Dispensing Optics April 2023

RODENSTOCK

MYCON CONTROLS

MYOPIA TO SECURE

EYE HEALTH FOR THE FUTURE

Learn more about the new MyCon lenses

features

14. CPD: C-104875

Myopia management update by Tina Arbon

Black

20. CPD MCAs: C-103893

Fitting the irregular cornea by Martin Conway

22. Report: 2023 buying trends

What do consumers want? by Kaye McIntosh

24. Report: 100% Optical

Uplifting and upbeat by Nicky Collinson

27. Take 5 with Safilo

28. Jottings

Motivation on myopia by Martin Goldman

DISPENSING OPTICS

The Professional Journal of the Association of British Dispensing Opticians

Volume 38 No 4

EDITORIAL STAFF

Editor Nicky Collinson BA (Hons)

Telephone 0797 903 3542

Email ncollinson@abdo.org.uk

Assistant Editor Jane Burnand

Telephone 0793 993 6827

Email jburnand@abdo.org.uk

Design and Production Duncan Taylor-Jones

Email dtaylor-jones@abdo.org.uk

EDITORIAL/ADVERTISING

Telephone 0797 903 3542

Email ncollinson@abdo.org.uk

Website www.abdo.org.uk

SUBSCRIPTIONS

UK £150

Overseas £175, including postage

Apply to: Edward Fox FBDO

Association of British Dispensing Opticians Godmersham Park, Godmersham, Kent, CT4 7DT

Telephone 01227 733911

Email efox@abdo.org.uk

Website www.abdo.org.uk

ABDO CPD

Head of CPD

Alexandra Webster MSc PGDipE FBDO CL FHEA FBCLA

ABDO CPD, Unit 2, Court Lodge Offices, Godmersham Park, Godmersham, Canterbury, Kent CT4 7DT

Telephone 01206 734155

Email abdocpd@abdo.org.uk

CPD REVIEW PANEL

Josie Barlow FBDO CL

Andrew Cripps FBDO PG Cert HE FHEA

Kim Devlin FBDO (Hons) CL

Stephen Freeman BSc (Hons) MCOptom FBDO (Hons) Cert Ed

Clare Hayes FBDO CL SFHEA

Claire McDonnell FAOI

Graeme Stevenson FBDO (Hons) CL

Alex Webster MSc PGDipE FBDO CL FHEA FBCLA

Gaynor Whitehouse FBDO (Hons) LVA

EDITORIAL COMMITTEE

Nicky Collinson BA (Hons)

Antonia Chitty PhD MCOptom MCIPR MPRCA

Alex Webster MSc PGDipE FBDO CL FHEA FBCLA

Max Halford FBDO CL

Daryl Newsome FBDO R CL SMC (Tech)

Alistair Bridge

Jane Burnand

Duncan Taylor-Jones

DISPENSING OPTICS IS PUBLISHED BY ABDO, Unit 2, Court Lodge Offices, Godmersham Park, Godmersham, Canterbury, Kent CT4 7DT

Dispensing Optics is printed by P&P Litho Ltd, Ashford, Middlesex TW15 1AB

© ABDO: No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means whatever without the written prior permission of the publishers

Dispensing Optics welcomes contributions for possible editorial publication. However, contributors warrant to the publishers that they own all rights to illustrations, artwork or photographs submitted and also to copy which is factually accurate and does not infringe any other party’s rights

ISSN 0954 3201

AVERAGE CIRCULATION: 8,967 copies (January to December 2022)

EVER - WIDENING CAREER PATHS

It was great to meet so many ABDO members and industry partners at 100% Optical. Those of you who visited ABDO’s stand would have been able to see a demonstration of foreign body removal by Max Halford, ABDO’s clinical lead. This is one of the skills taught on ABDO’s extended services course, which enables contact lens opticians (CLOs) to learn how to deliver minor eye conditions services (MECS) and then take the examinations provided by WOPEC – the Wales Optometry Postgraduate Education Centre.

For CLOs who have not yet taken the course and become extended services CLOs, there is good news. Health Education England has now agreed to fund 200 CLOs to complete the course (see news page 6). This is fantastic for CLOs and for the profession at large. It shows that dispensing opticians (DOs) are now recognised as having a valuable role to play in providing clinical services and relieving the strain on hospitals and GPs. We hope that the prospect of such exciting career progression will encourage more DOs to train to become CLOs too.

ABDO’s current campaign to raise awareness among employers of the value which DOs bring to optical practice showcases the various career paths available. And the wide range of CPD that ABDO offers enables members to develop their roles in line with their interests and aspirations.

For members who are interested in enhancing their management and leadership skills, there is now an additional offering in the form of bite-size online courses, starting with change management and conflict management. If you are not sure whether to do a formal qualification, such as the management diploma we run in collaboration with the Chartered Management Institute, one of these short courses could be an ideal way of dipping your toe in the water and gaining some CPD points in the process.

If you would like more information about the courses I’ve mentioned and all the other ways your professional body can help you develop your career, ABDO’s website has a wealth of information.

Alistair Bridge Chief executive

Newsome's Notes

Recycling specs: how do we do it?

We have collected old spectacles for years. We used to give them to Vision Aid Overseas – now rebranded Vision Action – via the Lions Club, but the charity has stopped using second-hand spectacles in order to quite rightly focus on training to support the development of eyecare services in the countries where it is needed. So, we have accumulated a lot of old specs.

Recycling spectacles isn’t straightforward. There is a small volume of several materials in most spectacles. Consider their intertwined presentation: metal reinforcement in plastic sides, plastic end-tips on metal sides, various polymers in the form of lenses with metal oxide coatings on some surfaces but not all, nose pads attached with screws of a dissimilar metal to the metal pad arm, which again can be a dissimilar metal to the rest of the frame.

From our point of view, this is a dilemma. We talk to patients about sustainability, ethics and the environment. People these days are informed but not universally, and not all to the same level. Some get it and some don’t believe in it.

We offer as many environmentally-friendly ranges as possible, but the conversations are continuous and the truth is this is a multi-layered issue. How can I say with certainty where the cotton used to make this cellulose acetate frame comes from? I know all my suppliers are working on this; they are aware and trying.

As a practice owner, I have signed up with Recycline to purchase a box for spectacle recycling. You fill the box up, and when it’s full you ship it to them. I have costed shipping and the cost of the box, and I estimate it will cost me around three pence to recycle each pair of specs. But I see plenty of benefits for my business. Not only will Recycline plant a tree when you have sent 100kg of spectacles, it stops my practice being overwhelmed with boxes of old specs. Beyond that, it’s something I can tell patients about so they know that the practice is really committed to the environment.

Have you thought about what your practice could do to deal with the problem of old specs? Let me know what you plan to do.

Daryl Newsome FBDO R CL SMC (Tech) President of ABDO

MECS grant for CLOs a "major step forward"

ABDO has secured a grant from Health Education England (HEE ) to cover the costs of its Extended Services Training course, which includes minor eye conditions services (MECS) and glaucoma repeat readings training and qualifications for contact lens opticians (CLOs).

The grant – available to 200 applicants – covers the ABDO extended services course and Wales Optometry Postgraduate Training Centre (WOPEC) final examinations, and is available both to new CLO applicants and CLOs who have already registered for the course but not completed and passed the final exams.

ABDO's clinical lead, Max Halford, said: “I am absolutely delighted that Health Education England has recognised the clinical value dispensing opticians can bring to patients in primary care, and has agreed to support 200 more CLOs to undertake the ABDO extended services course. The response from members so far has been fantastic.

“Securing this funding on behalf of our members is a major step forward for ABDO and the addition of a research grant from HEE to the Association's Research and Clinical Committee, to look at how DOs support patients with acute eye conditions, will allow us to look in detail at the scope of practice and engagement of DOs within eye health more broadly," Max added.

Candidates who have already received WOPEC module codes from ABDO can register their interest for the grant by emailing mhalford@abdo.org.uk

New candidates can find information on the registration process and FAQs at www.abdo.org.uk/extended-servicesfor-contact-lens-optician.

More than 100 CLOs have so far qualified to become Extended Services Contact Lens Opticians providing acute eyecare and glaucoma referral refinement services.

Journeying to the cosmos

Silhouette has partnered with aspiring female astronaut, Alyssa Carson, on its Titan Minimal Art collection. Carson, 21, is helping the brand continue its journey into the cosmos while it supports her dream of becoming the first human on Mars.

In an exclusive shoot with celebrated female fashion photographer, Alex Seifert, Carson wears the latest TMA – La Ligne frames. Made from high-tech titanium, Titan Minimal Art was launched in 1999 and has been worn by 73 astronauts on missions totaling 86,833 hours.

Max demonstrating foreign body removal

Alyssa wears Silhouette La Ligne

Renewed focus on wearer benefits

Stepper Eyewear has launched a new logo and refocused positioning "to convey, at every touch point, the wearer benefits of our frames," said Peter Reeve, managing director at Stepper UK.

"The first frames, designed in 1970 by Hans Stepper, were manufactured in a new material and process to provide an exceptional standard of fit," continued Peter. "This motivation remains true today. Good fit empowers the eyecare professional to deliver the best possible vision outcome for their patients and is paramount to the brand.

"Fit is Stepper Eyewear's strongest brand asset and, with the skills of an eyecare professional, can deliver the highest levels of wearer satisfaction," concluded Peter.

A new strapline, 'The Perfect Fit', is designed to reinforce the messaging and complement Stepper's World Fit concept launched last year.

Surprise award for eyecare stalwart

Dr Scott Mackie had a surprise on the ABDO stand at 100% Optical when he was awarded the Hamblin Memorial Prize for exceptional service to the advancement of opticians and, consequently, their professional organisation.

Scott, who is a qualified dispensing optician (DO) and optometrist (OO), received his award from Les Thomas, learning and development specialist for DOs and contact lens opticians for prize sponsor, Boots Opticians.

He was particularly recognised for his work bringing together the two

100% Optical back with a bang

100% Optical returned with a bang in February, with a 10 per cent increase in visitors numbers compared with its previous attendance record.

More than 10,500 visitors were zapped in over the three-day show, which provided

the largest contingent of independent and international eyewear designers yet, a vast CPD programme, an expanded focus on contact lenses, the 2023 Love Eyewear Awards and much more.

Turn to page 24 for a show round-up.

professions both as a student in Glasgow and throughout his professional career, including running CPD courses and conferences open to DOs and OOs, and his work with ABDO and the General Optical Council.

Scott said: "This prestigious award has been won by many people in the past whom I admire professionally, and I am delighted to accept it for my part in providing CPD and promoting the value of DOs. In particular, the synergy of working alongside optometry colleagues to provide person-centred patient care."

