The company works
with independent optical
practices in the UK and
enables opticians to offer
more value to their patients.
In exchange for a small
monthly fee, patients are eligible
for a range of eye care benefits
including free examinations,
lower prices on spectacles and
accidental damage cover.
Eyeplan has seen growth in
2009-2010 via an increase in the
number of practices adopting
the Eyeplan Business Model, and
more patients choosing to join
the scheme and receive greater
value from their eye care.
“Our healthy growth shows
that despite challenging
economic times, many patients
are still placing importance on
EFFORTS TO make the
recording of pupillary distance
(PD) measurements a part
of optical prescriptions have
been responded to by the GOC.
However, the organiser of the
campaign says he will take
the matter to the Office of Fair
Trading as a next stage.
As reported in OT (January
14) Metsuki.com managing
director Ewan McFarlane
handed in an online petition
to the Harley Street-based
organisation earlier this month.
The petition contains over
2,500 names. Mr McFarlane,
who has been campaigning on
the matter for several months,
receiving great value from their
eye care provider,” said Chris
Clemence, commercial director.
“We are delighted that our
commitment to care, quality and
value in optics has translated into
strong growth and a successful
year.”
Before Christmas Eyeplan
introduced a Bonus Bonds system
for its Eyeplan Associate Opticians.
The profit-sharing initiative is a
result of several years’ successful
growth for the company and an
increasing number of practices
adopting the Eyeplan Business
OFT is next step for PD man
said he hoped that those who
regulate the optical professions
would take note of the strength
of feeling of some of the
consumers who left comments
on the site.
Registrar of the GOC, Satjit
Singh, has written to Mr
McFarlane reminding him that
optometrists do not have to
provide PD measurements
when providing an eye test.
“It would appear that the
arguments you have raised
about requiring a PD refer to
the retail market,” Mr Singh
wrote. “As I have mentioned,
our primary function is to act
in the interests of public health
Model. Bonus Bonds have
been awarded to those
Eyeplan practices with 100
members or more and
each has been registered
to receive a certain number
of bonds, depending on
practice membership
levels.
At the declaration of
each Bonus Bond Dividend,
a proportion of Eyeplan’s profits
will be distributed amongst its
registered practices. More bonds
can be earned as membership
levels grow and there is no limit
on the frequency or value of the
payment.
“The Bonus Bonds scheme was
created by a desire to share in our
success and enable associates to
benefit financially from Eyeplan’s
continuing growth,” said Mr
Clemence.
The company has also
introduced discretionary Bonus
Bond awards.
and safety, but having said
that, our Council is currently in
the process of reviewing our
strategy and as part of that
process we are looking at the
changing environment in which
we operate. This includes a
range of issues, including sales
over the internet.
“Should our work conclude
that changes in the law are
necessary in the interests of
health and safety, we would
in due course be approaching
the Government who have
the ultimate power to amend
legislation. The timing and
process for this review has yet
to be agreed.”

education through inspiration
Vision For Life
Educational Roadshow
Coming to you soon
The Vision Care Institute is about to hit the road again, with this
year’s series of educational roadshows. Always extremely popular, they offer
a unique opportunity to gain knowledge and experience in all aspects
of contact lens wearing and fitting, and are hosted by a wide range of leading
professional figures. This year, the theme of the event is Vision For Life, exploring
vision correction for the whole of your patient’s life, and how this can help expand
your patient base and profitability.
Dates and Venues 2011
Sunday
6th February
Monday
7th February
Thursday
10th February
Birmingham
Austin Court
Leeds
Royal Armouries
London
Royal College of Physicians
The lectures are:
• Prescribing for Children in Optometric Practice
• Myopia Control: Can We Really Make a Difference?
• The Psychology of the Presbyope
• Keeping Mums and Dads in Contact Lenses
• The Ageing Eye
• Keeping Eyes Young
Last year’s educational roadshows were extremely successful, and because we predict
this year’s to be the same, call now and reserve your free place, before it’s too late.
FREE TO ATTEND
11 CET POINTS
(including distance learning)
The Booking Hotline – 0845 310 5347
THE VISION CARE INSTITUTE is a trademark of Johnson & Johnson Medical Ltd. © Johnson and Johnson Medical Ltd. 2011.
Tuesday
15th February
Thursday
17th February
Bristol
Watershed
Manchester
The Lowry Theatre

NEWS
12
28/01/11 NEWS
IN BRIEF
IP success for duo
Dr Scott Mackie – professional
services director at Optical
Express – and his wife Dr
Roisin Mackie are pictured
after collecting their Diploma
in Therapeutics, Independent
Prescribing (IP) award(s) at the
College of Optometrist ceremony
in Westminster. Their aim was to
become the first couple in the UK to
be awarded this higher qualification.
Mr Mackie stated that the Glasgow
Caledonian University IP course
was demanding and rewarding,
but would assist him in developing
optometrists. Ms Mackie said that
she would use it as part of a new
Acute Referral scheme in her local
Health Board. They thanked Dr Sanjay
Mantry, Stobhill Hospital, who acted
as mentor to both Drs Mackie.
Debate over 3D technology
grows with optics’ insight
WITH THE debate growing over
what 3D technology could mean
for eyesight, professional bodies
within UK optics have outlined
their positions.
With current concern regarding
the release of the Nintendo 3DS,
the AOP’s Karen Sparrow outlined
her views to the national press
this week (see page 8).
As 3D films and TV are
becoming more common place,
the College of Optometrists has
moved to reassure the UK public
that there is no evidence of any
long term harm being caused by
using 3D displays and they may
be helpful in uncovering some
‘subtle eye disorders’.
In a statement, the College
has said: “These eye disorders
may also cause difficulty when
doing tasks such as reading so we
would recommend that people
who have difficulties watching
3D have a full eye examination to
identify and correct any cause.’”
Loughborough University’s Dr
Peter Howarth is about to publish
a review of the potential hazards
of viewing 3D in the College’s
research journal Ophthalmic
and Physiological Optics. He
said: “Although people have
reported experiencing symptoms
when watching 3D content,
specifically headaches and
eyestrain, there have been no
studies whatsoever which have
detected any permanent damage.
Furthermore, stationary examples
of these types of pictures have
been around since Victorian times
(Wheatstone stereoscopes), and
films have been around since the
craze for them in the 1950s. The
normal eye is adaptable enough
to accept small 3D stereoscopic
content without stress. It is only if
there are large, prolonged effects
that people experience symptoms
of eyestrain.”
And ABDO has added its voice to
the debate. Its spokesman said: “It
is essential to advise any member
of the public who is seeking to
benefit from 3D technology, that,
prior to purchase, they should have
an eye examination to discover
if they will be able to enjoy the
benefits it offers. The association
also asks all manufacturers and
suppliers of such equipment to
clearly draw attention to the fact
that there are those who will be
unable to obtain a 3D view.”
Appeal for Week
Organisers of National Eye Health
Week are calling on organisations to
back a national campaign to educate
the public on the importance of eye
health and the need for regular sight
tests. It will take place during June
13-19 with sponsorship packages
available to purchase immediately
on a first-come, first-served basis.
Further details can be found at www.
visionmatters.org.uk
Retailing in focus
Key figures from Boots and Asda will
give tips and advice at Retail Week’s
2011 conference which will take
place on March 16-17 at the Hilton
London Metropole. The event, which
will hear how the British consumer
is changing, and that UK retailing is
at a crossroads, is offering admission
savings if attendees register before
February 4.
New GOC registrar is named
THE GENERAL Optical
Council has announced the
appointment of a new chief
executive and registrar.
Samantha Peters (pictured),
who has worked in the
health sector for 11 years,
leading the British Society of
Rheumatology, is expected
to take up the position from
March 28, and will replace Satjit
Singh, who has held the post in
an interim capacity since 2010.
Ms Peters has an MBA from
Cass Business School and
has been at the forefront of
Britain’s health professionals
in rheumatology. In these
roles, and as chief executive
of the British Youth Council,
she has worked closely
with an extended network
of professionals and wider
stakeholders, and has
strong policy, advisory and
communications functions.
In addition to her full-time
employed roles, Ms Peters
has held a number of public
interest posts focusing on
delivering services and
support for patients and the
wider general public, including
as a trustee of Arthritis Care
and of the Arthritis and
Musculoskeletal Alliance.
Anna Bradley, chair of
the GOC, said: “I am really
looking forward to Samantha’s
arrival. We have a challenging
organisational agenda and
live in interesting times in
the health sector. Samantha
will give us the clear and
personable leadership we
need to take the GOC forward.”
Ms Peters said: “I am
delighted to be joining the
GOC, and look forward to
helping it deliver its invaluable
role in promoting high
standards of optical care. I
welcome the chance to work
with the GOC’s Council, staff
and registrants to build on
its strong reputation for
protecting the public, and
delivering excellent service.”

NEWS
14
28/01/11 NEWS
BRIEFING
Optos reveals
double-digit
growth globally
Global retinal imaging company
Optos has reported over a 10% rise
in total revenue for the first quarter
of the financial year to September
30, 2011.
Total revenue for the threemonth
period ending December 31,
2010, stood at $25.7m compared
to $23.3m, a year-on-year rise of
10.3%.
Revenues from the ‘outright sales
of devices’ also saw a steep rise in
growth from $0.3m to $3.7m.
The company’s customer base
increased from 3,912 to 3,954, up
42, with 107 new installations and
65 sites de-installed.
In December last year the
acquisition of Opto Global Pty
Holdings, an ophthalmic device
company based in Australia, was
completed and plans to integrate
the two businesses are now
underway, Optos confirmed.
CEO, Roy Davies said: “We are
pleased to report double digit
revenue growth and continued
strong cash generation in the first
quarter. Further growth is expected
from the launch of our 200Tx
ophthalmology device next month
and as we begin to exploit the Opto
Global opportunity.”
US counts cost
of fireworks
Bottle rockets – part of a ban on
dangerous fireworks in this country
several years ago – can cause
significant eye injuries in children,
often leading to permanent loss of
vision, according to a report that
will appear in the May print issue
of Archives of Ophthalmology. Of
the estimated 9,200 emergency
department admissions resulting
from firework-related injuries
each year in the US, about 1,400
cases involve the eyes with a
disproportionate number of these
injuries caused by bottle rockets
which are about half the size of a
normal firework.
Sports vision clinic opened
with athletic stars’ approval
OPTICAL EXPRESS has
launched a ‘flagship’ Sports
Vision clinic in Glasgow city
centre. The clinic, which
opened in the company’s
outlet in Renfield Street on
January 20, aims to give
the public the chance to
improve their sporting skills
and increase awareness of
sports specific eye care.
It offers informed advice and
‘appropriate eye care correction
options’ based on an individual’s
requirements, and, the Scottishbased
company claims it is the
most comprehensive sports
vision service available in the UK.
The clinic, run by specially
trained sports vision optometrists,
will have a sports vision trainer
(SVT) and Bassin Anticipation
Timer (BAT) machines that users
can measure and improve their
coordination and awareness.
“Sports vision has been an
important aspect in the training
THE DANGERS of ‘vodka
eyeballing’ have been
highlighted by the College of
Optometrists following a BBC3
documentary on the dangers of
drinking games.
Ready, Steady, Drink!,
broadcast last Monday (January
17), showed comedy actress
Emily Atack investigating binge
drinking amongst young people
and included a segment on the
practice of vodka eyeballing
– taking in vodka through the
eyeball.
President of the College Cindy
and development of top athletic
and sporting professionals for a
number of years,” said an Optical
Express spokesman, “and has
been designed to maximise their
performance, enhance their
comfort and ensure their sporting
activity is both safe and enjoyable.
“Separate to elite athletes,
over 5.2 million UK adults have
membership of a private gym and
it is for them, sporting teams and
clubs, that Optical Express has
opened the Sports Vision Clinic.”
Colin Moulson, a qualified
sports vision optometrist at
Optical Express, commented:
“Many people don’t realise
there is a separate eye
examination available that
is specific to sports, nor
that following a simple
eye training programme
can help improve their
coordination and visual
awareness. Sport is serious
business these days, not
only for seasoned professionals
aiming to reach the top of their
game, but for the growing
population that are choosing to
improve their health and wellbeing
through a more active
lifestyle. Sport is a leading cause
of eye injury, so it is essential
to keep our eyes protected.”
Pictured is Scottish rugby star
Graeme Morrison who has been
training with Optical Express, and
the clinic has won the approval
of other sports stars, including
twice US Open winning golfer
Retief Goosen, and Olympic gold
medallist Daley Thompson.
Dangers of drinking game
linked to eyes is broadcast
Tromans said: “By putting
vodka, or in fact any alcohol, in
your eye actually means that
you are stripping away the
very delicate layer of skin on
the surface of the eye which is
there to protect it. Repeated
direct exposure to alcohol
could cause permanent corneal
scarring and potential loss of
vision.”
Pictured is Dr Tromans
with Emily Atack and Felipe
Dhawahir-Scala, a consultant
ophthalmologist at Manchester
Royal Eye Hospital.

