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10 November 2017 Volume 254 Number 6627 WEEKLY opticianonline.net
CAREER-LONG SUPPORT FOR OPTICAL PROFESSIONALS LENSES AND DISPENSING
COMING TO A
SCREEN NEAR YOU
Saturday 14th April 2018
w w w. o p t i c i a n a w a r d s . c o m
#opticianawards
Kindly sponsored by:
The natural comfort
your patients deserve.
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the pH balance of tears.*
With the pH level of tears,* Hy-Care™
is the multipurpose solution that’s gentle
on your patients’ eyes. And because
it contains Hyaluronan – a naturally
occurring lubricant found in the eye**–
your patients will enjoy naturally
comfortable vision.
www.coopervision.co.uk
* Abelson, M.D., Udell, I.J. and Weston, J.H. Normal human tear pH
by direct measurement. Arch. Opthalmol. 1981. Feb;99(2):301.
** Goa, K.L. and Benfield, P. Hyaluronic acid. Drugs. 1994.
47(3)536-566.
EDITOR’S COMMENT
Seeing through the season of mists
Autumn’s mists and mellow fruitfulness were were treated to a fascinating selection of talks on topics as
immortalised by Keats but as this week’s In diverse as the macula, migraine and mood. Blue light and sleep;
Focus reveals the season’s maturing sun takes its colour overlays and visual stress and Digital Eye Syndrome are
toll on wellbeing and can be a tough time for the all areas which have become a rich seam of interest for optics.
eyes. The explosion in the use of screens, smartphones and tablets
The onset of shorter, darker days would have been familiar to has created new areas of interest for optometrists and ophthal-
Keats’ contemporaries but today there are a whole host of new mologists and opened the door to a raft of new optical products.
visual challenges. Halloween brings on the familiar problems The role of blue light in the quality and duration of sleep is a par-
with cosmetic contact lenses, Guy Fawkes Night was until ticular area of interest as the colossal social and financial cost of
recently a grim night for the emergency services, on the roads sleep deprivation becomes apparent.
the clocks going back bring a host of problems not least the All of the above are issues which will be affecting your patients
scourge of High Intensity Discharge headlamps. and all issues which you, as optical professionals, can offer help
This week’s In Focus looks at Seasonal Affective Disorder just with.
one of a range of health issues increasingly being linked to What better way of enticing patients in on a dark November
vision. The interest in how visual stimuli affect the brain has afternoon than a cup of coffee and an autumn eye check.
gathered new impetus and was the theme running through
Norville’s Medi-Lens meeting in Gloucester last week. Delegates
CONTENTS Editor
NEWS CLINICAL
4 7 days 17 Comment
All the news from the past week Visual skews
6 In Focus 18 CET: Compliance in practice
Seasonal disorder Enhancing patient experience through
improved CL compliance
OPINION 26 CET: Stereopsis
8 Letters and Events Best assessment methods
Having your say and what’s coming up 32 Aftercarelessness
12 Yuniku launch The perils risked if aftercare is missed
PRACTICE or delayed
9 Showcase
Latest frames and fashions CLASSIFIED
10 Look local 37 Recruitment
Eye care in Colchester 39 Services
LENSES AND DISPENSING ...AND FINALLY
12 Yuniku launch 43 Puzzles, photos and personalities. Win
Hoya’s 3D system fully realised an Optician multi-use snood
14 Looking at labs
Sinclair Optical moves with the times
14 Looking at labs
Editorial enquiries Optician is the weekly, paid-for information source for optometrists, dispensing
020 7501 6745 opticians and the optical industry. For 125 years Optician has been the
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opticianonline.net 10 November 2017 OPTICIAN 3
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EDITORIAL 020 7501 6745
Editor and publisher
Chris Bennett 020 7501 6660
chris.bennett@markallengroup.com
Deputy editor
7 DAYS
To read the full stories and keep
Joe Ayling 020 7501 6665
joe.ayling@markallengroup.com
Senior reporter
up to date on the latest news
Simon Jones 020 7501 6667
simon.jones@markallengroup.com
Reporter
and views visit opticianonline.net
Luke Haynes 020 7501 6231
luke.haynes@markallengroup.com
Clinical editor
Bill Harvey 020 7501 6663
william.harvey@markallengroup.com
Features & education editor
Mike Hale 020 7501 6670 OO struck off after sexual guidance said.
mike.hale@markallengroup.com
Web editor
assaults Professor Mark Baker, director of
Melanie Leather 020 7501 6664 the centre for guidelines at NICE,
melanie.leather@markallengroup.com Middlesex optometrist Harj Sethi said: ‘Approximately 1.8 million
Production editor
Gary O’Connell 020 7501 6706 has been erased from GOC regis- people in the UK have an inner eye
gary.o’connell@markallengroup.com ters after he was convicted in 2016 pressure of 22 or 23mmHg. That
Art editor of two charges of sexual assault in puts a huge demand on secondary
Sara Challinor 020 7501 6666
sara.challinor@markallengroup.com the consulting room. care eye services for patients who
Journal assistant The panel heard transcripts of don’t need immediate treatment.
Hannah Driscoll 020 7501 6745 the judge’s summing up from Having a clear referral and treat-
hannah.driscoll@markallengroup.com
ADVERTISING & SPONSORSHIP Sethi’s trial at Reading Crown ment pathway to identify patients
Sales manager Court in August last year. with ocular hypertension and sus- Jonathan Lawson
Darren Ward 020 7501 6668 The first complainant was aged pected COAG ensures patients are
darren.ward@markallengroup.com
Display sales executive 17 at the time of the assault in 2014. assessed and treated in the most safety’ policy.
Joseph Lever 020 3874 5001 Sethi was said to have touched her appropriate setting. MPs including Barry Sheerman,
joseph.lever@markallengroup.com thigh, hip and lower back repeat- ‘Increasing the treatment thresh- Andy McDonald, Jack Dromey and
RECRUITMENT & CLASSIFIED
020 7501 6686
edly during a 15-minute eye old will not only lead to fewer Roads Minister Jesse Norman have
Key account executive Daniel Doherty examination. The second woman, patients being referred unnecessar- all had discussions with the multi-
Sales executive a young mother, attended with her ily but it should reduce costs ple, which highlighted research
Joseph Lever 020 7501 6708 child. During the consultation, without compromising patient that showed 30% of UK drivers
jospeh.lever@markallengroup.com
Managing director Anthony Kerr Sethi touched her breast without safety.’ were overdue an eye test and 4%
Group production manager permission and pulled back and admitting to never having had one.
