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MARCH 2021

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MARCH 2021

contents features 18.

CET – C-77198 Digital centration By Howard Collins, Paul Hopkins and Professor Leon Davies


CET MCAs – C-76298 A specialised skill. Signposting patients with visual impairment to increase their health outcomes By Jayshree Vasani



CPD Part 1 From CPD to CET and beyond By Alex Webster


In practice Going green in practice By Antonia Chitty


NCC update Eco practice: walking the walk By Tony Harvey




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DISPENSING OPTICS The Professional Journal of the Association of British Dispensing Opticians Volume 36 No 3

EDITORIAL STAFF Publisher Editor Email Assistant Editor Email Design and Production Email Admin. Manager Email

Sir Anthony Garrett CBE HonFBDO Nicky Collinson BA (Hons) ncollinson@abdo.org.uk Jane Burnand jburnand@abdo.org.uk Rosslyn Argent BA (Hons) rargent@abdo.org.uk Deanne Gray HonFBDO dgray@abdo.org.uk


0781 2734717 ncollinson@abdo.org.uk www.abdo.org.uk


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

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01227 733911 efox@abdo.org.uk www.abdo.org.uk


Alexandra Webster MSc PGDipE FBDO CL FHEA FBCLA ABDO CPD, Unit 2, Court Lodge Offices, Godmersham Park, Godmersham, Canterbury, Kent CT4 7DT

Telephone Email

01206 734155 abdocpd@abdo.org.uk

CONTINUING EDUCATION REVIEW PANEL Joanne Abbott BSc (Hons) FBDO SMC (Tech) Josie Barlow FBDO CL Keith Cavaye FBDO (Hons) CL FBCLA Andrew Cripps FBDO PG Cert HE FHEA Kim Devlin FBDO (Hons) CL Stephen Freeman BSc (Hons) MCOptom FBDO (Hons) Cert Ed Claire McDonnell FAOI Angela McNamee BSc (Hons) MCOptom FBDO (Hons) CL FBCLA Cert Ed Alex Webster MSc PGDipE FBDO CL FHEA FBCLA Gaynor Whitehouse FBDO (Hons) LVA

DO Dispatches A BATTLE HARD FOUGHT The General Optical Council (GOC) has concluded its Education Strategic Review – as we report on page 7 of this issue. The one really good outcome for all dispensing opticians (DOs) is that the GOC has finally agreed that all qualifications for DOs should be at the same academic level as ABDO’s Level 6 Diploma in Ophthalmic Dispensing – as we have always argued it should be. I would like to take this opportunity to thank all those members who wrote to the GOC about this issue, and did so much to support the Association in this very lengthy battle. As late as last autumn, it appeared that the GOC was doggedly holding on to the view that we were a Level 5 profession – even though the vast majority of DO registrants were already at Level 6, with its degree-level learning. Fighting this battle has been draining for all concerned and, frankly, could have been avoided had the GOC dealt with this properly at the commencement of the ESR. However, we can now face the many other challenges that the review has posed with the knowledge that we have confirmation of our very high standard of learning. This will provide many opportunities as we move forwards as a profession and as an Association. So, a very big thank you once again for your support during this very critical period.

Sir Anthony Garrett ABDO general secretary

EDITORIAL COMMITTEE Nicky Collinson BA (Hons) Antonia Chitty MA MCOptom MCIPR Alex Webster MSc PGDipE FBDO CL FHEA FBCLA Max Halford FBDO CL Debbie McGill BA (Hons) Sir Anthony Garrett CBE HonFBDO Jo Holmes FBDO DISPENSING OPTICS IS PUBLISHED BY ABDO, Unit 2, Court Lodge Offices, Godmersham Park, Godmersham, Canterbury, Kent CT4 7DT © 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: 8,848 copies (January to June 2020) ABDO Board certification




A DO and proud of it Let’s opt for a greener future f you have a hand in buying frames and accessories in your practice, have you thought about the companies you are buying How can we all support from and their green a greener industry? credentials? At 100% Optical last year, I visited the stands and asked just that question – with some interesting results. There were a couple of frame suppliers who told me they were totally eco-friendly; one in particular said their frame ranges were made up of 95 per cent recycled acetate that had been used as another product. They also have a bio-based element made from the castor oil plant, with five per cent metal which is not recycled. In addition, this company has a scheme where for every frame that is sold, a tree is planted in Africa. All its point-of-sale and packaging is made from recycled product, and it operates a scheme where a box is supplied with a pre-stamped address so that when the patient has finished with the frame, they can post it off to be recycled. Another forward-thinking company works in collaboration with fisherman around the world, collecting marine plastic and discarded fishnets and other waste. These are all separated and converted into polymers, which are graded to be used as recycled and re-used raw material for frames on the optical market. Its cases are made of cork, and all its packaging is recycled. Currently, these suppliers offer frames at a premium rate, which is not always affordable for all patients. It will be refreshing to see prices come down for eco-friendly frames as, I hope, more manufacturers take action. We know that manufacturers are at different stages in their journeys towards being more environmentally friendly. The companies I spoke to are going step-by-step, being mindful when changing their frame ranges, reducing packaging and switching to recycled packaging. Conscious of being as carbon neutral as possible, some companies have solar panels on their offices and warehouses too. When buying frames this year, please consider the green options available to you. Manufacturers are keen to embrace the demand for sustainable products. Our purchasing habits can support that.





ABDO ready to support new education system ABDO has stated it is looking forward to working with the General Optical Council (GOC) to address the strategic and technical issues that would arise from the implementation of new standards for qualification providers, and new outcomes for students to achieve, in order to register ABDO Level 6 diploma as a dispensing optician set as benchmark (DO) or optometrist. Responding to the GOC’s approval of the new system last month (see page 7), the Association welcomed the regulator’s decision that all qualifications for DOs should be at the same academic level as ABDO’s Level 6 Diploma in Ophthalmic Dispensing. ABDO CEO and general secretary, Tony Garrett, said: “I am delighted the GOC has recognised that ABDO’s Level 6 Diploma in Ophthalmic Dispensing, with its degree-level learning, provides the right benchmark for entry to the profession, particularly given the demand for DOs to develop their roles to help meet patients’ ever-expanding need for high quality eyecare.” ABDO also welcomed the GOC’s acceptance of its argument that to ensure consistently high standards of education, there should be greater detail in the new outcomes for registration about the clinical skills and knowledge required of newly-qualified practitioners, and recognition of the distinct roles and expertise of DOs and optometrists. ABDO expressed support for the GOC’s intention to commission ‘indicative documents’ that would provide additional information about the content of programmes leading to registration as a DO or optometrist. Requiring qualification providers to follow these indicative documents, or explain why they have not done so, would help to ensure consistent, high standards, while still allowing scope for innovation, the Association stated. ABDO also added that given that the outcomes for registration and indicative documents were mutually interdependent, it would be important – as the GOC had now acknowledged – to review the outcomes once the indicative documents had been produced. There remained significant risks associated with moving to the new standards and outcomes, not least in relation to the costs of implementing and operating the new system, the Association noted. It welcomed, therefore, the GOC’s intention to keep its impact assessment up-to-date, and to ensure that its approach to quality assurance was consistent and proportionate, and minimised the overall burden of regulation. As implementation of the new system begins, effective engagement with stakeholders would be vital, said ABDO, adding that it was looking forward to working with the GOC to address the strategic and technical issues that would arise.


MARCH 2021

Landmark GOC education changes approved The General Optical Council (GOC) has approved new education and training requirements for GOC approved qualifications leading to registration as a dispensing optician (DO) or optometrist. These will replace the current Education Quality Assurance Handbooks for optometry (2015) and ophthalmic dispensing (2011) – “and will ensure that all DOs and optometrists are equipped to deliver eyecare services in a rapidly changing landscape and meet the needs of patients in the future”. The requirements are outlined in three documents: Outcomes for Registration; Standards for Approved Qualifications; and Quality Assurance and Enhancement Method. A key change includes that for the first time, qualifications in optometry will have a specified minimum Regulated Qualification Framework of Level 7; and for DOs, this has been increased from Level 5 to Level 6. Immediate past GOC chair, Gareth Hadley, said: “The new requirements mark the most fundamental change for over 35 years in the way optometrists and DOs are prepared for entry to our register – and they will have direct and lasting positive impacts on patient care and safety. “The qualifications will also give greater assurance that our requirements are being met and risks are being managed, therefore continuing patient and public confidence in our ability to maintain and monitor high standards.” It is anticipated that most education providers would work towards admitting students to approved qualifications that meet the new outcomes and standards from the 2023/24 or 2024/25 academic year. Read more on this story on DO Online.

FMO rebrands as OSA The Federation of Manufacturing Opticians (FMO) has rebranded as the Optical Suppliers Association (OSA), with a new logo and website. In conjunction with ABDO, the new website at www.osa-uk.co.uk will for the


Star turn to drive sales Rodenstock has announced actor Patrick Dempsey as the face of its 2021 Porsche Design Eyewear collection. The Hollywood actor is starring in a new year-long campaign that includes digital content, practice window and point-of-sale marketing material, and extensive PR and social media activities. “Patrick Dempsey is the embodiment of Porsche Design values and is a perfect fit to represent the brand,” said Jan Becker, CEO of the Porsche Design Group. “The goal of the global campaign and the partnership with Patrick Dempsey is to entice and excite the consumer and thereby raise demand in the stores of our exclusive retail partners,” added Günther Herrmann, vice president and head of eyewear at Rodenstock.

Dr Anne Wright CBE has taken over from Gareth Hadley as chair of the General Optical Council (GOC). Dr Wright was chair of the National Lottery Commission for eight years until 2013, and a Member of the Bar Standards Board from 2012 to DR ANNE WRIGHT CBE 2017. Her

most recent appointment was as member and lay vice chair of the Nursing and Midwifery Council. She was awarded the CBE in 1997 for services to higher education. Dr Wright said: “I am delighted to have been appointed as the chair of the GOC. With transformative projects such as the Education Strategic Review and the introduction of a new continuing professional development model as well as future legislative reform, it is an exciting time to be joining the council.” Gareth Hadley, who was chair for eight years, said: “I’ve thoroughly enjoyed my time as GOC chair and I am proud of what we have accomplished.”

first time offer benefits to the employees of OSA members – with a new fee structure to be implemented from this month. OSA chair, Stuart Burn, explained: “The reason for the name change is to better convey exactly who we are and what we stand for. Our revised mission statement reinforces our message and our financial restructure gives us the

platform to re-energise the Association and provide the financial muscle to deliver lasting tangible support to optical suppliers and their staff. The OSA will also redouble its efforts to work more closely and collaboratively with other optical associations, particularly in this post Brexit landscape.” Read more on this story on DO Online.

New chair for GOC





Rise in the ranks Russell Bickle has been promoted to general manager at Shamir UK. A qualified dispensing optician, Russell has more than 20 years’ experience in the industry and profession. For the past two years, he has led Shamir’s sales and marketing team as national sales manager. The company stated: “Throughout what has proved to be one of the most challenging years to date, Russell adopted multiple additional responsibilities, going above and beyond what was expected to keep the company operating as close to full capacity as possible; all the while offering his colleagues support and guidance. “Everyone at Shamir UK is delighted that his efforts have been recognised, and strongly believe that Russell will continue to achieve brilliant things for the company as the new general manager.”

Event moves to autumn Members of the National Eyecare Group (NEG) will gather together in September for the group’s 2021 Building for Success Conference. Themed ‘The tools for success’, the two-day event for members, supported by title sponsor CooperVision, will take place at the DeVere Hotel Staverton Park, Daventry, on 26-27 September. Phil Mullins, NEG operations director, said: “Over the course of two packed days of CET, networking and business-building, we aim to share with members the valuable tools they require to develop their business, succeed in an ever-changing world, and help promote a strong independent sector in the UK.”




Myopia control lens launched Hoya Vision Care UK has officially launched its MiyoSmart lens in the UK and Ireland, following a two-year clinical trial. The lens, developed in collaboration with the Hong Kong Polytechnic University, features Hoya’s patented defocus incorporated multiple segments (DIMS) technology to create a myopic defocus effect, said to slow myopia progression and axial elongation in children. The technology received a Silmo d’Or award in October 2020 and the Grand Prize, Grand Award and Gold Medal at the 46th International Exhibition of Inventions of Geneva in April 2018. The lens also features a multi-coating that is water repellent, easy-to-clean and durable, whilst offering UV protection and impact resistance too. Results from a two-year randomised clinical trial conducted in Hong Kong, demonstrated that children wearing DIMS spectacle lenses had a reduction of 60 per cent in myopia progression compared to those wearing single vision lenses. Andrew Sanders, professional services director at Hoya UK, said: “We’re extremely proud to announce MiyoSmart to the UK and Ireland...The introduction of such an effective treatment only emphasises Hoya’s innovatory stance within the optical industry and we truly can’t wait to see the difference it will make.” The company is supporting the launch with a series of webinars and full training for those who plan to dispense the lens.