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NEWS
16
28/01/11 NEWS
IN BRIEF
New Leightons boss
Ryan Leighton has been appointed to
the position of chief executive officer
for Leightons Holdings, which runs
the Leightons Opticians group. In his
new role of CEO, he will provide
strategic direction for Leightons
Opticians, its franchises and
HearingCare business. Mr Leighton
will work closely with Sue Cockayne
in her position of managing
director of Leightons Opticians and
Leightons Franchises. She will also
take on responsibility for Leightons
HearingCare to enable Mr Leighton
to devote more time to his new role.
Found on Facebook
The victim of a robbery and mugging
from a man wearing ‘Elvis Costellostyle
glasses’ turned detective and
recognised his attacker from a
Facebook picture of the man wearing
the distinctive spectacles. Daniel
Bolton found the mugger Christopher
Bleasdale on the social networking
site, he was sentenced to 28 months
in jail for robbery at Burnley Crown
Court, reported the Daily Mail
(January 24).
Glasses impounded
A total of 150,000 pairs of prescription
glasses have been impounded in
Italy, optical news gathering agency
eyesway.com has reported. ‘Non-EU
nationals’ have been charged with
possession of large quantities of
counterfeit goods by Italian Tax Police
at Bari. The 10 non-EU nationals
were arrested at the end of a health
protection operation according to the
source, Ansa.it, and the seized models
were off-the-shelf reading glasses
with a dioptre of +4.00.
Milton Rogovin
One of the world’s most respected
photojournalists, who trained and
worked as an optometrist and
contributed to eye care in the Second
World War, has died. Milton Rogovin,
won fame from his photography
of America’s poor, worked as a
practitioner for the US Army and from
1942-45 ran an optometry business
until he was nearly 70, according to
the Press Association. He died this
month, aged 101.
J&J roadshows return
next month
JOHNSON & JOHNSON Vision
Care’s educational roadshows
return next month to explore
vision correction for patients
of all ages.
The ‘Vision For Life’ themed
free-to-attend events will run
from February 6-17, making five
stops across the country.
Booking is now open and
there are up to 11 CET points
available to those who attend.
Beginning the nationwide
tour at Birmingham’s Austin
Court on February 6, the
roadshow will then visit the
Royal Armouries in Leeds
(February 7), London’s Royal
College of Physicians (February
10), the Watershed in Bristol
(February 15) and The Lowry in
Manchester (February 17).
Key topics which will be explored
include: ‘Prescribing for children
in optometric practice’; ‘Myopia
control: can we really make a
difference?’; ‘Keeping mums and
dads in contact lenses’; ‘The ageing
eye’; and ‘Keeping eyes young’.
David Ruston, director of
professional affairs for J&J in
Western Europe, said: “Building
on the popularity of a heavily
over-subscribed event in 2010, the
‘Vision For Life’ roadshows from
The Vision Care Institute should
be immensely popular and aim
to help eye care professionals
keep up-to-date with the latest
vision correction techniques for
their patients, both young and
old. We aim to help strengthen
patient satisfaction and loyalty
from all members of the family
and to show practitioners how this
can help them to develop their
businesses.”
To book a place at one of the
roadshows, contact 0845 310 5347.
Learning disabilities scheme
is deemed a success
A PILOT SCHEME aimed
at increasing access to
eye care for adults with
learning difficulties has
been labelled a success by
Scrivens Opticians.
Introduced at the
independent’s Wokingham
branch a month ago, the Eye
Know project is designed
to encourage Wokingham
residents with learning
disabilities to have their
eyes examined at least
every two years. As well as
highlighting the importance
of eye health to the patient,
it aims to educate social
care professionals and
family carers.
Optometrist Francesca
Wilson will see all patients
who visit the practice under
the scheme throughout the
project’s nine-month period.
Lisa Wingate, managing
director of Scrivens Opticians
in Wokingham, said: “In
the first month we have
received a significant number
of enquires for this special
scheme and are hopeful that
its success will continue
for the next nine months,
ensuring the project delivers
on its targets to educate as
many people as possible.
“We take optical health
very seriously and anything
we can do as a store to make
sure local residents know
the importance of getting
their eyes tested on a regular
basis is something we aim to
pioneer.”
The scheme is funded by
the Wokingham Learning
Disability Partnership Board.

NEWS
16
28/01/11 NEWS
IN BRIEF
New Leightons boss
Ryan Leighton has been appointed to
the position of chief executive officer
for Leightons Holdings, which runs
the Leightons Opticians group. In his
new role of CEO, he will provide
strategic direction for Leightons
Opticians, its franchises and
HearingCare business. Mr Leighton
will work closely with Sue Cockayne
in her position of managing
director of Leightons Opticians and
Leightons Franchises. She will also
take on responsibility for Leightons
HearingCare to enable Mr Leighton
to devote more time to his new role.
Found on Facebook
The victim of a robbery and mugging
from a man wearing ‘Elvis Costellostyle
glasses’ turned detective and
recognised his attacker from a
Facebook picture of the man wearing
the distinctive spectacles. Daniel
Bolton found the mugger Christopher
Bleasdale on the social networking
site, he was sentenced to 28 months
in jail for robbery at Burnley Crown
Court, reported the Daily Mail
(January 24).
Glasses impounded
A total of 150,000 pairs of prescription
glasses have been impounded in
Italy, optical news gathering agency
eyesway.com has reported. ‘Non-EU
nationals’ have been charged with
possession of large quantities of
counterfeit goods by Italian Tax Police
at Bari. The 10 non-EU nationals
were arrested at the end of a health
protection operation according to the
source, Ansa.it, and the seized models
were off-the-shelf reading glasses
with a dioptre of +4.00.
Milton Rogovin
One of the world’s most respected
photojournalists, who trained and
worked as an optometrist and
contributed to eye care in the Second
World War, has died. Milton Rogovin,
won fame from his photography
of America’s poor, worked as a
practitioner for the US Army and from
1942-45 ran an optometry business
until he was nearly 70, according to
the Press Association. He died this
month, aged 101.
J&J roadshows return
next month
JOHNSON & JOHNSON Vision
Care’s educational roadshows
return next month to explore
vision correction for patients
of all ages.
The ‘Vision For Life’ themed
free-to-attend events will run
from February 6-17, making five
stops across the country.
Booking is now open and
there are up to 11 CET points
available to those who attend.
Beginning the nationwide
tour at Birmingham’s Austin
Court on February 6, the
roadshow will then visit the
Royal Armouries in Leeds
(February 7), London’s Royal
College of Physicians (February
10), the Watershed in Bristol
(February 15) and The Lowry in
Manchester (February 17).
Key topics which will be explored
include: ‘Prescribing for children
in optometric practice’; ‘Myopia
control: can we really make a
difference?’; ‘Keeping mums and
dads in contact lenses’; ‘The ageing
eye’; and ‘Keeping eyes young’.
David Ruston, director of
professional affairs for J&J in
Western Europe, said: “Building
on the popularity of a heavily
over-subscribed event in 2010, the
‘Vision For Life’ roadshows from
The Vision Care Institute should
be immensely popular and aim
to help eye care professionals
keep up-to-date with the latest
vision correction techniques for
their patients, both young and
old. We aim to help strengthen
patient satisfaction and loyalty
from all members of the family
and to show practitioners how this
can help them to develop their
businesses.”
To book a place at one of the
roadshows, contact 0845 310 5347.
Learning disabilities scheme
is deemed a success
A PILOT SCHEME aimed
at increasing access to
eye care for adults with
learning difficulties has
been labelled a success by
Scrivens Opticians.
Introduced at the
independent’s Wokingham
branch a month ago, the Eye
Know project is designed
to encourage Wokingham
residents with learning
disabilities to have their
eyes examined at least
every two years. As well as
highlighting the importance
of eye health to the patient,
it aims to educate social
care professionals and
family carers.
Optometrist Francesca
Wilson will see all patients
who visit the practice under
the scheme throughout the
project’s nine-month period.
Lisa Wingate, managing
director of Scrivens Opticians
in Wokingham, said: “In
the first month we have
received a significant number
of enquires for this special
scheme and are hopeful that
its success will continue
for the next nine months,
ensuring the project delivers
on its targets to educate as
many people as possible.
“We take optical health
very seriously and anything
we can do as a store to make
sure local residents know
the importance of getting
their eyes tested on a regular
basis is something we aim to
pioneer.”
The scheme is funded by
the Wokingham Learning
Disability Partnership Board.

OPTRAFAIR
Software companies will vie
for your attention at Optrafair
18
28/01/11 SHOW COUNTDOWN
PAPERLESS PRACTICES, remote
access to patient appointment
books and data, multiple
branch management and
improved communications
will be the key aspects of the
bespoke optical IT systems
promoted at Optrafair – which
is just 71 days away.
Practitioners thinking about
updating their current system
or computerising their practice
for the first time are urged to
attend the show at the NEC,
Birmingham on April 9-11.
Six of the sector’s major
software suppliers – Optix
Software, See 20/20, Optisoft, Opticabase, Optinet and Ocuco – will
be present to offer hands-on demonstrations of their products to
attendees throughout the three-day event.
Managing director, Michael Prais (pictured) commented: “New
features added to Opticabase, include SMS and email messaging, online
tutorials, one-click lens ordering and a link to
frame tracer, a link to receipt printer and cash
drawer, electronic NHS form submission and
much more.”
Elsewhere in the exhibition, Optisoft will be
promoting, among other things, its new ‘easy’
Apple iPad dispensing tool.
Talking about Optisoft’s products,
managing director, Keith
Sheers said: “Our digital diary
and recall, supported with
easy to use SMS and email
functions, are expected to gain
many new users as practices
see the mounting costs of
mailing patients by post. The
electronic GOS forms to PCTs
are also a great talking point.”
Returning to the biannual
show after a “fantastic
response” in 2009, Opticabase
has a number of new additions
to highlight to attendees.
Managing director of Optix
Software, Trevor Rowley,
believes attending Optrafair will give practitioners a unique opportunity
to review the systems on offer across the market. “There tends to be
some inertia in optics about something that does the job but a good IT
system should be paying for itself many time over in revenue.”
To book a place at Optrafair visit www.optrafair.co.uk
• Bookings are now being taken for educational lecture series OT
Live – see news pages – which will have a large presence at the
show. The Platinum sponsors for the event have been confirmed
as Johnson & Johnson and Topcon. Other sponsors include Zeiss,
Optos, Optegra, Grafton and Transitions. To book go to www.
otlive.co.uk or call 0845 1801 318, or to find out more, call Karen
Sparrow on 0207 207 2194.

The AOP and SECO International are pleased to offer AOP
members a complimentary Delegate Pass to the largest
Optometric Continuing Education meeting in the world.
®
Over 400 Hours of Continuing Education / Largest Optometric Meeting Exhibit Hall in the US / Unlimited Networking Events
YOUR COMPLIMENTARY
DELEGATE PASS INCLUDES:
15 hours of Special Session education
EDUCATION
SECO 2011 is The Education Destination ® and will feature more than 400 hours
of continuing education for eye care professionals around the world.
EXHIBITS
SECO 2011 will host Optometry’s Marketplace at SECO , the largest exhibit
hall in optometry. Nearly 275 participating leading industry companies will
feature the latest ophthalmic equipment, products and services.
Optometry’s Marketplace at SECO will also feature two FREE lunches, a wine
& cheese reception as well as a daily prize program.
and unlimited access to our Optometrist
Continuing Education Program (COPE/CET)
Breakfast, lunch and dinner SECO Symposiums
Admission to the exhibit hall
VALUED
AT UP TO
$490
Networking receptions and social events:
• The Wednesday Night Opening Reception
• Wine & Cheese Reception, President’s
Reception & Thursday Night Highland’s Hop
• Friday’s Alumni and Special Receptions
• The SECO Saturday Night Party
EVENTS
SECO 2011 will include more than 50 affiliate events and functions, including
nightly social events. SECO 2011 should be your education and entertainment
destination.
Course Handouts CD-ROM
Access to 13 hours of FREE virtual continuing education
For additional information about SECO 2011
please visit www.SECO2011.com
For more information, to register your interest or to book
your trip please contact Karen Sparrow on
0207 207 2194 or email karensparrow@aop.org.uk.
CONTINUING EDUCATION
March 2–6, 2011
OPTOMETRY’S MARKETPLACE AT SECO
March 3–5, 2011
LOCATION
Georgia World Congress Center
Atlanta, Georgia USA
SECO2011.COM
The SECO [2010] conference was outstanding in terms of content, subject
matter, presenters, workshops and its organisation.
Graham Park, MCoptom FAAO
Optometrist, North Wales