Read more on this story on DO Online.

Small rise to NHS vouchers

The Department of Health and Social Care (DHSC) has announced a 4.5 per cent uplift to all NHS vouchers starting on 1 April 2023.

Noting the rise, the Optometric Fees Negotiating Committee (OFNC) stated: "Although well below both current and recent levels of inflation, this is at least a small attempt to help those patients in most need during the cost-of-living crisis.

"As this NHS patient benefit is already targeted at those in most need, the OFNC had hoped the DHSC would have corrected for inflation in this very tough year for patients. However, this small uplift is a step towards minimising the risk that NHS patients in England may put off essential eye health examinations and risk long-term damage to their eye health."

The OFNC added it was still awaiting the DHSC's decision on "the chronically underfunded NHS sight test fee, which continues to put NHS primary eyecare under considerable pressure and risk".

Fitting new logo and messaging

New Designer Award winner, Ffin Eyewear's Anna Lewis

Dr Mackie receives his award from Les Thomas

A winning formula

Police, the proprietary De Rigo Group lifestyle brand that celebrates its 40th anniversary this year, has renewed its sponsorship agreement with the Mercedes-AMG Petronas Formula One Team for the fifth year in a row.

Police will be the Official Team Supplier of the team that has re-defined F1 standards thanks to eight consecutive victories in the Constructors’ Championship. The Police logo will be visible on the helmets of Lewis Hamilton and George Russell, and the brand’s sunglasses and optical frames will be worn by the drivers and the racing team.

All about low vision

Optelec has launched its new 2023 Low Vision Optic brochure, featuring its range of low vision aids.

The catalogue includes everyday tools such as handheld magnifiers and lighting, as well as more high-tech text to speech devices such as the Pebble and OrCam Read Smart. The device has recently had a firmware update, which now means it will read text in any orientation, plus detect and read out barcodes as well as banknotes.

Optelec is still offering free CPD points via its Optical Versus Electronic Magnification Course.

New home in STEMM hub

Exeter Eyewear – a legacy project to commemorate the 75th anniversary of the NHS – has established R&D offices at the Exeter Science Park, a beacon for innovation in STEMM (science, technology, engineering, maths and medicine).

"This is an amazing opportunity to collaborate with other businesses and open resources as we focus on the development of young people’s eyewear," said Rob Barrow, Spec-Care and Exeter Eyewear founder/director and qualified dispensing optician.

Last year Rob and Spec-Care were selected by the Parliamentary Trust to represent optical providers at the NHS's 75th birthday celebrations in 2023. In just eight months, Exeter Eyewear has gone from concept to the design and manufacture of four ranges of frames. TR-lite, TR-active and CLIC zero metal eyewear are exclusively distributed by Norville Inspecs, whilst iPlay is exclusively distributed by Bondeye.

"Collaboration in business has always been integral to my career," continued Rob. "I recognise the strengths of other industry providers, and enjoy working with them to deliver eyewear that is more affordable and more dynamic than a fully in-house business can offer."

Rob will be at the Palace of Westminster on 6 September for the launch of the 'NHS at 75' celebrations.

Roadworthy vision campaign

Alongside a host of motoring, road safety and optical organisations, ABDO is supporting a major new public information campaign launching this spring.

The 'Is your vision roadworthy?' campaign will share the results of a roadside vision screening exercise carried out last month by police forces across the UK, during which motorists were asked to read a number plate from a distance of 20m.

Under legislation known as Cassie’s Law, drivers who fail a roadside number plate test can have their licence revoked on the spot if a police officer deems them to be unsafe to be on the road. Other penalties for not meeting the legal eyesight standards include a possible fine or licence penalty points.

In addition to the roadside vision checks, a vision and driving webinar, hosted by TV and radio presenter Valerie Singleton OBE, was held on 14 March.

Further details of the #IsYourVisionRoadworthy campaign, and details about how practitioners can get involved, will be shared soon.

OrCam Read Smart

Lewis Hamilton strikes a pose

Exeter Science Park

STEPPER (UK) Limited sales@stepper.co.uk steppereyewear.com

For UK frame availability, please consult website.

New £1.5m Aberdeen lab

The Duncan and Todd Group has opened a new £1.5m lens manufacturing laboratory in Aberdeen.

Buoyed by continued growth, the investment in Caledonian Optical has tripled the manufacturer's current capacity – allowing it to increase production volumes of high-tech lenses.

Mark Robertson, head of manufacturing at Caledonian Optical, said: “After more than 40 years at our city centre location, the whole team at Caledonian Optical and Duncan and Todd are hugely excited about our move to new premises. We have been able to create a bespoke space and invest in the very latest digital lenses technology.

Nikon Lenswear UK has launched Facebook and Instagram social media channels to provide an online community for consumers and drive traffic into its independent partner practices.

Its new ‘Details unveiled’ campaign brings to life the concept of highprecision details through augmented reality (AR) filters. By visiting www.detailsunveiled.com/en-UK users can launch different AR filters using their smartphones, then share their experiences on social media using the hashtag #DetailsUnveiledUK

Isabelle Abrieux, director of marketing and strategy, said: “2023 promises to be a year dedicated to securing patient loyalty and driving consumers into the practices of our Nikon Lenswear Partners. Through our well-known and trusted brand, we will be supporting the independent community with a strategy designed for their benefit.”

Driving consumer buy - in Awards nominations invited

There's still time to submit nominations for the 2023 British Contact Lens Association (BCLA) Awards and beat the 11 April deadline. Held as part of this year’s clinical conference and exhibition at Manchester Central on 9-11 June, the awards will include Dry Eye Management Practitioner of the Year, Myopia Management Practitioner of the Year, Young Contact Lens Practitioner of the Year and the Industry Award.

Entries are also invited for the Diane Gould Photography Competition and the BCLA Poster Competition by 1 May, with winners and runners-up to be announced at the event.

BCLA chief executive, Luke Stevens-Burt, said: “Recognition from your peers is arguably the ultimate accolade and the BCLA Awards are held in incredibly high esteem across the profession. We look forward to receiving a high standard of nominations and submissions and the competition is sure to be strong.”

Find out more and nominate at www.bcla.org.uk

* Register for this year's Love Your Lenses Week at www.loveyourlensesweek.com and receive a FREE resource pack. The BCLA-led campaign will run from 4-10 September and the first 200 practitioners to register will receive both a printed and online resource pack, including t-shirts, pens, stickers, posters and digital assets.

“As long-time pioneers of innovation in optics, the new lab will offer the very latest equipment for manufacturing bespoke prescription lenses for our customers. Continuing our work within digital lens solutions, used to create next-generation glasses, we’re also progressing our latest children’s lenses for myopia management, Imperium,” added Mark.

The new facility offers more sustainable practices for the lens manufacturer as it has invested in new machinery that uses recycled wastewater for processing.

Turn to page 13 for more on Caledonian's new myopia control lens, Imperium.

Luxurious Italian styling

New from Marcolin in the Max Mara collection is model Eileen – feminine sunglasses presented in a limited edition with a personalised Max Mara pouch.

A bold, oversized mask with a square shape and dynamic style, MM0073 Eileen is crafted entirely in thick acetate and features the metal Max Mara logo on the sides.

Max Mara was founded in 1951 by the late visionary Achille Maramotti, and epitomises Italian luxury and style with its contemporary collection of ready-to-wear clothing and accessories. The brand is recognised for its timeless designs and luxurious fabrics.

Using AR filters to showcase precision

Max Mara model Eileen

Grafton Optical: one-stop-shop for independents

“Like a lot of our customers, we're a small family business so we understand many of the challenges independents face," says Grafton Optical CEO, David Thickens. "We aim to be a one-stopshop for them with a full range of diagnostic and refractive devices, consulting room furniture, instruments and consumables – tools, near vision test cards and practice essentials."

The 40-year-old business is led by David, son-in-law of the founder, Brian Bowles, known to many in optics. The team of 13 – many of whom have worked for the business for more than 30 years – aim to offer a full service. “Offering expert support and advice, supplying new and pre-owned equipment, installation, training, IT and marketing support, plus servicing, repairs and maintenance, we are proud to provide new and emerging technologies along with quality education in partnership with leading experts," continues David.

With the current economic uncertainty, Grafton is continuing to provide innovative equipment to help customers grow their businesses with enhanced services. A long-standing OSA member, Grafton gains much from being part of the UK optical supplier body, as David explains: “Guidance from the OSA on matters relating to the new medical devices regulations, as well as direct representation at the MHRA has been invaluable over the last year. The ability to ask questions and get expert advice and support has been vital and helped us to form our strategy."

A keen user of the OSA green glossary, Grafton’s sustainability journey is already well underway, says David: “Small changes can make a big difference. We have a recycling programme for all office waste and do our best to conserve energy at our premises by using natural light where possible, motion sensor lights in our warehouse and energy saving lightbulbs

Become a registered Dispensing Optician

Study BSc (Hons) Ophthalmic Dispensing*

• Designed for colleagues in the optical industry to gain quali昀cations whilst working.

• Blended learning delivery, online study combined with residential blocks on campus.

• Brand-new purpose-built vision sciences facilities including specialist dispensing and refraction labs.

• A fast-track two-year degree with the route to registration embedded within the course.

• Opportunity to transfer onto our MOptom on completion of this course if you meet the requirements.

WE SEE YOU ACHIEVING YOUR POTENTIAL

throughout the building, and by switching off all devices when not in use rather than leaving them on standby. We buy ecofriendly office supplies and have reduced our in-office printing by 55 per cent since 2020. Our new telecoms system enables many meetings to be held via video link, thereby reducing travel.”

Like many other suppliers, Grafton has stopped producing printed catalogues and product brochures and made everything available digitally, a policy which is appreciated by customers, David believes.

Grafton Optical CEO, David Thickens

New fitting heights

Digital lens now in stock

Eyezen Start from Essilor is now available as a stock lens. The lens uses Dualoptim S technology to optimise both distance and near vision zones, with no required power boost.

Alan Pitcher, commercial director at Essilor, said: “Single vision wearers deserve the best visual solution to support their eyes when using digital devices and leading a connected life. The vast majority of standard single vision lenses are built on 100+ year old technology, but...for most patients their modern lifestyles create new visual demands which standard single vision lenses just don’t meet.

“So making Eyezen Start available as a stock lens offers a cost-effective single vision solution for those who don’t necessarily want a premium bespoke lens but still need all the benefits and visual comfort that come with this innovative lens design,” added Alan.

Essilor is supporting the Eyezen brand with a national media campaign on Facebook, Instagram and Google Ads. Practitioners can download Eyezen digital assets and social media posts from the EssilorPRO portal and take part in its window display and direct mail campaigns.

