Dispensing Optics May 2024

NEWS, INFORMATION AND EDUCATION FOR OPTICIANS

MAY 2024

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contents features 18.

CPD: C-108143 Shedding light on cataracts: causes, symptoms, diagnosis, treatment and prevention by Lisa Farrell

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16.

22.

CPD MCAs: C-107280 Young adult myopia

by Kathryn Webber and Dr Matthew Cufflin

24.

Tech Corner Freeform single vision lenses by Tony Calvo

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26.

In Practice Small things matter by Kaye McIntosh

28.

Research Review: Part 3 Virtual reality, AI and more Dr Neema Ghorbani Mojarrad

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Take 5 with Dr Monica Jong

regulars 18.

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Front Cover ADVERTISEMENT: Johnson & Johnson Vision

stay in touch

DO Online DO Twitter DO Instagram ABDO Facebook ABDO Twitter ABDO LinkedIn

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Comment

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Newsome's Notes

6.

News

16.

Product spotlight: Eyewear

25.

OSA meet the member: The Body Doctor

32.

Q&As: How do I join my LOC?

33.

DO’ing something different Eyecare FAQ OA Corner

ACUVUE® OASYS Max 1-Day contact lenses www.acuvue.co.uk M AY 2 0 2 4 D I S P E N S I N G O P T I C S

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The best Varilux progressive lens ever* Powered by artificial intelligence, for instant sharpness even in motion.** * As reported in Essilor R&D simulations – 2022 – calculation based on lenses measurements weighted by the level of importance of each criteria for progressive lenses declared by users (Quantitative Consumer study - Ipsos - Q1 2022 - BR/FR/IT/UK/US - n=4000 progressive lens wearers). ** Varilux® XR series™ – in-life consumer study - Eurosyn – 2022 – France (n=73 progressive lens wearers). © Essilor International – March 2024 – Essilor® and Varilux® XR Series™, are trademarks of Essilor International. Frames: Persol®, Oliver Peoples®

DISPENSING OPTICS The Professional Journal of the Association of British Dispensing Opticians Volume 39 No 5

CONTINUING SELF-IMPROVEMENT

EDITORIAL STAFF Editor Telephone Email

Nicky Collinson BA (Hons) 0797 903 3542 ncollinson@abdo.org.uk

Assistant Editor Telephone Email

Jane Burnand 0793 993 6827 jburnand@abdo.org.uk

Design and Production Email

Duncan Taylor-Jones dtaylor-jones@abdo.org.uk

EDITORIAL/ADVERTISING Telephone Email Website

0797 903 3542 ncollinson@abdo.org.uk www.abdo.org.uk

SUBSCRIPTIONS UK Overseas

£150 £175, including postage

Apply to:

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

Telephone Email Website

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

ABDO CPD Head of CPD

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

Telephone Email

01206 734155 abdocpd@abdo.org.uk

CPD REVIEW PANEL Josie Barlow FBDO CL Andrew Cripps FBDO PG Cert HE FHEA Kim Devlin FBDO (Hons) CL Stephen Freeman BSc (Hons) MCOptom FBDO (Hons) Cert Ed Clare Hayes FBDO CL SFHEA Claire McDonnell FAOI Graeme Stevenson FBDO (Hons) CL Alex Webster MSc PGDipE FBDO CL FHEA FBCLA Gaynor Whitehouse FBDO (Hons) LVA EDITORIAL COMMITTEE Nicky Collinson BA (Hons) Antonia Chitty PhD MCOptom MCIPR MPRCA Alex Webster MSc PGDipE FBDO CL FHEA FBCLA Max Halford FBDO CL Daryl Newsome FBDO R CL SMC (Tech) Alistair Bridge Jane Burnand Duncan Taylor-Jones DISPENSING OPTICS IS PUBLISHED BY ABDO, Unit 2, Court Lodge Offices, Godmersham Park, Godmersham, Canterbury, Kent CT4 7DT Dispensing Optics is printed by P&P Litho Ltd, Ashford, Middlesex TW15 1AB

2024 is the final year of the current three-year cycle of continuing professional development, or CPD, so with only eight months of the year to go, now is a good time to check whether you are on track to meet all the requirements set by the General Optical Council (GOC). For those of you who are, congratulations. For those who still have work to do, we are here to help.