INDUSTRYNEWS
New frames for
mature women
20
28/01/11 INDUSTRY NEWS
ORANGE EYEWEAR has enhanced its
Contessa label with a number of new
frames for mature women. Designed
specifically for the “from-40+” age
group, Contessa is designed to be an
affordable range available exclusively to
independents.
Contessa features a range of classic
looks with a modern twist, together
with delicate finishes and a variety of
side detailing. A number of frames have
the option of narrower side widths
for women who find bolder sides too
overpowering.
Highlights of the new collection
include model Con105, (pictured
above). Available in two colourways,
pink/lavender and gold/brown, the
soft-coloured supra eye-shape blends
into contrasting metal side detailing.
Together with spring hinges, the model
is enhanced by a subtle criss-cross design
that flows into colour co-ordinated
acetate sides. These have the added
benefit of being shortened, as necessary.
Model Con106 is also available in two
colours, coffee and violet and has a soft
squoval eye-shape, deep enough to
accommodate a progressive lens. It is one
of a selection of petite frames for those
women requiring smaller eye sizes.
Hanna Nussbaum, Orange’s managing
director, said: “The latest additions reflect
a growing desire for a versatile collection,
combining style and subtlety.”
0161 773 5555
Boost your
New Year sales
TO REACH over 20,000 potential
customers, send details of your
product launches with accompanying
photographyany pictures for
OT’s industry news by emailing
robinamoss@optometry.co.uk
Fully automated
camera is launched
HAAG-STREIT UK has launched the new DRS fully automated retinal imaging camera, which
requires “minimal operator training”.
The company believes that the digital system
offers “excellent value for money for the modern
optometric practice, without compromising on
image quality”.
The DRS has been designed to maximise patient
flow, whilst simplifying operation through an
intuitive touch screen interface.
Single button operation enables the DRS to
automatically detect the patient, self-align to
the patient’s eye, focus on the retina, adjust
the flash level and capture a high quality
image in less than 30 seconds. The image can
then
stored on the system or on a USB memory stick,
stick,
printed, or transmitted to another PC or network via
the
integrated Wi-Fi and Eithernet connections.
The design is compact and features an integrated PC with a 160 GB hard drive, enabling the
storage of thousands of images. A low power LED flash helps to ensure patient comfort.
01279 456261

Water way
with frames
SCANDINAVIAN EYEWEAR’S own
brand Skaga has the design theme
“underwater” for its new collection
for spring. Life on, by, and under the
water has influenced Skaga’s creative
design team, mainly in the choice of
colours and shades.
The details of the frames are
inspired by glittering fish scales, the
shifting, transparent movements of
jellyfish, shimmering seaweed and
billowing reeds as seen in the frame
Skaga 3812, pictured left. The shape
has a slight 1950s influence but with
a modern twist. The frame is available
in purple, black, petrol and golden
brown. There are styles for men as
well, and the frames are the work of
Skaga four-strong team of designers
based in Sweden.
For more information see www.
scandinavianeyewear.se or contact
the UK distributor.
0800 376 1050
A touch of
denim
Ordering is now
child’s play
DUNELM OPTICAL has launched its new website this month. It has been updated to make it
easier for practitioners to browse the company’s 900-frame portfolio at www.dunelmoptical.
co.uk. Larger pictures showcase the frames in more detail, and there is a more user-friendly
ordering system.
“We’re really pleased with the new website,” said Dunelm Optical director Peter Beaumont.
“Not only is the functionality much better, we’ve also let the pictures do the talking. We’ve made
model photography more prominent as our customers told us that these types of images have
more impact. We hope people will be pleased with the result.”
01388 420420
21
28/01/11 INDUSTRY NEWS
THE CHARMANT Group has
launched the Esprit optical range for
spring/summer. The designers of the
new urban collection have blended
Esprit’s positive, youthful spirit with
this year’s revived passion for denim.
Typical denim features such as fly
buttons are included as in frame
E17302, pictured, a women’s metal
frame available in brown, black,
purple, silver and gold.
The new collection comes in the
latest in saturated primary and neon
colours with light metallic and
bolder two-toned frames some of the
keynotes of the new range.
020 8992 9911
Sales will help charity
MID-OPTIC HAS added the Magnifeyes Ready Reader range to its Guide Dogs product
portfolio, with a donation made to the charity for every product sold.
The Magnifeyes Ready Readers are supplied in 15 clear lens designs and three Sun Reader
designs with UV400 lenses. Powers range from +1.00 to +3.00. Mid-Optic is donating 50p to
the charity for every pair it sells.
The frames can be bought
individually but those purchasing
a selection of 20 frames will
receive a free counter display
unit showing the Guide Dogs
branding.
Mid-Optic has now
sponsored its second Guide
Dogs puppy called Barley,
through sales of its Guide Dogs
Ready Readers and Microfibre
Cleaning cloths.
01332 295001

NEWS
Opti opens with sports theme
22
28/01/11 NEWS
THE TRADITIONAL curtain raiser
to the European optical show
calender, Opti Munich, opened
today with a concentrated
presence of collections for
summer and winter sports.
Over 50 manufacturers of
sports eyewear will present
their latest collections over the
next three days, with the likes of
Adidas, Nike and Oakley lifting
the veil on new developments.
Aimed at all winter sports fans,
Adidas’s Supernova Pro features
a new filter shape which gives a
wider field of view and prevents
sunlight entering from the side,
and is presented at the Silhouette
stand. Sports brand Uvex – at
the Rodenstock display – is
showcasing six new products at
Opti, including a pair of sports
glasses that gives protection for
eyes in all weather conditions.
The variomatic tinted lenses from
Uvex automatically adjust to
changing light conditions.
The Vortex model from
Bushnell, aimed at mountain
bikers, features lightweight,
impact-resistant lenses, which
give protection against stones
kicked up on downhill slopes.
Also for cyclists is the Gozen
model. At the show, Rudy
Project is currently presenting
these sports glasses for the
first time; a special flip-change
technology enables lenses to
be exchanged quickly. ‘Seeing
and being seen’ is the tag-line
from the new Nike sports
eyewear collection Vintage. The
Vintage range is inspired by
1970s design.
The show, which started in
1998, had 434 exhibitors last
year, and has topped the 450-
mark in companies supporting
it this time, with over 160
businesses from outside
Germany will be taking part
this time from 25 countries.
Britain’s presence includes
Cutler & Gross and Tom Davies.
New at Opti ´11, in the
‘country pavilions’ which
are centred in Hall C1, will
be the presence of seven
Turkish exhibitors showing
their collections for the first
time outside of their home
country. The Turkish products
on show range from frames
and sunglasses to children’s
spectacles. France will have a
total of 13 firms present, among
them François Pinton and
Vuillet Vega.
A full report on the show will be
published by OT next month.
Kilimanjaro climb
raises VAO £5,000
THE STORE director of a
London-based Specsavers has
climbed Mount Kilimanjaro and
raised £5,000 for Vision
Aid Overseas.
Shak Hirani, who runs the
Hammersmith branch of the
multiple, was accompanied
by two friends as he made the
5,900ft climb over five days.
Pictured at the peak of the
Tanzania mountain, Mr Hirani
said: “We began training for
the climb six months before
the departure date to ensure
we were still in peak physical
condition. This included a
gruelling training schedule,
a 12-hour charity football
marathon and a climb to the
peak of Mount Snowdon.
“Nothing though could
have prepared us for what
we faced, including freezing
temperatures, unbearable
altitude sickness and an
extraordinary challenging
climb. Despite all this I think it
was also the most exhilarating
experience of my life; just one
that I doubt I’ll repeat anytime
soon.”

DIARYDATES
All minds
on Georgia
The fast-growing city of Atlanta,
Georgia, USA is once again hosting
SECO this year.
Billed as ‘the education
destination’ as well as the promised
world-class lectures, between
March 2 and 6, almost 300
companies will exhibit at the World
Congress Center.
To book, or for more information,
visit www.seco2011.com
23
FEBRUARY
1 NEOS, The Harvey Suite, Ravensdene Lodge Hotel, 55 Consett
Road, Lobley Hill, Gateshead, ‘Dots, blots and haemorrhages.
A guide to medical retinal problems’ 7.15pm (simonraw44@
hotmail.com)
NEW… 1 North London AOP, Moorfields Eye Hospital,
London, EC1V, ‘Binocular vision and incomitancy’ 1 CET point
(stevedross10@hotmail.com)
2-3 J&J, The Vision Care Institute, Pinewood, Berkshire,
‘Returning to work confident and refreshed’ two day course,
18 CET points (www.thevisioncareinstitute.co.uk)
9 West Sussex LOC, Post Graduate Medical Centre,
Worthing, ‘Anterior eye – what to refer’ 7pm
(consult@bridleopticians.co.uk)
10 LOCSU, Winchester Royal Hotel, St Peter
Street,Hampshire, Winchester, ‘Regional training
roadshow’ SEE ABOVE
NEW… 10 J&J, Royal College of Physicians, London,
‘Vision for life roadshow’ 11 CET points SEE ABOVE
14 LOCSU, Belfry, Mellor’s Way, Nottingham, ‘Regional
training roadshow’ SEE ABOVE
28/01/11 DIARY DATES
3 LOCSU, Ramada Piccadilly, Portland Street, Manchester, M1
4PH, ‘Regional training roadshow’ SEE ABOVE
NEW… 4 Pinpoint Scotland, 9 Gayfield Square, Edinburgh,
‘Practical OCT course’ (Maureen.broomhall@mcht.nhs.uk)
6 Eyecare 3000, Hilton Hotel, Belfast, 6 CET points on offer
(www.eyecare3000.com)
6 Glasgow Caledonian University and NHS Education for
Scotland, Dundee, venue TBC ‘Communication skills in
optometry’ (Karen.reid@gcal.ac.uk)
NEW… 6 J&J, Austin Court, Birmingham, ‘Vision for life
roadshow’ 11 CET points (0845 310 5347)
NEW… 7 J&J, Royal Armouries, Leeds, ‘Vision for life
roadshow’ 11 CET points SEE ABOVE
NEW… 7 Nottingham and Derby Optical Society, The Village
Hall, Chilwell, ‘Vitreo-retinal disorders’ 7.30pm
(ndos@live.com)
7 LOCSU, Maunsel House, North Newton, Somerset, ‘Regional
training roadshow’ SEE ABOVE
8 CIBA Vision, Bridgewater Hall, Lower Mosley Street,
Manchester, M2, ‘The Big Fit’ (www.cibavisionacademy.co.uk)
14 CIBA Vision, BMA, Tavistock Square, London,
WC1 9JP, ‘The Big Fit’ SEE ABOVE
14 Lancashire Optical Society, Swallow Hotel, Preston,
‘Surgeons’ choice’ (ruthcuth@btinternet.com)
15 BCLA, 76 Portland Place, London, ‘Scientific
evening meeting’ (www.bcla.org.uk)
NEW… 15 J&J, Watershed, Bristol, ‘Vision for life
roadshow’ 11 CET points SEE ABOVE
17 LOCSU, Menzies Hotel, Barr Hill, Cambridge,
‘Regional training roadshow’ SEE ABOVE
NEW… 17 J&J, The Lowry, Manchester, ‘Vision for life
roadshow’ 11 CET points SEE ABOVE
17-18 Innovative Sclerals, 73 Railway Street,
Hertford, ‘An introduction to scleral lens practice’
(www.sclerals.com)
21 TMR, Holiday Inn City Centre, Birmingham,
‘Optical assistant/receptionist course one’
(info@tmr.co.uk)
22 TMR, Holiday Inn City Centre, Birmingham,
‘Optical assistant/receptionist course two’
SEE ABOVE