Joint venture takeover plan EssilorLuxottica and CooperCompanies are to create a 50/50 joint venture for the acquisition of SightGlass Vision, a US based life sciences company developing spectacle lenses to reduce myopia progression in children. “We are excited to join forces with CooperCompanies, a company with a strong track-record in addressing major vision conditions, including myopia, and leverage together the SightGlass Vision technology,” said Francesco Milleri and Paul du Saillant, respectively CEO and deputy CEO of EssilorLuxottica. Al White, CooperCompanies CEO and president, added: “By combining our strengths, we look forward to increasing the life-changing offerings available to global eyecare practitioners to combat childhood myopia.” The joint venture will acquire SightGlass Vision from CooperCompanies, with the closing of the acquisition and creation of the joint venture subject to regulatory approvals and other customary closing conditions. CooperCompanies previously held a minority ownership interest in SightGlass Vision and completed its acquisition of the company in January 2021.

DISPENSING OPTICS I MAR2021 Unique insights into sight loss ABDO head of communications, Antonia Chitty, is hoping her newly acquired PhD in creative writing will help expand our knowledge of what it’s like to live with sight loss. As part of her PhD from Goldsmiths College, University of London, Antonia produced a critical paper using postcolonial and disability theories to look at sight loss in literature, from the perspective of academics with experience of it. Having already achieved an MA in creative writing in 2015 from the

University of Sussex, Antonia has also written a novel about an ophthalmologist who loses their sight. This formed part of the work assessed for her PhD. She said: “I have really enjoyed working on my doctorate alongside my work at ABDO. It has been a privilege to have the chance to delve deeply into an underexplored area of study, looking at the crossovers and tensions between postcolonial theory, literary theory and disability theory in relation to writing about lived experience of sight loss. “I’m so pleased to have passed the written and viva examinations with positive feedback from the examiners, and my main

New role for ‘lens geek’ Self-confessed ‘lens geek’ Paul Jones is the new national sales manager at Norville (20/20). Paul started in optics 28 years ago and has worked in practice as an optical technician, dispensing optician and practice manager. He joins the company after 11 years


ANTONIA AT HER MA GRADUATION thought now is how to find time to continue work on this topic,” she added.

with Hoya Lens UK, latterly as its regional business development manager. Paul said: “When it comes to lenses I can be quite geeky, but I’m very interested in supporting customers to be able to improve the lives of their customers, by giving them the best optical solution. I believe with the backing and support of our parent company, Inspecs, we can build on the heritage that Norville has and enter into a new future.”

NEWS Patient incentive schemes Essilor has introduced a new ‘total satisfaction’ guarantee to cover the loss and breakage of lenses. If a patient is not 100 per cent satisfied with their new personalised lenses, or loses or breaks them, they can be exchanged or replaced within a 12-month guarantee period. The promise applies to purchases of Frame fit f-360°/ E2, Near Vision Behaviour, Eyecode and AVA lenses. Tim Precious, managing director at Essilor, said: “It’s the first time we’ve extended a guarantee like this to cover the loss and breakage of lenses as part of a growth strategy, but we are confident it will help ECP efforts to regain momentum and drive new and existing customers back in-store.” The company has also launched its annual multi-pair Take Two promotion, offering patients complimentary or discounted second pairs of lenses. The promotion includes all branded lenses, is supported by national digital advertising, and runs until 25 November. Participating practices will appear on the Essilor optician finder, with practice posters and digital assets available. * Visit Essilor’s new virtual flagship store at essilorvirtualexperience.com, which brings to life its products, technologies, marketing and sales support tools.

Clinical Hub for members launched

Current Clinical Hub topics ABDO has launched an online Clinical Hub for members to bring together upto-date research and current knowledge on a range of topics. The hub will be constantly expanded, and launches with a focus on myopia management, along with a DO guide to eye diseases and a section on extended services. Members can also access useful



MARCH 2021 New tool for dry eye The electronic eyelid hygiene device, NuLids, is now available in the UK from Positive Impact. Designed for use in the practice, or by the patient at home, NuLids massages an eye-cleansing foam on the eyelid, exfoliating the lid and stimulating meibomian gland expression. According to PI’s Nick Atkins, results from a multi-centre clinical study in the

ELECTRONIC MASSAGE DEVICE US showed the device was safely used by patients, whilst delivering a statistically significant improvement in the signs and symptoms of dry eye disease.

Trio plans eco eyewear overhaul Thélios, the eyewear arm of luxury goods group LVMH, is joining forces with acetate-sheet manufacturer Mazzucchelli 1849 and specialty materials provider Eastman – a pioneer in molecular recycling – to push forward sustainable innovation in the eyewear industry. The partners are exploring a series of eco-responsible formulas, using certified recycled content and bio-sourced materials. Based on Eastman Acetate Renew, the aim is for the new formulas to match both the technical and aesthetic qualities of traditional acetates, while being highly sustainable. “This project is part of a sustainability path that Mazzucchelli has been pursuing for several years,” said Giovanni Orsi

Mazzucchelli, chairman and shareholder of Mazzucchelli 1849. “It is thanks to the commitment of each individual player that it will be possible to achieve a full sustainable transformation of the eyewear industry.” The first collections composed of the new acetates will be released by Thélios in 2022.

resources such as a guide to acronyms used in eyecare and eyewear, a glossary of terms, as well as links to ABDO’s clinical advice and guidelines, patient leaflets and information to share with patients. The hub was developed by ABDO clinical lead, Max Halford, who said: “This hub is for members looking for support on topics from children’s eye issues to supporting older people with their visual needs. It offers headline information followed by a deeper insight into each subject, and is fully backed up by, and linked to, available research. “No matter what stage you are at in your career, we hope that the resources and links provided will prove useful,” Max continued. “In each main section, you will find an overview of the topic, as well as fuller articles and resources.

“We need to be sure that the patients we care for are fully informed and participate in decisions around their eye health – and to do this we, as clinicians, need to ensure our knowledge and understanding is up-to-date and relevant. DOs are part of a wider clinical multi-disciplinary team and we hope this new Clinical Hub will help them contribute as widely as possible in patients’ eye health decisions.” Other topics planned for 2021 include healthy living optical practices, contact lenses, low vision and dry eye. ABDO members who would like to contribute to a topic by conducting a review of current research and drawing together useful resources, should contact mhalford@abdo.org.uk Members can explore the Clinical Hub on the ABDO website.



New chapter at ‘lens bible’ hil Gilbert has stepped down as editor of Ophthalmic Lens Availability (OLA) Online after 10 years in the role, and retired to Spain after a career in optics spanning 30 years. Phil is a qualified dispensing optician (DO) who started his career in optics straight from school at Melson Wingate. After qualifying, he worked in a number of practices before joining Zeiss in 1982 as a lens representative. His forte was not just in sales but also in education and, with the advent of CET, Phil became a regular provider through Zeiss, optical magazines and ABDO. Keith Cockram worked with Phil at Zeiss. He told Dispensing Optics: “Phil has been an optical friend and colleague for many years. He was always very active within ABDO, and very passionate about optics. He approached his job from the perspective of ‘excellence of optics’, and that’s what made him successful. “Later in his time at Zeiss, Phil took up the challenge of equipment, instruments and diagnostics, training people how to use our optical devices


PHIL ENJOYING LIFE IN SPAIN and dispensing tools. His passion for optics never changed,” Keith added.

BUILDING A LASTING LEGACY The original OLA book was conceived by Dr Alan Tunnacliffe and Phil took over updating it on behalf of ABDO in 2011, with his first issue published in 2012. As a qualified DO working within the lens industry, Phil was well placed to enhance the book’s content during the most expansive period in optics when freeform lens production took over conventional production for almost every manufacturer.

Exclusive resource for members OLA Online is a key resource, exclusively available to all ABDO members, and brings together data found in manufacturers’ catalogues. The site contains an interactive search function, enabling members to view lenses available from all of the contributing manufacturers in one place. Further information on these products can be found via links to online catalogues and websites. Members can also read educational and informative articles about specialist lenses, educational information, hidden lens engravings, interactive tools, digital dispensing and further reading in optical miscellany. Access OLA Online in the members area of the ABDO website.

Easy online search tools

Phil was a member of the Technical Committee TC172 for British Standards, reporting to the Federation of Manufacturing Opticians. He was a frequent lecturer on the CET circuit until 2014, and had many contacts within the industry and profession, which allowed him to expand the publication. Phil came up with the idea of moving OLA to a website, but it was not until Antonia Chitty took over the role of ABDO head of communications that this was developed. After a year of complex population of the site, OLA Online is now firmly a part of ABDO member resources rather than an expensive and cumbersome printed tome. Phil said: “I have thoroughly enjoyed my editorship over the past 10 years but am now fully retired from optics, enjoying living in the sun in Spain.” Antonia commented: “I have been continually impressed by Phil’s vision, dedication and lens knowledge. In moving OLA online, he successfully completed a mammoth task, and it has been a pleasure working with him. ABDO members will benefit from the legacy of OLA Online for years to come.”

NEW EDITOR APPOINTED Kevin Gutsell has been appointed to take over as editor of OLA Online. An ABDO board member, and well-known throughout the profession and industry, Kevin said: “I am both delighted and excited to take on the position of OLA Online editor. Tremendous work has already been completed by Phil and Antonia in order to take the printed information, and more, and place this on a modern platform.” Previous knowledge of ophthalmic lenses in practice, representing ABDO on the British Standards Institute standards for lenses committee, and being responsible for analysing the market and marketing lenses for a manufacturer, are expected to stand Kevin in good stead as he takes OLA Online forward. “I look forward to engaging members and suppliers in taking OLA forward in the coming months and years,” Kevin added. MARCH 2021 DISPENSING OPTICS


NEWS New chair for board of trustees Angela McNamee has handed over the chair of ABDO College’s board of trustees to Clive Marchant, after completing the maximum term of eight years as a trustee. Having been chair of the board of trustees for the past five years, Angela said it had been an honour to serve in the role. She told Dispensing Optics: “It’s been such a privilege to serve as an ABDO College trustee, seeing the College grow both in its scope and in its outstanding reputation. Then, to be chosen as chair of the trustees five years ago, was truly an honour. “It’s a position that I’ve been very proud to hold, and never more so than in the past year when I’ve witnessed Outgoing chair, how amazingly Angela McNamee

Unique New Year intake pays off ABDO College’s plan to offer a one-off January intake to the contact lens optician (CLO) course has paid off, with another excellent intake. ABDO College head of operations, Steve Hertz, explained: “We know that a lot of dispensing opticians weren’t in the position to apply for the course, which started in September 2020, perhaps because they were furloughed or their employer was facing uncertainty about their business. We didn’t want this cohort to miss out on the chance to take the course.” The College has made temporary adaptions to the course to make the most of online teaching while residential block releases have not been possible. Dan Palfrey is studying to become a CLO, and talks about his experience of online learning: “I’m used to the online environment having been an ABDO College tutor for a couple years, but



Jo Underwood and her team have coped with the unprecedented demands inflicted on them by the pandemic,” Angela continued. “I wish every future success to the College and to the trustees as they go forward under Clive’s very safe and capable leadership.” Immediate past president of ABDO, Clive Marchant, commented: “I am absolutely delighted to be appointed chair of the College trustees. It is 20 years since ABDO College was established, a time to celebrate its success to date, but the pandemic is a time of great challenge as the College team adapts to delivering first class education remotely. “Jo Underwood, the College’s founder principal, is soon to retire. Through her leadership, the College has grown to become a world-renowned educator of opticians. Jo should be immensely proud of all she has achieved. The College will be in good hands when her successor, Dr Robert Cubbidge, takes post this summer. “With change comes new opportunities,” continued Clive, “and ABDO College will continue to be at the forefront of delivering world-class

learning online was a bit different to what I was used to. My FBDO was done before the VLE [virtual learning environment] so I had to post off all my assignments. But the interface is really easy to use. “My tip for new students would be to take the time to download all the assignment PDFs right at the start, and save them onto your PC or phone so you can read ahead. “Learning during the pandemic was an additional challenge of course,” Dan continued, “but for me it paled in comparison to the challenge of learning with a baby in the house. I was nervous about not being able to meet my practical training deadlines or not seeing enough patients due to the pandemic, but my supervisor and director have been really supportive. My tutor was very flexible when I wasn’t quite able to complete the tasks in the exact way asked for in the assignment. “So far I’m getting good marks and enjoying the course. It is a nice change of pace stepping away from my DO role into

education for the optical profession. I look forward to working with the trustees and College team as we develop and approve the College’s strategic New chair, goals and Clive Marchant objectives.” Tony Garrett, secretary to the trustees, said: “Angela McNamee has had five highly important and successful years as chair of the ABDO College trustees. She has shown great leadership during these recent, most difficult of times – and has always put the long-term interests of the College first. Her keen sense of duty will be greatly missed by her fellow trustees and College staff alike. “Clive Marchant assumes the chair at this challenging time, and his considerable experience as an ABDO board member and president will certainly be invaluable in the months ahead.”