Jon Redmayne 020 7501 6724
jon.redmayne@markallengroup.com then looked down the woman’s jog- Multiple lobbies MPs on ‘The current Highways England
Production director Richard Hamshere ging bottoms. strategic plan for road safety is
Chief executive officer Ben Allen Sethi was given concurrent four
short-sighted road safety overlooking the fact eye health is
Chairman Mark Allen
EDITORIAL ADVISORY BOARD month sentences for each offence, Vision Express has lobbied MPs an issue,’ said Vision Express CEO
Will Ayliffe PhD FRCS FRCOphth DO; suspended for 18 months. He was ahead of Road Safety Week Jonathan Lawson. ‘We are encour-
Sally Bates FBDO; Dr Frank Eperjesi PhD also placed on the Sex Offenders (November 20-26) to raise aware- aged by parliamentarians’ interest
BSc MCOptom FAAO; Professor Bernard
Gilmartin PhD FCOptom FAAO; Graham Register for 10 years. ness of vision problems being a in this issue and plan to continue
Hutchison MBA; Professor Mo Jalie SMSA In making the decision, the com- major contributor to traffic acci- raising awareness to get our mes-
FBDO FCGI MIMgt; Dr Lyndon Jones mittee, chaired by Eileen Carr, dents and what the multiple sage across about the importance
PhD FCOptom DCLP DOrth FAAO; Geoff
Roberson BSc FCOptom; Dr Steve Taylor said: ‘Any lesser sanction than eras- described as ‘short-sighted road of regular eye tests for drivers.’
PhD MSc FCOptom; Graeme Young MPhil ure would not meet the needs of
FCOptom DCLP FAAO
public protection and would serve
Dispensing optician Ian Squir
SUBSCRIPTIONS 0800 137201
Subscribe or renew 01722 716997 to undermine the trust and confi-
subscriptions@markallengroup.com dence in which the public hold the
BACK ISSUES 01722 716997 profession.’
REPRINTS 020 7501 6790 ISSN Surrey dispensing optician Ian Squire, pictured, has been killed
0030.3968
Glaucoma referral in Nigeria after being taken hostage three weeks ago.
It is understood that Squire and fellow Christian charity
threshold increased workers David and Shirley Donovan and Alanna Carson, a
Fewer people will need to be Specsavers optometrist based in Fife, were working as
referred for further specialist inves- missionaries when they were abducted from their
tigation and possible treatment for accommodation in the southern Delta state in the early hours of
www.markallengroup.com glaucoma following updated guid- October 13.
Optician is published every Friday ance by NICE. Squire had previously visited Nigeria three times to carry out
© 2017 MA Healthcare Ltd
St Judes Church, NICE recommended a higher work for his self-founded charity, Mission for Vision, which
Dulwich Road, London SE24 0PB. inner eye pressure threshold of makes annual eye care trips to remote regions of Africa.
Telephone 020 7738 5454 24mmHg to prompt referral and A statement released by the UK Foreign Office said: ‘We are
Website: www.opticianonline.net
treatment, up from 21mmHg supporting the families of four British people who were
ISSN 0030.3968 previously. abducted on October 13 in Nigeria, one of whom was tragically
Printed in Britain by Pensord Press, Patients with an inner eye pres- killed.
Tram Road, Pontllanfraith, Gwent, NP12 2YA
sure below 24mmHg should ‘This has clearly been a traumatic time for all concerned, and
continue regular visits to their pri- our staff will continue to do all we can to support the families.’
mary ECP for further detection, its
4 OPTICIAN 10 November 2017 opticianonline.net
Twitter @opticianonline
NEWS IN BRIEF
Investment firm eyes ‘This collaboration illustrates VIEW FROM
premium brand growth
ABDO
that Carrefour intends to expand
its number of customer services
German investment firm Premium and that Atol wants to reach a com-
Equity Partners (PEP) has acquired plementary customer base,’ a joint Having just read the latest edition
majority shares in eyewear manu- statement said. of Optician (November 3, 2017) I
facturer ic! berlin for an was glad to see pictures of sup-
undisclosed sum. CCG plans Avastin AMD port staff and technicians being
Ralph Anderl, who was the sole awarded their diplomas and
owner of the company, will now
treatment choice Phoenix Building, University of Bradford prizes by the newly installed
take up a position on a newly-cre- A clinical commissioning group Master of the Worshipful
ated advisory board. Chairman of (CCG) has set out to save money by Bradford students move Company of Spectacle Makers,
the new board is Wolfgang treating AMD patients with bevaci- across campus Felicity Harding. As a WCSM
Rebstock, former CEO of zumab (Avastin), which it said is Liveryman I am pleased to see so
Eschenbach Optik. Jorg Reinhold cheaper and as effective. Optometry students at the many people achieve recognition
has been named the new CEO. Dr David Hambleton, chief University of Bradford have moved for the hard work that goes in to
‘With PEP I was able to success- officer of the South Tyneside CCG, into a new ‘Digital Health studying for and achieving these
fully initiate the succession for my has told the British Medical Journal Enterprise Zone’ at the campus. qualifications.
company,’ said Anderl. ‘Together commissioners in the area agreed The university’s department of We are now firmly in the optical
we will continue along ic! berlin’s to use a cheaper AMD treatment, Optometry and Vision Science and ‘awards season’. I am fortunate
unapologetic path. I am happy that despite potential legal disputes. university eye clinic have been to be invited to the College of
we were able to inspire our new co- He said 12 CCGs in the region placed in the same building as part Optometrists Diploma Ceremony
owners with our plans for the had agreed to offer the thousands of the move. Pharmacy, physiother- next week to see the many newly
future.’ of wet AMD patients the choice of apy and health promotion were qualified optometrists get
The company employs around bevacizumab as a preferred treat- also housed within the Phoenix ‘capped’ and those achieving
190 staff in Berlin and across ment. The drug is used to treat Building, following investment higher qualifications. Of course,
Europe, Asia and North America. cancer but not licensed for macular from the university, City of our own ABDO Graduation and
degeneration in this Bradford council and private Prize Giving Ceremony takes
Carrefour enters optical country. companies. place at Canterbury Cathedral
Dr Hambleton said bevacizumab Professor Edward Mallen, head later this month. It will be my priv-
sector was as clinically effective and safe of the School of Optometry and ilege to confer graduation to new
French supermarket Carrefour has as the more expensive but com- Vision Science at Bradford, said: dispensing opticians with a cere-
launched its own optician and monly used ranibizumab ‘The students have the start of the monial handshake and
hearing care network in partner- (Lucentis). He said this ‘has been journey and the end of it right here congratulate those who have
ship with cooperative optical chain shown comprehensively’. He esti- in one space.’ achieved further qualifications.