Eyezen Start Stock is available in Orma 1.5 and Ormix 1.6 with Blue UV Capture and Crizal Sapphire HR as standard.

Game-changing anti-fatigue lens

Jai Kudo Lenses, part of the Millmead Optical Group , is tackling visual fatigue in the online gaming community with its new lens – the XP Pro.

Billed as an anti-fatigue lens, the XP Pro is specifically designed to help gamers play for longer and with greater comfort, whilst enhancing accuracy and recognition of fastmoving objects.

The lens comes with Jai Kudo's Honeycomb coating as standard to ensure optimum clarity and controlled light scatter, with reduced glare and eye fatigue. Its yellow tint is designed to imp rove reaction times such as with fast moving objects, while it comes with UV420 protection as standard.

To help relax the eyes, each lens has a 0.50 Add to reduce stress, with an anti-reflection coating and a super-hydrophobic layer to repel water and oils, and ensure an easy clean. The lens comes in indices of 1.5, 1.6 and 1.67 from -6.00D to +7.00D in cyls up to -4.00D.

The XP PRO was introduced to practitioners at 100% Optical in February for the first time and generated great interest on the stand.

AI-powered and eye-responsive

In developing the new Varilux XR series progressive lens, EssilorLuxottica scientists gathered more than one million data points to create a behavioural modelling system that predicts how presbyopes view objects around them. This knowledge was combined with that gained from the study of 6,500 presbyopes to better understand their lifestyles and visual challenges.

"The power of artificial intelligence lies in the quantity, quality and variety of data and the way they’re analysed," commented Norbert Gorny, co-chief operating officer at EssilorLuxottica. "The insights we established from data collected from customer orders, reallife wearer tests, in-store measurements and physiological models are exclusive to EssilorLuxottica. Thanks to the digital twinning technology, we can now establish a visual behaviour profile for every single prescription and provide the first eye-responsive lens that respects the natural behaviour of the eye.”

Based on in-house simulations, the company found that Varilux XR series wearers benefitted from instant sharpness, even in motion, with up 49 per cent more vision volume compared to the Varilux X series.

Also an eco-design, the Varilux XR series was certified by a lifecycle analysis run by an independent third party; this revealed a 19 per cent reduction in plastic consumption resulting in six per cent reduction in CO2 emissions. It will be available in Europe and other international markets over the coming months.

Eyezen Start social media campaign

The XP Pro's yellow tint enhances reaction times

Exclusive insights with the Varilux XR Series

Myopia control without compromises

Rodenstock's new MyCon myopia control lens is based on freeform technology and is a peripheral defocus lens with a horizontally asymmetrical design. It has a central vision zone, to provide stable refraction around the optical centre, while the outer areas create a peripheral progression along the horizontal meridian.

The lens has three distinct zones: 1) central zone, where the optical power corresponds to the wearer’s nominal refraction; 2) a temporal zone of progressively increasing power up to 2.50D; and 3) a nasal zone of progressively increasing power up to 2.00D.

The design allows light entering the optical centre to be focused correctly on the retina as with standard lenses. But in contrast to standard lenses, MyCon refracts light from the periphery to be focused in front of the retina to reduce axial elongaton.

An independent clinical study examining myopia progression in Caucasian children aged seven to 14 years over a period of five years has shown that myopia control lenses built on the principles of Rodenstock MyCon are effective in reducing the progression of myopia by up to 40 per cent (Tarutta et al 2019).

MyCon lenses are available in indices of 1.5, 1.6, 1.67 and 1.74, along with practice marketing materials.

Tackling childhood myopia head on

Caledonian Optical, part of the Duncan and Todd Group, believes its new Imperium lens provides an "affordable and effective" myopia management solution for children –reducing the need for stronger, thicker spectacle lenses and the risk of developing associated eye diseases.

Imperium is based on peripheral defocus, with the vertical meridian providing the prescribed power and positive sphere power in the periphery of the horizontal meridian.

Imperium is produced at Caledonian’s new £1.5m lab in Aberdeen using cuttingedge digital technology to support studies which indicate that there is potentially a dominant effect to visual signals in the horizontal meridian of the retina. Introducing positive spherical blur in the horizontal meridian creates a myopic defocus reducing the stimulation of axial growth, said the company.

Gillian Sibeth, product development manager at the Duncan and Todd Group, said: “The team at Caledonian Optical has been working closely alongside our lens partner to develop this new and innovative approach, which can ultimately revolutionise clinical outcomes and change the trajectory of childhood myopia.”

Training is available from Caledonian to support the dispensing of Imperium and communicating its benefits to patients.

Advanced clarity, durability and protection

Stars of the show at the Nikon Lenswear UK stand at 100% Optical this year were the company's brand new SeeCoat Next coating and Pure Blue UV lens with enhanced UV and blue light protection.

SeeCoat Next is the first new addition to Nikon's premium lens coatings portfolio in seven years, and is said by the company to bring "stunning clarity and unparalleled durability, tested and p roven to handle the rigors of daily wearing conditions".

Thanks to a new 'best-in-class' topcoat, SeeCoat Next boasts an enhanced resistance against smudges and scratches. Its new – and unique –diamond booster technology is said to ensure the topcoat sustains the highest levels of durability, even after prolonged use.

Pure Blue UV is a brand new material, which the company claims offers enhanced protection against UV and blue light without compromising lens aesthetics. The lens features a cuttingedge intelligent light purifier for "all-inone protection without any unsightly blue reflection". Pure Blue UV is available exclusively with SeeCoat Next.

In the spotlight this month are some of newest lens technologies taking patient-centric dispensing to new heights...

Campaign materials to support the launch of MyCon Imperium is based on peripheral defocus

New Nikon PureBlue UV offers all-in-one protection

LEARNING DOMAINS

Myopia management update

PROFESSIONAL GROUPS

By Tina Arbon Black BSc (Hons) FBDO CL

CPD CODE: C-104875

MCQs AVAILABLE ONLINE: 1 April 2023

CLOSING DATE: 7 July 2023

ANSWERS PUBLISHED: August 2023

This CPD session is open to all FBDO members and associate member optometrists. Successful completion of this CPD session will provide you with a certificate of completion of one non-interactive CPD point. The multiple-choice questions (MCQs) are available online only from Saturday 1 April 2023. Visit www.abdo.org.uk. After member login, scroll down and you will find CPD Online within your personalised dashboard. Six questions will be presented in a random order. Please ensure that your email address and GOC number are up-to-date. The pass mark is 60 per cent.

CPD CODE: C-104875

In last month's continuing professional development (CPD) article, Keith Tempany discussed the importance of evidence-based practice and patient communication in the field of myopia management. This article will provide an update on what has happened in the last 18 months –since this author's 'Myopia progression and management' article was published in Dispensing Optics in May 2021 1 . It will also consider the specific fitting criteria and importance of understanding paediatric frame and facial measurements when dispensing myopia management spectacle lenses. This author's previous article highlighted the role of relative peripheral refraction in stimulating axial eye growth, existing myopia management interventions as well as reviewed the supporting evidence. Even though there is now an extensive amount of research on myopia and interventions for myopia management, and considerable CPD sessions freely available to optometrists

and dispensing opticians, some practitioners have yet to fully integrate myopia management as part of routine optometric practice 2 . Whether due to what can appear to be an overwhelming amount of research, time restrictions or costs, as registered and regulated healthcare professionals, optometrists, contact lens opticians and dispensing opticians are expected, as part of the General Optical Council (GOC) Standards of Practice for Optometrists and Dispensing Opticians, to keep knowledge and skills up to date 3 ( Figure 1 ).

Myopia management has put a spotlight on paediatric eyecare –although it is becoming evident that many children are not having regular eye examinations. Swystun and Davey 4 found that, in Essex, only 34.4 per cent of children received an NHS eye examination over an 18-month period, with the average age of a child’s first examination being between six and seven years of age. This is particularly concerning, as the school vision

FIGURE 1: GOC Standards of Practice: 5. Keep your knowledge and skills up to date 3

5.3 Be aware of current good practice, taking into account relevant developments in clinical research, and apply this to the care you provide.

screening service is inconsistent across England. Greater education for parents of young children is needed now more than ever on the importance of regular eye examinations.

SPECTACLE LENS DESIGNS

All currently available myopia management spectacle lenses utilise the mechanism of the peripheral defocus theory as the basis of lens designs. In common with multifocal contact lenses, they adopt a simultaneous vision approach. This creates a clear foveal image as well as peripheral myopic defocus – reducing the stimulus for eye growth. Like simultaneous vision multifocal contact lenses, it is essential that manufacturers' guidelines relating to fitting criteria are followed to ensure optimum performance of each myopia control spectacle lens design.

Hoya MiYOSMART

Using Defocus Incorporated Multi Segment (DIMS) technology, Hoya MiYOSMART was launched in the UK in February 2021 – with data from a threeyear double-masked randomised controlled trial 5 (RCT). Since then, there has been a three-year follow-up study with results showing a sustained myopia control effect 6 . The second study consisted of 128 children; those in the original DIMS group continued to wear the DIMS lens but children from the single vision (SV) control group were switched to the DIMS lens for a one-year period.

Compared to the historical control group, the DIMS lens group showed a (mean difference) reduction in myopia progression of -0.18D and axial length of 0.08mm. The control-to-DIMS compared to the historical control showed a reduction in myopia progression of0.30D axial length of 0.12mm.

In June 2022, an abstract publication giving six-year results of data from 90 children, also showed that for children wearing the DIMS lens throughout the six years (n=36) the lens maintained its effect of slowing myopia progression 7 . Children who wore SV lenses for the first two years (n=18) then switched to the DIMS lens until 3.5 to six years, at which point they stopped DIMS lens wear and exhibited faster myopic progression. At present, there is no published research on the rebound effect of MiYOSMART.

One-year results Huang et al 10

Essilor Stellest lens two-year results13

MiYOSMART fitting criteria 8,9

The MiYOSMART lens design requires the selected frame to have a vertex distance of 10mm or less, with a pantoscopic angle close to zero and face form angle no more than 5°. The frame needs a B size of more than 25mm with at least 12mm above the pupil ensuring a sufficient area of defocus. Lens centration measurements are taken in the same way as progressive lenses by locating the pupil centre. The material is polycarbonate, refractive index n= 1.59 with a multicoat. Adaption time can vary between children, but is usually around one to two weeks.

A recently published retrospective cohort study Huang et al 10 using medical records of Chinese children who underwent a combination treatment consisting of 0.01 per cent atropine and DIMS lenses simultaneously produced promising results. The study used three groups: DIMS and 0.01 per cent atropine (combination group); DIMS monotherapy (DIMS group); and a control single vision group (SV group) ( Table 1 ).