Trainee CLO, Dan Palfrey, with his daughter the clinic a couple times a week. My DO experience comes in handy in the clinic more than I had expected. Looking forwards, I hope to sit my theory exams in the summer and the practicals in the winter all being well.” To learn more about training to become a CLO, visit the courses section of the ABDO College website.

ABDO COLLEGE I MAR2021 OA course off to a flying start The January intake for the Optical Assistant (OA) course has got off to a flying start, with a number of students joining so that they can start the FBDO diploma course in September. ABDO College head of operations, Steve Hertz, explained: “If you are missing some of the essential qualifications to join the diploma course and qualify as a dispensing optician [DO], the OA course will help you progress. It allows you direct entry into the first year and covers all the possible gaps in your knowledge of maths, anatomy and optics, as well as helping you with your written and communication skills.” Fabio Carmo completed the OA course last year and is now in the first year of his DO training. He said: “The OA course was a great way to build upon my optical knowledge whilst gaining the necessary qualifications to proceed onto the diploma. It also helped me get accustomed to the distance learning format of weekly assignments whilst working full-time. This meant I had a good level of base knowledge, and felt at ease with the online portal.” OAs on the course have also been able to make the most of the College’s expertise in online tuition with a new webinar introducing key concepts in maths and anatomy.

Rian Love, ABDO College courses coordinator for optical support programmes, explained: “The first OA webinar is just an introduction to the College, with guidance on who’s who, how to submit assignments, format and layout, walk through the VLE [visual learning environment] and where to find resources and distance learning tips. “We have now introduced a second webinar on anatomy and maths,” Rian continued. “As a result, students seem a lot more confident moving into the trickier maths papers. Several students watched the recording after the live event, in some cases two or three times, so it is a great resource. Overall, the marks in those assignments were very good.” Along with trigonometry, Rian covered basic anatomy of the eye. He added: “I gave students a full walk through and understanding, which they seemed to find very interesting with several great questions.” Students commented: “Maths seems less bad now and the eye is very interesting”; and “I got a lot out of the webinar, it’s a good way to learn.” Student DO Sudha Singh has also completed the OA course as a preliminary to starting the DO course. She said: “If you have not come fresh out of studying A level, then the OA course is the ideal foundation course to complete prior to the DO course. It is a major

OA course covers maths, anatomy and optics stepping stone preparing you for all of the maths and physics you will be introduced to. Without completing this course and having a little taste of what to expect in the DO course, I would have found it a bit overwhelming.” Sudha added: “The OA course truly allows you to take on the DO course with confidence, giving you knowledge and familiarity with the coursework. You develop people and customer service skills, which is key in optics. This is a perfect all-rounder course from which any individual, either stepping into or developing their pre-existing skills, in optics will benefit from – and good value for money.” Find out more about the OA course on the ABDO College website – and apply now for the September intake.

Getting on top of IT New IT support officer, Symon Borny, has been working hard to transform ABDO College’s server room. With a 32-years plus career in IT under his belt, Simon joined ABDO College in January following the retirement of Peter Goldsmith. His main task is to provide day-to-day technical assistance to staff and tutors, whilst maintaining the College’s computer systems and network. Simon said: “ABDO is one of the best companies I have worked for, with a really welcoming attitude. 10 out of 10 so far.”




NEWS Supporting the next generation As reported in last month’s issue, Les Thomas, Claire Walsh and Helen Wilkinson have joined the board of trustees of ABDO College. This month, we learn more about the new faces on the board. A former ABDO College student, Les Thomas is now the learning and development specialist for dispensing opticians (DOs) and contact lens opticians (CLOs) at Boots Opticians. He is also an ABDO practical examiner and practice visitor. Les said: “Since I trained at the College 11 years ago, a lot has changed – but the essence of ABDO College has stayed with me my whole working life. It’s an absolutely incredible training facility with amazing lecturers, past and present. My only ambition in wanting to become a trustee was to make LES THOMAS this amazing

College the best it can possibly be – and to support the next generation of dispensing training.” Claire Walsh has been a supervisor and distance learning tutor for 10 years. She said: “I’ve been a DO in independent practice for around 25 years, a CLO for 19 years, and an SMC (Tech) for about three years. I am extremely passionate about my profession CLAIRE WALSH and tutoring. I love supporting and helping to develop DOs, CLOs and optical support staff. Having a place on the board seems like the perfect next step. “I look forward to working with and supporting the fundamental running of the College. Hopefully, I can add insight from a tutoring and supervisory perspective to aid the continuing success of all courses and a thriving future,” added Claire. Helen Wilkinson is a locum DO, and was one of the first graduates of the ABDO College/Canterbury Christ Church University BSc (Hons) degree programme. She has been a College tutor for 11 years.

Now a senior tutor, Helen said: “I am proud to have aided the success of several students working towards their qualifications as dispensing opticians as well as study at the College myself. It is an honour to have been appointed as a trustee, and I am excited to be able to contribute further to the future of our profession and the College.” Claire and Helen HELEN WILKINSON replace Kim Devlin and John Hardman who will retire as trustees in July. Les replaces Angela McNamee, former trustees chair. Commenting on the appointments, Tony Garrett, secretary to the trustees, said: “Les, Claire and Helen bring a wide range of skills and experience to the table, and I am sure that they will make a significant contribution to the future development of the College. “They are replacing three experienced and dedicated trustees who have given great service to the College. I would personally like to thank them for their unstinting support.”

Spring is in the air As spring approaches, ABDO College is looking forward to new life and beginnings, green shoots of learning and education, and a better year ahead for all students, staff and tutors. Did you know that Grade II listed Godmersham Park has associations with the writer Jane Austen. The celebrated author stayed at Godmersham Park when it was the home of her brother, Edward Austen Knight, and it is thought to be the inspiration for her novel, Mansfield Park. Godmersham Park Mansion is also depicted on the Bank of England £10 note issued in 2017. It was established as a centre of excellence for ABDO College in 2001, and in 2019 College trustees were successful in extending its lease to 2040. Learn more about the College’s history on its website, and follow ABDO College on Instagram for the latest photos of this beautiful location.





EYEWEAR A design fit for life

Give patients the feel-good factor with the StepperS STS-30050

“StepperS frames are designed with ‘fit for life’ characteristics so they feel just as good when you take them off at the end of the day, as they did when you first put them on,” says Peter Reeve, Stepper UK managing director. The StepperS STS-30050, weighing just 6.6g, has ‘fit for life’ characteristics in abundance starting with the material it’s made of: hypoallergenic TX5. This innovative plastic is lighter than traditional acetate, putting less pressure onto the touch points of the face. The front is moulded in a single process so the anatomical curve is set throughout its lifetime. An integral bridge on the StepperS STS-30050, available in Crystal, Hot Pink, Electric Blue and Jade, is the result of decades of experience in creating best-fit nose shapes began by founder Hans Stepper, a German Master Optician. “When you look good, you feel good – and this StepperS ensures this feel-good effect is long lasting,” added Peter.

Swing into spring Swing into spring with this sensational selection of frames and sunglasses – ranging from edgy eco designs to high-tech titanium trends... Glamorous sun styles with a retro vibe

Silhouette Sun Lite model 3192

Silhouette has unveiled its 2021 Sun Lite collection featuring a revival of retro shapes, nostalgic colour palettes and popular shapes. The three fresh styles – one ladies’, one men’s and one unisex – combine full-rim design with Silhouette’s signature lightness. Traditional colours have received a refresh with mirrored lenses, while popular shapes have been brought up-to-date with softened edges. Model 3192 (pictured) is a cat-eye design for ladies available in four colourways. In the colourway shown here, a pastel lavender shade has been applied to the lenses, fading into a soft pink, with a coordinating mauve shade rim. The Sun Lite collection is available under Silhouette’s Light Management programme on both prescription and non-prescription frames across brown, grey and green lenses.

Turning the tide on plastics Cleverly created with recycled and bio-based materials, Eco Ocean is the latest collection from sustainable eyewear brand Eco by Modo. To create the frames, Modo teamed up with Waste Free Oceans, an NGO that works with local fishermen to collect used plastic. These items are then checked, cleaned, cut, dried and prepped. After that, they are extruded into plastic granules that become the Eco Ocean frames. The frames are lightweight with a smooth, matte finish in oceaninspired shades like Aqua, Ink and Clay, as well as classic Black, Olive and Blue. There are eight new optical styles and eight sunglasses, in both polarised and non-polarised forms. Naturally, the cases and packaging are made from sustainable materials like corn starch and recycled PET. And for every frame purchased, Modo will plant a tree: 2.4 million so far.

Lulu Love is all around

Eco Ocean model Laguna

Great British design steeped in ‘Lulu Love’ sums up the 2021 Lulu Guinness Eyewear collection from International Eyewear, featuring six new optical styles and six new sunglasses. Playful yet practical, the new designs draw inspiration from the classic Lulu Guinness heritage, encompassing distinctive style with MARCH 2021 DISPENSING OPTICS



bold colours and statement designs. Model Lulu Guinness L937 (pictured) is a metal design with a nylon brow insert in pastel hues of Dark Silver/Blue and Gold/Pink. Two-tone plating has been used to accentuate the feminine shape. All styles are supplied with a branded Lulu Guinness case and cloth. Vintage point-of-sale package includes a three-piece display stand, A1 poster and showcard available with every 12 frames purchased.

Anatomically designed for ‘perfect’ dispensing

Lulu Guinness L937 in dark silver/blue

For younger patients requiring new frames, Dibble Optical has extended the Miraflex range. Bell and Parks are the latest additions to the Miraflex Flexible & Safe collection, and feature a slightly firmer front and sides. Two comfort bridge options are available to aid ‘perfect’ dispensing. Each model is slightly different in shape but both have a varied option of two-tone colours, with adjustable tips. Bell would be suitable for children aged from around three to five years, whilst Parks is a slightly larger frame more fitting for children from around five to eight years. The Miraflex Flexible & Light collection is crafted from lightweight TR90 and the frames are anatomically designed to suit the contour of a child’s face. There are three new models in this range: Sirius, Urano (pictured) and Venus aimed at children aged four to nine years.

Japanese minimalism meets European design

Miraflex Flexible & Light model Urano

For spring/summer 2021, Charmant has launched a premium titanium collection for men and women – Charmant Titanium Perfection – pairing European design with superior Japanese titanium expertise and materials. The new collection is optimised for comfort and sophistication, with slender, straight or flowing lines complemented by flexible beta titanium sides. Neutral pastels, warm berry tones and cat-eye shapes all feature in the women’s designs, while the styles for men encompass rounded, rectangular and hexagonal shapes enhanced by hand-painted colour contrasts. Each new model has a note of designer individuality like a vintage bridge, sandblasted sides or a 3D side detail in darker tones.

Ode to materials, fashion and functionality

Charmant Titanium Perfection CH 29717

April launch for Odeeh | Neubau collection

Neubau Eyewear and German fashion label Odeeh have collaborated to launch a joint collection of eyewear as an ode to materials, fashion and functionality. Debuting next month, the collection represents Neubau’s first foray into titanium eyewear. The three optical and two sunglass styles feature a screwless hinge system, while the colour nuances are inspired by natural materials like ceramics – harmonising with Odeeh’s spring/summer 2021 clothing collection. “The collection is all about bold statements that also exude an elegant understatement,” said Odeeh designers Otto Drögsler and Jörg Ehrlich. “In our understanding of a modern wardrobe, which encompasses both fashion and accessories, this balance was so important to us. We always design with our responsibility to the environment in mind, which is why our creations outlast the seasons. Longevity and a respect for the environment are what connect us with Neubau Eyewear.”