PRE-REGFOCUS
Sponsored by
Why a hospital placement
shouldn’t be overlooked
Newly qualified optometrist Nadeem Rob discusses his hospital pre-registration placement
24
28/01/11 PRE-REG FOCUS
A common myth is that you can’t accomplish
a hospital pre-reg placement unless you’re a
‘super optom’ or the model student, writes
Nadeem Rob (pictured). But I’m here to put all of
you current/future hospital pre-regs at ease.
The demands of hospital optometry are
different to the High Street and often involves
much more patient contact time. Just a simple
refraction with an NHS patient can take up
to an hour. Far more patience is required to
complete tests where you often have to explain
everything to the patient, even if their treatment
doesn’t always involve you. Ultimately, you are
just one piece of the puzzle in the NHS.
Hospital pre-reg timetables are often split
into general clinics. This is broken down into
refractions, contact lenses, low vision aid and
dispensing. However, this can vary from place
to place.
Refraction is what it is. During a hospital prereg
placement you may only be expected to do
diagnostic refractions on patients that require
or have already had treatment. Doctors might
just need to know what their best corrected
VA is. Additional tests can be done at your own
discretion, but remember optometry is only one
part of the treatment.
Your contact lens experiences will also be
slightly different to what you’d get on the High
Street as the majority of hospital patients require
RGP lenses rather than soft contact lenses.
However, the beauty about this is that you often
get to see the extreme and interesting cases. Be
careful not to forget soft contact lenses as you
become an expert of everything RGP though
because you will suffer for it in your assessments
if you do.
Low vision clinics are something you might
not come across much on the High Street.
In a nutshell, patients referred and treated
by the hospital may still have a low corrected
VA. Therefore they often need additional
help with magnifiers, telescopes and CCTV,
as well as general advice on lifestyle changes
and what help is available to them. Your aim
is to improve their daily activities, including
reading, cooking, shopping, etc. I have found
that it is one of the most rewarding parts of
hospital optometry, even though it is often
given a softer focus during university.
Dispensing can be the most testing part
of your hospital pre-reg unless you have a
specific dispensing department and it is often
the hardest thing to get through. Even though
you get to see a greater range of dispensing
episodes in a hospital, the College focuses
on the number of dispensing episodes you
complete over the period. With 250 as a
minimum requirement you can often face a
struggle to reach this, and as a result some
hospitals send their pre-regs out to multiples
to gain these numbers. I would also advise
that you have a weekly target to reach, but be
prepared to be flexible because you can never
predict what will come through the door on
your day of dispensing.
With so much ophthalmology around
you, the chance of seeing something unique is
endless. Let doctors know you are around for
when interesting cases come in and don’t feel
like you’re restricted to your timetable.
Inherently some things, like pathology, will
come naturally to you while routine testing
may not. You may have noticed that the
College Scheme of Registration is geared
towards the work of High Street pre-regs; this
is not of their fault, there are just far more High
Street candidates. An example which I can
relate to personally is completing a routine
test on a pre-presybopic patient in 45
minutes for an assessment. This may
sound simple to the majority of pre-reg
optometrists, but for hospital candidates
it’s not a daily activity. As a result, I would
suggest trying to arrange regular days out to
your local High Street practice if a scheme is
not already in place at the hospital you are
based. Also, practise on colleagues and on
other staff members. Even though a simple
refraction is enough for you to count as an
episode, keeping to the strict time limit and
compulsory tests for your assessments is
often difficult.
With the wealth of knowledge you
can submerse yourself within a hospital
environment, it is an opportunity you should
not take lightly, the satisfaction you gain is
second to none and it eventually provides you
with the finest foundations to become the
best optometrist you can be in the future.

BEST 50
50 Great
moments...
optometrytoday
To celebrate our half-century we are listing 50
great moments in our sector’s history from the
past 100 years or so.
25
Inventor’s mission: To help
a billion with poor sight
The ambition of the inventor of ‘Ad Specs’
Professor Josh Silver (pictured left) has
come a long way since coming up with
his idea in the mid-1980s. Then, 25 years
ago, he started to consider the way our
eye-brain adaptive optical system works,
and Professor Silver believed that self-refraction with suitable adaptive
lens eyeglasses could be a useful procedure, and potentially for
correcting refractive error.
After trying such a procedure on himself, he made several adaptive
lens eyeglasses (adaptive eyewear), and then carried out research
backed by the Department for International Development. This
revealed that self-refraction with adaptive eyewear was a useful
procedure for bringing vision correction to many of the world’s
population who need, but do not have, corrective eyewear. The
adjustable spectacles work by means of fluid-filled lenses that use the
incompressibility of liquids to change the physical shape of the lens.
The lens is constructed with two flexible membranes on the optical
surfaces, held in place by a solid surround.
The power of the lens is changed by pumping fluid into or out of the
central lens reservoir – less fluid causes the flexible membranes to bow
inwards due to the reduced internal pressure, and more fluid causes
the membranes to expand outwards. This causes the lens to change
refractive power, which makes it suitable for adjustable eyeglasses.
In 1996 Professor Silver formed Adaptive Eyecare to help develop the
invention, and in 2000 he won the Popular Science Best of What’s New
Award.
Professor Silver now directs the Centre for Vision in the Developing
World, and hopes to see a billion people having vision correction by
the year 2020.
What should we include in our 50 great moments
list? To suggest your choice, email David Challinor,
davidchallinor@optometry.co.uk
28/01/11 50 GREAT MOMENTS

GLOBAL
26
28/01/111 ANTARCTIC
Voyage to the
bottom of the world
Contact lens specialist Andrew Gasson reports from Antarctica
on optical pioneering, penguins, and extreme distance learning
DURING MY four-week journey on board
the Kapitan Khlebnikov, with my copies
of Optometry Today, we visited the
United States Antarctic bases at Palmer
Island and McMurdo; New Zealand’s
Scott Base; and Siple Island. The latter
is a remote spot on the Phantom Coast,
so called because it hadn’t even been
mapped until the 1960s. It is scarcely
ever possible to visit and then only by
means of an icebreaker.
Being some 8,000 miles from London
certainly gives a new meaning to the
concept of ‘distance learning’. Sending
the answers home in time would present
further difficulties since the nearest post
office is at Scott Base about 500 miles
west along the Ross Ice Shelf.
At the Palmer Research Station,
the ship was close to the British Port
Lockroy – established in 1944 – and a
little under 100 miles from Rugg Peak.
Look up these destinations yourselves,
but according to the Geographical Place
Names of Antarctica, this is located
at 66.19 S and 65.23 W, on the west
coast of Graham Land on the Antarctic
Peninsula.
It was named in 1959 for Andrew
Rugg-Gunn an English ophthalmologist
who “in 1934 brought together the
relevant data on radiation and protective
glasses to improve the design of snow
goggles.” Rugg-Gunn is also of particular
interest to the contact lens world as he
was one on the pioneers of glass scleral
lens fitting, using afocal Zeiss lenses in
the early 1930s.
He featured in the Contact Lens
Pioneers booklet published by the BCLA
in 2004. This previously unpublished
photograph (right) of him has only
recently come to light, courtesy of his
grandson. More details of Rugg-Gunn
can be found in Contact Lenses – the
Story by Tim Bowden and at www.
andrewgasson.co/pioneers/Rugg-Gunn.
Such a remote voyage also makes one
realise that optical problems are never
far away. The ship’s captain, himself,
was struck with Bell’s Palsy but was
still able to perform some amazing feats
of precision manoeuvring among the
Antarctic icebergs. His practical solution
to the problem was the use of ocular
lubricants and wearing dark glasses at
all times. This did not look unduly out
of place since at these high latitudes in
mid-summer the sun literally never sets
and there is daylight 24 hours a day.
Some passengers were using
scopolamine patches to ward off sea
27
sickness but
as a side effect
encountered
blurred vision
because of
transient
mydriasis and
cycloplegia. It
could have been
worse since
dizziness and
hallucination
might also have occurred. Motion
sickness medications all seem to require
some degree of caution since other
commonly available remedies such as
cinnarizine (Stugeron) and hyoscine
hydrobromide (Kwells) list similar side
effects and all are obviously contraindicated
where there is a risk of narrow
angle glaucoma.
Another participant’s varifocal
spectacles ended up with the right and
left lenses at an angle of approximately
45 degrees to each other which did
little to improve her binocular vision.
Her spare pair languished in her main
luggage which, by courtesy of Iberia,
never arrived in time for the voyage and
spent three or four weeks flying between
Madrid and South America.

One passenger required assistance
with insertion and removal of contact
lenses. She had recently been fitted in
South Africa and not yet mastered the
technique of lens handling. She was
therefore using lenses on an extended
wear basis with no guidance as to the
possible risks involved.
Another passenger confessed to
reusing daily disposables until they
began to irritate and compounded
her indiscretions by keeping them
overnight in saline without cleaning
and disinfection. It’s amazing what
patients will admit to when outside the
constraints of the consulting room.
Antarctica can be regarded as an ice
desert and continuing this informal
survey of contact lens wearers on
board predictably showed that silicone
hydrogels performed well in the
extremely dry conditions. There was one
long standing gas-permeable hard lens
wearer who needed to exercise caution
since there was a tendency for lenses to
fall out.
Fortunately there were no cases of
photokeratitis snow blindness amongst
the ice flows since most passengers
wore dark glasses to protect themselves
from the ultraviolet radiation. Contact
lenses which included a UV inhibitor
obviously offered an additional degree of
protection.
During my trip the vision of penguins
seems to have been the subject of some
debate as to how they can see both on
land and at sea.
Most authorities suggest that their
eyes are adapted to give best vision
under water in order to hunt for food
and to spot potential predators such
as leopard seals. Investigations in the
1980s of various species by means of
retinoscopy and photorefraction (Martin
and Young) suggested penguin corneas
are relatively flat with a refractive
power of about 29D which is neutralised
under water.
The major refractive component of the
penguin eye is the crystalline lens has
a power of about 100D and is thought
to have sufficient accommodation to
compensate for the loss of corneal
refractive power. In air render they
are therefore less myopic than would
otherwise be anticipated despite their
commonly observed peering posture
(Sivak, Howland and McGil-Harelstad).
Penguin pupils on land also constrict to
a diameter of about 1mm which would
improve depth of field. In a 1987 New
Scientist article Martin postulated a
mechanism for negative accommodation
by means of a very muscular
ciliary body to reduce the power
of the eye’s refractive system.
Binocular vision is also a problem
with some species since the beak
intrudes into the horizontal field
of vision and partly explains jerky
head movements.
Penguin retinas also show
further adaptation with an
absence of red receptors and a
preponderance of violet, blue
and green cone pigments to
allow better discrimination when
swimming at depth under water.
This particular trip was
organised by Quark Expeditions.
Mainly for environmental reasons,
there will be just one more season
in Antarctica for the Kapitan
Khlebnikov and fellow icebreakers
before they return to full time duties
in Russian waters. After 2011 it is
possible that some of the places visited
- amongst the most remote on the planet
and which cannot be reached except
by specialised vessel - may never be
revisited. Optometry Today is unlikely
ever to be seen this
far south again.
27
28/01/111 ANTARCTIC

PROFILE
20 Questions – Garrey Haase
Yorkshire-based optometrist Garrey Haase purchased Michael James Opticians six years ago with
his dispensing optician wife Karen. OT spoke with him for the latest in our Q&A series
How are you?
Good question, I think I am fine.
Lake District with the family and golfing to
Florida with my dad and brothers.
28
28/01/11 20 QUESTIONS
How is business generally right
now?
Business is okay but times are tough.
We constantly have to review things to
ensure we keep our heads above water.
Have you had any campaigns/
promotions that were
especially successful?
We have two annual events that bring us
closer to our community. The first is the
annual Santa drawing competition for all
school children in the region.
The second is our charity of the Year.
Since its inception in 2007 we have raised
over £4,000.
What do you like about
working in optics?
I love the diversity of the patients and the
fact that I can work with my wife.
What’s the best thing that’s
happened in the profession
during your time working in
the sector?
This is really hard to answer as I feel the
profession has struggled to maintain
the recognition it deserves since
deregulation. There have been many
good developments in optics over the
last 20 years but we are not good enough
about telling the public about them.
Who do you admire in the
sector in which you work?
There are four people. From an
educational point of view, Dr Alan
Tunnacliffe and Professor David Elliott, the
two best lecturers I had.
From a business point of view I found
that I learnt a huge amount from Neil
Brosgill and Mike Procter.
Where are your favourite places
in the world that optics has
taken you?
Storrs Hall, Windemere, in the Lake District.
I went there to marry my wife, who I met
through optics.
Are you superstitious?
Only in sport.
If you were granted one wish for
the profession what would you
wish for?
Recognition of the clinical side of the job.
Decent fees for the job that optometrists
do.
Do you have a favourite film
or TV show?
Love Actually, The Jazz Singer and Match of
the Day.
Outside of the profession, what
are your hobbies?
Golf, dinning out with Karen and friends,
and walking.
Sum up your feelings for the
next 12 months in five words.
Hard work but great opportunity.
Where do you go on holiday?
When we can get one, Center Parcs or the
What are your favourite
products in the optical sector?
Topcon 2000 OCT and my digital
phoropter.
If you weren’t in the profession
what would you be doing?
Golfing or spending my days with my wife
and the kids.
What’s your favourite singer or
musical group?
I am tone deaf – they all sound the same .
What do you put down your/
your company’s success to?
The great teamwork between Karen and
I. She is the ideas person and I am the
implementer. We also have a great team.
What’s your favourite season,
and time of year?
Winter, I love those cold clear crisp days.
Where would spend your
perfect day?
Augusta, Georgia on the Masters golf
course.
Any final thoughts?
As someone who left school with one ‘O’
level. I always tell people that with the right
determination and attitude as well as some
luck you can achieve what you want. Don’t
let knock-backs put you off.