Atol. mated the policy could save the Undergraduates had been based I think what we witness at these
The new concept, Carrefour region’s NHS up to £13.5m a year at the university’s Richmond build- ceremonies bodes well for the
Optique et Audition, was hoped to over the next five years, which ing, while the eye clinic has moved future as we seek to deliver ever
launch early next year, with both would fund 270 nurses or 266 across from the Forster building. expanding services to our
stores and a digital presence. heart transplants every year. patients and with the speed of
Independents must technological change that is no
mean feat. Regardless of our role
n Squire killed in Nigeria invest in technology
Around 20% of independent prac-
tices do not offer advanced eye
in optical practice, the public are
surely better served by clinicians,
registrants, technicians and sup-
examinations to patients, accord- port staff that are well trained and
ing to Myers la Roche. deliver excellent service.
The study, which examined the The roles in optics of tomorrow
level of equipment and services are yet to be defined, however,
provided by independent practices, one thing is a certainty – we will
found that 18% of independent need well trained, passionate
practices did not provide either individuals to deliver services to
fundus photography or OCT scans. the public, most likely with the
The study also found that 29% of help of technology. So as we look
practices surveyed upgrade less forward to what the future brings,
than a fifth of their patients to the I for one am very glad to be work-
advanced test, with Myers la Roche ing within a vibrant sector of well
recommending a target of at least trained individuals who work in
one third. teams across the country to look
Myers la Roche warned that after the eye care needs of the
independent practices who failed whole nation.
to invest in new technologies Fiona Anderson, president, ABDO
risked being left behind multiples.
opticianonline.net 10 November 2017 OPTICIAN 5
NEWS facebook.com/opticianonline
IN FOCUS
It’s a sad SAD situation
but therapies can help
Seasonal affective disorder (SAD), also known as ‘winter
depression’, has returned to the public consciousness as
many leave work after dark. Joe Ayling reports
D
arker evenings,
colder weather
and plans for
Christmas will be
high on the list of
small talk topics for patients and
practitioners this November.
Another more chilling
conversation point might also be
seasonal affective disorder (SAD),
an unwelcome side effect of getting
less natural sunlight also referred
to as the ‘winter blues’.
SAD has moved further into the
public consciousness, with
recognised therapies now
including light therapy. Products
flooding the market have included
SAD table lamps, alarm clocks and
futuristic glasses. In addition to Luminette light therapy glasses
light therapy, lens tints have also
been suggested to help patients computer, phone and tablet based as well as traditional tube bulb sales channels.
suffering from SAD. entertainment we spend more lights that were proven to be Delloye said: ‘I would say the
According to SAD.org, only 10% time than ever indoors and miss medical devices. opticians is a natural shop for light
of the UK population now works out on the light cues our body However, the organisation said directed glasses and we have
outdoors, down from a figure needs,’ the organisation said. while dawn simulators treated received quite a lot of requests from
closer to three-quarters two Melatonin is one hormone some of the symptoms of SAD, they opticians to use our glasses.’
centuries ago. In addition, it noted closely linked with SAD, and could not be classed as a medically Having witnessed the light
that working days were getting thought to be an underlying driver proven SAD light. therapy market for more than a
longer and resulting in ‘a dramatic for the circadian rhythms that Belgian company Luminette has decade, Delloye did not believe
increase in light deficiency govern our metabolic processes. It produced SAD light therapy glasses there were more cases of SAD that
symptoms’ for some patients who is found in higher serum since 2005, with strongest sales in needed treatment – pointing out
struggle to maintain their circadian concentrations during the hours of France, Belgium, US, Netherlands that hours of darkness remained a
rhythms and subsequent mood. darkness but lower concentrations and Switzerland. constant.
‘In the distant past humans lived during daylight hours. Luminette managing director ‘SAD is not getting bigger but
in the outdoors and were exposed Eric Delloye told Optician there was what has increased is the interest in
to sufficient levels of sunlight the SEEING THE LIGHT stronger awareness of SAD among light therapy and the awareness of
whole year round even in the A range of light therapy and optical the UK public than in most other consumers about SAD, especially
northern and southern tints have been designed to tackle European markets. However, the in the UK,’ he said.
hemispheres. However, nowadays light deficiency. company had only seen moderate Meanwhile, in markets with
our lives are mainly carried out Indeed, SAD.org has provided a success in the UK and mainly extreme hours of winter darkness,
indoors due to work pressures, list of white light and blue light through digital channels such as such a Scandinavia, he had seen no
busy lifestyles and changes in social products that can be used to Amazon. In France and Belgium extra demand for light therapy.
behaviours. With the advent of effectively replicate sunshine. This Luminette also used pharmacy ‘Naturally you would think these
television and now the growth in included the use of LED Lightboxes and optical practices as effective populations would be affected
6 OPTICIAN 10 November 2017 opticianonline.net
Twitter @opticianonline NEWS
VIEW FROM
Research has come to light
‘I cannot overestimate the importance of light with regard to vision.