Action on climate through bio-eyewear

Mulberry VML122 in gradient green 16


As a proud signatory of the UN Fashion Industry Charter for Climate Action, Mulberry’s sustainable approach extends to the brand’s eyewear. Its spring/summer collection comprises of three sustainable models: one sunglasses style and two prescription frames. The frames are manufactured by De Rigo using bio-acetate, a biodegradable and recyclable cellulose acetate obtained from renewable resources such as seed fibres derived from cotton, and wood


fibres derived from conifers and deciduous trees. The sunglasses feature nylon bio-lenses derived from the castor plant, with cases made from recycled materials. Model VML122 (pictured) is a sustainable bio-acetate prescription frame. The round front piece is personalised with metal pins, while the broad sides reveal the inner metal core and are embellished externally by the Mulberry logo.

Accessible fashion with a minimalist edge Reykjavik Eyes has added three new minimalist ophthalmic styles to its Black Label collection for men and women. Designed and crafted in Italy utilising lightweight Japanese titanium, the frames offer a seamless finish for the “ultimate in comfort and performance”. Our photo show model Rikhard; it features a geometric square front with a double bar bridge along the brow line for an understated titanium look. Model Aria is a classic cat-eye for women, while new model Frederik is a large rectangular frame with a two-tone titanium front which is hand-sprayed. The Reykjavik Eyes collection is exclusively distributed in the UK by Continental Eyewear, part of the Millmead Group.

Vibrant styles for sunnier times ahead “It’s been a tough year for everyone and as spring and summer approach, we hope these seasons bring with them the ability to look forward to a brighter time ahead,” says Clare Gaba, head of marketing and communications at Louis Stone Optical. “And in the interest of spring and summer vibrance, Louis Stone Optical brings you the Icy 312 in Under the Sea.” The company’s Icy eyewear collection comes in a spectrum of vibrant colours and retro designs ensuring there’s something for all tastes, skin tones and face shapes. Icy 312 in Under the Sea (C2) comes in size 53-17-135 and is also available in Countryside (C1).

New model Rikhard by Reykjavik Eyes

Louis Stone Icy 312 Under the Sea

Super light and super flexible The Superlite rimless eyewear collection available from Norville (20/20) now has more than 60 designs made from high quality materials including titanium, stainless steel and TR-90. The range has been created to give practitioners choice and flexibility with the option to pick and mix any combination of frame colour, lens shape and eye size. This enables patients to match their eyewear to their own style, with “something for everyone”. “Superlite Rimless are the lightest spectacles ever, and coupled with the attractive complete glazed package simplified lens listing, it really is exceptional value for money,” stated the company. The collection also comes with a ‘no quibble’ two-year guarantee.

Superlite rimless colour and shape options

Intelligently curated in statement colourways Guided by its founding principle of the ‘intelligent use of colour’, Eyespace’s new Cocoa Mint capsule collection of six frames for the spring/summer season showcases vibrant, thoughtfully curated colours. Model 9110 (pictured) is a statement acetate created using a highly technical layering process. The rounded eye shape comes with Italian branded flex hinges, while tonal marble colours are balanced with lighter variations of acetate. Cocoa Mint signature branding features on the sides. Sized at 54-18-140, the frame is available in two vibrant colourways: C1 is a bold blend of red and violet toned marble, while C2 is a teal tortoiseshell with a tropical turquoise lamination. Next month, our Product Spotlight will showcase what’s new in the contact lens sector.

Cocoa Mint 9110 in teal MARCH 2021 DISPENSING OPTICS


CET COMPETENCIES COVERED DISPENSING OPTICIANS Standards of Practice, Optical Appliances OPTOMETRISTS Standards of Practice, Optical Appliances

Digital centration By Howard Collins BSc (Hons), MCOptom, Paul Hopkins BSc (Hons), MCOptom and Professor Leon Davies PhD, FCOptom, FAAO, SFHEA

s an integral part of ocular healthcare, eyecare practitioners (ECP) should provide patients with an accurate refraction, thereby enabling the appropriate optical appliance to be dispensed, which fully encompasses the patient’s visual needs. Providing optimal visual performance in such appliances is vital to ensuring the quality of the patient’s experience, which in turn should help to maintain practice reputation and minimise rechecks, which can be costly both in terms of chair time and spectacle remakes. Errors in dispensing account for a significant proportion of rechecks1, therefore several important aspects should be considered during the dispensing process in order to reduce the recheck risk. Firstly, a judicious choice of frames and lenses. Not only does the patient need to be happy with the frame choice, but it must also be suitable for the type of lens that is being dispensed. Careful advice about frame size and style, to ensure the best cosmetic outcomes, must be augmented with a knowledge of lens properties in order to provide the patient with their ideal visual solutions. Having made these choices, it is then vital that accurate facial and frame measurements are taken and recorded, as without these values even the best possible lens will perform sub-optimally.

A This CET has been approved for one point by the GOC. It is open to all FBDO members, and associate member optometrists. The multiple-choice questions (MCQs) for this month’s CET are available online only, to comply with the GOC’s Good Practice Guidance for this type of CET. Insert your answers to the six MCQs online at www.abdo.org.uk. After member login, go into the secure membership portal and CET Online will be found on the L menu. Questions will be presented in random order. Please ensure that your email address and GOC number are up-todate. The pass mark is 60 per cent. The answers will appear in the July 2021 issue of Dispensing Optics. The closing date is 4 June 2021.

WHICH MEASUREMENTS SHOULD BE TAKEN? The College of Optometrists and the Association of British Dispensing Opticians (ABDO) guidance advises that appropriate facial and frame measurements are taken and that the fit of the frame should be assessed2,3. So, what are ‘appropriate measurements’? As a minimum, this includes the most common measurements required in order to dispense spectacles: interpupillary distance (IPD), either binocular or monocular, for all lens types; and the segment height or fitting height for bifocals and progressive addition lenses (PALs), respectively. Monocular IPDs should be considered for all lens types, as they will ensure correct lens centration and assist in eliminating induced horizontal prism. According to BS EN ISO 13666:20194, monocular IPD is defined as the distance between the centre of the pupil and either the mid-line of the bridge of the nose or the spectacle frame when the eye is in the primary position. However, due to the natural asymmetries inherent in faces5, accurate horizontal positioning of the optical centres (OCs) is best achieved using ‘the mid-line of the bridge of the spectacle frame’ and should be taken once the spectacles have been fitted correctly; this provides what is known as the centration point (CP) of the lens (Figure 1).


C-77198 Approved for one CET Point



For all the latest CET available from ABDO visit the Events section of the ABDO website. Here you will able to see the latest online interactive CET sessions available for booking. Online sessions include discussion-based workshops, a great way to learn in a small group of your peers. Online discussion sessions are available for all professional roles and are approved for three CET points. New sessions will be added regularly. Additionally, we continue to host our monthly CET webinar series featuring a range of topics and speakers. Each CET webinar will be approved for one interactive CET point.

Figure 3: Pupilometer

Figure 1: Illustrating the potential error of not fitting a spectacle frame correctly before taking measurements. (a) During dispensing the frame is laterally displaced 2mm to the left of the ideal fitting position (grey vertical line) due to poorly fitting nose pads. However, monocular PDs are measured appropriately, using the midline of the spectacle bridge. (b) On collection of the spectacles, the nose pads are adjusted so that the frame sits correctly, the lens OCs are now decentred 2mm in each eye relative to the patient’s pupil centres Fitting heights are required for PALs and bifocals but may be beneficial for single vision lenses to maximise the benefits of customised freeform lenses, and for higher powered, aspheric lenses (or lenses with one or more aspherical surfaces) or anisometropic prescriptions, minimise differential prism in the primary gaze position. It is also important to remember the requirement in British Standards BS 27383:2004+A1:20086 for the ECP to measure and record the vertex distance on all prescriptions over ±5.00D – although this this could be extended to lower prescription powers, particularly for freeform lenses. Other perhaps less commonly taken measurements include pantoscopic angle (PA) and face form angle (FFA). These are important, however, particularly for higher powered prescriptions, where the fitting heights should be adjusted in line

Figure 2: IPD rule

with PA, and OCs displaced horizontally to compensate for FFA7. Failure to make these adjustments can result in changes to the effective lens power and induce unwanted prism7.

WHY TAKE MEASUREMENTS? The main reasons for taking frame and facial measurements are to ensure that: 1) the OCs (or centration points if prism is prescribed) of the lenses coincide with the patient’s visual axes, thereby providing clear vision free from induced prism; and 2) that the correct lens power is provided. However, freeform lenses are increasing in popularity and have been shown to provide greater patient satisfaction than standard lenses8. With advances in freeform lens technology comes the possibility of ever more individualised lens tailoring9, but in order to maximise the potential benefits that freeform lenses offer, a full range of

frame and facial measurements must be taken9. In many cases, taking minimal measurements will prove sufficient and patients will be satisfied with the finished product. However, increasing competition both on the High Street and from online retailers means that it is more important than ever to provide a service geared at building patient confidence and maintaining practice loyalty.

HOW ARE MEASUREMENTS TAKEN? Traditional methods Interpupillary distance is by far the most common measurement taken when dispensing spectacles, with two popular methods employed for this purpose. The first method is by hand with an IPD rule (Figure 2) using Viktorin’s method10. The zero edge of the IPD rule is lined up with an anatomical feature of the patient’s right eye (e.g. pupil centre or limbus) and measured to the corresponding point on the patient’s left eye. When using the limbus, the measurement is taken from the temporal limbus of one eye to the nasal limbus of the other10. Although this method is quick and convenient, it has been shown to have significant inter and intra examiner variability10-14 – with variation of between ±1-4mm. This method may suffer from the effects of parallax where large differences between the IPD of patient and examiner exist15,16 and whilst there are corrections that can be applied to account for this17, it has been suggested that these are not commonly performed10. Literature relating to monocular IPDs taken by ruler is sparse, but Walsh and Pearce10 found the variability to be marginally less than that of binocular IPD. However, a number of practitioners in the MARCH 2021 DISPENSING OPTICS



Figure 4: The effect of parallax study admitted to ensuring the same total value for monocular and binocular IPD measures, which may cause an underestimation of the variability of the monocular results. The second traditional method of assessing IPD is with a pupilometer (Figure 3), which can be used to measure both monocular and binocular IPDs for a range of working distances. Studies have shown pupilometers to give more repeatable measurements13 with less variability13,18 when compared to those using Viktorin’s method10,11. However, in terms of absolute accuracy, they are by no means perfect, with average errors of up to 2mm18.

Figure 5: Pantoscopic angle



Additionally, while some pupilometers have features to help hold the device parallel, e.g. a head rest, others do not and so can easily be held at an angle to the patient, decreasing the accuracy of the measurement. Fitting heights are also specifically defined in British Standards4 and are referenced relative to the horizontal centre line (HCL)6; these are, however, often measured as the vertical fitting distance between the centration point and a horizontal tangent to the lower lens edge. As this is in reference to an edged lens, the measurement must include the height of the edge profile (i.e. the bevel) if present. The standard method of

measuring fitting heights is for the patient to look straight ahead while the practitioner sits opposite and marks the relevant height, using the lower limbus as a reference for bifocals, and the pupil centre for PALs and single vision lenses. Practitioners must ensure that their eyes are level with the patient’s and that the patient has their head in its customary position; failure to do so may lead to parallax errors19 resulting in the lenses being centred too high/low (Figure 4). For a practitioner 30cm away from a patient wearing a frame 12mm from their eye, an alignment error of 2.5cm high or low will lead to a fitting height error of 1mm. Vertex distance is defined in BS EN ISO 13666:20194 as the distance between the back surface of the lens and the apex of the cornea with the eyes in the primary position. Changes to this distance alter the effective power of the lens, with higher lens powers affected to a greater extent. Differences between the vertex distance used during refraction and that in the final spectacle frame, therefore need to be accounted for. The measurement is taken with the patient wearing the frame and may be acquired with a ruler, although vertex callipers may be easier7. If using a ruler, the practitioner must be at the same height as the patient and view square on to the side of the frame to avoid the effects of parallax. The ‘as-worn’ pantoscopic angle (PA) is also measured with the patient wearing the frame, and is the angle between the line of sight of the eye in the primary position (for most patients this will be horizontal) and a line perpendicular to the plane of the front surface of the frame, passing through the frame grooves4. PA should be measured with the patient looking straight ahead with their habitual head and body posture (Figure 5). Like vertex distance, changes in PA can change the effective power of the lens7 and the fitting height should be adjusted to compensate for this: 1mm lower for every 2° increase in PA17. There are various gauges and instruments that can be used to take this measurement (Figure 6), but before taking the measurement, it is important to ensure that the frame has been fitted correctly to the patient and is in the position where it will be habitually worn. Again, as with

Figure 6: Pantoscopic angle tool using any device to take a measurement, the practitioner must ensure alignment to avoid the effects of parallax. Face form angle (FFA), also called wrap angle is the angle between the plane of the spectacle front and the plane of the lens shape4 (Figure 7), i.e. how much the frame ‘wraps around’ the patient’s face. FFA can be thought of as the horizontal equivalent to PA and needs to be compensated for by horizontal decentration in an equivalent fashion20, i.e. 1mm temporal decentration for every 2°. The measurement itself is taken directly from the frame, rather than in the ‘as worn’ position, and can be done with a simple protractor; although specific devices are available.