OT CET Video
C-15345: Contact Lenses: Latest
Technologies and Current
Attitudes Amongst Children
In association with our sponsors CIBA Vision, OT Multimedia is
pleased to bring you two presentations from CIBA’s ‘Maintaining the
Edge’ and ‘Fit for Life’ Roadshows.
Beginning with footage filmed at the CIBA Vision ‘Maintaining the
Edge’ Roadshows, Dr Christine Purslow (Cardiff University) discusses
the latest developments in contact lenses, including approaches
taken to improve comfort and vision.
Section 2 continues with Dr Purslow considering toric and
multifocal lens designs, assessing of the risk of infection in CL
wearers and predicting future applications of contact lenses.
In the final section Professor David Thomson (City University)
provides an overview of the results of an investigation undertaken
study the attitudes of secondary school children to vision correction,
including their attitude towards correction with contact lenses.
You must be logged in to the website before you can watch this video and take the exam.
The video is one hour in length and is accompanied by 12 MCQs accredited with 2 free
contact lens CET points for optometrists, dispensing opticians and contact lens opticians.
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 submission
is February 28 2011.
SPONSORED BY
www.optometry.co.uk/cet

NEWS EXTRA
LOCs must ‘build an attack
plan’ to win enhanced services
LOCSU roadshow begins its tour to advise LOCs on achieving their goals in the ‘new NHS’
30
28/01/11 COMMISSIONING
DELEGATES FROM LOCs from London and the Home Counties were
given vital advice on negotiation skills and dealing with GP consortia
by industry and healthcare experts in the first LOCSU roadshow this
week. The roadshow will travel across England and Wales between now
and March. This week’s morning session, at the AOP offices in London,
featured specialist optometric adviser from
Primary Care Commissioning, John Hearnshaw
(left) who explained the current GOS contract
in depth and gave his opinion on how the new
commissioning process will work in the future.
Discussing the Government’s new White
Paper, he highlighted the parts most relevant to
optics: “A GP commissioning consortia will not
commission the other family health services [which includes primary
ophthalmic services] – these will be the responsibility of the NHS
commissioning board. However, the consortia will be able to commission
services from primary care contractors, for instance, if they wish to
commission optometrists to help manage glaucoma. “Presumably the
same would apply to all other enhanced care services.”
With this in mind, he told LOC representatives that now was the
ideal time to get enhanced optical services on the wider healthcare
agenda. Although he expects the Bill to take a year to go through the
parliamentary process, he believes the earlier that LOCs prepare for the
changes, the more likely they are to achieve their goals.
“Now is a good time to be seeking those new, enhanced optical
services. The new GP commissioning consortia may have open minds,
but empty wallets – that’s not necessarily a bad thing though, if we can
show them some savings,” he said. “Primary eye care will generally be
cheaper than hospital eye care. In 2011-12 the hospital tariff charge is
£112 for first attendance at ophthalmology outpatients plus £65 for a
follow up, the likely high street charge should be much cheaper, but is
up to you to negotiate. If you price yourself too low your members won’t
play ball, too high and you price yourself out of the market.”
Delegates were advised to build an ‘attack plan’ so that as soon as the
new GP consortia come into being, LOC representatives can be ready to
put forward a strong case.
Key to this, he added, was
that each LOC had to ask their
colleagues which enhanced
services they felt comfortable
providing and to prioritise
them accordingly, using
feedback from optometrists
and data on which services
would be in most demand
in their community, based
on demographics and the
current costs for treating these
patients in secondary care. “Some enhanced services should be treated
as your birthright,” he added.
Practitioners at the roadshow were given a list of treatments which
have been commissioned and are currently working somewhere in
England:
screening services into primary care
With the ‘battle plan’ in their minds, the
afternoon session saw LOC members taken
through negotiation techniques by Dr Mark
Davies (left), a consultant psychiatrist and
director of Res Consortium, which works with
GPs’ consultants and managers on business
development, focusing on commissioning and
healthcare strategy.
“All providers have to give evidence of QIPP – quality, innovation,
productivity and prevention,” said Dr Davies. “You need to pitch
yourselves as the eye care experts who can offer something new and
innovative while also providing a saving.
“The White Paper talks about a patient-centred NHS. What can you
offer to persuade commissioners that you offer a patient-centred
service? It is also very important to tell them what you can offer in terms
of outcomes. The more evidence of clinical success you can supply, the
stronger your case.”
The importance of preparation before entering into negotiations with
commissioners was shown to delegates with the help of actors (one
pictured performing, left) who illustrated scenarios where LOC pitches
to commissioners were going badly. Delegates were then invited to
direct the actor portraying the LOC Chair on how to improve their pitch.
Highlights of the evening session included FODO chief executive
David Hewlett discussing ‘setting the scene for the optical sector’ and an
update on LOCSU activity with its director of operations, Katrina Venerus.
Each roadshow will feature a local expert to discuss GP
commissioning in their area, at Monday’s London roadshow this
was Dr Naz Jivani from the Kingston GP consortium. Yesterday the
LOCSU roadshow visited Birmingham (January 27) and will address
delegates in Tunbridge Wells (January 31), Manchester (February 3),
Taunton (February 7), Winchester (February 10), Nottingham (February
14), Cambridge (February 17), Newcastle (February 28), Leeds (March
3), Cardiff (March 7) and finally Oswestry (March 10). To book, email
cameronmitchell@locsu.co.uk.

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VALUATIONS
32
28/01/11 MEMBER BENEFITS
How is the current downturn
affecting practice values?
Director of R A Valuations Mark Ridout looks at the current state of play in the sector’s business
property market, and details the essential things to do to increase a practice’s worth
OVERALL, optical practices have not
suffered the knocks that other small
businesses have. However, many have,
nonetheless, taken a significant hit on
their profits in the last two years.
Overheads have risen against static
sales levels as patients strive to save
money by extending intervals between
eye tests and shopping around for lower
dispensing charges.
The credit crunch is taking its toll
on practice ownership transfers too.
Bottlenecks are occurring as purchasing
parties struggle in their attempt to raise
finance after an internal or open market
deal has otherwise been successfully
agreed. Indeed, banks will continue to
request firm evidence of a achievable
return on any investment well after the
green shoots of recovery have genuinely
sprung.
As a result of this, common sense
suggests that if a practice is going on the
open market today, it will be restricted
by fewer potential purchasers in its
catchment area compared with a few
years ago.
An economic downturn inevitably
creates opportunities for the shrewd,
such as those seeking to buy up smaller
practices to form a multi-site business.
However, ambitious owners of single
site practices seeking to build a group of
networked practices should be mindful
that overheads incurred in running more
than one site can be disproportionately
high when compared to the enlarged
revenue.
Market value
Business valuation for professional
practices is a prerequisite for many
circumstances including partnership
or director change, practice sale or
purchase, incorporation, tax negotiations,
divorce settlements and so on. Arriving
at an accurate valuation is not easy; it
depends very much on the individual
business and the intended purpose of
the valuation.
A ‘market value’ is determined by
valuation professionals as the price a
practice should be able to justify and
achieve on the open market; reflecting
a justifiable return on investment (ROI),
and what a willing purchaser is likely
to pay and a willing vendor likely to
accept in the current market conditions.
Market value may or may not include
a margin for negotiation. A ‘fair
price’ also takes both ROI and market
value into consideration to derive a
pinpointed figure without a negotiating
margin. It is typically used for the
purposes of incorporation, internal
transfers, partnership or director
change, matrimonial and litigation, and
so on, ie, purposes where no one party
should perceive a gain over and above

the Goodwill from the value held within
the business.
Goodwill usually represents the bulk
of the business value. It is, therefore,
the most critical and influential figure
effecting a valuation figure. Goodwill
valuation is a function of the profit – or
surplus – left after taking account of all
legitimate trading expenses and making
appropriate adjustments necessary to
arrive at a ‘true’ trading value.
The days when an asking price was
arrived at using empirical means such
as a multiple of Annual Turnover (Sales)
are, thankfully, long since gone. It is rare
for two practices having the same level
of turnover to show identical levels of
profit and, therefore, Goodwill. The RA
Valuation Services database contains
many examples of this comparison.
Clearly, a practice having, say, £500,000
annual turnover and a surplus (or pre-tax
profit) of £100,000 is worth more than
another practice also showing £500,000
turnover but a surplus of only £50,000.
That said, a practice with little or
no surplus (or profit) may still have a
useful market value and could appeal
to a prospective owner not wanting the
hassle of setting up an organic – or green
field – business from scratch. There is,
however, no substitute in valuation for
a recent set of trading accounts showing
healthy profits.
Valuation process
Other criteria that can influence value,
and should be taken into consideration
in the valuation process, include
external factors, such as the economic
climate, the market conditions
within the business sector, location/
demographics/competition, regulation,
red tape and threat of litigation. Also
internal influences, turnover (sales
or income), gross profit (sales less
cost of sales), trading trends, practice
presentation, premises and permanence
of location, and potential.
Whilst it requires complete
independence, expertise, experience and
industry knowledge to value a particular
business, it is the business owners who,
knowingly or not, exercise the greatest
influence on Goodwill by the way they
run their business. If they do it right,
they could be enhancing their retirement
plans. If they get it wrong, they could be
Mark Ridout
“There is no substitute for a recent set of
trading accounts showing healthy profits”
in for a prolonged struggle to realise the
full potential value of their business.
When thinking of how to increase
your practice’s value during a
downturn, there are steps that can be
taken to maintain, or even increase, the
potential value of your practice.
Firstly, exit strategy. All business
owners should have in mind an exit
strategy. This may simply be a ‘wish
list’ reflecting the owners’ desires, or it
could comprise part of a detailed formal
business plan. Either way, an exit
strategy should, ideally, be planned at
least three years ahead if a satisfactory
valuation and successful sale or transfer
are to be achieved. If you feel you
haven’t got the experience or the time
to develop a plan, hire a consultant or
someone who can help you.
In addition you must prepare your
business for sale. There are many things
to do, most of them simple, if you are
planning to put your practice on the
open market. For example, you must
ensure that the physical appearance
is up to scratch. As with selling a
house, so called ‘kerb appeal’ is vitally
important. When a homeowner wants to
sell their house, they may paint it and
fix up a couple of things that needed
to have been done during the last few
years. First impressions count and can
be the difference between a successful
or unsuccessful sale.
Last but not least profits – and profit
growth – are the most important.
Clearly, financial performance - and
growing trading profit in particular
– must validate that the practice is
performing well. As an example of
the dramatic effect of profit growth
on business value, in a recent oneyear
update valuation of a business
undertaken by R A for a client one
year after the original valuation, sales
had increased over the last year by an
insignificant 5% but purchases were
maintained at the same level and
overheads cut by 5%. The resultant
goodwill was valued at over 40% higher
than the previous year solely as a result
of these changes.
Keep purchases of supplies at sensible
and pragmatic levels, and a close eye
on all overheads, effectively manage
budgeting and cash flow, and be realistic
about the value of your practice. Don’t
underestimate it, but do be realistic.
Remember that the bank will want to
see that the potential buyer can pay
back the loan. Ultimately, it all comes
down to profit. Get all of the above
right and the financial figures will
speak for themselves.
MEMBERSHIP OFFER
In celebration of its long association with
the AOP, R A Valuations has agreed to
offer members a 10% discount for the
provision of a business valuation – this
is in addition to the normal membership
discount, and additionally gives a
considerable reduction against
its fees to non-members. The offer runs
until February 28 2011.
33
28/01/11 MEMBER BENEFITS

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. Successful completion will result in two CET points. VRICS
regularly appears in Optometry Today.
Anterior Eye & Contact Lens Assessment
COURSE CODE: C-15341 O/D/CL
Dr Shehzad Naroo BSc (Hons)
MSc PhD MCOptom FIACLE
FAAO FBCLA
34
1. Which of the following statements about the technique shown
in Image A is FALSE?
a) The observation and illumination should be decoupled
b) Illumination should be placed at the limbus
c) The angle between observation and illumination should be about 45°
d) Magnification should be set at 16-25x
28/01/11 VRICS
A
2. For which of the following can the technique shown in Image
A be used to assess?
a) The location of a corneal foreign body
b) The depth of a corneal foreign body
c) Corneal thickness
d) The presence of corneal staining
3. Which of the following statements about the instrument
shown in Image B is FALSE?
a) It has a cold light source
b) It allows quantitative assessment of tear break-up time (TBUT) over the
whole cornea
c) It allows measurement of corneal curvature
d) It allows qualitative assessment of the lipid layer of the tear film
B
C
4. Which of the following filters CANNOT be used with the
instrument shown in Image B?
a) Blue filter for sodium fluorescein assessment of the tear film
b) Placido disc filter for assessment of corneal shape
c) A filter for assessment of tear osmolarity
d) Grid filter for measurement of non-invasive tear break-up time (NIBUT)
5. Which of the following statements regarding the instrument
shown in Image C is FALSE?
a) It is a one-position keratometer
b) It is a two-position keratometer
c) It can be used to measure tear break-up time (TBUT)
d) It can be used to measure irregular astigmatism
6. When looking through the eye piece of the instrument shown
in Image C, what is indicated by the appearance shown in the far
right panel of Image C?
a) There is mild keratoconus present
b) The subject is not fixating steadily
c) There is corneal warpage present
d) There is regular astigmatism of over 1.50D