Older readers will remember well having to pass an exam on
BCLA
lighting and lighting design in the old professional qualifying We have recently all been turning
exams. It is sad that this no longer is a requirement, when many of our clocks back, signalling the
our patients benefit greatly from good advice regarding lighting start of the British winter. The
and light protection. nights draw in and we all have to
‘Recent research has emphasised the significance of specific drive home in the dark but it is
wavelength visible light in stimulating the light responsive ganglion just an hour. In the grand scheme
cells which help to regulate melatonin production and thus the of things, not much changes.
metabolic clock. Turn the clocks back 10 years
‘Health issues linked to artificial lighting, non-diurnal shift work though and the world would be a
patterns and excess pre-sleep light exposure have been confirmed now by good solid research. Eye very different place.
care practitioners need to be up to speed in this area as they should be the professionals best In optometry, dry eye disease
placed to offer appropriate advice regarding light influences.’ (DED) was barely acknowledged
Bill Harvey, Optician clinical editor a decade ago. It has seen a huge
rise in prominence across the
world ever since, with clinical care
more but from my experience they guidance on seeing depressed that those people who were short- for those affected now provided
do not seem to respond how you patients. In its guidance College sighted had over three times more by professionals from a multi-
would expect.’ members were advised to only melatonin in their system than disciplinary background
He said the Luminette glasses work within the limits of their those who were not. including pharmacists, GPs,
were more practical than professional competence. The objective was to determine optometrists, opticians and
stationary lamps that require users The guidance said: ‘If you whether disrupted sleep patterns ophthalmologists.
to remain in the same place for half observe a sign or symptom which in childhood were related to short- Awareness has never been
an hour at a time. ‘If this therapy is you cannot manage within your sightedness and whether greater, and the advent of the new
not convenient and demands too competence, you must refer behavioural interventions and TFOS DEWSII definition and
much you will simply quit the patients to an appropriate sleep pattern management could classification, published in July,
therapy. But you can carry out your practitioner who is registered with serve as a low-cost strategy to gives guidance on how to help
daily routine with Luminette a statutory regulator. managing the condition. Findings individuals affected by DED.
glasses on.’ ‘In the case of depression, that follow on from previous research Understanding the
Delloye also pointed out that by would typically be a person’s GP conducted by the university that pathophysiology of the disease
using glasses for light therapy, the and those affected by depression found there were now twice as provides us with an evidence-
distance between the light source should be referred to a relevant many post-primary school-aged based definition and
and the face was always fixed – a expert for help.’ children in the UK diagnosed as contemporary classification.
more difficult task using the light The College does not offer short-sighted than there were 60 The diagnostic and
source. specific guidance on seasonal years ago. management guidelines of DEWS
Boosting natural sunlight by affective disorder (SAD) and said Professor Saunders said at the II indicate specialist ophthalmic
heading for the outdoors was evidence on light therapy as time: ‘If, as we suspect, disruptions equipment is required to
recognised by healthcare providers preventive treatment for patients to the natural body clock are shown diagnose and manage DED yet
as the most practical measure of all, with a history of SAD was limited. to be influential in the hospitals do not have the
while yellow tinted lenses have also Indeed, the market for light development of short-sight, capacity and primary care is not
been marketed for the disorder. therapy treatment in the UK still modifications to lifestyle that funded to provide this service.
lags behind other countries. target strengthening healthy sleep There are also considerable
KNOWING YOUR ROLE Nonetheless, the lifestyle and activity patterns could differences in the UK for referral
Many practitioners will be aware benefits of exposure to natural light positively affect both general and and management pathways.
that SAD is also referred to as and the outdoors go beyond SAD. eye health. It is imperative the profession
‘winter depression’, and the College The emergence of a ‘myopia ‘Ulster University’s previous works together to optimise
of Optometrists has issued epidemic’ has increasingly called research has already shown that patient quality of life. We are
on children to spend more time children who spend less time delighted to be hosting a debate
outdoors and less time glaring at outdoors and less time in sporting at our forthcoming Visionaries
computer screens. activities are at increased risk of event, chaired by Professor Tefi
Furthermore, in August a team short-sight, and this new research James, on managing DED within
of scientists from Ulster University may go some way to explaining the community.
established a link between myopia why that is the case.’ We fundamentally hope this
and melatonin levels. A group of Therefore, as the link between will be the starting point for a new,
young adults were assessed over a vision, time outdoors and related joined-up way of dealing with a
period of 18 months, during which health conditions deepens, growing problem. As more people
their melatonin levels were researchers are casting new light become aware of DED we have to
measured first thing in the on the impact of modern be best-placed to deal with it.
Eric Delloye morning after fasting. It was found lifestyles.•
opticianonline.net 10 November 2017 OPTICIAN 7
PRACTICE OPINION LETTERS Buyer beware of full consideration. Conjunctival rupture resulting from However, this will require the unsupervised sale of Halloween approval of our statutory body and contact lenses – a case history. also our professional bodies. An 18-year-old male patient of It should be pointed out to the ours telephoned to report he had powers that be that the use of the experienced bleeding of his left title Doctor by optometrists in eye, pictured, after trying to Canada, a member country of the remove Halloween contact lenses. British Commonwealth, is socially He does not wear spectacles or very well established. contact lenses and had bought We should also be aware that the the lenses from a retail store in first examinations for our Bath which sells a variety of profession in the UK were cosmetic and beauty products conducted by the BOA in 1896. including fashion/cosmetic At that time optometry as a contact lenses. profession did not even exist in At presentation his left eye rupture the bulbar conjunctiva in contact lens sales. many countries. The title ‘Doctor’ is exhibited a temporal his efforts to remove the lens. He Michael Killpartrick, Bath now already in use by optometrists subconjunctival haemorrhage, and described mild discomfort which in several of those countries. on upward gaze a contusion in the was reducing and on this basis he British optometry must move inferior temporal bulbar was prescribed an unpreserved Doctor title forward. conjunctiva was revealed. ocular lubricant to reduce the With reference to the privilege for Professor Rishi Agarwal, director of Fortunately his vision was discomfort and told to report back the use of the title Doctor by British postgraduate education, Institute of unaffected and there was no if the symptoms worsened. optometrists, the aspirations of the Optometry, London. corneal involvement. As he had This case illustrates a typical Mandel brothers (Joshua and Visiting professor, Faculty of Health reported bleeding from the eye it example of ocular complication Michael) and those of like minded and Social Care, London South Bank would appear he had managed to arising from unsupervised optometrists in the UK are worthy University EVENTS & EDUCATION TOPCON UNIVERSITY THE SCOTTISH OPTICAL day events at specially OPTICOMMERCE NATIONAL OCT CONFERENCE selected venues and will MARKETING WORKSHOPS CONFERENCE WHEN November 26 provide our members and VIP WHEN November WHERE Hilton London Paddington WHERE Radisson Blu Glasgow guests with even more WHERE Various WHEN November 19 and 20 Costing £49 for 15 GOC CET opportunities to network and OptiCommerce has partnered The programme of skills and points, the Autumn conference build strong professional with Google for a series of discussion workshops, lectures will be delivered by key opinion connections.’ workshops on how to build a and peer review will be leaders. Workshop programme: successful online presence. announced later in the year for Speakers include Bill Harvey, The company said most of the Topcon’s National OCT Teifi James, Gunter Loffler and • Scotland & North East – November practices it speaks to struggle Conference. contact lens guru Nick Howard. 25, 11am-4.30pm ‘6 essential with increasing traffic to their At last year’s event, which scloss.org.uk steps to more clients’ Business & websites as well as creating a followed on from the inaugural Marketing Workshop, Radisson ‘buzz’ around their marketing. conference in 2015, Topcon SIGHT CARE REGIONAL Blu Hotel ‘The internet is constantly increased its attendance to WORKSHOP SERIES changing and if you are not nearly 300 delegates. CET points WHEN November-January • Bristol & South West – December changing and adapting with it, were on offer through a range of WHERE Various 4, 10am-4pm SightCare CET your practice will be left behind,’ lectures, skills and discussion Independent support group Sight Business Workshop with lens said Paul Clare, co-founder of workshops and, peer Care has set a programme for its production tour, Essilor, Thornbury OptiCommerce. discussions. The conference national workshops. Workshops will be held at catered for practitioners with all Sight Care chief executive • South – January 15, 10am-4pm venues in Glasgow, London, levels of OCT knowledge, from John French said: ‘The new SightCare CET Business Workshop Coventry, Manchester and Leeds. beginners through to expert programme will include a mix of with factory tour, Coopervision, opticommerce.co.uk/google/ users. both evening meetings and full Fareham internetworkshop 8 OPTICIAN 10 November 2017 opticianonline.net
Twitter @opticianonline
SHOWCASE Clinitas
®
RAYOVAC
dry eye
soothing
Power arranger
Hearing aid battery manufacturer Rayovac has unveiled new technology which it said
would provide wearers with longer lasting and better performing devices throughout the
solutions
life of the battery.