ISSUES OF INACCURACY Taking seven or more individual measurements per pair of spectacles certainly provides scope for error, but how

Figure 7: Face form angle

important are these potential errors to the patient’s experience of their new lenses? The standards laid out in BS EN ISO 21987:2017 specify the manufacturing tolerances of vertex power, cylinder axis, add power and prism imbalance21. Whilst the exact tolerance for lens power depends on the overall sphere and cylinder of the lens, for the most commonly dispensed prescriptions a general guide would be a tolerance of ±0.12D, with the tolerance becoming slightly larger as the power of the lens increases. This is in contrast to cylinder axis where tolerance decreases on higher power lenses, with an allowed margin of error of ±2° on a cylinder power over 2.50D. Fitting heights and monocular horizontal centration must be within ±1mm of the ordered values, meaning that a specified IPD could have a total manufacturing error of 2mm and still be within tolerance. Even taken monocularly, a -5.00D spherical lens could induce 0.5 prism dioptres (Δ) of unwanted prism horizontally or vertically, and that is before any errors of the measured IPD or heights are taken into account. IPDs taken with a pupilometer have been shown to be subject to errors of up to ±2mm18 with similar errors shown for fitting heights8. With these errors combined, monocularly the -5.00D lens could now have horizontal errors of ±2mm and vertical errors of ±3mm, generating unwanted prism of 1.0Δ and 1.5Δ respectively.

Finally, there is also a tolerance for prism at the ordered centration points (see Table 5 in BS EN ISO 21987:2017)* which for the -5.00D lens could be up to 1Δ, further compounding the problem. Leaving the manufacturing tolerance of prism aside, -5.00D spectacle lenses could easily be made ‘correctly’ and yet leave the patient experiencing a total of 2Δ horizontal and 3Δ vertical unwanted prism. This is important when considering that patient tolerance to induced prism has been shown to be approximately ≤1Δ horizontal and ≤0.5Δ vertical prism22. Whilst the scenario of maximum error leading to 3Δ unwanted vertical prism is unlikely – large differences in vertical fitting heights would be expected to be checked for accuracy prior to ordering the lenses. This illustrates the need for accurate measurements to be taken in the first place. Unwanted prism can potentially cause a range of symptoms from headaches and dizziness to double vision and asthenopia22-24, which have obvious implications for patient comfort and tolerance of their spectacles. Other clinical effects have been reported, particularly for vertical prism, such as reduced stereoacuity25,26 and contrast sensitivity27, even for levels of induced prism which would fall within the BS tolerances for spectacle manufacture. Interestingly, the effects on contrast sensitivity were shown to be worse under lower (mesopic) lighting conditions27, which has important implications for patients wearing their spectacles for night driving. Induced horizontal prism can affect the vergence system26 and base out (BO) prism has been shown to be particularly problematic in terms of inducing symptoms28. These symptoms possibly arise from induced exophoria, reducing the capacity for comfortable convergence. This effect may be similar to the condition of convergence insufficiency, where a reduced ability to maintain convergence has been suggested as the cause of similar symptoms such as dizziness29,30. The effect of BO prism is particularly relevant given that the increasing use of digital devices like computers and smartphones means that people are spending more time using near and intermediate working distances, thus placing more demand on their convergence. MARCH 2021 DISPENSING OPTICS



Figure 8: Tablet-based digital centration device As an aside, induced prism can also be the product of poorly fitting frames which have moved from their ideal facial position28. It is, therefore, imperative that both patient and practitioner are happy with the frame fit before any measurements are taken, and that patients should feel comfortable to return periodically for spectacle adjustments as required. Other than induced prism, errors in fitting heights for PALs may lead to patients looking through an inappropriate part of the lens, either inducing blur if the lens is set too high, or causing the patient problems finding the near vision area if set too low. This is particularly relevant as PALs are associated with an increased risk of falls in general31,32, so any errors in fitting height may potentially increase this risk. For measurements of vertex distance, PA and FFA, the main impact of errors is from changes to the effective power of the lens; either through changes to the sphere and cylinder powers themselves in the case of vertex distance, or by inducing unwanted cylinder power in the case of PA and FFA. For example, a +5.00D lens has a manufacturing tolerance of ±0.12D, which means it could have a back-vertex power of +5.12D and fall within tolerance. If this is coupled with a failure to account for a 5mm difference in vertex distance between trial frame and spectacle frame, the patient could experience a lens which is effectively over-plussed by 0.25D. Prescription errors even of this magnitude,



particularly over-plussing/underminussing, have been shown to be poorly accepted33,34 and are a major cause of non-tolerance and spectacle rechecks1,35.

THE ONLINE ISSUE Patients are increasingly asking for their IPD to be supplied with their prescription in order to facilitate the purchase of spectacles from internet companies. However, there are also guides on these websites for patients to measure their own IPD, or for someone else to do it for them, but these ‘DIY’ methods have been shown to produce results which are far from accurate or repeatable14. Even when the IPD is supplied by a practitioner, the position of the frame on the patient’s face is not taken into account, which can lead to centration errors as discussed above. Studies have found that the standard of spectacles purchased online can be poor in terms of optical quality in general36, with more deemed unacceptable for issues like incorrect centration than those purchased from a practice37. It is perhaps worth gently highlighting these issues to patients by explaining the number of measurements, and the precision which is required, in order to provide accurate lenses, alongside the availability of expertise at hand within the practice.

GOING FORWARDS In order to provide excellent patient service and maximise the benefits of freeform lenses, a number of careful measurements must be taken, requiring familiarity with a number of different instruments. The resulting dispensing

process may then take somewhat longer than simply measuring IPDs and fitting heights. Depending on the practice and the number of staff available, this could lead to delays, which are likely to have a negative impact on patient perceptions of customer service38,39. However, more recently a number of manufacturers have developed digital centration devices (DCDs), which are aimed at reducing the overall time, and increasing the accuracy, of frame and facial measurements. And, in a world where the majority of people use smartphones or digital technology on a daily basis40, research has shown that investment and use of technology positively impacts the customer’s perception of quality41. Generally speaking, DCDs come in two formats: floor standing devices such as the ZEISS i.Terminal 2 and the Essilor Visioffice; and tablet-based systems like the ZEISS i.Terminal Mobile and Hoya’s visuReal. Digital images of the patient are taken and displayed on a screen where practitioners can set markings for the various measurements. The computer then calculates the measurements accurate to 0.1mm. As the image is still, and the computer will signal if a picture is not positioned optimally, the effects of parallax or head movements are negated, allowing the possibility of much more accurate measurements. For any remaining parallax, some devices include error correction to help minimise the effect. Many DCDs require a frame calibrating clip of some kind to provide the computer with reference points from which it can work out measurements (Figure 8). However, some like Shamir Spark Mi or ZEISS VISUFIT 1000 allow measurements to be taken without the use of a calibration tool, increasing the likelihood that patients will adopt their habitual head posture and further increasing measurement reliability (Figure 9). As well as the potential for increased accuracy, there are also likely to be considerable savings in dispensing time. All the measurements are taken from a minimal number of pictures on one device and, at busy times, the images can be stored and the measurements calculated after the patient has left. The recent situation surrounding Covid19 has also raised the profile of DCDs as they enable a distance to be maintained

and minimise contact between practitioner and patient. In the case of clipless devices, the patient only makes direct contact with the frame for measurements to be accurately taken. ZEISS VISUFIT 1000 can actually take this a step further, with centration able to be performed using a virtual frame, allowing the dispensing process to be truly contactless. In terms of their accuracy, a 2009 study42 looking at a variety of now older model DCDs, compared their repeatability to measurements taken with pupilometers. The variation of measurements as given by the standard deviation was far less with the DCDs (0.09mm for one device), indicating very good reproducibility of results. Similarly, measures of fitting heights and PA were also found to be very accurate. Given the continuous advances in technology, it is likely that more recent devices will be able to offer even greater improvements in accuracy and repeatability – but further studies are needed to verify this. As well as taking fast, accurate measurements, some DCDs now go well beyond the remit of measurement device, offering support throughout the dispensing consultation including frame styling and tint/coating demonstrations. The ZEISS VISUFIT 1000 mentioned above can even enable a virtual ‘try on’ by creating a 3D avatar of the patient. This allows them to try on frames from a virtual catalogue, as well as being able to display specific tints and coatings in a chosen frame so that the patient can see the finished combination before ordering. This has a number of benefits and when combined with a detailed analysis of patient needs by the practitioner, allows an individually tailored visual solution to

Figure 9: Clipless centration device in use

be dispensed in a manner perhaps more in line with today’s modern consumer.

CONCLUSIONS The increasing popularity of freeform lenses, and the potential visual improvements they can offer, means that taking accurate frame and facial measurements is more important than ever – and could save a lot of unnecessary rechecks either with a dispensing optician or optometrist by minimising errors in lens power and induced prism. Increased competition for spectacle sales from online retailers and on the High Street means that practices need to be able to set themselves apart in terms of the service they can provide to patients. Digital centration devices offer the required levels of accuracy that will maximise the benefits of individualised freeform lenses, alongside convenience, but without sacrificing the patient’s perception of the service that they are receiving. This should pave the way for reduced dispensing errors, greater patient satisfaction and, ultimately, repeat business. HOWARD COLLINS is an optometrist with over 15 years’ clinical experience. He has worked in High Street practice and has delivered clinical teaching for the optometry degree programmes at both Bradford and Aston Universities. He is currently in the final stages of writing up his PhD thesis at Bradford University whilst working on a collaborative research project with Aston University and Zeiss Vision Care. PAUL HOPKINS is an optometrist and professional services manager at Carl Zeiss Vision UK. After achieving a DipHE with Distinction in Ophthalmic

Dispensing with Management from Bradford College, Paul graduated from the University of Bradford in 2005 with a Degree in Optometry. LEON DAVIES is professor of optometry and physiological optics and head of the school of optometry at Aston University. He is a liveryman of the Worshipful Company of Spectacle Makers, editor-inchief of Optometry in Practice and vice president of the College of Optometrists. * All ABDO members have access to key British Standards as a membership benefit via the ABDO website.

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CET 9. Meister DJ, Fisher SW. Progress in the spectacle correction of presbyopia. Part 2: Modern progressive lens technologies. Clinical and experimental Optometry 2008;91(3):251-264. 10. Walsh G, Pearce EI. The difference between belief and reality for Viktorin’s method of inter-pupillary distance measurement. Ophthalmic and Physiological Optics 2009;29(2):150-154. 11. McCormack G, McGill E. Measurement of interpupillary distance with chromostereopsis. American Journal of Optometry and Physiological Optics 1982;59(1):60-66. 12. Kawagoe W, Vasques DG, Maia N, et al. Comparação entre métodos de medida da distância interpupilar. Arquivos Brasileiros de Oftalmologia. 1998;61(2): 172-175. 13. Holland BJ, Siderov J. Repeatability of measurements of interpupillary distance. Ophthalmic and Physiological Optics 1999;19(1):74-78. 14. McMahon TT, Irving EL, Lee C. Accuracy and repeatability of selfmeasurement of interpupillary distance. Optometry and Vision Science 2012;89 (6):901-907. 15. Brown WL. Interpupillary distance. In: Eskridge JB, Bartlett JD, Amos JF, eds. Clinical Procedures in Optometry. J.B. Lippincott; 1991:39-52. 16. Elliott DB. Clinical Procedures in Primary Eye Care. 4th ed. Elsevier Health Sciences; 2013. 17. Jalie M. Ophthalmic Lenses and Dispensing. Elsevier/Butterworth Heinemann; 2008. 18. Obstfeld H, Chou BR. A study of the accuracy of corneal reflection pupillometers. Ophthalmic and Physiological Optics 1998;18(6): 527-531. 19. Kozol F, Capone RC, Kozol ND. Determining the vertical and horizontal positioning of multifocal and progressive lenses. Survey of Ophthalmology 1998;43(1):71-82. 20. Blackman A. Single vision lenses – now it’s personal. Dispensing Optics Published online 2012. Accessed June 1, 2020. https://www.abdo.org. uk/wp-content/uploads/2012/06/ CET131.pdf 21. British Standards Institution. BS EN ISO 21987:2017 Ophthalmic Optics. Mounted Spectacle Lenses. British Standards Institution; 2017.