Clearly, combining these two treatments, applying both peripheral myopic defocus, pharmacological action and synergistic effects, increased the total myopia control effect. The study points out that 0.01 per cent atropine on its own produces ‘weak’ myopia control but combined with optical methods, presents a good choice for children.

Interestingly, the subjects in the DIMS only group compared to the SV group showed myopia progression reduced by 26 per cent – a lower effect than found by

Lam et al 6 . It was noted that children in eastern mainland China experience earlier myopia onset, which progresses faster than children in Hong Kong. This suggests perhaps a higher myopic defocus may be required in some groups where there is earlier onset and faster myopic progression 10

Essilor Stellest

Essilor Stellest lenses use Highly Aspherical Lenslet Target (HALT) technology, consisting of a central single distance zone with aspherical lenslets spread on 11 concentric rings formed by contiguous aspherical lenslets having a diameter of 1.1mm 11 with a clear central zone of 9mm 12 . The design of the aspherical lenslets creates a volume of myopic defocus (VoMD), which ensures visual signals focus in front of the retina following the retinal profile reducing stimulus for eye growth 11

Two-year results from a doublemasked RCT of 157 Chinese children were divided into three groups: lenses with highly aspherical lenslets (HAL); slightly aspherical lenslets (SAL); and SV spectacle lenses 13 ( Table 2 ). With a wearing time of at least 12 hours (fulltime wear), the study reported a doseresponse relationship with HAL group efficacy at 0.99D and 0.41mm for fulltime wearers. The best corrected visual acuity did not significantly differ at distance or near between the SV group and those in either the HAL or SAL group 10 – although low contrast visual acuity and reading speed were reduced 14

1: Combined 0.01 per cent atropine and DIMS lens study results

TABLE 2: Aspherical lenslets study results

Stellest fitting criteria

Lens centration measurements are again taken in the same way as progressive lenses with monocular centration and vertical heights. The centration point = the reference point, which is also used for prescription verification. The lens material is Airwear polycarbonate n= 1.59 15

SightGlass Vision

EssilorLuxottica | CooperVision

DOT 0.2 lens

Diffusion Optics Technology (DOT) uses microscopic diffusers applied to the lens surface to scatter the light, reducing retinal contrast 16 . Each diffuser is irregular in shape and translucent, with a diameter of ≈ 0.14mm and height 0.2mm. There is a 5mm aperture outside, and the entire lens is integrated with microscopic diffusers in a Trivex lens material.

Children aged six to 10 years, which is younger than other studies, wore assigned spectacles constantly (more than 10 hours per day).

A multicentre (14 sites in North America) double-blind, RCT has published 12-month results. CYPRESS study 16 subjects were randomised into three groups: a SV control group; Test-1 marketed as DOT 0.2 0.365mm; and Test-2 0.240mm more closely spaced ( Table 3 ). The results show a faster progression in the younger age group.

DOT 0.2 fitting criteria

This lens design is also measured like a progressive lens, accurately locating the pupil centre so that the 5mm clear aperture is aligned with the pupillary axis, with the eye in the primary position.

The pantoscopic angle should be flat (i.e. as close to zero as possible), so that the centre of rotation condition is satisfied and oblique astigmatism is avoided.

Norville My-Nor lens

A recent feature in Optician 17 discussed My-Nor and a comparative study where on average a 40 per cent reduction in myopia progression was found. The study consisted of 94 children aged seven to 14-years split into two groups –a SV group and a treatment group – over a period of five years. This lens is available in a range of indices and has a freeform back surface design with horizontal progression, creating relative peripheral myopic defocus in the horizontal meridian. There is clear correction at the centre, and horizontal peripheral defocus starts at 6mm nasally and 4mm temporally.

My-Nor fitting criteria

17

Once again, lens centration measurements are taken in the same way as a progressive lens, but when selecting a suitable frame there must be least 5mm above pupil centre and 12mm below. There should also be a minimum boxed size of 37mm x 17mm to enable >25mm temporally and >12mm nasally from the pupil centre.

On collection, explaining the lens design and location of the defocus areas is essential as well as the need to look centrally through the lenses which will help the child to adapt more easily. Adaption is usually within a day but can take up to two weeks. Correct frame fit is essential and the child and parent/carer should be advised to return to the practice for adjustment if there is any slip, or the frame becomes out of alignment.

This spectacle lens is a new addition to myopia management, and training and support is available from the manufacturer.

FRAME SELECTION FOR MYOPIA CONTROL LENSES

With all spectacle lenses, vertical centration should take into account the centre of rotation condition, so that the visual axis intersects the optical centre of the lens normally, enabling the optical axis and visual axis to coincide, and oblique astigmatism aberration to be minimised ( Figure 2 ). With conventional SV lenses, including aspherics, this means measuring pantoscopic angle and heights to the pupil

3: Diffusion Optics Technology study results

FIGURE 2: Pantoscopic angle

centre and then compensating for tilt by dropping the optical centres 0.5mm for every degree of tilt.

Experience tells us that pantoscopic tilt in children is very much less than in adult patients. Frames must be designed to take into account a less developed bridge and naturally chubbier cheeks if the frame is to fit well, without resting on the cheeks. Figure 3 shows how to measure pantoscopic tilt, in this case using a Zeiss pantoscopic gauge. However, all major manufacturers offer such devices.

Often the instructions say to remove the dummy lens in order to ensure a clean contact with the rims and an accurate measurement. However, in cases where the lens cannot be removed (rimless and supra styles) or combination frame designs where the top rim is much thicker than the bottom, this is not appropriate, and care must be taken to ensure an equal gap at top and bottom of the lens. It should be noted that despite what can be found online, pantoscopic tilt is an ‘as worn’ measurement with the frame on the face and is not the same as angle of side 18

The nature of all lenses designed specifically for myopia management means that there is a small central aperture, which must be positioned very accurately with the optical centre on pupil centre so that the area responsible for peripheral defocus is effective. It should be clear, therefore, that when dispensing frames to be fitted with myopia management lenses, the only

pantoscopic angle that is appropriate is one of zero degrees.

Manufacturers offer centration tolerances of 1mm vertically and 0.5mm horizontally regardless of lens power which, in effect, means the pantoscopic tilt can be between -2 and +2 degrees with the OC on pupil centre. Using Figure 3 as an example, a frame fitting as shown in the image with a pantoscopic tilt of 10 degrees would be unsuitable to consider for myopia management, since once adjusted to a tilt of zero there will be a large gap between the cheeks and bottom rim. Additionally, the B measurement (vertical box height ens depth) needs to be ≥ 25mm if a Hoya MiYOSMART lens was dispensed.

Understanding the differing lens designs is essential to ensure areas of peripheral defocus can be fully effective. For example, the Norville My-Nor lens requires at least 12mm nasally and 25mm temporally from pupil centre, although a minimum eyesize of 37mm is unlikely to be problematic.

It is important that the child looks through the lenses for all visual tasks, and does not, for example, look below the bottom rim for close tasks. Therefore, it is important to select a frame that is sufficiently deep without touching the cheeks. Because of the fine tolerances involved, even in low powers it is important that the frame can be easily adjusted both for pantoscopic tilt and, ideally, vertical centration. Altering centre heights after manufacture would, of course, require adjustable nose pads, which can also be helpful in allowing adjustment of back vertex distance.

Regardless of lens power, back vertex distance is an important consideration and, as is the general rule for all dispensing, lenses should be fitted as close as possible to the eye without touching the eyelashes, with manufacturers stipulating 10mm or less as required. The principle here is the same as for progressive lenses where a keyhole effect is in operation. Whether this is the intermediate zone on a varifocal or, as here, the central zone on a myopia management lens, the closer the eye is to the keyhole then the wider the field of view, and the easier the lens will be to use with less head movement required for optimum vision.

Some frame suppliers have started to develop frame ranges with specific features designed for myopia management lenses, and some lens manufacturers offer complete package value pricing for specialist lens and frame combinations. For example, Wolf Eyewear’s Wolf Cubs MY collection includes design features such as extra lens depth and joints positioned to give a flat pantoscopic tilt as is required for Hoya MiYOSMART lenses, as well as a range of colours and sizes and optional clip-on sunglasses on some models ( Figure 4 ).

FIGURE 3: Measuring pantoscopic angle

FIGURE 4: Wolf Eyewear Wolf Cub frame

Following new research in paediatric facial anatomy and spectacle fit 19 , it is anticipated that there will soon be available new frame ranges that also specifically consider the facial anatomy of children and the final fit of the frame.

CONTACT LENS DESIGNS

The article in Dispensing Optics May 2021 discussed the designs and treatment actions of contact lenses available for the management of myopia. Next we shall look at the research available since that time.

CooperVision MiSight 1day

CooperVision MiSight 1day is a dualfocus soft contact lens with a central distance zone (3.36mm) surrounded by a treatment zone that creates 2.00D of peripheral myopic defocus; this alternating pattern is then repeated 20 Chamberlain et al 21 have been carrying out one of the longest running continuous myopia management studies, which now provides data for MiSight over a six-year period.

This study began as a three-year double-blind multicentre RCT of children aged eight to 12 years with two groups: a control using Proclear 1day lenses; and the treatment group wearing MiSight 1day. Part two was again three years but all subjects wore MiSight 1day lenses so there was no longer a control group for comparison and analysis of efficacy.

The two cohorts remained separate becoming the T6 group (children who had received six-years of MiSight 1day treatment lens) and the T3 group (children who had switched from the Proclear 1day control lens to MiSight receiving three years of the treatment lens).

Looking at the six-year results, the T3 group progressed by an average of -1.55D and in the T6 group, for 23 per cent of eyes, there was no clinically significant change over the six-year period. Mean axial length progression for the T3 group increased by an average of 0.81mm and in the T6 groip increased by an average of 0.49mm over the total trial period.

This study provides longitudinal evidence of efficacy as well as the beneficial effects of myopia management even when treatment is started at an older age. Whilst there is limited research covering rebound effects in optical treatment, Ruiz-Pomeda et al22 showed

that in cessation of MiSight 1day for a oneyear period there was no rebound effect. A rebound effect is where, on the cessation of a myopia management treatment, the myopia progresses faster to the level it is thought it would have progressed to without treatment. Higher dose atropine therapy has hitherto demonstrated a significant rebound effect 23 whereas less invasive optical interventions do not appear to create a rebound effect 24 . However, this is an area where more research is needed.