Active Core Technology has been designed for the needs of the current crop of high
performance hearing aids. New design elements, including a new mechanical cell form
allowing for more critical ingredients to be
included, a new anode formulation that
increases quality performance throughout
the life of the battery and a new sealant
process for stability, form the basis of the
new technology.
The battery is also mercury-free, wireless
approved and compliant with new
legislation around the use of mercury in
button cell batteries.
• rayovac.com
NO7 CONTACT LENSES
Swift reflexes
Demand for No7 Contact Lenses’ colour matching
zero preservatives
product Reflex Colours has gone global, the
company has revealed.
‘We are receiving orders from around the world
from practitioners looking to help patients with
scarred or damaged corneas and iris defects. The
maximum sodium
potential for the lens is enormous and a clear way to
differentiate a practice,’ said No7 sales and
hyaluronate 0.4%
marketing manager Danny Pepper.
The natural-looking tones of SiH Reflex Colours
are built up with an underprint, iris and limbal ring,
Clinitas Soothe® &
offering an impressive choice of realistic colour
options. A patented pad printing process works in
Clinitas Soothe® Multi
much the same way as printing on golf balls, or other
curved surfaces, via a ‘cliché’ which transfers the pattern. The company also has a
• Choose from resealable
hand painted service where technicians can produce a matched lens from digital individual droppers (with 12
photographs supplied. hour use) or a multidose soft
‘No other company makes lenses in this way, and by involving the patient in the
creation of the lens we can ensure the most successful outcome with some delighted
tip dropper (with 3 month use
customers,’ Pepper added. from opening)
• no7contactlenses.com • Highest strength sodium
hyaluronate available on the
DUNELM OPTICAL market
Clamour for glamour • Preservative free and contact
Dunelm Optical has lens friendly
released the autumn
styles for its Janet Reger
ophthalmic frame
collection. For further information and product
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opticianonline.net 10 November 2017 OPTICIAN 9
PRACTICE
LOOK LOCAL
Eye care in Roman outpost
WHO’S IN TOWN
Total: 10
Independents: 4
Multiples: 6
AVERAGE COSTS
The price of an eye exam in
Canterbury ranged from £19 to
£40, producing an average
Martin Hogg, optical cost of £24.02.
manager,
Asda Opticians
POPULATION
B
75+
elieved to be one of Colchester was a provincial capital in Roman times. 8% 0-14
the oldest settlements 60-74
in the UK, Colchester Luke Haynes finds out what it’s like now 18%
is a town bursting
12%
with history. there are plans to increase this the same high quality of service,
During the Roman era, the Essex number to 14. Technology is the independent practice treats 15-29
settlement began life as a fortified another area where Specsavers patients of all ages from small 23%
military camp before it was named Colchester is developing. In infants to seniors. 30-59
a provincial Roman capital of February 2016, the store got a Roots explains that the majority of 39%
Britain. Topcon Maestro OCT-1, making it his patients are 50 years or older;
In 2004, the remains of a chariot the first practice in the town to something which he believes is
racing track were found under the own an OCT. ‘We invest heavily in ‘indicative’ of modern independents.
local army barracks, while a collec- all aspects of the practice, ensuring As a result, the partner and his col- Colchester City 119,441 (ONS 2011)
tion of Roman jewellery, known as all our team work with the latest leagues treat an array of conditions.
the Fenwick Hoard, was discovered and best equipment,’ adds Hagan. ‘The practice has got a reputation COMMUNITY EYE CARE
during excavations beneath Clive Roots, a partner at Owen for being a bit of a specialist for According to the Locsu Atlas
Williams and Griffin department Aves Opticians, says ‘Colchester is people with eye problems. My pre- Map of Optical Variation, Essex
store 10 years later. a very vibrant university town with vious partner Richard, who passed Local Optical Committee has
Today, Colchester has a popula- an active arts scene.’ Roots has been away a couple of years ago, started secured a contract for North
tion of around 122,000 people and working in optics for 30 years and up a self-referral service with the East Essex CCG in Glaucoma
is a popular commuter town given joined the practice eight years ago local GP some 10 or 15 years ago, so Referral Refinement, Minor Eye
its proximity to London. after having previously worked in we have a tradition of seeing more Conditions Service and
‘Colchester is a really good place South Essex. complicated cases,’ says Roots. Children’s Vision.