22. Du Toit R, Ramke J, Brian G. Tolerance to prism induced by readymade spectacles: setting and using a standard. Optometry and Vision Science 2007;84(11):1053-1059. 23. West CE, Hunter DG. Displacement of optical centers in over-the-counter readers: A potential cause of diplopia. Journal of American Association for Pediatric Ophthalmology and Strabismus 2014;18(3):293-294. 24. Osuobeni EP, al-Zughaibi AM. Induced prismatic effect in spectacle prescriptions sampled in Saudi Arabia. Optometry and Vision Science 1993;70 (2):160-166. 25. Fry G, Kent P. The effects of base-in and base-out prisms on stereo-acuity. Optometry and Vision Science 1944;21 (12):492-507. 26. Jiménez J, Rubino M, Diaz J, Hita E, del Barco LJ. Changes in stereoscopic depth perception caused by decentration of spectacle lenses. Optometry and Vision Science 2000;77 (8):421-427. 27. Tunnacliffe AH, Williams AT. The effect of vertical differential prism on the binocular contrast sensitivity function. Ophthalmic and Physiological Optics 1985;5(4):417-424. 28. Moodley V, Kadwa F, Nxumalo B, Penciliah S, Ramkalam B, Zama A. Induced prismatic effects due to poorly fitting spectacle frames. African Vision and Eye Health 2011;70(4):168-174. 29. Anoh-Tanon MJ, Bremond-Gignac D, Wiener-Vacher SR. Vertigo is an underestimated symptom of ocular disorders: dizzy children do not always need MRI. Pediatric Neurology 2000;23 (1):49-53. 30. Wiener-Vacher SR, Wiener SI, Ajrezo L, et al. Dizziness and convergence insufficiency in children: screening and management. Frontiers in Integrative Neuroscience 2019;13:25 31. Lord SR, Dayhew J, Sc BA, Howland A. Multifocal glasses impair edge‐contrast sensitivity and depth perception and increase the risk of falls in older people. Journal of the American Geriatrics Society 2002;50(11):1760-1766. 32. Haran MJ, Cameron ID, Ivers RQ, et al. Effect on falls of providing single lens distance vision glasses to multifocal glasses wearers: VISIBLE randomised controlled trial. British Journal of Medicine 2010;340:c2265.

33. Miller AD, Kris MJ, Griffiths AC. Effect of small focal errors on vision. Optometry and Vision Science 1997;74 (7):521-526. 34. Atchison DA, Schmid KL, Edwards KP, Muller SM, Robotham J. The effect of under and over refractive correction on visual performance and spectacle lens acceptance. Ophthalmic and Physiological Optics 2001;21(4): 255-261. 35. Hrynchak P. Prescribing spectacles: reasons for failure of spectacle lens acceptance. Ophthalmic and Physiological Optics 2006;26(1): 111-115. 36. Citek K, Torgersen DL, Endres JD, Rosenberg RR. Safety and compliance of prescription spectacles ordered by the public via the Internet. Optometry 2011;82(9):549-555. 37. Alderson AJ, Green A, Whitaker D, Scally AJ, Elliott DB. A comparison of spectacles purchased online and in UK optometry practice. Optometry and Vision Science 2016;93(10):1196-1202. 38. Maister DH. The psychology of waiting lines. In: Czepiel J, Solomon M, Suprenant C, eds. Service Encounter: Managing Employee/Customer Interaction in Services Businesses. Lexington Books, DC Heath & Company; 1985. 39. Davis MM, Heineke J. How disconfirmation, perception and actual waiting times impact customer satisfaction. international Journal of Service industry Management. Published online 1998. 40. Deloitte. Global Mobile Consumer Survey: UK cut, Plateauing at the peak, The state of the smartphone. Published 2019. Accessed June 12, 2020. https:// www2.deloitte.com/content/dam/ Deloitte/uk/Documents/technologymedia-telecommunications/deloitteuk-plateauing-at-the-peak-thestate-of-the-smartphone.pdf 41. Mithas S, Krishnan MS, Fornell C. Research note – Information technology, customer satisfaction, and profit: Theory and evidence. Information SystemsResearch.2016;27 (1):166181.Ophthalmic and Physiological Optics 1985;5(4):417-424. 42. Wesemann W. Moderne Videozentriersysteme und Pupillometer im Vergleich, Teil 2. DOZ–Optometrie & Fashion. Published online 2009:32-39.


Multiple choice answers A specialised skill. Signposting patients with visual impairment to increase their health outcomes By Jayshree Vasani FBDO. C-76298 – published November 2020 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 CET. What is the leading cause of visual impairment in the UK? a. Uncorrected refractive errors b. Age-related macular degeneration c. Cataracts d. Diabetic retinopathy a is the correct answer. Uncorrected refracted error accounts for 39 per cent, AMD 23 per cent, cataract 19 per cent, glaucoma seven per cent and diabetic eye disease five per cent. More information can be found at: https://www.rnib.org.uk/sites/default/files/Eye%20 health%20and%20sight%20loss%20stats%20and%20 facts.pdf Which of the following charities provide a counselling services to their patient groups? a. RNIB and Diabetes UK b. Macular Society and RNIB c. SeeAbility and Guide Dogs d. Glaucoma UK and Nystagmus Network b is the correct answer. The RNIB offers emotional support through its sight loss counselling team, a group of professional telephone and online counsellors for any sight loss condition. The Macular Society offers counselling to anyone with Macular Degeneration only. The RNIB estimates that every day, 250 people start to lose their sight. After diagnosis, what percentage of people with sight impairment or severe sight impairment were not offered formal counselling by the eye clinic, either at the time or later? a. 83 per cent b. 50 per cent c. 23 per cent d. 17 per cent a is the correct answer. Once the patient gets to the hospital, they will get their diagnosis and some may see the eye care liaison officer (ECLO) to be signposted to the services and support they need. However, not all ophthalmology departments have an ECLO and so may not be provided with this service. What does the acronym ECLO stand for? a. Eye contact liaison officer b. Eye care link office c. Eye clinic liaison officer d. Eye clinic lead officer

c is the correct answer. Currently, not all NHS trusts provide an ECLO service. In 2019, the RNIB reported that of the top 150 NHS trusts providing ophthalmology services in England, 43 per cent had no accredited ECLO service in place. What does the role of an ECLO encompass? a. Provides emotional support, including counselling b. Signposting to charities, mobility and sight guiding c. Advises about welfare benefits and advice about remaining in employment d. All the above d is the correct answer. More information about the role of an ECLO within the hospital eye service can be found at https://www.rnib.org.uk/advice/eyehealth/who-does-what/eclo What information do you need to type into the website https://www.sightlinedirectory.org.uk/ to enable you to find an ECLO for a patient with low vision? a. The word ‘ECLO’ and patient’s visual acuity b. The word ‘ECLO’ and the patient’s date of birth c. The word ‘ECLO’ and the patient’s postcode d. The word ‘support’ and the patient’s visual acuity c is the correct answer. The sightline directory lists services aimed at helping people with sight impairment or severe sight impairment in the local area by using the postcode and can list ECLOs, charities, support services, low vision services to name a few. Who can refer a patient to the sensory services/rehabilitation team? a. GP only b. Ophthalmologist or referring optometrist c. Ophthalmologist only d. Optometrist, dispensing optician, ECLO and or the patient can self-refer d is the correct answer. It is important that the referral can happen at any point in the patient’s pathway and the earlier the better. With reference to the ‘10 Principles of Good Practice in Vision Rehabilitation’, which of these are false? a. All blind and partially sighted people receive initial contact by telephone within two working days of receipt of a Certificate of Vision Impairment (CVI), referral or self-referral

Participants are advised that the GOC’s Enhanced CET Principles and Requirements v4 document states that for text article CET questions: “A proportion of the questions should require the application of existing professional knowledge to determine the answer”. This can include personal research online, or following up the article references.



MCAs b. Vision rehabilitation services are provided free of charge to all blind and partially sighted people, to meet agreed assessed needs c. It is important that all vision rehabilitation officers/ teams are trained to understand the person’s sight loss related needs d. Vision rehabilitation is ‘one-off’ service and a person with sight loss is unable to access it if their circumstances change and they need further support

When a person with visual impairment is in the kitchen, which of the following is true? a. It is important to use plates and mats of the same colour

b. When cutting food, it important to use a very sharp knife c. If offering a friend/colleague a hot drink, they should make sure the drink is poured out safely using a liquid level indicator or from a one cup kettle d. It is useful to have one big bright light in the centre of the room as opposed to under cupboard and task lighting c is the correct answer. A liquid level indicator or a one cup kettle is an easy way to safely pour a hot drink. Contrast is especially important to a patient with sight loss. A white plate on a blue mat is easier to see than a white plate on a white mat. Cutting food should be done in a safe manner using the right technique to ensure safety. In the kitchen, task lighting or under cupboard lighting, in addition to a main light, is more useful together with an assessment tailored to the individual needs to the person.



d is the correct answer. Vision rehabilitation is not a ‘one-off’ service. A person with sight loss can access it if their circumstances change and they need further support.


Many people will remember Christine Harm FBDO (Hons) CL as a professional, straight-talking dispensing optician. Christine was this and so much more. At seven years of age, Christine joined the Girlguiding movement and started wearing spectacles; each visit to the practice enhanced her interest in all things optical. Working as a ‘Saturday girl’ in practice made her decide to follow an optical career, therefore in 1974 she attended Bradford College as a full-time student. Christine’s pre-reg position was at TH Collison Opticians in Slough, which proved to be a major influence in her career. Under the guidance of Brian Collison, she learnt her firm foundation knowledge of contact lens fitting through working in the London eye hospitals, her spectacle dispensing and low vision dispensing skills, and her business acumen. At 21, Christine became a Freeman of the City of London through the Worshipful Company of Spectacle Makers, and later a Liveryman. She was extremely proud of both honours. Christine moved to the Stockport area in 1984 when she was employed at George Davis Opticians, and was subsequently promoted to contact lens manager for the D&A Opticians nationwide group. Her responsibilities lay with training contact lens opticians (CLOs). Later, she was part of the team responsible for opening the first Vision Express stores in the UK. Training and enhancing fellow colleagues’ skills was a passion of Christine’s. She became an ABDO council member, distance learning course tutor and dispensing



practical examiner in 1985, which led her to teaching and examining overseas. Christine was always firm, fair and friendly – and was able to see potential in everyone. It was a natural progression for Christine and her husband to purchase an optical business in Ellesmere Port, Cheshire. The business recently celebrated its 21st anniversary. Throughout this time, Christine continued to work as a visiting CLO at the Countess of Chester Hospital, where she enhanced so many patients' sight. Christine’s passion for training and education was fulfilled by becoming a General Optical Council education panel visitor. Christine will not only be missed by her fellow colleagues and her patients, but also by her Girlguiding family. She was actively involved with the Guides, achieving the position of county commissioner, organising camps, weekly meetings and, once again, enhancing the lives of so many young people she met.


From CET to CPD and beyond t present, the General Optical Council (GOC) is in the process of confirming changes to the mandatory continuing education and training (CET) scheme, for when the current cycle comes to a close at the end of 2021. In this article, we look at the changes we anticipate seeing, and consider what these could mean for dispensing opticians (DOs) and contact lens opticians (CLOs). We already know that the name of the scheme will be changing from CET to continuing professional development (CPD). As other UK health and social care regulatory bodies currently use the name CPD for the professional continuing education schemes they oversee, this change will allow GOC registrants to be more aligned with them. This, and other changes we expect to see to the GOC scheme, should enable more inter-professional understanding and potential for shared learning with other healthcare professionals. Another change is that the core competencies will no longer be a framework for structuring the scope of continuing professional education. Instead, the standards of practice for optometrists and DOs will be utilised. This follows the changes expected for undergraduate education, as a consequence of the GOC’s Educational Strategic Review. Here, the core competencies are being removed to be replaced with ‘learning outcomes for registration’.