Visioneering Technologies

NaturalVue Multifocal 1 day, Menicon Bloom Day

This lens is a centre distance, simultaneous vision, extended depth of focus lens. A RCT known as PROTECT is currently being undertaken by Visioneering Technologies, which expects to publish one-year follow up data in the last quarter of 2023 25 . Current evidence for this lens by Cooper et al 26 consists of a retrospective case series analysis, which found that for 75 per cent of children myopic progression stopped.

Interestingly, results for 6.25 per cent of children showed refraction regressed, and 90.6 per cent of children showed a 70 per cent decrease or greater in myopic progression.

Whilst this study does provide realworld data, the authors themselves acknowledged that it lacked the scrutiny provided by a RCT. There was no control group, and a lack of full baseline refractive status or axial length measurements.

ORTHOKERATOLOGY

Orthokeratology remains an effective treatment option for myopia management. A recent review concluded that orthokeratology slowed myopic progression from 32 per cent to 63 per

cent compared to SV spectacles 27 . There is still a lack of data regarding rebound effects although there is evidence suggesting that orthokeratology lens wear should be continued until after 14 years of age to avoid a more rapid increase in axial length 28 .

PHARMACOLOGICAL INTERVENTIONS

Atropine is currently still not licensed in the UK although there are a small number of private clinics that offer this method of treatment off label 30 . There are clinical trials being undertaken; CHAMP UK (Childhood Atropine for Myopia

Progression in the United Kingdom) is evaluating the efficacy of low dose (0.01 per cent) atropine eye drops over a two-year period at several UK sites including Cambridge, Belfast, Birmingham, Glasgow and London 31

There is also emerging research for combination treatments where different myopia control mechanisms are combined (DIMS + 0.01 per cent atropine). Peripheral myopic defocus, pharmacological action and the synergistic effects increase the total myopia control effect. A recent systematic review combining 0.01 per cent atropine with orthokeratology also found there was a synergistic effect showing similar efficacy to high dose (0.5-1 per cent) atropine 32

ENVIRONMENTAL FACTORS

Increasing time spent outdoors has shown to delay myopia onset – but whether it slows the progression of already myopic eyes is still a topic of debate 33 . The mechanism is thought to be linked to the release of dopamine from the retina arising from brighter daylight conditions, which acts as an inhibitor for eye growth 34

FIGURE 5: GOC Standards of Practice: 3. Obtain valid consent 28

3.1 Obtain valid consent before examining a patient, providing treatment or involving patients in teaching and research activities. For consent to be valid it must be given:

3.1.4 By an informed person. Informed consent means explaining what you are going to do and ensuring that patients are aware of any risks and options in terms of examination, treatment, sale or supply of optical appliances or research they are participating in.

Increasing time spent outdoors has many health and mental health benefits as well as being free. In order to maximise the efficacy of a prescribed myopia management treatment, parents/children should be made aware of the potential beneficial effects of increasing time spent outdoors.

OBTAINING VALID CONSENT

It is essential to obtain informed valid consent from patients (and parents/carers) when dispensing any optical appliance 29 before proceeding with myopia management ( Figure 5 ).

TALKING TO PARENTS AND CHILDREN

It is clear from the growing evidence base surrounding myopia progression, and the availability of effective interventions that can slow progression, discussion for those at risk of myopia progression should take place at the earliest opportunity. This can be challenging as discussions need to be tailored to each individual child and parent/carer; some may have a greater knowledge and understanding than others particularly if the parents are myopic. Remember to keep it simple: many parents and children will not understand the terminology used.

Start with the good news that the child’s eyes are healthy then move on to the rate of eye growth. Here, a clear understanding of the emmetropisation process is essential. By explaining that when eye growth happens too quickly, it is later in life that consequences occur. Most importantly, reassure the parent and child that there are ‘safe and effective’ treatments that can slow myopic progression.

There are great resources available for practitioners, which were identified in last month’s CPD article, along with excellent

leaflets produced by manufacturers. The key point is to explain and reassure both the parent and child ( Figure 6 ).

We have already seen financial sanctions levied on the employers of eyecare practitioners who have failed to treat amblyopia in a timely fashion 35 , and it is likely that practices who do not engage with treating myopia progression will also find themselves liable in the future. We owe it to our patients to offer the latest evidence-based solutions 36

CONCLUSION

Whilst no intervention can provide a cure for myopia progression, there are now safe and effective spectacle and contact lens treatment options. The spectacle lens industry has seen most change, with more lens designs now commercially available. There has been considerable research published in the last 18 months and the evidence base has grown.

It is essential that all eyecare practitioners include the management of myopia in routine optometric practice. Remember: it is incumbent on all registered opticians to remain up-todate, appraised of current research evidence, and to obtain informed valid consent from patients (and parents) when dispensing any optical appliance. Discussions with parents and children should happen at the earliest opportunity. By following and using evidence-informed practice, healthcare practitioners can make the best clinical decisions and improve patient outcomes.

Professional guidance can be found on the ABDO website at www.abdo.org.uk/regulation-andpolicy/advice-and-guidelines . The ABDO Clinical Hub is an excellent resource at www.abdo.org.uk/dashboard/clinicalhub/focuson-2/myopia-managementoverview

REFERENCES

References can be found when completing this CPD module. For a PDF of this article with references, email abdocpd@abdo.org.uk

TINA ARBON BLACK is co-founder of accredited CPD provider Orbita Black, which provides optical, retail and business improvement training and advice to the optical sector and assists over 30 manufacturers and suppliers in the provision of CPD to their customers – registered opticians. She is an ABDO practical examiner, practice visitor/auditor/assessor and theory exam script marker, and a distance learning tutor for ABDO College. In 2019, Tina graduated from Canterbury Christ Church University with first class honours in Vision Science.

LEARNING OUTCOMES FOR THIS CPD ARTICLE

DOMAIN: Clinical Practice

5.3: Be aware of the latest research behind myopia management treatment options and consider how you will apply this knowledge in your day-to-day clinical practice.

7.5: Provide effective patient care and treatments for myopic paediatric patients based on current good practice.

DOMAIN: CL speciality

Understand the mechanisms and limits of contact lenses designed for the management of myopia, based on the research evidence, alongside other treatment options that may be available to support myopic paediatric patients.

Clinical Practice

Speciality: Contact Lens Opticians

2.1 Give patients information in a way they can understand. Use your professional judgement to adapt your language and communication approach as appropriate.

FIGURE 6: GOC Standards of Practice: Communicate effectively with your patients 34

Multiple choice answers

Fitting the irregular cornea

By Martin Conway FBDO, FIACLE, FBCLA

CPD CODE: C-103893

Published in December 2022

Which of the following options are all accepted causes of an irregular cornea?

a. Pellucid marginal degeneration, corneal transplant and keratoconus

b. Corneal transplant, keratoconus, simple myopia

c. Pellucid marginal degeneration, mixed astigmatism and keratoconus

d. Lenticular astigmatism, corneal transplant and pellucid marginal degeneration.

a is the correct answer. Pellucid degeneration, corneal transplant and keratoconus cause physical changes to the shape and regularity of the corneal. Other causes include corneal ectastia, which can be an unwanted consequence of laser surgery. Myopia and corneal astigmatism do change the curvature of the cornea but these changes are regular and even across the meridian effected.

Over recent years, information from the Netherlands seems to suggest that the prevalence of keratoconus has increased from one in 2000 to 265 in 100,000. What is the most likely reason for this finding?

a. Practitioners are more aware of keratoconus and are looking for it more than they did in previous years

b. Changes to diet

c. Fundus photography has become more common in practice

d. Topographers are increasingly replacing keratometers in practice

d is the correct answer. Topographers are the best way to spot keratoconus as a measurement is taken of the curvature of the cornea as a whole and an image is produced using colour to represent the variation in curves. This makes the irregularities much easier to spot. A keratometer only measures the central 3mm of the cornea and, therefore, if the cone or distortion is not within this area, keratoconus can be missed –particularly if it is early.

Six of the following questions were presented online to entrants to comply with the General Optical Council’s best practice specifications for this type of CPD.

What is corneal cross-linking?

a. A study looking at corneal irregularities across different countries

b. A randomised clinical trial looking at different treatments for keratoconus

c. A treatment for keratoconus

d. A new underground rail system in London

c is the correct answer. Corneal cross-linking is a relatively recent development in the treatment of keratoconus. It is recommended that this treatment is used as early as possible in progression of the condition as the aim is to stabilise and almost reinforce the cornea to halt (or slow) progression of the condition. This treatment cannot restore the cornea to its original condition and, therefore, will not imp rove vision, but it aims to prevent it from becoming worse.

What fitting pattern does image one of a specially designed RGP sitting on a keratoconic cornea show?

a. A flat fit

b. A steep fit

c. An aligned fit

d. An ideal fit

d is the correct answer. This is a lens sitting on an irregular corneal so no matter how well fitting this lens may be, it will never show an alignment fitting as the cornea is irregular. This pattern shows an ideal fit; a good fit for this type of lens and corneal. There appears to be very slight touch in the centre and a little pooling in the mid periphery which is what the design aims for.

Which of the following statements around fitting irregular corneas is false?

a. K-readings from a keratometer are of little use

b. Using multiple lenses from a fitting set is often the best method to determine BOZR

c. The use of anaesthetic drops should be avoided

d. The technicians at your RGP supplier are a good source of fitting advice

c is the correct answer. As practitioners, we are always reluctant to use corneal anaesthetic as we are well aware of the risks associated. However, under carefully controlled conditions, with sparing use, anaesthetic can help the fitting process for both patient and practitioner. If multiple lenses need to be trialled this is a slow and often uncomfortable experience for the patient. By using anaesthetic, discomfort is largely removed and reflex tearing is reduced. This means the practitioner can assess multiple lenses on the eye quite quickly. It also imp roves the patient experience and hopefully, will not put the patient off for collection of their own lenses.

Which of the following is an option for fitting keratoconic corneas?

a. Soft lenses

b. Scleral lenses

c. RGPs

d. All of the above

d is the correct answer. All of these options are valid for different stages of the condition. Early keratoconus may successfully be fitted with soft spheres or soft torics and this may give satisfactory vision. As the condition progresses, more complex designs are needed to improve the fit and vision. Patients will often move on to RGPs and specialist RGP designs. If the condition progresses further or vision and comfort cannot be achieved with a RGP then the practitioner may move on to a scleral lenses.