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.
2 FREE CET POINTS
Approved for Optometrists Approved for DOs Approved for CLPs
About the author
Dr Shehzad Naroo is senior lecturer at Aston University where his teaching
responsibilities include contact lenses, anterior eye and therapeutics. He is
global vice-president of the International Association of Contact Lens Educators
(IACLE), and editor-in-chief for the journal, Contact Lens & Anterior Eye.
Associated reading:
The Contact Lens Manual: A practical guide to fitting
(fourth edition) by Andrew Gasson and Judith A. Morris.
Eye essentials: Rigid Gas-Permeable Lens Fitting by Ngaire
Franklin, Elsevier Health Sciences, 2006
Corneal Topography by Amar Agarwal, Elizabeth A. (FRW)
Davis, Anshan, 2009
Contact Lens Practice by Nathan Efron, Butterworth-
Heinemann, March 2010
7. Which of the following statements regarding the output
shown in Image D is FALSE?
a) Steep points are represented by hotter colours eg, red
b) Flat points are represented by cooler colours eg, blue
c) Bow tie shapes indicate irregular astigmatism
d) Nipple shapes indicate an area of steepening
35
D
8. Which of the following statements about the technique
used to obtain Image D is TRUE?
a) A diameter of 2-3mm is measured with 5-20 data points captured
b) A diameter of 5-6mm is measured with 50-200 data points captured
c) A diameter of 9-10mm is measured with 500-2000 data points captured
d) A diameter of 9-10mm is measured with 5000-20000 data points
captured
9. Based on the readings shown in Image E, how much corneal
astigmatism is present in the right eye?
a) 0.25DC
b) 0.75DC
c) 1.50DC
d) 3.00DC
28/01/11 VRICS
E
F
10. Based on the readings shown in Image E, what would be
the most appropriate back optic zone radius (BOZR) of an RGP
contact lens to select initially for this eye?
a) 7.70
b) 7.75
c) 7.85
d) 7.95
11. Which of the following parameters can be evaluated using
the instrument shown in Image F?
a) Back optic zone radius (BOZR) and lens thickness
b) Back optic zone radius (BOZR) and back optic zone diameter (BOZD)
c) Back optic zone radius (BOZR) and back vertex power (BVP)
d) Back optic zone diameter (BOZD) and lens thickness
12. If a reading of 0.15mm is obtained using the instrument
shown in Image F, which of the following is this likely to
represent?
a) Centre thickness of an RGP contact lens
b) Peripheral thickness of an RGP contact lens
c) Back optic zone radius of an RGP contact lens
d) Back optic zone diameter of an RGP contact lens

COMPETITION
Win with OT’s Mystery Year
competition – Week two
36
28/01/11 MYSTERY YEAR
As part of our 50th anniversary celebrations, we are
giving one lucky reader £500 worth of shopping vouchers
for the store or website of their choice.
In each issue before Optrafair we will print an
advertisement from an archive copy of OT and all you
have to do to get an entry in our prize draw, is to tell
us which year the image was first printed. Last issue’s
answer was 1965, congratulations to all those who got
that correct, you each get an entry into the big Optrafair
draw.
The second Mystery Year image is pictured below, the
first two paragraphs read: ‘One Style Fits All? It’s just a
harmless 3D movie, but it looks like something straight
out George Orwell. He had a grim version of mass society
with standard clothing and universal inhumanity. That
vision didn’t come true, and we couldn’t be happier.
We stand for a society of individuals who dress, adorn
themselves, fit in, or stand out as their own desires
dictate.’ Followed by an advertisement for Optyl’s ranges.
To enter simply guess the Mystery Year and send the
answer, along with your contact details to: Mystery Year
(January 28), Optometry Today, 61 Southwark Street,
London, SE1 0HL.
For full terms and conditions or to enter online, see
www.optometry.co.uk
Looking back
optometrytoday
Since our first issue readers have been writing in to give
their opinions on all things optics. Throughout the year
we’ll be sharing some of the best letters we’ve received
over the years. This week, we look back to 1963 and 1964.
Contact lens fitting by dispensers
Sir – My local AOP committee has raised with the
AOP secretary the question of the position of dispensing
opticians indulging in sight testing techniques when fitting
contact lenses from a prescription.
It is a matter of fact that the final prescription for contact
lenses, as ultimately handed over may be very different from
the prescription as originally presented. The considerable
modification necessary is brought about by the result of
refractive assessment, mostly subjective, at various stages of
contact lens fitting. There is no doubt that, in my opinion,
in doing this dispensing opticians are testing sight. This is
contrary to the Opticians Act and no enabling formula can
get away from this.
The definition of sight testing in the Act is reasonably
clear and cannot be interpreted in any other way than the
restriction of sight testing to medical men and ophthalmic
opticians.
R G Stephens, Birmingham (October 19 1963)
The fee for the job
Sir – I am wholly at a loss to understand the reluctance on
the part of the appropriate ministry to grant ophthalmic
opticians the very much over-due increase in fees, in view of
the fact that a wage increase appears to have been awarded to
every Tom, Dick and Harry in the country, in many instances
by the same ministry. The last straw is the proposed increase
for MPs. The main point put forward against making this
much overdue award to opticians appears to be that no one
knows how much opticians earn. Have the same objectors
any idea whatsoever how much MPs earn.
R.N.Birt, Cowes (January 11 1964)
A January rhyme about fees
Bung ho to the optical jester,
Who being an accomplished tester,
At seventy still does the job,
For a miserable sixteen bob.
Robert S. Green, Birmingham (January 11 1964)
For more letters from the era, visit www.optometry.co.uk

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Visual features of
Parkinson’s disease
AGEING VISION PART 2
Visual neurology and
Parkinson’s disease
A number of studies have shown
deficits in magno-, parvo-, and koniocellular
pathways in patients with PD.
Sartucci 5 suggests that the konio-cellular
subpopulation of retinal ganglion cells
(RGC) may be particularly vulnerable in
early stages of PD whilst Silva 4 suggests
that sensory deficits within the visual
domain have been associated with
independent damage to both magno- and
parvo-cellular pathways. People with PD
may demonstrate thinning of RGC axons,
reminiscent of ocular neurodegenerative
diseases such as glaucoma. 6,7 Indeed,
Armstrong 8 suggests that PD is associated
with a range of visual signs and symptoms,
including defects in visual acuity (VA),
colour vision, the blink reflex, pupil
reactivity, saccadic and smooth pursuit
movements and visual evoked potentials.
Scigliano 9 has also identified
compromise of the central and
peripheral autonomic nervous systems
in idiopathic Parkinson’s disease (IPD)
COURSE CODE: C-15421 O
Geoff Shayler BSc FCOptom, FCSO
Ageing causes general loss of visual function. This article investigates the visual
problems that are associated with Parkinson’s disease (PD). A later article in
this series will consider a number of tests that can be used to identify which
patients have these visual processing difficulties, as well as to identify those
with the potential to be helped with appropriate optometric vision therapy.
One of the main factors identified in some patients with PD is a
contraction of the functional visual field. 1,2,3 This causes problems with
balance, posture, and stability, as well as reading, concentration and
attention. 4 Based on neurological models of vision, it has been postulated
that these problems occur as a result of both damage and (stressrelated)
dysfunction of the magno-, parvo-, and konio-cellular pathways.
resulting in reduced sympathetic and
parasympathetic function. Pursiainen 10
indicated that long-term parasympathetic
cardiovascular regulation is impaired
in untreated patients with PD, which is
more pronounced at night. 10 Indeed, this
supports the reported damage that occurs
to the dorsal stream of visual processing
in PD (see part 1 of this series) (Figure 1).
What causes Parkinson's
disease?
PD is characterised by loss of nerve cells
in the substantia nigra. 11 These cells are
responsible for producing a chemical
known as dopamine, which allows
messages to be sent to the parts of the
brain that co-ordinate movement. With
the depletion of dopamine-producing
cells, these parts of the brain are unable to
function normally. When about 80% of the
dopamine has been lost, the symptoms of
PD appear and the level of dopamine will
continue to fall slowly over many years.
The cause of the loss of dopamine in
people with PD is currently unknown.
Figure 1
Dorsal/ventral stream processing. Reproduced
with kind permission from Prof Dutton, Glasgow
Caledonian University
Most researchers believe that many factors
play a role and areas of research include
genetics and environmental factors.
Indeed, scientists have, to date, identified
nine genes linked to PD, of which the
“parkin” gene 12 is most commonly
associated with the familial form of PD.
Abnormalities in this gene are particularly
prevalent with young-onset PD.
Relationship between Dopamine and
Melatonin
Melatonin 13 is a hormone primarily
produced by the pineal gland 14 at night,
and influences circadian 15 and seasonal
rhythms, 16,17 most notably the sleep–wake
cycle and seasonal reproduction. The
pineal gland and the retina synthesise
melatonin in the absence of light, but light
does not inhibit melatonin synthesis in
other tissues. When light enters the retina,
a signal is sent from the intrinsically
photosensitive RGC 18 through the optic
nerve via the retinohypothalamic tract to
the suprachiasmatic nucleus within the
hypothalamus, situated directly above
the optic chiasm (Figure 2). Exposure
to sunlight suppresses melatonin
production. Melatonin release in turn
inhibits the release of dopamine 19,20
in specific areas of the mammalian
central nervous system (hypothalamus,
37
28/01/11 CET

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38
28/01/11 CET
Figure 2
Pathways taken by melatonin to the brain (see text for details). Blue line represents the retinohypothalamic
tract. Light blue line represents the pupillary light reflex pathway. SCN = suprachiasmatic nucleus; OPN =
olivary pretectal nucleus; EW = Edinger-Westphal nucleus. Reproduced with kind permission from http://
flipper.diff.org/app/items/info/2474.
hippocampus, medulla-pons, and retina).
It is possible that this in turn plays a
role in the cause of PD since inhibition
of dopamine will have consequences on
bodily movements. However, whereas
melatonin may exacerbate symptoms
in PD, it’s antioxidant nature may
protect against neurodegeneration
by virtue of its antioxidant effects on
mitochondrial activity. 21 Of importance
is that the relationship between
dopamine and melatonin may help
to explain features of PD and open
doors for possible treatment options.
Posture in Parkinson’s disease
Parkinsonian gait (Figure 3) is characterised
by a distinctive unsteady walk, stooped
posture, slowness to start walking, short
shuffling steps and a tendency to run with
reduced arm swing. 22 This develops over
time as a result of bradykinesia (slowness
of movement), loss of postural reflexes, and
rigidity (increased tone). 23 A forward head
and/or head down posture results from a
reduction of normal cervical and lumbar
curvature of the spine, which results in
loss of vital lung capacity by as much as
30%. 24 Arm swing is diminished or absent
and people with PD tend to take small
shuffling steps (called festination). 25 While
freezing of gait is typically considered
a motor impairment of PD, the fact that
it occurs more frequently in confined
spaces suggests that perception of space
might contribute to this condition. 26
The importance of posture in PD
is made evident by the possibility
that there is reduced input of light to
the inferior retina (Figure 4), which
may lead to an increase in melatonin
production; therefore a downward head
posture could lead to a reduction of
dopamine and perhaps progression of PD.
Visual problems in Parkinson’s
disease
VA and Eye Movements
Blurred vision or difficulty in focusing may
be due to problems with eye movements
27.28
or due to the side effects of drug
therapy, especially anti-cholinergics. 29 This
problem may occur on starting
treatment but can normally
improve over time. Diplopia
usually occurs in PD due to
problems in moving the eyes
in alignment from side to side,
such as when reading. This may
occur as a result of impaired
coordination and fatigue of the
muscles moving the eyeballs
or a form of hallucination. 30
Difficulty in moving the eyes
may manifest in two ways: (i)
difficulty in starting a movement
of the eyes or (ii) problems with
moving the eyes quickly when
following a fast moving object.
Instead of moving smoothly, the eyes move
in a slow and jerky way. For this reason,
driving a vehicle may pose difficulties. 30,31
Excessive tearing of the eyes and/or dry eye
symptoms may also be associated with PD,
most likely due to reduced blinking of the
eyes. 32 Idiopathic blepharospasm may be a
sign of the eventual development of PD. 33
Bálint's syndrome, is a disjointed
psychic paralysis of gaze with haphazard
scanning, found in patients with bilateral
damage to the posterior parietal cortex. It
is characterized by optic ataxia (lack of coordination
of hand and eye movement),
oculomotor apraxia (the inability to
voluntarily guide eye movements/change
to a new location of visual fixation),
and simultanagnosia (the inability to
perceive more than one object at a time,
even when in the same place). It may
also occur or be misdiagnosed in PD. 34
Contrast & Colour
People with PD may experience difficulty
with seeing in dim light, or perceiving
lightly coloured objects against a light
background, or with reading very fine
print. It is thought that this is due to
dysfunction of dopamine receptors within
the retina. 35 Colour vision may be affected
due to damage to the optic nerve and