EQUALITY OF LEARNING The GOC states: “Our Standards of Practice define the standards of behaviour and performance we expect of all registered optometrists and dispensing opticians”. As the standards of practice are the same for all GOC registrants, the use of these for the basis of the CPD scheme should allow for equality in learning across the optical professions. The mission statement of the GOC is: ‘To protect the public by upholding high standards in the optical professions ’1. The majority of optometrists, DOs and CLOs work in teams with other GOC registrants, be it in High Street practice or in the hospital eye service. Members of the public accessing optical services frequently take a journey that sees them engaging with more than one GOC registrant. The public should expect the same standard of optical care and professionalism whichever GOC registrant they are dealing with.

With all registrants accessing CPD, which uses the same standard of practice as its reference, it should be easier for inter-professional learning to take place where the patient’s overall journey and experience can be considered and aligned. For CPD purposes, it is anticipated the standards of practice will be divided into four domains of learning: • Professionalism • Communication • Clinical practice • Leadership and accountability Learning across all domains will be expected in the CPD three-year cycle. It is expected that registrants on one of the speciality registers (optometrists with a therapeutic prescribing speciality and CLOs) will also have to complete CPD in a fifth domain that will be related to their specialism. More details of how this will be managed is expected from the GOC, and we will look at what this will mean for CLOs when we are able to.

MONITORING ONGOING CHANGE The Covid-19 pandemic has highlighted how there can be significant and rapid change in healthcare practice and the need to consider the possible impact of future change. The GOC has indicated its intention to be able to invoke a sixth CPD learning domain, should the need arise. It is expected this would be in place to require GOC registrants to access CPD covering a specific risk within the professions that has been identified. The ABDO CPD Department continues to support all ABDO members with their current CET requirements, and we encourage everyone to check, at this point in the final year of this cycle, that they are clear about what their individual CET needs are, and consider how they will access their learning. It is anticipated that CET will remain as remote delivery from CET providers for the majority of 2021. We will continue to provide information on the new CPD scheme and what to expect throughout this year.

REFERENCE General Optical Council. GOC mission and values. Available at: https://www.optical.org/en/about_us/ mission_and_values/index.cfm [Accessed 7 February 2021] ALEX WEBSTER MSC PGDIPE FBDO CL FHEA FBCLA is head of the ABDO CPD Department. MARCH 2021 DISPENSING OPTICS



Going green in practice midst all the changes in practice required by the Covid-19 pandemic, it can be hard to continue initiatives to reduce the environmental impact of your practice. Now, more than ever, though, we need to take action. This month, discover four ideas that you can put into practice at work, and get inspired by what other practitioners are doing. Every business has a duty to keep waste to a minimum: you need to do everything you reasonably can to prevent, reuse, recycle or recover waste. Here are four key principles to follow in everything you do:


Think about what you can prevent from coming into the practice that ultimately ends up as waste. This could be small things: could you purchase coffee in low waste packaging? Could your practice move to being paper free? Thinking bigger, look at what fills up your black bags. If packaging is an issue, contact your suppliers and ask them to reduce the packaging they send you – or take it back to be reused.

REUSE Packaging isn’t the only thing that can be reused, but it’s a great place to start. Getting your suppliers involved in reusing packaging can make them think in more depth about their business practices, with a beneficial effect for everyone they supply to. Paper is a quick win when it comes to reuse: keep a box for paper that has information on one side only, and always have some on the reception desk for notes. Read this month’s case study to find out more about Daryl Newsome’s link with his local craft shop, and look for the growing number of local organisations that will take phones, computers and other electrical equipment to be renovated and reused, such as WeeCharity.





Could now be the time to review your practice’s waste contract to maximise what is recycled? Some waste removal companies have a zero waste to landfill policy, which aids the environment and benefits businesses. In the long-term, this could make a massive difference to the ultimate destination of anything that can’t be prevented or recycled.

If you are keen to make a change, why not pick one of the following places to start developing your business’s sustainability? Where you put your business finances also has ethical and environmental implications. The Ethical Consumer has been offering advice since 1989 and suggests there are four questions to ask when choosing a bank: • Does it have an ethical lending policy? • Does it eschew dodgy investments? • Does it invest in unethical corporations? • Does it avoid tax? Triodos bank is usually mentioned as the top choice when banks are rated by ethics. Also look at building societies and some of the newer banks like Monzo and Starling. If your business is keen to help support the community, look into local credit unions, some of which offer accounts for small businesses. Ethical Consumer provides ethical and

RECOVER Where some items have to leave your practice as waste, there are initiatives to reduce the use of new raw materials and recover more from waste. Plastic, paper, aluminium, glass and metal are examples of items that can be recovered. Talk to your waste contractor and find out if they are involved in ensuring that waste recovery is implemented. Check out the WRAP website for ideas that businesses can use to help with all these initiatives.

Protecting the natural world Alongside being a dispensing optician and member of the ABDO National Clinical Committee, Ruth Shelton is a senior advisor to Natural England. She says: “I’m working on an amazing strategic partnership between 11 different local authorities aimed at protecting heathland in the Thames Valley.” When working in practice, Ruth suggests: “We have recycling bins in practice, and use recycled paper and paper bags not plastic. We also take part in a scheme for contact lens packaging recycling.” If you want to think about your energy use, Ruth advises: “Look at energy providers who offer ‘green’ energy. Turn lights off where possible, and ensure that nothing is left on standby overnight. Reuse, reduce, recycle as much as possible.

Ruth Shelton, helping to protect nature I’ve been amazed how we throw away something that’s not needed today and then order it again when it is needed. “Wherever I am, I set up a little chest of drawers of spares. I have a drawer for supra cords, one for spare sides, one for the screws kits from Luxottica, interesting nose pads and so it goes on.”

Crafty approach to repurposing “In our practice, we’re asking lots of questions," says Daryl Newsome, ABDO vice president. "Ask your sales agents questions like, ‘How is it sourced? Is it ethical, is it eco-friendly? Is there any child labour involved?’ Some have preprepared answers while others look like they are facing these sorts of questions for the first time. The sales side of the industry need to be better informed and inform practitioners.” The Eco eyewear range is one of Daryl’s best sellers. He says: “The range is made from recycled and bio-based materials, and we sell two to three pairs a day.” Daryl also has some unusual ways of ensuring nothing goes to waste. He explains: “We supply the

lady who runs our local craft shop with rubber bands and frame bags, which she uses to pack her stock. I have also given her a box of plastic lenses, tinted and untinted,

environmental ratings for accounts for small businesses. The Big Six energy suppliers – British Gas, EDF Energy, E.ON, Npower, Scottish Power and SSE – offer green business contracts, but whether you qualify may depend on the size of your business. There are a growing number of suppliers with renewable business energy tariffs. Some suppliers are greener than

others; check suppliers’ websites and your energy bill to see the percentage of the electricity that comes from renewable sources. PPE is one of the biggest sources of practice waste at present, and it is vital not to compromise on safety. However, many people are concerned about the impact of the use of masks, aprons and gloves, which has led to the development

Daryl with his Eco eyewear display

to see if she can find someone who might use them, perhaps to make a lampshade. One of my team has also taken items like those into a primary school to see if they can be used for crafts.” Daryl adds: “I have also been thinking about the amount of plastic waste from glazing houses that goes to landfill. If you leave it in hessian sacks, the water drains out and it forms a solid block: this makes me wonder if it could be used in a similar way to eco bricks. And I have yet to find somewhere to recycle items like disposable tonometer heads. We have, however, moved to using Epson liquid printers to avoid ink cartridges, and we recycle batteries.”

of products such as plastic free face shields and biodegradable clinical gloves. Why not ask your supplier if they offer more environmentally-friendly options for your practice? ANTONIA CHITTY BSC (HONS), MA, MCOPTOM, MCIPR is ABDO head of communications and author of 20 books on business, health and special needs.

Responsible, clean manufacturing Stepper Eyewear has a responsibility policy, which covers cleaner energy, climate control, cleaner water, minimised consumption, as well as wellbeing, education and decency, encompassing corruption, child labour and forced labour. Head of brands and marketing, Alex Davis, explains: “Our responsibility policy document brings together everything Stepper is already doing on sustainability; it takes a 360-degree approach. It’s not a static document but it shows our clients the direction we’re going in.” Stepper is constantly looking to extend its approach to sustainable eyewear. Alex says: “One of our strengths is that we design, manufacture and distribute, which means we understand the whole supply chain. In our factory, we have seem massive improvements made in the amount of waste water and electricity usage. For the future, we are working with a chemical manufacturer from Switzerland on biodegradable materials, but we need to be sure that the final product will work well on the patient’s face.” Peter Reeve is managing director of Stepper UK. He says: “I’ve been visiting the

factory in Shenzhen since 2007. Every time you go, you can see the changes. It’s a constant project and the drive comes from the very top.” The factory is a family business started by Michal Ng. Peter says: “There are several thousand employees. With its roots as a family business, combined with the responsibilities of being listed on the Hong Kong stock exchange, there is a huge emphasis on the wellbeing of employees. Several staff live on site and they all have access to social clubs, a swimming pool and a health centre. There are no underage workers, and there is a queue of people trying to get a job in the organisation.” Reflecting on the manufacturing process, Peter says: “Many of our frames are made from nylon, but the injection moulding process is very low waste.” Stepper has also considered its packaging. Peter says: “The temple sleeve is needed to prevent scratching during transportation and to protect the print, but it is now recyclable. We were using a plastic box, and there may be some still in the supply chain, but frames are now shipped

Stepper’s TX5 and the injection moulding process ensures the exact amount of raw material is used out in recyclable paper packaging. And we are looking at dummy lenses and how we can make them recyclable.” Stepper's responsibility document can be downloaded from its website, www.steppereyewear.com MARCH 2021 DISPENSING OPTICS



Walking the walk t a National Clinical Committee (NCC) meeting last year, ABDO vice president Daryl Newsome spoke of his growing frustration with the amount of plastic waste in the typical optical practice. It sparked an interesting conversation on personal wastage ‘pet hates’. For some time now, I have been concerned by this ongoing – and worsening – issue, surely it wasn’t a problem to be solved at practice level,? And anyway, wasn’t it all the fault of the suppliers and manufacturers? At our next NCC meeting, Daryl raised the issue as an agenda item and set out a clear brief for the committee: to address the level of plastics waste created by the optical industry, and do something about it. A working group was formed to investigate and report back, comprising of myself, fellow NCC member, Ruth Shelton, and ABDO head of strategy, Alistair Bridge. ABDO president, Jo Holmes, head of communications, Antonia Chitty, and London regional lead, Abi Page, who have already done some great work in this area, also joined our group. Ruth created a project plan, arranging monthly progress meetings, and we all took on various actions; Antonia also set up a Google Docs site to compile information, and shared her vision for a Green Summit.


WASTED JOURNEYS I work in a busy High Street practice, and have often pondered on our ‘glasses journey’. In full personal protective equipment (PPE), I open a cardboard box wrapped in parcel tape, remove the frame with plastic dummy lenses, enclosed in a plastic bag. The sides have their own plastic sheathes too. After discarding all this packaging, the frame is eventually dispensed and the dummy lenses discarded. A pair of plastic lenses are then glazed using water, creating excess material and residue. The finished job is cleaned, then packaged in protective material before being presented to the patient. The lens markings are removed with wipes or meths on a tissue, which are discarded. We supply a carrying case, or a designer brand case in a box with an outer box. In the case of a re-glaze, we offer the old lenses to the patient. When a new patient arrives, I doff my PPE and don a new set plus my visor, then bin the doffed kit. I wash and sanitise my hands, creating paper towel and plastic sanitiser bottle wastage. All that land filling, ocean clogging, bird strangling, fish choking, food chain disrupting waste – in order to dispense one spectacle frame. I hear of similar concerns about waste from audiology and contact lens colleagues; though the larger contact lens manufacturers do seem to be addressing the issue.