Which of the following statements about scleral lenses is true?

a. They are easier to insert and remove than soft or RGP lenses

b. Developments in design and material has made these lenses more popular over the last 10 years

c. Scleral lenses are often uncomfortable as they rest on the sclera

d. Fitting scleral lenses is very difficult and often only fitted in a hospital eye clinic

b is the correct answer. The idea of scleral lenses has

always been a good one. However, historically, they were handmade of PMMA. This material allows very limited oxygen exchange and leads to long term problems. Scleral lenses are now made with high DK/t materials and designed using cutting edge computer design technology. These advances have made them more comfortable and healthier for the eye.

Which of the following is not necessary to fit a keratoconic patient?

a. A slit lamp

b. A keratometer

c. A topographer

d. Fluorescein

b is the correct answer. A keratometer is not particularly useful when fitting a patient with keratoconus. A topographer is more accurate at representing the irregular curvature to allow a lens to be selected from a fitting set. The use of fluorescein with a slit lamp will be needed in order to assess fit unless the practitioner has access to an anterior eye OCT.

Which of the following statements is false?

a. Keratoconus can be cured

b. Corneal cross-linking is currently considered the gold standard treatment for keratoconus

c. The use of contact lenses is to provide the best corrected vision

d. Recorded prevalence in the UK is likely to increase a is the correct asnwer. Sadly, there is no cure for keratoconus or any other corneal ectasia. The focus is on management of the condition. Cross-linking is the gold standard form of treatment and aims to stabilise the cornea and prevent progression of the condition. Contact lenses are used to imp rove the vision that is as a result of the irregular corneal surface. As the condition progresses, the best corrected vision often reduces and can only be imp roved with the use of contact lenses or corneal graft.

It is expected that prevalence of keratoconus in the UK will increase. This is following on from a study in the Netherlands that showed a marked increase in prevalence. The reason for these findings is not that prevalence is actually increasing but that by using topographers and OCTs more commonly in routine practice, keratoconus and other corneal conditions causing irregularities are detected more easily than they would have been previously.

PLEASE NOTE: an error was in the printed CPD multiple choice answers for ‘Managing patients presenting in practice with conjunctivitis’ (C-103566), which were published in the March edition. The question, ‘Signs of acute allergic conjunctivitis include’, should have read, ‘Signs of acute allergic conjunctivitis do not include’.

IMAGE ONE FROM QUESTION 4

LEFT: graphic representation of quadrant specific design.

RIGHT: ideal fit for a regular cornea ( courtesy of Menicon )

What do consumers want?

People are under more pressure than ever when deciding where to spend their money – so keeping up with consumers' changing desires is essential for practice owners. What do they want when they walk into your practice – and what are the key factors influencing their decisions? These questions and more were the centre of a panel discussion at 100% Optical in February, led by Natasha Cazin, senior consultant at market research experts Euromonitor.

Unveiling the top consumer influences for 2023, Natasha told the audience: “Understanding consumers’ attitudes and purchase motivations is vital – but the forecast is complex. The world continues to be a challenging place. Just as we thought it was safe to re-engage, the global economy started to look fragile. Consumers are preparing for a rocky time ahead by budgeting – but they are keen to get back into their stride, with some indulging and embracing quick gains."

TRENDS AND TRIBES

Age ranges are crucial in recognising different types of consumers ( see Table 1 ) – as Natasha explained: “Millennials are parents, home-makers and key decisionmakers and they are going to be turning presbyopic, so they are really important.” The ageing population – the silent generation and baby boomers – are already presbyopic and should be coming for regular eye examinations.

Two other generations that “optical businesses should really be keeping an eye

on”, suggested Natasha, are Gen Z, young people aged 12 to 27, and Generation Alpha, children aged up to 12. Gen Z are now a quarter of the global population and map onto the ‘young and disrupted’. “Gen Alpha may not have their own income but they have influence on their parents, their grandparents and their peers, so they can’t be ignored," Natasha added.

KEY TRIBES

BUDGETEERS: the cost of living crisis means they think carefully before spending. Affordability is often more important than brand loyalty. Optical businesses must develop solutions that help people get value for money.

HERE AND NOW: Consumers who are not abandoning financial responsibility, but they are taking a short-term buying approach with some discretionary items.

YOUNG AND DISRUPTED: Gen Z, digital natives who stand up for their beliefs. Authentic and relevant content draws their attention.

Euromonitor has identified three key tribes cutting across these demographics ( see box above ). The ‘budgeteers’ are people reining in their spending, concerned about the cost of living. After the struggles of the last few years, the ‘here and nows’ want to treat themselves without waiting. The ‘young and disrupted’ grew up with the internet and are recovering from the chaos of the pandemic, which interrupted their education.

CONSUMERS ON A BUDGET

Budgeteers feel their financial stability is threatened so they are choosier about where they spend their money. In 2022, the top reason consumers shopped digitally was to get the best price. Euromonitor warns that optical businesses must adapt by implementing or developing solutions that help budgeteers save.

Joining Natasha on the panel at 100% Optical was Lorna Robinson, head of buying at the Hakim Group, who said: “We need to make sure there's a really sensible, accessible price point for these patients so that they don't feel they're having to compromise. They still want to go out feeling good about themselves, but in a way that's appropriate to their budget.”

Practice owners must avoid assuming everyone falls into this 'budgeteers' group, continued Lorna: “One of the most dangerous things to think is, I'm worried about the economy and therefore everyone that comes into my practice is going to be spending less. Make sure that you and your teams in practice are not falling into that trap because people still have money to spend.”

Lorna advised practitioners to have a "sensible range, without compromising on the premium end" and to “think carefully about what the value is". She added: “If you can explain to somebody really clearly why this frame costs £400 pounds, and all the features and benefits it can deliver, and why this frame costs £100, and all the features and benefits that can deliver, and why they are potentially suitable for the patient's lifestyle, they can then make an informed choice.”

TABLE 1. Consumers in numbers

Gen Z represent the ‘young & disrupted’ tribe

IN THE HERE AND NOW

Consumers identified as being in the 'here and now' group are those giving themselves permission to 'live a little'. They’re not abandoning financial responsibility – but something that sparks joy, in the words of clutter-busting guru Marie Kondo, can be a buying motivator. Euromonitor suggests companies should offer innovative products and purchase methods to help consumers access what they want without waiting.

During the discussion, Natasha pointed to coffee shop loyalty cards, which offer a free drink once you’ve been back eight times. In the optical world, she said: “BBR Optometry [in Hereford] has a

YOUNG AND DISRUPTED

The young and disrupted group grew up with the internet and are immune to traditional advertising, the audience heard. They map onto Gen Z, and they seek authenticity and social impact. They want to feel a genuine connection when engaging with brands that have an ethical purpose.

Lorna explained more: “The chances of a younger consumer coming into your practice having never Googled you are pretty slim. It’s not just social media, it’s the whole website experience: if that isn’t delivering what they are looking for immediately, they think – 'this isn’t the right place me'.”

Kirk& Kirk also recently reached out to the young and trendy crowd with a onemonth pop-up shop in Shoreditch, East London. Jason said: “We did it to connect with our consumers. To learn from them, understand what they were looking for and how they wanted to experience retail. It was more like a fashion store than a traditional opticians.”

While the pop-up attracted people who knew the brand already, it also drew those who wanted to feel part of the ambience, explained Jason, who believes independent practices "shouldn’t be afraid to express what you are paying for when you pay a little bit extra. Help the customer to understand what the value is in a pair of frames or lenses. Young customers will have done their research before they come in, so you need to be able to have a detailed conversation with them."

The young and disrupted are also ethical consumers, who want to see environmental and social benefits when they spend. They are interested in sustainable ranges and what the practice is doing to reduce its carbon footprint.

fantastic eyewear plan which gives patients a range of benefits including loyalty discounts.” Instalment plans are another option, she added.

Lorna suggested that business owners should investigate flexible payment solutions: “I would really encourage practices to think about how that may work on a local level, and whether there are things you can do so your patients don't need to compromise, so they can still have what they want. It’s not just about great prices; here and now consumers are exceptionally demanding of where they spend their money and the value they get in return.”

Optics is a high transaction value industry and practice owners need to recognise value isn’t just about price, Lorna continued. “Walk into your practice with a fresh pair of eyes as if you were a consumer. Go to the reception desk. What's the first thing you see when you walk in? What are you looking at when sitting in the waiting area? If you're not being inspired, you've maybe got some work to do with your merchandising.”

They want to connect with brands that reflect their ethical beliefs, added Lorna: “Think about your ranging; what are those brand stories and, crucially, do the team know them?”

As the discussion continued, Natasha highlighted a recent campaign by Kirk & Kirk featuring models “with a unique gender story” – trans, queer and non-binary.

Kirk & Kirk founder and fellow panellist, Jason Kirk, explained: “We have a really good dialogue with our audience. They're communicating to us. It's part of creating a community and I think it's really important for any independent store to understand where their niche is, who they're talking to, who they want to attract, and then build a community around that. Part of our community is creative, interesting people who just want to express themselves.”

Lorna also pointed to Linda Farrow Eyewear as an example of great use of online try-on tools to connect with the young and disrupted. These also help the budgeteers know whether practices carry eyewear that might suit them.

The key role independent practices play in the community “is the kind of connection young people can really get behind,” said Natasha. "Talking about your charity work or any good causes you sponsor on Instagram or TikTok will help to reach them," she added.

IF YOU ONLY DO ONE THING…

The most important advice for the year ahead, to target all consumers, was to take a fresh look at your appeal.

Jason concluded: “Don’t play it safe. Every inch of your retail space is massively important. Look at your merchandising, look at the products and see how much repetition there is. Be bold, clear it out to make space for every single frame that is going to excite and inspire your audience. Because if you don’t, they aren’t going to spend money and they aren’t going to come back.”

KAYE MCINTOSH is a freelance writer and the former editor of Health Which?, Pregnancy & Birth and WI Life magazines.

Natasha, Lorna and Jason (L-R) talk consumer trends, along with 100% Optical's Nathan Garnett

Bold frames on the 100% Optical catwalk

Uplifting and upbeat

100% Optical 2023 was a goldmine of product innovation, CPD education, networking and business insights, recording a total of 10,657 attendees – a 10 per cent boost on its previous record attendance. “The show was a phenomenal success," said event director, Nathan Garnett. "From a massive uplift in visitor numbers to the greatest range of top brands in attendance, we couldn’t be happier with the results."

ABDO president, Daryl Newsome, commented: “The show seemed bigger and busier than last year; the exhibitors were very buoyant and those I spoke to all seemed happy with the footfall and the level of business gained. Of course, the highlight was the people. It was so nice to talk to so many members and potential new members, with many enquiries about courses. Of particular interest to me was the AI [artificial intelligence] presence and the variety of opinions regarding its use and delegated functions, which must be part of our future."