RGC axons, which can cause particular
program, researchers have demonstrated
problems with differentiating between
deficiencies of static form and motion
slight colour differences, especially for
coherence processing in Alzheimers’s
shades of blue or blue-green. 35,36 The
disease (AD) 44 and the present author has
medication levodopa (L-DOPA) has been
identified a similar situation in people
shown to improve colour vision in PD. 37
with PD. In particular, motion processing
Spatial Localisation
Problems with visuo-spatial orientation
or depth perception could be the reason
why a person with PD may have difficulty
in assessing the distance between objects;
is adversely affected to a greater extent
than static processing, but these results are
limited by the numbers of patients seen in
a 'normal' High Street optometric practice;
further controlled studies of this nature
are required to investigate this possibility.
39
many people with PD may need to reach
out to touch a wall or objects around
them whilst walking. This in turn is
very likely to create problems with
driving too. 38 Indeed, some people with
PD cannot judge the speed of moving
objects, which may be dangerous if
driving or trying to cross the street. 38
Hallucinations, illusions and/or visual
misinterpretations are more likely to occur
in those people who have had PD for a long
time. 39 It may be due to the disease itself,
associated with Charles Bonnet syndrome 40
or due to anti-Parkinson drugs. 41
Useful Field of View test (UFoV)
An individual’s useful field of view (UFoV)
is the area over which information can be
extracted from a rapidly presented display.
The size of ones UFoV is affected by the
amount of clutter in the visual display,
Figure 3
Posture and gait in Parkinson’s disease.
up to five years in some individuals)
and robust in that almost all individuals
with normal age-related cognitive
slowing show a benefit from training.
While speed of processing training
has been applied to a number of subpopulations
(eg, stroke, closed head
injury, PD and Alzheimer’s disease),
Glaucoma, visual field and falls
Individuals affected by glaucoma are
over three times more likely to have
been involved in falls 45 and motor
vehicle accidents 46,47 than persons of
the same age without the condition. In
addition, the prevalence of glaucoma
in people with PD may be increased. 48
Because both PD and glaucoma affect
the same nerve processes, patients
with both conditions are more likely
to have faster progression of visual
loss, and therefore need more frequent
screening/monitoring. Furthermore,
according to the Parkinson’s Disease
Society in the UK, certain medications
such as benztropine, amantadine and
L-DOPA can cause problems in patients
with open-angle glaucoma, and should
therefore be used with caution. 49
28/01/11 CET
foveal task demands, the distance of
critical information from the fovea, and the
length of time the display is available. The
UFoV test 42 is a computer-based program
that captures the effects of these variables
on the size of an individual’s UFoV over
a series of three subtests, which are then
combined to yield an overall measure of
this research is very preliminary and
the benefits for these populations,
if any, is not well understood. 43
Static form and motion coherence
processing
Static form visual processing is undertaken
primarily by the central parvo-cellular
Corneal damage and cataract
New research has indicated that
some antidepressant SSRI (selective
serotonin reuptake inhibitor) drugs
used to treat patients with PD both
increase the risk of cataract development
and cause corneal changes. 50
the UFoV. Performance on the UFoV is
highly related to automobile crash risk.
Recent research has also demonstrated
ventral processing stream, whilst motion
processing is performed primarily by the
magno-cellular dorsal stream. Though
Treatment of visual problems
in Parkinson’s disease
that the size of the UFoV can be increased
there is a lot of interaction between the
Blurred vision is usually treated by
with training (speed of processing
two systems, static form and motion
refractive correction and perhaps
training). This training benefit has been
processing are carried out in separate
modification of anti-cholinergic
shown to be relatively enduring (lasting
areas of the brain. Using a computer-based
medication doses through co-

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management with a patient’s
GP. Diplopia improves with
anti-Parkinson medication
and by resting the eyes, but
prismatic or temporary Fresnel
lenses can be prescribed until
symptoms stabilise. Dry eye
symptoms can be managed by
advising the use of artificial
tear supplements and a
recommendation to avoid
dry, hot and smoky places.
More complex visual
symptoms will need to be
managed by control of the
underlying PD. Appropriate
referral to a patient’s GP
will be required to improve
difficulty with eye movements
through anti-Parkinson drugs.
Indeed, contrast and colour
vision can be enhanced by
treatment with L-DOPA
and other anti-Parkinson
medicines. Hallucinations
and other visual disturbances,
however, will require the
use of neuroleptics such
as clozapine and quetapine.
Light therapy
Light therapy has been used for many
years to treat depression and seasonal
affective disorder (SAD) but has also been
used to treat human motor problems.
Light, when it reaches certain levels
of intensity, can inhibit production of
melatonin, which in turn can increase
production of dopamine. When production
of melatonin can be inhibited, there should
be a consequent increase in the production
and use of dopamine in the brain.
A number of studies have shown that
light therapy can be beneficial in PD. 51
Although bright light therapy (BLT), as
used in typical SAD lamps, suppresses
melatonin release and is an established
treatment for depression and sleep
disturbances, it has only recently been
Figure 4
Exposure of the retina to sunlight in primary gaze eg, straight posture (top of
Figure) and in down gaze eg, forward posture with head-down tilt in Parkinson’s
disease (bottom of Figure)
evaluated in PD. Examination of the effects
of BLT on motor symptoms, depression,
and sleep in PD in a randomised placebocontrolled
double-blind study found
significant improvement of tremor
and depression in the active treatment
group but not in the placebo group. 52
Another study of people with PD exposed
to white fluorescent light with an intensity of
1,000 to 1,500 lux once daily for two weeks
commencing one hour before bedtime,
demonstrated marked improvement in
bradykinesia and rigidity in most patients.
The authors also claim that elevated mood,
improved sleep, decreased seborrhoea,
reduced impotence, and increased appetite
were observed after light therapy. 53
Low-level green light technology as used
in Sunnex Biotechnologies Lo-LIGHT lamps
peaking near 500nm has been shown to be
as effective as BLT, 54 with this wavelength
being the most effective for
suppressing melatonin. 55
Conclusion
This article has highlighted the
possible causes of PD and the
consequences that this disease
has on visual function. There is
evidence that people with PD are
at risk of co-morbidity such as
glaucoma, and visual problems
that may lead to a greater risk
of falls. Indeed, individuals
with PD are likely to suffer
problems with their functional
visual field, and therefore it
is important to detect such
changes as early as possible, in
order to instigate appropriate
therapy. Neural damage in
the disease cannot be treated,
but deficient neural function,
which is associated with
stress, can be and could lead to
improvement in quality of life
and/or extending the period
before PD symptoms negatively
affect a person’s lifestyle.
About the author
Geoff Shayler qualified as an optometrist
from City University in 1973. He is in
private practice in Dorset. His special
interests involve developing and utilising
new assessment and therapy techniques for
conditions that are affected by dysfunction
or damage to the neural pathways,
such as Streff syndrome, strabismus,
mild traumatic brain injury, stroke,
Alzheimer’s and Parkinson’s diseases.
References
See http://www.optometry.co.uk
clinical/index. Click on the article
title and then download "references"
For the module questions to this
article, please turn to page 45.

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Sight saver, life changer:
Part of a day’s work for an
eye care practitioner
COURSE CODE: C-15475 O/D/CL
41
Dr Cameron Hudson BSc (Hons) PhD MCOptom
Many practitioners at some point will have been asked the question ‘What
does being an eye care practitioner involve?’ Because of the multidisciplinary
nature of the role, the day-to-day role of an eye care practitioner (ECP) can be
difficult to describe, especially in lay terms. It’s fair to say however that most of
us would provide an answer that includes ‘detecting various eye disorders’ and
‘measuring and correcting common visual disorders/refractive errors’. If indeed
this is the case, how can we measure the impact of our work and the benefits
patients gain from our services? What can we do to improve these benefits
for our patients? This article looks at how these questions might be answered.
The role of an eye care practitioner is
rewarded by the piece of mind that
comes from knowing we are helping to
prevent blindness and visual disability
amongst those who seek our expertise.
Many ECPs are fortunate enough to be
able to contribute to ‘sight saving’ on a
greater level, for example, by working
overseas as part of charity projects or
working in secondary or tertiary care
hospital optometry clinics to name
but a few. And, for the vast majority
of primary ECPs, the opportunity to
‘save’ a patient’s sight (for example, by
appropriately dealing with a medical
or emergency condition) is one of the
most rewarding and fulfilling aspects
of the role. However, for the vast
majority of practitioners, opportunities
to ‘save sight’ are a relatively infrequent
occurrence when considering the
proportion of patients who make use
of primary eye care services on an
annual basis. In relative terms therefore,
correcting refractive error with the
aid of spectacles or contact lenses
contributes significantly more to what
the vast majority of practitioners do
within their professional environment.
If correcting peoples vision is, to the
largest extent, ‘what we do’ as ECPs,
is it possible to quantify the impact of
our work and if so, how? How much
fulfilment should we be able to take
from this and are there ways to help
patients benefit from and value our
ability to manage refractive error? To
answer these questions it is worth
looking at the measures typically
used to quantify patient ‘satisfaction’
and/or ‘quality of life’ (QoL).
Measuring ‘satisfaction’ and
quality of life
Traditionally, the measurement and
correction of refractive error has been
characterised by clinical measures
such as visual acuity (VA) or contrast
sensitivity (CS). Whilst these measures
provide vital information regarding
a patient’s vision, they provide little
indication of the impact we are
making on the person as a whole.
To obtain a more complete sense
of what a patient feels, it is more
appropriate to assess their satisfaction
with their vision and/or their QoL.
There is no single method of
refractive correction that is appropriate
or appealing to all patients. However,
some patients and practitioners may
restrict their correction options based
on such factors as previous experience,
current knowledge/understanding of a
given correction method, and ease of
provision. However, understanding the
relative impact of different methods
of refractive correction on QoL is
beneficial for ECPs for several reasons:
positively influence their contribution
to a patient’s QoL
communicate more effectively and
quantify their patients relative QoL
gain 1
consistently fulfil their patients
expectations
which patients stand to gain the most
from a given method of refractive
correction 2
‘bespoke’ eye care
and loyalty. 3
What is ‘quality of life’?
In health terms, QoL encompasses
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(PREP). 9 Typically, respondents are
required to answer each question in
the form of a subjective rating, for
example on a scale between 1 and 5.
This allows the patient greater scope to
express their preferences and opinions;
42
28/01/11 CET
the physical, functional, social and
emotional well-being of an individual.
QoL is an important metric used
routinely in many areas of healthcare
and especially in oncology and chronic
illness where QoL information is used as
a prognostic indicator and aids decisionmaking.
Information about QoL provides
vital detail about a particular course of
action or decision, which is based on
more than clinical opinion alone. There
are over 150,000 published papers that
investigate QoL with 1,700 relating
to vision. As highlighted by Lesley
Fallowfield, Professor of Psychology,
Brighton and Sussex Medical School,
“the challenge remains to encourage more
clinicians to use them [QoL information]
outside of a clinical trial setting.” 4
QoL related to methods of
refractive correction
The QoL contribution made by different
forms of refractive correction has
received growing attention since
methods to measure vision specific-QoL
(VS-QoL) were first described about ten
years ago. Since then researchers have
developed more robust methods and the
standard approach is through the use
of questionnaires (or ‘instruments’). 5,6
Several instruments have shown
promise in accurately measuring VS-
QoL with respect to the different
methods of refractive correction,
including spectacles, hard and soft
contact lenses and refractive surgery 7,8
and also within specific groups, for
example paediatric contact lens wearers 9
and contact lens wearers with abnormal
ocular conditions such as keratoconus. 10
VS-QoL instruments include the
Refractive Status and Vision Profile
(RSVP), 11 National Eye Institute
Visual Function Questionnaire (NEI-
VFQ), 12 the Quality of Life Impact of
Refractive Correction (QIRC) 8 and
the Paediatric Refractive Error Profile
closed questions (ie, ‘yes’ or ‘no’ type
questions) are purposely avoided. By
applying an analysis algorithm such
as Rasch Analysis, investigators are
then able to generate a VS-QoL ‘score’,
which relates to a measure of that
specific method of refractive correction.
Several investigators have compared
VS-QoL scores between different
methods of refractive correction. 8,9
Using the QIRC instrument, Pesudovs
et al. 8 compared the VS-QoL scores
for spectacle wearers, contact lenses
wearers, and individuals who had
undergone refractive surgery. Their
findings indicate significantly better
QoL outcomes for individuals who had
undergone refractive surgery (Mean
score of 50.2±6.3 logits) than those
who wore contact lenses (Mean score
of 46.7±5.5 logits), who in turn were
significantly higher than spectacle
wearers (Mean score of 44.1±5.9 logits);
scores were especially higher in those
people with high refractive error. The
authors suggest that the enhanced
QoL that comes through ‘spectacle
freedom/reduced dependence on
spectacles’ occurs due to factors
including less difficulty with driving
in glare conditions, being able to use
non-prescription sunglasses, greater
convenience during exercise, and being
more confident in their appearance. 8
Spectacle wearers only achieved a
higher QoL score than both contact lens
wearers and refractive surgery patients in
one area, that being ‘concern for medical
complications’. 8 Interestingly the
authors point out that a small proportion
of individuals who had undergone
refractive surgery (6.7%) exhibited

significantly reduced QoL outcomes, as
a result of post-operative complications. 8
In a separate study, Rah et al. 9 utilised
the PREP instrument to assess the benefits
to wearing spectacles versus wearing
contact lenses amongst children under
the age of 12 years. 9 During the three-year
investigation, the study group observed
a significantly greater improvement in
mean QoL score in children who wore
contact lenses (increase of 14.2±18.1
units) compared to children wearing
spectacles only (increase of 2.1±14.6
units) (P