to be and it’s a lovely town to work The company comes from a rich Located on the edge of town is
in,’ says Nick Hagan, one of three heritage with Owen Aves – founder Asda Opticians Colchester. Martin HEALTH AND AFFLUENCE
directors at Specsavers Colchester. of the practice established in 1957 Hogg, optical manager, says there • The average house price in
Hagan manages a large team of – believed to have fitted the very is a demand for the latest frame Colchester is £315,639
around 60 employees and believes first progressive lens. Maintaining deigns due to a large student popu- (Zoopla) compared with a UK
the town is ‘blessed’ to have a pro- lation. But convenience is a crucial average of £223,257 (Land
active Local Optical Committee factor. ‘Our clinics are very popular Registry, 2017)
(LOC) that offers a Mecs, GRR and with children after school and at • Colchester’s average salary
paediatric scheme. the weekend when parents like to is £23,708 (PayScale, 2017)
With a ‘huge’ patient base, the do their shopping in store and com- • In 2015, there were 3,650
practice currently operates with bine this with an eye check,’ he people living with diabetic
eight consultations rooms, but said. • retinopathy in Colchester (RNIB
Sight Loss Data Tool 2015)
FACT FILE • It is estimated that, by 2020,
• In Roman times, Colchester Europe can be found in there will be 8,100 people
was known Camulodunum. Colchester. Colchester Castle, pictured, is a living with Drusen, an early
• The Essex town has the largest surviving Grade I listed building and is built on the stage age-related macular
Roman gateway in Britain. It was built to foundations of the earlier Roman temple of degeneration (RNIB).
defend Colchester after the Boudican Claudius. • By 2025, it is estimated that
rebellion in AD60. • A major earthquake struck Colchester in there will be 1,830 people in
• The largest surviving Norman keep in 1884. Colchester who suffer from
glaucoma (RNIB).
10 OPTICIAN 10 November 2017 opticianonline.netJUST 5 SCANS PER WEEK COVERS YOUR INVESTMENT*
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1957-2017
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Finance options available but not included in this example.FRAMES
TECHNOLOGY
Accustomed to your face
In the first of a two-part report, Simon Jones looks at Hoya’s Yuniku platform,
which puts vision at the centre of the 3D printed eyewear revolution
T
he bespoke potential of addi- visual needs and generates a 3D model of
tive manufacturing has been their face. Software calculates the ideal
realised in other medical position of the lenses in relation to the
sectors for several years, but eyes, and then decides the dimensions of
only now are the optical the frame based on those parameters.
benefits of the technology beginning to be Using the attached PC, the practitioner
leveraged in the eyewear sector. then confirms the location of pupil centres
A production method that did not need and the tops of the ears, allowing PD and
special tooling, development or minimum length to bend measurements to be gener-
order quantities was always going to appeal ated within the software. Prescription is
to eyewear designers whose primary con- also entered manually by the user.
cern was aesthetics. But the individualised Depending on the patient’s facial feature
elements of 3D printing, combined with measurements, Yuniku will provide a
high resolution cameras and complex soft- selection of frame shapes that are suitable
ware, has brought the technology to a for the patient. Parameters such as eye size
wider set of developers concerned with and B measurement can be adjusted within
outright optical performance. a set range.
They may have taken a while to become Using the computer-generated scan,
a reality, but a little over two years ago, the patients can see what the selected frame
first prototype facial scanning systems The Yuniku will look like once they have been tailored
began to filter into the trade exhibition cir- 3D Scanner to fit. Different frames, colours and tex-
cuit. The concept was relatively simple: tures can also be loaded. It is here when
Patient image capture; avatar creation; systems such as Yuniku come into their
frame overlaid on patient using data from own, allowing the patient to engage in a
the photo; bespoke frame delivered to memorable practice experience of co-cre-
patient. ating a bespoke pair of spectacles.
While the theory behind the concept Patients are able to select frames from
may sound simple, the execution for every- four designers: Hoet, Hoet Cabrio, We
one in this niche sector has been incredibly DDD and Orgreen. Each brand has its own
difficult. Some of the systems that were distinctive design traits and the portfolio
first shown over two years are either still in includes everything from avant-garde to
testing with a limited number of practices every day wearables. As Yuniku is an open
or have been shelved indefinitely. platform, it is expected that more design-
The first prototype of Hoya’s Yuniku plat- ers will ‘plug-in’ to the system in the near
form was unveiled at Silmo last year, future.
lagging slightly behind some other devel- At present, delivery time for the com-
opers. But for good reason, it was a much optical performance, without compromis- plete spectacle with Hoya’s Yuniku
more accomplished system, even at the ing on style or fit.’ premium lenses, is quoted at around three
launch. It also took a different approach, to four weeks, but this time is expected to
with vision-centric ethos. With the launch THE PROCESS come down over time. Three lens options
of Yuniku, there is now an alternative to The Yuniku set up does not look too intimi- are available progressive, single vision and
the old model of lens parameters having to dating to the patient or so technical that indoor/office.
be adjusted and compromised to suit a would look out of place in practice. Two At £12,500, the cost of the Yuniku scan-
frame. cameras sit either side of a long mirror and ner is significant, but there are a number of
‘Yuniku is an exciting step forward in two vertical racks of sample frames. The financing options available with Hoya and
custom eyewear. By capitalising on patient is asked to stand on a marker before its potential as a practice differentiator
advances in 3D printing technology, we the camera height is adjusted and a photo should not be underestimated.
have removed the limitations posed by tra- taken. Optician recently got a feel for the Yuniku
ditional spectacles,’ says Jon Warrick, vice Bespoke software developed in conjunc- patient journey, the results of which will be
president global marketing. ‘For the first tion with additive manufacturing specialist published in next month’s Lenses and
time, wearers can enjoy the ultimate in Materialise, then assesses the patient’s Dispensing issue. •
12 OPTICIAN 10 November 2017 opticianonline.netWith over 2,400 partners, the time is right for you to join the next generation of proud business owners Joint Venture Partner Nationwide With 62 new stores opening nationwide, the timing couldn’t be better to become a Specsavers partner. We fully support our Joint Venture Partners so you can enjoy all the benefits of running a successful business. Secure in the knowledge of help from the Specsavers team, you can take pride in what you’re good at. Visit jobs.specsavers.co.uk
LENSES
LOOKING AT LABS
Changing with the times
Optician talks to Sinclair Optical Services site manager
Dave Pitt about how the lab has adapted to the changing
face of the profession over the past 30 years
S
inclair Optical Services began
in humble surroundings in
1984, working from a small
barn at founder Arnold
Sinclair’s home. What started
as a glazing workshop fulfilling 30 orders a
day for independent opticians is now, some
6.1 million lenses later, a full-service lens
laboratory that supplies independent
opticians across the UK.