MOUNTAINOUS CHALLENGE Looking at how I could do more in practice, I start with the waste bins. We have a regular bin collection by a company called, appropriately, Gone Green. Each load goes into a recycling and waste management process. However, they do not sort plastics, metal, cardboard and so on, if it is in a black bag. PPE, which is more than half our waste by volume, is left in black bags to be Covid-safe. Gone Green does offer a bespoke waste collection at an extra cost, for which you can pre-sort cardboard and paper, plastics (careful with PPE), metal, cans and food waste. But where would we house all the extra bins? We already accommodate sanitary bins, NHS sharps and waste bins – and the space to the rear of the building is insufficient. So, thinking about what I could do, I decided to put out five boxes in the checking area for: 1) rubber bands; 2) scrap plastic frames and dummies/lenses; 3) plastic frame bags; 4) dead batteries; and 5) scrap metal frames. The boxes started filling quickly, so I had to work out where to empty them. There are around 7,000 opticians businesses in the UK, so just imagine the size of our collective waste. I pay my domestic refuse collector to separate waste and recycling bins; surely a few dummy lenses wouldn’t be a problem? Best not. How about my local waste tip? Would the carbon footprint of the journey negate the impact of a small amount of recycling? Probably. Or could we send the waste material back to the manufacturer? A bit impractical, I feared. Some enlightened companies are already using recyclable materials for frames, dummies, packaging, tape and wrapping, and/or recycling water and lens waste amongst other initiatives. All of this is to be applauded. If we only purchased from those green suppliers, would it change the situation? Probably not. But if 7,000 businesses did the same? This is about the size of our challenge – but I believe we are up to it. Look out for a progress report soon... TONY HARVEY FADO FFDO is practice manager at Bayfields Opticians and Audiologists, a member of ABDO National Clinical Committee and a member of the General Optical Council Advisory Panel.


Onwards and upwards t the time of writing, here in Northern Ireland we have been in lockdown again since one minute past midnight on Boxing Day. The current restrictions were due to last until mid-February, but the general consensus is that restrictions will be extended further. We’re fortunate to be able to continue providing emergency and essential eyecare to all our patients. We had our first online regional event in December, which was well received. We received a comprehensive update from ABDO president, Jo Holmes, and head of policy and public affairs, Debbie McGill, and it was a great success. As previously discussed, one size does not fit all – as we have seen with the devolved nations making government decisions about restrictions at a local level. Moving forwards, promoting healthy living seems very appropriate in the current times. With hospital appointments being severely affected by the pandemic, there’s very real concern that low vision patients are being overlooked. Certainly, there’s an opportunity here to support low vision patients in practice in greater numbers. ABDO has worked in partnership with Optometry Northern Ireland (ONI) throughout the pandemic, and in November/December we received further supplies of personal protective equipment from Health and Social Care Northern Ireland (HSCNI). These were delivered to the ONI chair and arrangements were made for practitioners to collect this second distribution. Following negotiations with HSCNI, ONI negotiated the continuation of the flexi-furlough scheme for practitioners, at least for the next few months. ONI will strongly push for further assistance going into 2021/22. All practitioners and optical staff are eligible to obtain a Covid-19 vaccination – and slots at hospital hubs across Northern Ireland can be booked online. Many have already had their vaccination, and the process is smooth, well run and very professional. I’m grateful and very fortunate to have been among the first cohort to receive a vaccine. There is light at the end of the tunnel. Stay safe and if anyone is in need of support, please do get in touch.


GERI DYNAN FBDO works in an independent practice in Belfast. She is an ABDO practical examiner, ABDO College trustee and distance learning tutor. Email gdynan@abdoregions.org.uk

PLANNING FOR THE FUTURE I’m pleased to report that colleagues in Wales are coping well under the current amber lockdown, with everyone taking the appropriate precautions and adhering to the regulations. Many members have received their first dose of a vaccine, with second doses booked in, and some are even helping with the vaccination roll-out. The Welsh Optometric Committee (WOC) and Optometry Wales (OW) are currently undertaking a Welsh Eye Care Review – planning for the next three to 10 years. ABDO’s Debbie McGill and clinical lead, Max Halford, met with Barbara Ryan and Sharon Beattie from the WOC on 27 January to discuss the review of eyecare services in Wales. Local leads, Abi Crutcher and Kate Hooper, also attended; both members sit on regional optical committees (ROCs) and are involved with informing the Welsh Eye Care Review. Topics covered during the meeting included: dispensing optician (DO) education; the evolving world of optics; and the opportunities for DOs to deliver more eye health care services – ranging from refraction, low vision, paediatric eyecare, and minor eye conditions services to name a few. The group also discussed mentoring services from local DOs. ABDO already provides a peer-to-peer mentoring support service, and we will be doing more to promote this to members locally. Visit the ABDO website and search ‘Mentoring’ for articles on the topic. You can also register for ABDO peer-to-peer mentoring, or find out more from your ABDO local or regional lead. Many members may not be in direct contact with their ROC, so if you would like constant updates on what is happening in your region and what your ROC is doing, please join their Facebook page. Simple search using the acronym for your ROC, for example ‘SWWROC’. The ABDO CPD Department is running a range of CET/CPD events, mostly in the evenings but also on Sundays. So do visit the Events section of the ABDO website and book on to a session. You will often come into contact with old friends and colleagues – thus providing the perfect chance to catch up and learn something new. There are exciting times ahead in Wales for eyecare and eye health, with DOs becoming more and more involved. This will hopefully see the profession being utilised to its full potential. Onwards and upwards. KEVIN MILSOM FBDO R FEAOO is a locum dispensing optician, past president and ABDO practical examiner. Contact Kevin by emailing kmilsom@abdoregions.org.uk MARCH 2021 DISPENSING OPTICS



From test chart to test and trace s I left the practice on that Saturday evening back in March 2020 – with a cheery “See you next week!” to my colleagues – little did I know that I wouldn’t be back that year, or possibly even the next. I’d been working as a contact lens optician (CLO) for Colin Lee Opticians for 11 years after selling my own practice, and was comfortably working a few days a week with a vague plan to retire in two or three years’ time. Then a global pandemic would bring my career to an abrupt halt. The early months of lockdown were strange, but in some ways quite enjoyable. In my 40-year career, it was the longest period I’d ever been off work. Spring was in the air and I spent a lot of time walking, gardening and cycling – but I knew at some point I would have to start earning some money again. I run a part-time domiciliary business along with my optometrist wife Denice but, of course, this was put on hold during lockdown. A recent change in our accounting status, from a limited company to self-employed status, meant we weren’t eligible for the chancellor’s support package. The graph of my pension plan looked like a map of the Alps – with a very steep downward slope in March 2020. Having been rejected by two local fruit farms (I like to think I was over qualified) I happened to see a post from my old friend Richard Rawlinson on the ABDO Facebook forum advising that NHS Professionals were looking for registered practitioners to become clinical case workers in the test and trace team. Denice and I both applied and after lots of form filling and document checks, we started our online training.


TRANSFERABLE SKILLS The test and trace modules were very comprehensive with webinars and training videos, but it was still with some trepidation that I found myself sat at my desk with headset on waiting for my first case. Like any new role, it was daunting to begin with. The computer system was very different to anything I’d used before, and I was used to dealing with people face-to-face not over the phone. It was a very steep learning curve but after a few weeks, I began to get more confident as I realised it was just like being a dispensing optician (DO) in so many ways.




I am phoning a lot of people who are lonely and scared; after all, they have just been told they have contracted this horrendous virus, which is constantly on the news. I speak to single parents locked down with bored and frustrated children, who understandably just want to rant at me. Never have my listening skills been so important. Just like working in practice, a successful encounter is all about building a rapport with the patient, using my questioning skills and maintaining a friendly but professional approach. Test and trace is more than just finding out where people have been and who they have been with; we put people in touch with support organisations if they need them, and answer any questions they may have about their condition and about self-isolation. We try to put their minds at rest. I enjoy working from home in many ways: I can get out of bed and be ready for work in less than five minutes. I don’t miss the early starts and the commute to work, but I do miss being part of a practice team and I miss all the friends I worked with. I know many DOs have lost their jobs through the pandemic and may have to look outside of optics for work – even if only in the short-term. Starting any new role can be daunting but remember – so many of the skills you have learned as a DO can be transferred to almost any job. I will continue with this role for as long as it lasts. Hopefully this won’t be too long as the vaccination programme rolls out and cases reduce. Then let’s see what the future holds. ‘Not just a DO’ has never rung so true as it does now. PHIL CROSS FBDO CL is is currently employed by NHS Professionals, and sits on the General Optical Council Fitness to Practise Committee.





aving a social media plan in place will save you time in the long run. There is nothing worse than sitting in front of a screen wondering what to post. Take a little time each month to plan for the month ahead: your plan doesn’t have to be detailed to give you inspiration each day. You can include any offers you have coming up, as well as awareness days/weeks. For example, in March there is St David’s Day, World Glaucoma Week, International Women’s Day, No Smoking Day and St Patricks Day. Plan in social media posts for these events. You could also include posts introducing staff, eyecare advice or motivational quotes. Having an overview for the month ahead will allow you to be consistent with posting. Use the EyecareFAQ graphics and information on your social media account. They are available to share free of charge as a benefit of ABDO membership here.


Did you know that as an optical assistant (OA) you can improve your chances of a successful encounter by asking different types of questions – such as open, closed, focusing and clarifying? Open questions can be used at the beginning of a conversation to gather information. They often start with, ‘tell me about’, ‘how’, ‘what’ and’why’. Closed questions usually just require a ‘yes’ or ‘no’ response. Focusing questions can be used to explore a subject in more detail, while clarifying questions may confirm you have understood correctly. An open question is a great way to start talking to patients. If they are browsing frames, perhaps ask: “Do you have any particular styles or colours in mind, or are you open to suggestions?” Use Are you asking the right questions? clarifying questions to help narrow down choices and uncover what the patient likes, and a closed question once you think the patient has made a decision. Read OA Part 3 in full on DO Online – and discover more examples of different types of questions, and how and when to use them.


NO MORE ‘ACCIDENTAL MANAGERS’ Accidental managers are those who have been promoted with no coaching, training or support – and they should become history. Management and leadership education is highly important both to the business and to the individual.

APPLY NOW FOR ABDO MLT The closing date for applications for the next ABDO Diploma and Certificates in Leadership and Management courses and qualifications is 9 April 2021. The courses are now open to anyone working in the optical sector – and all ABDO members receive a discount. Current student, Emily Lyth, dispensing optician (DO) and assistant store manager, tells DO: “Since qualifying as a DO in 2016, I felt the next stage in my career was to understand the skills required to become a successful manager. “I’m coming to the end of my course now and have learnt a huge amount about leadership styles, and how to address employees with different learning styles. I now appreciate I have to adapt my approach according to my audience.

“I thoroughly enjoy learning new skills and knowledge that I can use and apply in my everyday role. I would certainly recommend this course to anyone wanting to develop their skills and take on more responsibility.” Accredited by the Chartered Management Manager in the making, Emily Lyth Institute, which assesses and awards the qualifications, the courses and assessments are all online, with remote support from tutors. Assessment is by written assignment for each unit, with no exams. “Don’t miss this great opportunity for self-development during 2021,” enthuses Emily. “If you employ or work with anyone who may be interested, please pass on this information.” To find out more about and apply, visit the MLT section of the ABDO website. MARCH 2021 DISPENSING OPTICS



Is your practice going greener? Are you passionate about a career in eyecare? ABDO is working with Youth Employment UK to promote careers in eyecare. If you are age 18-25 and would be willing to talk about your job and your career, please email achitty@abdo.org.uk

ABDO wants to hear from you Do you have any environmentally friendly or ethical initiatives in your practice? As part of ABDO’s ongoing campaign to support the profession and industry in implementing greener practices and processes, we are looking to compile a portfolio of case studies. If you would like to get involved, please get in touch with Antonia Chitty, ABDO head of communications, by emailing achitty@abdo.org.uk

Visit DO Online Jobs Vacancies to place your recruitment adverts – or search for new opportunities. Your advert will reach some 8,000 ABDO members via eNews direct, making DO Online one of the most cost-effective platforms for DO recruitment. Vacancies are also promoted through ABDO’s active social media channels. Special reduced rate for ABDO members.




Fellowship Dispensing Diploma (FBDO) Develop your career and learn while you earn Want to become a dispensing optician? ABDO College offers you the chance to combine online learning with in practice experience and block release. The course: Leads to a registerable FBDO qualification. Has a proven track record of success with consistently high theory and practical exam results. Gives you a platform to advance your career.

Entry requirements Level 4 or above GCSE in English, mathematics, science and two other subjects, including evidence of recent learning (Grade C pre-2017). You must be working in practice as a trainee dispensing optician for a minimum of 30 hours per week and have the support of your employer. For more details and to apply: visit www.abdocollege.org.uk call 01227 738 829 (Option 1) or email info@abdocollege.org.uk Applications close: 30th July 2021






Profile for ABDODispensingOptics

Dispensing Optics March 2021  

The monthly journal of the Association of British Dispensing Opticians

Dispensing Optics March 2021  

The monthly journal of the Association of British Dispensing Opticians