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and opportunities, which in the broadest
terms, contribute to QoL. Indeed, it has
been shown that whilst non-surgical
refractive corrections provide ‘good/
very good health and safety’, refractive
surgery (LASIK) was stated as the
preferred method of refractive correction
under hypothetical conditions where
all methods of refractive correction
had equal health and safety, visual
clarity, doctor recommendation
and cost. 2 This highlights the
understandable desire amongst
ametropes to have ‘normal vision’.
The way in which refractive correction
methods and their associated QoL benefits
are communicated/recommended
to patients has a large influence on
whether or not the recommendation
is (a) acted upon, and (b) understood.
If information provided to patients is
difficult to comprehend it may fail to
achieve the desired change in knowledge
or behaviour. 15 If the information is
understood by the patient but the
practitioner fails to explain the relevance
of the information to the patient,
then the same outcome may occur.
Shared decision making, between
patient and practitioner, appeals to a
patient’s ‘need’ for information regarding
their health and wellbeing 16 and is
commonplace in the medical profession.
Whilst shared decision making is the
gold standard approach, patients also
seek to place the responsibility for
decision making with the practitioner. 17
These findings emphasise the need for
optical practitioners to provide clear,
unambiguous information about the
refractive correction options available
to a patient and also to provide clear
avocation for the most appropriate or
relevant option/s. In combination with
the desire to ‘know’ and ‘understand’,
patients also have a desire to feel
‘known’ and ‘understood’. Making
recommendations that are relevant
to information gathered throughout
the consultation process helps
patients to feel that their ‘needs’
have been acknowledged and acted
upon. The choice of language used
by an ECP is extremely important
in demonstrating this to patients.
As an example, it may seem
appropriate to ask patients who are
suitable for contact lenses the question
“have you ever considered contact
lenses?” or “would you like to try contact
lenses?” There are several limitations
to these (or similar) questions: (a) they
do not demonstrate the practitioner’s
understanding of a patients specific
visual requirements (b) they portray no
sense of shared decision making, and (c)
they provide no information regarding
what contact lens wear involves. Thus
the specific language used whilst
communicating a recommendation is
very important. A possible alternative
recommendation may be: “There are
several simple ways to correct your
vision which could provide you with
advantages over spectacles, especially
whilst ... [eg, playing golf]. On a scale
of 1 to 10 how desirable is being able
to see clearly without your spectacles?”
The same ‘principle’ can be applied
to any recommendation made by an
optical practitioner to a patient. The
decision whether or not to accept
the recommendation still remains
with the patient; the support of the
practitioner towards a particular option
is strengthened and the patient gains
an understanding of the ECP’s raison
d’être for presenting the opportunity.
Conclusion and implications
It is important for optical practitioners
to understand the contribution
of different methods of refractive
correction to an individual’s QoL. In
order to measure the significance/
impact of the contribution, Optical
practitioners must employ a reliable
method of measuring QoL both within
a single visit (cross-sectional) and
between visits (longitudinal). Whilst
robust VS-QoL instruments have
been developed for use in research,
appropriately constructed lifestyle
questionnaires may provide ECPs with
a useful surrogate measurement of QoL
in a primary eye care setting. Attitudes
towards refractive corrections appear to
change with time 2 and are influenced
by a range of factors. Therefore,
ECPs need to be aware of how to best
communicate the benefits and risks of
refractive corrections to patients, in
order to facilitate the correct selection
and to maximise satisfaction and QoL.
About the author
Dr Cameron Hudson is the professional
services manager for CIBAVision, UK
References
See http://www.optometry.co.uk/
clinical/index. Click on the article title
and then download “references”

Module questions
PLEASE NOTE There is only one correct answer. All CET is now FREE. Enter online. Please complete online by midnight
on February 25 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 this exam will be uploaded to Vantage on March 7 2011.
Course code: C-15421 O
1. Visual deficits in Parkinson’s disease are caused by neural damage in
which of the following?
2. Which of the following visual problems is NOT associated with
Parkinson’s disease?
3. Symptoms of Parkinson’s disease become apparent when dopamine
producing cells within the substantia nigra have been reduced by
what extent?
4. Which of the following statements about melatonin and dopamine is
FALSE?
5. Bálint’s syndrome is NOT associated with which of the following?
Course code: C-15475 O/D/CL
1. Which of the following does NOT contribute to an individual’s
health-specific quality of life (QoL)?
2. Which of the following can be used as a surrogate measurement of
VS-QoL in a primary eye care setting?
3. What is the difference in increase of VS-QoL score for children who
wear contact lenses compared to those who wear spectacles only?
4. Which of the following best describes the questions/answers
typically used in ‘quality of life’ questionnaires?
5. Which of the following best describes the benefit of understanding
how different methods of refractive correction affect QoL?
45
28/01/11 CET
6. Which of the following is NOT a reason why driving can be a
dangerous occupation for patients with Parkinson’s disease?
6.Using the QIRC instrument which of the following VS-QoL scores
was achieved by spectacle wearers?

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Positive Impact is a unique vision-care sales and training company. Our Consultants
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These are unique opportunities to join an entrepreneurial and dynamic team in a
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Day in the diary of Rubinder Panesar
NAME: Rubinder Panesar
LOCATION: Yorkshire Region
QUALIFICATIONS: BSc (Hons) MCOptom, DIP H.E. Ophthalmic Dispensing
START DATE: 2009
How do you start your day?
We have a team meeting to discuss what our
aims are for that day. after the meeting
i review the records of patients that are
coming in, researching their previous
prescription and lifestyle notes. this helps me
to assess if there is an opportunity to improve
their visual outcome. the rest of my day is
filled with patient appointments.
What does your role involve?
mainly eye examinations, fitting glasses and
contact lenses and advising people on the
range of eye care solutions available to them.
i also work with specialist laser optometrists
to inform patients about the refractive choices
we offer; laser eye surgery and intraocular
lenses (iOLs). additionally, i carry out
pre-screening tests on patients undergoing
refractive consultations.
What do you find most challenging
about your role?
at Optical Express we strive to provide a
world class experience for every patient and
this is something the team and i take very
seriously. i want to deliver the best service
possible. Like any business, we have targets
to meet so i always know what the team
numbers are and try to think of innovative
ways to improve them.
What do you enjoy most about
your job?
Working with the public, as no two people
are the same. to be a good optometrist your
patients have to trust the advice you give
them and i enjoy working hard at developing
positive relationships with my patients.
How would your colleagues describe
the way you work?
i have quite a loud personality so in a team
i am often the leader. We have a great team
here; everyone respects each other and the
way in which we work as individuals and as
a group. Respect is fundamental to a strong
team. i guess my colleagues would comment
on my eccentric personality and ability to
lead well.
What motivates you in your job?
delivering the best care to my patients on
a daily basis. it’s hugely rewarding to know
that every day i’m helping people to see
more clearly. i feel very proud when patients
tell me how much their lives have been
improved by the service we’ve delivered.
What do you think differentiates
Optical Express from other optical
providers?
apart from delivering the best service and
being a great company to work for there’s a
whole range of career opportunities available
at Optical Express. as an Optical Express
optometrist i am exposed to refractive
solutions along with glasses and contact
lenses. We have international centres, so
Optical Express employees who want to travel
and live abroad can do so and stay with the
company.
What advice would you give
someone considering a career
in optometry?
go for it. if you’re willing to work hard, have
a desire to help people and you enjoy interacting
with colleagues and patients then
you’ll enjoy optometry.
What qualities should you possess to
be an optometrist/DO/CLO?
People skills are essential as you are working
with the general public every day and as
part of a team. Patience is important when
advising elderly patients or young children.
How important do you feel it is to
provide and receive support from
your colleagues?
it’s vital to my work, without each other
we couldn’t deliver the best service to the
patient.
What’s Your Story?
Each of the roles carried out in store is
important. Serving a customer is like a chain,
if someone breaks the chain it makes
everyone’s jobs much more difficult and
not as enjoyable. But it is not only when
serving customers that the team works
together. in the recent bad weather, when
travelling distances to work was difficult,
my colleague insisted that i stayed in her
house instead of a hotel. Kindness like that is
invaluable in a team and it really brightens
your day.
Are you involved in any additional
training courses as part of your role?
i’ve attended accredited CEt courses and
training workshops provided by Optical
Express, all of which i’ve enjoyed.
What is your biggest career goal?
Becoming a fully qualified optometrist was a
huge goal for me. now that i have done that
i think it will be to volunteer for a vision
charity and to keep working my way up the
career ladder at Optical Express.
Describe one career highlight to date
Previously i worked in a large clinic with
multiple optometrists but i’ve since moved
to a smaller clinic where i’m the only
resident optometrist. i enjoy the greater
responsibility i now have for our patients
and achieving targets.
How do you see your career
progressing with Optical Express?
With an ever expanding company like
Optical Express the sky’s the limit! i’m happy
here and i like my team so i plan to remain
here for a long time and develop my career.
opticalexpress.com

Reach the top with
Optical Express
At Optical Express, our unique approach
to optical and refractive solutions offers a
challenging and structured career pathway for
our optometrists. Through continuous training
and development, Optical Express optometrists
are given the opportunity to advance their clinical
skill level and broaden their knowledge. Whether
you are committed to clinical excellence, training
and education and/or commercial optometry, we
offer an opportunity, which will satisfy all of
your career requirements.
As a provider of the complete range of refractive
solutions; glasses, contact lenses, laser eye
surgery and intraocular lenses, Optical Express
optometrists are uniquely positioned to meet the
needs of each and every patient.
We have exciting career opportunities for
optometrists across the UK. Current vacancies
include: Edinburgh (IOL position), Hull, Inverness,
Leeds, Portsmouth, Plymouth, Taunton and York.
We are a global organisation and unique in
our approach, offering a competitive
salary and benefits based on location
and experience.
For the first step on your new journey,
and a full list of our vacancies please visit
www.opticalexpress.com/careers
or contact Ed Sweeting on 07917 350293
or email edwardsweeting@opticalexpress.com
opticalexpress.com
UnitEd KingdOm | CROatia | FRanCE | gERmany | HOLLand | iRELand

“I made a
difference to her life.”
Sarah has worked for The Outside Clinic for 2
years, the feeling of pride she gets from delivering
a much needed service makes this her ideal job.
We need more people like Sarah
Ready for a change? Give us a call today.
For the latest optometrist
vacancies please visit
www.outsideclinic.com/vacancies.html
Contact Jim Gilbert for more details:
tel: 01793 648607
email: jim@outsideclinic.com

MARKETPLACE
To place an advertisement call
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& Advice on ...
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Informed MARKETPLACE
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020 7878 2313 or email haley.willmott@tenalps.com
Computer systems
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If you would like
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To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
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advert .indd 1 10/09/2010 16:17
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28/01/11 MARKETPLACE
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PRACTICE FOR SALE
WIBSEY, BRADFORD
WITH FREEHOLD
EST 1968
VILLAGE HIGH STREET
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MARKETPLACE
To place an advertisement call
020 7878 2313 or email haley.willmott@tenalps.com
Practice fitting
54
28/01/11 MARKETPLACE
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The BIG FIT
Change patients’ lives and grow your practice
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February 8th Manchester
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Lecturers include:
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Topics include:
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© CIBA VISION (UK) Ltd, a Novartis company, 2011. The BIG FIT logo, CIBA VISION and the CIBA VISION logo are trademarks of Novartis AG. The eycon figure is a registered
design mark of Novartis AG. *Up to 8 CET points for Optometrists and Contact Lens Practicioners – includes points from distance learning.