Initially lending a hand during his spare
time to help the company get off the
ground, site manager Dave Pitt went on
to become one of the company’s first
employees.
The past 32 years have seen major devel-
opments both in the industry and within
Sinclair Optical, and Pitt recalls the early
stages of the company’s trading when key
components were put in place that helped
to set it on the road to where it finds itself
today.
‘We have faced many challenges over the
years, particularly in the beginning, but Dave Pitt at the lab accommodate a surfacing and glazing
we’ve always strived to stay one step ahead department. The workforce doubled to 20
of the competition,’ he says. to meet growing demand,’ says Pitt.
‘Frames started becoming more of a fash- “We were one of the first in the By the end of the 1980s, the company
ion accessory rather than just a means to was producing its own label frame and lens
hold lenses on the head during the mid- region to introduce a van delivery packages. This was innovative at the time
1980s. We saw this as an opportunity and service and respond to the and proved a big success among the optical
set about recruiting frame representatives industry, says Pitt. Frames were manufac-
to further meet our customer’s needs.’ industry’s need for a door-to-door tured in-house which allowed for more
Within 18 months the lab had six frame competitive pricing. But after 10 fruitful
reps travelling all over the country and service.” years, this began to slow down as frame
orders rocketed from 30 to 300 a day. manufacturers became more competitive.
In 1987, a van delivery service was ‘The frame and lens package concept
launched and became a real turning point significant one for the company. It began was very popular at first but then all of a
for the company. ‘We were one of the first manufacturing its own uncut lenses to sudden we weren’t the only company offer-
in the region to introduce a van delivery keep up with competitors and started pro- ing these combination packages. Some of
service and respond to the industry’s need ducing up to 500 lenses a day to opticians the larger frame companies made their
for a door-to-door service,’ says Pitt. and smaller labs. It had also outgrown the frames more accessible to labs for package
‘Opticians really liked the personal touch barn location and moved to its current offers and it became harder to compete,’
this added, as they still do today. It also premises in Corse Industrial Estate, Corse, says Pitt.
meant our customer could be more com- Gloucestershire to accommodate growth. ‘This left us exposed to being lumbered
petitive and pass on a quicker service to ‘Launching unfinished lenses was a real with a high volume of old stock, which
their customers.’ turning point for the lab which quickly out proved a huge risk for us as a business. The
The following year, 1988, proved to be a grew its premises and expanded to optical industry is always changing and ➔
14 OPTICIAN LENSES & DISPENSING 10 November 2017 opticianonline.netWorth
the
drive
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* VSE registered customers onlyLENSES
LOOKING AT LABS
we had to move with the times to survive or
risk being killed off by the frame manufac-
turers. We made the decision to cut the
VFM range and this was quite a low point
for the company.’
In the early 1990s, the lab expanded
once again to incorporate a coating plant in
Ross on Wye and introduced its own
branded coating, Ultimar.
‘At the time, we were one of two labs
offering lens coating so we were in a
unique position,’ says Pitt. ‘As coatings
advanced we kept up to date with the latest
offerings including easy clean and were a
top spec coating facility, well known and
trusted throughout the industry, with
smaller labs sending work to us.’
Once again, industry evolution meant
the coating plant closed in 2015, due to big- Youngster being fitted by Liz Ellis
ger lens suppliers introducing cheaper
coating and Sinclair losing sales.
THE KEY TO SURVIVAL
Helping to streamline the business
Pitt was promoted from head of logistics Long standing customer and director of Benjamin’s Opticians, Liz Ellis, talks about how
and customer services to site manager in working with Sinclair Optical Services has helped the family-run Skipton based company
March 2016. One of the first things he keep patients happy.
introduced was flexi time. ‘Over the years, ‘At Benjamin’s, we have always strived to offer the best service to our patients and keep up
we’ve always put our customers first and with the latest technology since setting up in 1962.
tried to adapt to their needs. Speed is cru- ‘Sinclair Optical Services has helped us achieve this and that’s why we’ve continued to
cial now and we’ve most recently work with them for the past 30 years.
introduced flexi time among staff to meet ‘We’ve always had our own workshop to fulfil glazing jobs but a huge surge in business
the needs of the business to ensure deliver- three years ago left us unable to keep up with demand.
ies are met,’ he says. ‘It was at that point we made a decision to outsource more work to Sinclair’s lab using
‘Staff can also now move in and around remote edging tracer technology. Since then we’ve become much busier and they now do
the lab to offer further flexibility. The lab 99% of our glazing jobs for us because we simply do not have the manpower.
can turn around uncoated RX orders in two ‘Working with Sinclair has alleviated much of the stress and pressure for us in a small lab.
days and opens at the weekend to ensure a It gives us a wonderful service and allows us to concentrate on other aspects within our
Friday order can be fulfilled for Monday.’ day to day business. We find the team extremely efficient and the lab is essentially an
Today, Sinclair Optical prides itself as extension of us. They help our back office function so we can concentrate on helping more
being a ‘one stop shop’ for lenses. Its seven- patients and offering an efficient service.
person strong customer service team, with ‘Clearly the customers don’t see this “behind the scenes” side of our business, but overall
an average service time of 10 years, help using Sinclair has helped streamline our business, leading to an improved experience for
customers in every way they can, so client our patients.
retention is high. Pitt says the lab has ‘We’ve always found Sinclair Optical Services to offer an exceptional support and the
become the back-end of the practice for customer service team really do go the extra mile to help. There’s always a familiar voice at
customers so they can focus on the front- the end of the phone if we want to check on an order or have any questions and that’s why
end and have more time for eye exams. • we’ve happily worked with them over the years.’
• sinclairoptical.co.uk
“Over the years, we’ve always put
our customers first and tried to
adapt to their needs. Speed is
crucial now and we’ve most
recently introduced flexi time
among staff to meet the needs of
the business to ensure deliveries
are met.”
16 OPTICIAN LENSES & DISPENSING 10 November 2017 opticianonline.netCLINICAL
IN THIS SECTION
Pressure point
1
100%
Correctly behaving wearers
80%
60% It’s been a week where pressure has
40%
point very much figured in the eye news.