Alistair Bridge, ABDO CEO, commented: “It was fantastic to meet so many members over the course of the weekend, and to speak with employers

and suppliers about their plans and how ABDO can work with them. Seeing the remarkable range of spectacles, lenses and technological solutions on offer was fascinating too. I would like to thank everyone from ABDO and ABDO College who participated and to highlight the successful launch of our campaign to promote the valuable and diverse roles which dispensing opticians and contact lens opticians play in optical practices.”

ABDO’s CPD workshops attracted “fantastic engagement across the three days” said Alex Webster, ABDO head of CPD. “CPD is about learning but also about reflecting on your professional practice and development needs,” continued Alex, “and the ABDO CPD sessions certainly helped attendees with both of these areas.”

ABDO clinical lead, Max Halford, provided on-stand demonstrations of foreign body removal, part of the training provided through ABDO's minor eye conditions services course, while head of communications, Antonia Chitty, joined a panel discussion on sustainability – an ever-growing focus for profession and industry alike.

The Association of Optometrists (AOP) provided more than 140 CPD accredited sessions, across 11 different hubs.

Dr Ian Beasley, AOP head of education, said: “We’re thrilled with the results of this year’s event. Nine years later we’re still seeing the show go from strength to strength. Heading into our landmark 10th year,

that speaks volumes about how much practitioners appreciate the opportunity to come together, meet hundreds of exhibitors, and consume education from world-class speakers.”

MECCA FOR PRODUCT LAUNCHES

It was product launch galore on the show floor in every sector imaginable – from AI-driven imaging and dry eye solutions, to myopia control lenses and contact lenses to practice management software and amazing eyewear designs.

The Body Doctor launched the Eye Doctor Hypochlorous Eyelid Spray, developed by ophthalmologists for dry eye disease, blepharitis and styes. The spray is said to be an effective cleanser, with a clinically-tested anti-microbial solution. Alcohol and preservative-free, the spray is non-irritant and compatible with contact lenses.

Positive Impact launched the TearRestore Thermal Mask, describing it as "the first and only open-eye warm compress enabling patients to be active during their daily compress session". The mask uses 'anatomical norms' to target the meibomian glands while avoiding the eye globe, and allows the patient to blink throughout treatment,

Prue Leith on the main stage

Contributing to CooperVision's Fresh Thinking campaign

resulting in natural oil gland expression.

Grafton Optical launched the DEA Dry Eye Analyser by Moptim, whose compact design can be operated in three modalities: stand-alone, slit lamp mounted and handheld. The device offers a quick tear film evaluation, corneal staining, tear meniscus height, meibography, interferometry, bulbar redness and blepharitis. A built-in DEQ-5 questionnaire can be used in combination with objective findings to aid in diagnosis, and the Efron International Grading Scale helps to assess dry eye disease severity.

Caledonian Optical launched its brand new £1.5m lab, experienced via a VR headset, and demonstrated how the Aberdeen location is tripling capacity. The company also launched its new myopia control lens, Imperium ( see page 13 ).

Amongst its lenses, frames and instruments innovations, a big focus area for EssilorLuxottica was raising awareness of the free training available through its learning platform, Leonardo. Practitioners can use it to up-skill in key areas, with CPD-app roved discussion workshops and a myopia management certification programme. Content is delivered by national key opinion leaders and industry experts.

CooperVision launched its new 'Fresh thinking' campaign to spark conversations and gather insights around the contact lens patient journey. This was first phase of the campaign with over 200 questionnaire completed, 60 video interviews, over 100 votes cast and over 100 short survey completed. The results will be shared soon under phase two.

Growing green movement

The expected buzz around sustainability included the roll-out of a Net Zero Optics programme by Practice Building, designed to enable optical businesses to reduce their carbon footprint and plastic waste and become a certified Net Zero business. The green initiative won 100% Optical’s Sustainability Innovation Award.

A practice that has successfully followed the Net Zero Optics programme to become Net Zero certified would be awarded a certificate to promote the achievement along with window badges and digital stickers. The scheme is verified by the not-for-profit Net Zero Eyecare company.

Following an earlier soft launch, the first

Virtual reality contact lens experience

Bausch + Lomb showcased its next generation daily silicone hydrogel, Bausch + Lomb Ultra One Day, through an immersive virtual reality experience.

"Visitors to our stand went away particularly impressed by how this contact lens delivers outstanding comfort for a full 16 hours of wear and how it works in synergy with the tear film, releasing comfort and eye health ingredients throughout the day," said Petra Vacca, business unit director UK/I and Nordics, Bausch + Lomb Vision Care. "And the icing on the cake? We received the 100%

Optical Best Space Only Stand."

The company also launched its Academy of Vision Care and the Bausch + Lomb FitBetter app. The Academy is a web-based learning tool with CPD-accredited materials consisting of e-learning, videos, in-practice resources and news updates. The FitBetter app offers a suite of tools and resources to support eyecare practitioners fitting contact lenses in practice, including lens recommendation and visual acuity conversion tools, as well as fitting guides and product information.

business to become Net Zero was Performance Finance and the first practice, Clark Family Eyecare of Donington.

The work began when Andy Clark’s son Andrew, an environmental scientist and film-maker, joined the family-owned Practice Building company as its net zero manager.

Andrew said: “Our aim was to take the complexity out of environmental strategy and make it simple and, some have said, fun to follow. Our framework also enables practices to work with others, creating an environmental community within the optical industry. The response at the show was great, with practitioners showing relief that they can now do more to save the planet without it affecting their bottom line."

Panel discussion on sustainability

As well as showcasing its new Acuvue Oasys Max 1Day and Acuvue Oasys Max 1-Day Multifocal contact lenses and hosting a range of educational sessions, Johnson & Johnson Vision discussed its sustainable sourcing of materials at its paperless stand. Visitors learnt facts such as: a wind turbine installed at the company's Limerick site is generating enough energy to power 550 homes each year; all Acuvue lenses are made with 100 per cent renewable energy; and 10 tons of plastic is being saved each year by the removal of plastic pouches for Acuvue delivery notices in Europe.

AI: from code to clinic by Janice English

With AI currently one of optics' key buzzwords, delegates heard from AI expert Professor Pearse Keane at the Optical Suppliers Association stand. Pearse is professor of artificial intelligence at University College London and Moorfields retinal disease specialist. He told delegates AI was going “from code to clinic” – with optometry and ophthalmology leading the way.

Pearse confirmed that optical coherence tomography (OCT) imaging had become the dominant ocular modality, with Moorfields Eye Hospital acquiring more than 1,000 OCT scans a day.

clinical validation, regulatory approvals are also required before such systems can be used for direct clinical care.

Pearse also unveiled oculomics, a recently coined term describing the use of advanced retinal imaging, big data and AI to use the eye as a window to the

Whilst highlighting the latest frames across its brand portfolio and its new XP Pro gaming lens from Jai Kudo ( see page 12 ), the Millmead Optical Group brought along its Heavy-Light sculpture fashioned from discarded demo lenses and lens waste (swarf). Created by sustainability designer, Yair Neuman, Heavy-Light aims to inspire everyone to think about their sustainability journey. It will eventually be housed at Godmersham Park, the home of ABDO College.

Emily Andrews, product director and chief sustainability officer at Eyespace Eyewear, ran a workshop-style presentation exploring frame materials with an introduction to ‘the green movement’ and sustainable terminology. She discussed re-used materials, sustainable materials and packaging as well as the advantages and disadvantages, adjustability, glazability, patient suitability, durability and identification of suitable patients.

“We believe that the NHS has the largest amount of data in one resource in the world – the challenge is how we analyse this and make clinical judgements," said Pearse. "We are drowning in the number of patients we need to see, but new technology can address some of these problems by applying deep learning to these images. Technology is really advancing ophthalmology and optometry, which are at the forefront of AI in healthcare. The promise of AI is how we bring world-class expertise out of specialised hospitals and potentially into the community and homes of patients.”

The collaboration between Moorfields and Google/DeepMind is progressing, ensuring that clinical AI is robust, reliable, safe and fair. Alongside

rest of the body. With blood vessels and nerves exposed and visible, it is possible to determine non-ophthalmic pathologies. With oculomics, it will be possible to reveal the sex, age, blood pressure and smoking status of the patient from retinal photographs. In the future, this may allow prediction of other systemic diseases, said Pearse.

“The retina is the only part of the brain that we can visualise, and is important in linking risk factors for stroke, heart attack and dementia, even schizophrenia and Parkinson's. There are huge implications to picking up systemic disease early,” he added.

There were far too many launches, events and innovations to mention within these pages, but we'll be keeping readers as up-to-date as possible within the magazine and on DO Online with all that's going on in the wonderful world of optics...

Daryl Newsome with Bayfields team members

Kids sunglasses on the catwalk

Next year marks 100% Optical's 10th anniversary – and the show dates are slated as 24 to 26 February. The AOP and Media 10 have extended their partnership to deliver the event until 2025, and 2024 will see a new ophthalmology section and education programme.

Professor Keane on the OSA stand

Navigating the new reality

Dispensing Optics editor Nicky Collinson talks business, brands and sustainability with Oscar Cera, managing director for the UK and Nordics at Safilo…

NC: HOW DID THE PANDEMIC IMPACT SAFILO AND ARE THERE ANY CONTINUED CHALLENGES?

OC: The impact of the pandemic was felt across our industry and markets because of the supply chain disruptions and the closure of some retail spaces. We saw a bigger impact on the sun category, while demand remained resilient in corrective eyewear due to their essential nature. To navigate the new reality, we offered our partners the appropriate tools to connect with our teams despite the restrictions.

The continued challenges we see today are related to the cost-of-living crisis, so our priority is to explore ways to help customers mitigate them. It is important for Safilo to capitalise on its rich and diverse portfolio to offer the best value-for-money solutions across all eyewear segments.

NC: WHAT IS SAFILO’S CORE STRATEGIC FOCUS GOING FORWARDS?

OC: Our strategic focus is to position Safilo as the privileged and strategic partner of opticians – enabling them to be more competitive in the market through our innovative tools and digital resources. We are committed to consistently providing excellent support and service to our customers and contributing to their success. We are building a strong and balanced portfolio of brands, geographies, products and channels, which will help us develop our business across the categories.

NC: HOW IS SAFILO ACHIEVING SUSTAINABILITY?

OC: Safilo has a purpose-led strategy based on three sustainability pillars: planet, product and people. Sustainability is at the core of our business strategies and is based on developing projects and initiatives that can address the global challenges of tomorrow. We always look for the best balance between present and future, and believe in projects that are not limited to the short term and that have a strong environmental and social responsibility.

For example, we have partnered with Eastman to introduce Eastman Acetate Renew and Eastman Tritan Renew in our sunglasses and optical products. We have also introduced Eastman Tritan Renew in our polarised lenses. This is a first in the eyewear sector: a bilateral collaboration with Eastman regarding technical innovation.

We also joined the Fashion Pact in 2022, a global coalition of companies in the fashion and textile industry including their suppliers and distributors, all committed to a common core of key environmental goals in three areas: stopping global warming, restoring biodiversity, and protecting the oceans.

NC: HOW IS SAFILO SUPPORTING PRACTITIONERS IN BUSINESS?

OC: Our diverse portfolio of brands enables us to provide our customers with the right offering regardless of the challenges they face. This is in line with our strategy to continuously rebalance our brand portfolio with targeted additions that will allow us to gain a leading position in the market.

We are very proud of our fantastic house brands Carrera, Polaroid, Smith, Blenders, Seventh Street, and Privé Revaux, which have an appeal spanning consumers of all ages and demographics. Alongside our premium brand offer, including Boss, Isabel Marant, Missoni, Jimmy Choo, Moschino, we have many lifestyle brands and diffusion ranges such as Tommy Hilfiger, Kate Spade, David Beckham, Love Moschino, M Missoni to name a few.

Our wider team is constantly following up with customers and exploring ways we can work together to navigate the current climate. As a result, we are rolling out different tools to support practitioners as part of an ongoing company-wide, customer-centric digital transformation strategy.

Launched in 2020, our B2B tool You&Safilo is our one-stop-shop solution to order from Safilo’s portfolio of licensed and house brands, manage warranties and access digital marketing materials. We believe it sets a new standard for user-friendly navigation, ease-ofordering, order verification and tracking. The tool is enabling us to strengthen our relationships with customers in remote areas and expand our marketing touchpoints. Following on the success of Y&S, we have launched a WhatsApp channel to offer a simple, quick and effective way to connect with our customer service teams.

NC: WHAT NEW BRANDS ARE IN THE PIPELINE?

OC: We are excited about our recent launches with new licenses like Dsquared2 and Carolina Herrera helping Safilo strengthen its position in the fashion luxury segment – as well as the athletic performance space with Under Armour. The new Chiara Ferragni partnership also highlights Safilo’s willingness to be more present in the digital universe.

OSCAR CERA

Motivation on myopia

Iam now a semi-retired, experienced, grumpy old man – taking locum work occasionally but keeping up with the latest news. I also continue to take my CPD requirements seriously. Over the past 45 years, I have seen changes in both attitudes and work practises with regards to how we perform our task of looking after the sight of our communities. I have even written a book about it.

I always like to do the best for my patients and believe they appreciate my efforts. About 44 years ago, I fitted an eight-year-old with gas permeable contact lenses for the first time; 10 years later he told me that it changed his life as he was being bullied at school and having his glasses broken on a weekly basis.

The current buzz is around controlling the progression of myopia in children, so they are less likely to develop severe visual impairment in later life. Research has been undertaken for many years now and has determined the seriousness of myopia progression. The evidence is available thanks to a worldwide collaboration between the profession, industry and academia. Many products are now available for myopia control, including both contact lenses and spectacle lenses, along with the use of atropine – though the latter has not yet been licensed in the UK for myopia control purposes.

It would appear that we (as practitioners) are convinced – but we have to explain ourselves and our motivation to both the parents and the child who may or may not want (or be able to afford) treatment.

TAKING THE TIME

For children, I would say that personal motivation is the major factor. There are numerous CPD presentations available explaining how important it is for children to be offered myopia management options if necessary. We seem to know the cause of myopia progression and can offer advice, regardless of whether our explanation of possible outcomes prompts the parents to take more direct action.

The explanation to the child's parent/carer as to why some action should be taking place does require extra time. It has been suggested that just 10 minutes of additional chair time is required, however, it will depend on how long the practice's standard eye examination appointment is – along with other business considerations.

Consider the multiple practice – served by fully qualified optometrists, dispensing opticians and contact lens opticians. We all went to the same colleges and universities. There is no getting away from the fact that,

even if we enjoy solving patients' visual problems, at the end of the day we need to be paid for our service. Can we see 21 patients as effectively as 10 in one day?

The use of advanced equipment is commonplace in High Street practice, but the plea that equipment enables a shortening of the test time is unfounded in my view. Rather, it is a reason for the consultation to be longer. Advanced or additional equipment enables us to investigate more deeply and accurately, predicting conditions that have not yet manifested themselves. Certainly, the NHS is way behind in recompense for eye examination fees, which privately range in my area from zero to £105.

The subject of myopia control is a very serious one that has not – until now – been wholeheartedly adopted by the multiples. Offering a service of specialist soft contact lenses for the control of myopia is, in isolation, inadequate. If we are to offer a clinical service to mitigate a potentially severe future myopia epidemic, then the full spectrum of solutions should be offered. There is good evidence that myopia control works. Is myopia less important than cataract or glaucoma?

We have identified a growing concern that can be eased if the right action is taken soon enough. Is it time to hear our eye warriors stating our case? The system and process is already in place. It just needs the strength and determination we see in other professions to push our important agenda forward.

Martin Goldman FBDO the author of iC Through the Eyes of an Optician, and is a contact lens optician based in Dorset.

Are we doing our best for young myopia patients?

SOCIAL MEDIA TIPS: HAYFEVER AND HEALTH

COMMON LEGAL ISSUES

In this month's OA Corner, dispensing optician Sue Deal considers some of the legal issues encountered in practice that the optical assistant (OA) ought to be knowledgeable about.

She will begin with an overview of the Opticians Act of 1989, which covers the sale of optical appliances, and how it relates to prescribing to children. Sue will also discuss the sale of ready-readers, both in retail outlets, online and in optical practices – and consider the criteria required for an OA to dispense a prescription and the rules that apply.

Read OA Corner Part 28 in full on DO Online

This month, EyecareFAQ will focus on how spectacles fit, parts of the eye, and retinal detachment. April also sees World Health Day (7 April) and Allergy Awareness Week (20-25 April), which is a good opportunity to remind patients that you can help with hayfever symptoms.

Here are some suggested social media posts: 'Opticians can help you if you have itchy eyes caused by hay fever. #AllergyAwarenessWeek'; 'Never had an eye exam? Eye exams pick up eye disease before you notice any problems. Book one now! #WorldHealthDay #HealthForAll #WHO75'

Find Q&As on all these topics and in the EyecareFAQ section of the ABDO website and graphics in the EyecareFAQ resources for members section

Find EyecareFAQ on the ABDO website, Facebook , Twitter , Pinterest and Instagram .

BUSINESS BITES

IN PEOPLE WE TRUST

“Leaders can no longer trust in power; instead, they must rely upon the power of trust,” Charles H. Green,

CEO

of Trusted Advisor Associates

Trust is not just important between leaders and teams though. For true collaboration to take place, there needs to be trust between companies and between individuals within companies. The three pillars of trust that, in turn, produce nine habits of trustworthiness are as follows:

HABITS OF ABILITY

1. Choosing to deliver. People trust you when you have a track record of success. That means you follow through on your commitments and deliver results.

2. Choosing to coach. When leaders develop the habit of acting like a coach, they put the needs of their people ahead of their own.

3. Choosing to be consistent. Predictable and consistent behaviour is essential for being a trustworthy leader. Your people trust you when they can rely on you to act, and react, in a consistent manner.

HABITS OF INTEGRITY

4. Choosing to be honest. Honesty is the foundation of integrity. It means you tell the truth, admit mistakes, and make ethical decisions.

5. Choosing to be open. Trustworthy leaders share information in an open and transparent fashion. They keep their team members informed so they can make responsible decisions.

6. Choosing to be humble. Trustworthy leaders are humble leaders. Humbleness doesn’t mean meekness; humbleness is strength under control.

HABITS OF BENEVOLENCE

7. Choosing to evangelise. Leaders need to be evangelists who spread the good news of all the great things happening in their organisations.

8. Choosing to be brave. Leaders have to make tough decisions, often in uncertain conditions with sparse information. Trustworthy leaders demonstrate bravery by making decisions in alignment with their values and those of the organisation.

9. Choosing to be kind. Kindness should not be underestimated when it comes to building trust. Extending common courtesies, praising and recognising team members, and building personal rapport are all ways leaders demonstrate kindness.

RECOMMENDED READING

Blakey J. The trusted executive: nine leadership habits that inspire results, relationships and reputation. ISBN-13 : 978-0749474225.

KEEP ABREAST OF RULES AND REGULATIONS

ABDO

A LIFELINE FOR MEMBERS

The ABDO Benevolent Fund is a registered charity that assists those members, past and present (or their dependents), who are suffering financial hardship.

As an ABDO member, if you know a colleague who you feel might benefit, or if you find yourself facing a difficult financial situation, please contact Jane Burnand by emailing jburnand@abdo.org.uk or telephoning 0793 993 6827.

All enquiries are handled in strictest confidence. Any ABDO member can make a charitable donation to the fund.

CALL FOR CONTRIBUTORS NEW

Do

Tips & Tricks series

Study for a degree

with ABDO College

If you want to further your career in optics and learn while you earn, why not study for a degree with ABDO College?

You can:

Study online and learn new skills to use in practice

Attend block release, experience college life and make great friendships

Learn from dedicated and experienced academic staff

Be supported by helpful course tutors.

abdo

You will take a two-year Foundation Degree course followed by a third year BSc Degree course in ophthalmic dispensing – leading to BSc (Hons) and the ABDO Level 6 FBDO qualifications.

Earning a degree is an opportunity to: Develop knowledge and expertise in a subject you enjoy Build transferrable skills in communication, leadership and problem solving Improve your career prospects

In most cases, student finance is available to those undertaking the degree.

For more details and to apply: visit www.abdocollege.org.uk call 01227 738 829 (Option 1) or email info@abdocollege.org.uk

Your membership. Your benefits.

Your ABDO membership provides a range of rewards and services that will benefit both your personal and professional life, saving you money every month.

BENEFIT SPOTLIGHT

Travel Discounts

ABDO MEMBER BENEFITS INCLUDE:

• Professional indemnity insurance

• Personal accident cover

• Counselling helpline - FREE 24-hour service

• CPD

• Dispensing Optics

• Access to selected British Standards

• FREE legal helpline

• Discounts on everyday purchases

• Member benefit plans with HMCA

• Access to over 3,000 + health clubs, gyms and leisure centres

• Mobile phones on the best rates available from EE

• Savings on all your travel needs

• Totum card powered by NUS Extra

• Membership of the International Opticians Association (IOA)

• Save on travel insurance policies

• Savings on Apple products

• Advice and Guidelines