20%
To begin with, the new NICE guid-
0%
ance for the diagnosis and
No excess (EW)
Rub and rinse
Correct solution
Replacement
Case cleaning
No ON wear (DW)
Handwashing
No topping off
management of glaucoma was
released. We will be covering this in detail in the com-
ing weeks, but two key points are worth a mention
18 CET: Patient compliance here. Firstly, good to see that the intraocular pressure
Better outcomes through (IOP) threshold for referral for further investigation
improved CL compliance has now changed from 21 to 24mmHg or more as
measured with a contact tonometer. I am sure this will
reduce some unnecessary IOP-only referrals.
Hopefully, the days of referral based on a single over
21mmHg non-contact measurement are long gone.
1
point
When Scotland first introduced their wise changes
some years back, I was lucky enough to be involved in a
training course for people a little rusty with
Goldmann. Using each other as patients, it was
instructive to see how many people firstly had non-
contact IOP in the 21 to 25mmHg range that, on
contact assessment, fell below the then magic
21mmHg. And when those measured as 21 to
25mmHg with Goldmann then had pachymetry per-
formed on them and the IOP adjusted for corneal
22 CET: Stereopsis thickness, hardly any of the ‘suspects’ fell into any cate-
Best assessment methods gory worthy of further assessment. Secondly, I note the
mention of ‘OCT (if available)’ for the first time relat-
ing to first assessment. Is there any argument left for
these instruments not becoming standard kit?
On a more left field note, I notice marijuana coming
back as a hypotensive agent. A US company has devel-
oped a corneal surfacing nanotechnology capable of
slow release of the active cannabis constituents able to
lower IOP without any of the other well-known side
effects. We are reassured that there will not be a reoc-
currence of elderly patients held up at customs with
‘medicinal’ cannabis.
Do you have an idea
for a clinical feature?
32 Aftercarelessness Email the clinical
The perils of avoiding aftercare
editor bill.harvey@
markallengroup.com
COMPETENCIES IN THIS ISSUE
COMING SOON
• First in a major series
See the full on paediatric
optometry developed
range of CET with Great Ormond
competencies and keep Street Hospital looks
at dispensing
This week’s CET covers three up with all the latest appliances to the
very young
competencies for optometrists and
dispensing opticians and two for challenges online at • Our latest legal
contact lens opticians interactive exercise
opticianonline.net
opticianonline.net 10 November 2017 OPTICIAN 17CLINICAL
CET 1
point
Enhancing patient experience
through improved contact
lens compliance
Professor Philip B Morgan and Sarah L Morgan discuss targeting
contact lens wearer behaviour and explore the practitioner-patient
opportunities to minimise risk and optimise safety amongst contact
lens wearers. (C58137, one distance learning CET point suitable for To take part in CET exercises go
optometrists, contact lens opticians and dispensing opticians) to cet.opticianonline.net
and complete the questions
I
n the area of personal healthcare humans often do not act mortality are put at risk when compliance is poor, patients fail to
in their own interests. In 2008, Gordon Brown change their behaviour. More immediately relevant to eye care
announced the NHS ‘Health Check’ initiative to provide practitioners is the situation with glaucoma treatment. In com-
nationwide assessments for common diseases such as dia- mon with hypertension, compliance here is generally poor. In a
betes, heart disease and dementia.1 Despite the generally 2009 study, Okeke and colleagues assessed the use of glaucoma
easy access of the community to these free services, uptake is low. drops which were instilled using a dosing device which contained
When over 5,000 people at high risk of cardiovascular disease in a memory chip which recorded each time the bottle of drops was
London were offered a screening assessment, fewer than 50% squeezed. The drops were prescribed to be instilled once per day,
attended, an outcome which is sufficiently low to question the at night-time, and 282 glaucoma patients were tracked over a
potential impact of the scheme on the health of the population.2 three-month period. Fifty six per cent of the group applied their
When we are provided some form of clinical treatment which drops on 75% or more of the treatment days and around one in
we control (as distinct from that administered by a healthcare five patients used drops on half of the days, or fewer.6
professional), the situation becomes more complex and worse. It Against the backdrop of low compliance with prescribed treat-
is evident that the extent to which a person’s behaviour is in line ment for systemic and ocular diseases, it is clear that eye care
with healthcare advice provided – the definition of compliance professionals face some significant challenges when outlining the
adopted for this article – is often poor. appropriate use of contact lenses and associated care products to
In general medicine for example, compliance with treatment their contact lens patients. Furthermore, perhaps in common
for chronic diseases stands at around 50% only.3 A well studied with hypertension medication and glaucoma drops, there are
area is compliance with medication for hypertension. The 1998 minimal immediate gains when correctly adhering to prescribed
Health Survey for England found that 42% of adult men and 33% contact lens care. Certainly on a day-to-day basis, vision and com-
of adult women were hypertensive. The dangers of hypertension fort will usually be consistent, so helping patients adhere to
are well known; if systolic blood pressure is maintained at less appropriate lens care is principally related to the ability of the
than 140mmHg, there would be tens of thousands fewer related practitioner conveying messages about best practice to their
deaths in the UK each year, and an even greater reduction in non- patients.
fatal events. Yet, despite readily accessible, low cost drug therapy As outlined below, however, it is clear that there are steps
for this well understood condition, fewer than 10% of hyperten- which patients can take to reduce their own likelihood of an eye
sives are able to maintain their blood pressure below this infection during lens wear and eye care practitioners have the
threshold.4 There are numerous factors which lead to this poor opportunity – and the responsibility – to help their contact lens
clinical outcome, but the key reason is patient non-compliance. wearers minimise this negative consequence of contact lens
Of course, drug treatment may be confusing to some patients and wear. To that end, this paper considers the key areas of patient
there can be concerns around side-effects and other issues, but an behaviour on which we can focus, so that compliance can be
overall compliance rate of only 20-50% with hypertensive medi- improved to help patients reduce the likelihood of corneal infec-
cation4 – treatment which may prevent death by a stroke or heart tion or inflammation.
disease – reveals the challenge faced by healthcare professionals
in having their patients act in their own best interests. CONTACT LENS ADVERSE EVENTS WHICH MAY BE RELATED TO
Perhaps more surprisingly, fewer than 80% of patients cor- WEARER COMPLIANCE
rectly adhered to advice to take tamoxifen, 12 months after its There is a range of adverse events that may arise during contact
recommendation as a therapy for breast cancer.5 lens wear but the issues which are most worthy of consideration
In these examples, when personal morbidity and even when discussing wearer compliance are those that appear to be
18 OPTICIAN CET 10 November 2017 opticianonline.netYou can also read