The wide range of CPD which ABDO provides – online, in-person and through articles in Dispensing Optics – covers all the required areas and enables you to keep your skills and knowledge up-to-date, as well as developing new areas of interest and expertise.

At ABDO we are also focusing on learning and development and recently rolled out a new training programme for all our team members. One of the first modules focused on equal opportunity and discrimination – explaining the different types of discrimination and how discrimination against certain groups can happen, both directly and indirectly.

The training also highlighted the benefits of promoting equality of opportunity, including increased innovation and creativity, increased job satisfaction and improved customer service.

We know that harassment and discrimination is of concern to many of our members, and together with the GOC and other optical sector organisations, we have committed to a zero-tolerance approach to bullying, harassment, abuse and discrimination across all working environments. This followed a meeting to discuss the GOC’s research showing that registrants reported experience of significant levels of such behaviour.

The elections to ABDO’s Board are now underway, and all qualified members have an equal opportunity to stand.

To ensure the Board is representative of the Association’s membership, we are encouraging members who are currently underrepresented to put themselves forward.

This includes people from Black, Asian and minority ethnic backgrounds, disabled people and LGBTQ+ people.

To learn more about what is involved in being an ABDO Board member, please join the second of our webinars at 7.30pm on Thursday 23 May.

Alistair Bridge Chief executive

© 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: 6,846 copies (January to December 2023)

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OUR MONTHLY COLUMN FROM THE ABDO PRESIDENT DARYL NEWSOME

Newsome's Notes Signing off on a high note

S

o this is my last column for Dispensing Optics as ABDO president. That means two years have flown by and it will soon be time to hand over to our new president Kevin Gutsell – someone in whom I have great faith.

So what of the future? My time on the ABDO Board has seen some great changes, some real progress and I finish confident we are on the right course with the right people. It has been my privilege during the last two years to present our fellowship diploma to three cohorts of dispensing opticians (DOs) and, of course, newly qualified DOs are the future.

As I said at the last month’s graduation in Canterbury Cathedral, there are many ways for qualified DOs to engage with this industry and profession, and I would encourage you all to look at being more involved. Make yourself known to your ABDO regional lead, volunteer as a STEM ambassador, join your local optical committee, write articles for various publications, become an ABDO distance learning tutor... The list is endless; but I promise, getting involved beyond practice level will reward you in ways you cannot imagine.

The future of dispensing optics is for you, our members, to direct. This is a membership organisation and what ABDO delivers has to benefit and satisfy the members. If it doesn't, then get involved and help deliver change.

When I qualified 40 years ago, there was no 1.6 plastic, no 1.67, no 1.74, no plastic photochromic lenses. Even aspheric lenses were in their infancy. If I had not kept asking questions and learning about new products, I would have been left behind.

And it’s not just about CPD; your commitment to lifelong learning is necessary to keep you relevant and current. No longer constrained or directed by a syllabus once we qualify, we are free to pursue our own areas of interest and expand our scope of practice – and that we must.

Change is happening at a faster rate than ever before, and that rate is only accelerating. Have you heard of the new photochromic materials becoming available this year in all plastic indices? Or about the new techniques to apply Polaroid films to plastic lenses?

What about the next generation of progressive power lenses? Did you know there are more than 1,000 to choose from now? Your suppliers are a huge source of information; ask them questions, be inspired by their enthusiasm.

Here is a call to action: commit to learning about one new product or service a week, whether your practice supplies it or not.

Research it, read the papers behind it, and become a better informed dispensing optician – engaged and enthused about the future of dispensing optics and new opportunities.

My parting advice to you is this: care well for our profession and it will care for you in return. I will be watching with great interest to see what you do next.

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

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Nominations now open for ABDO Board elections Nominations are now open for all fully qualified ABDO members to put themselves forwards for a seat on the ABDO Board.

There are five vacancies to be filled this year – and the Association is particularly encouraging members who are underrepresented to stand for election.

ABDO president, Daryl Newsome, explained: "ABDO is committed to equality of opportunity, to being fair and inclusive, and promoting equality of opportunity.

We are keen, therefore to ensure that the Board is representative of the Association’s membership – and so we particularly encourage JOIN A SPECIAL ELECTIONS members who WEBINAR ON 23 MAY are currently underrepresented to stand for election. This includes members from Black, Asian and minority ethnic backgrounds, disabled people and LGBTQ+ members."

In order to better understand the role, members will have another chance to attend a special webinar on 23 May from 7.30-8.30pm. Chaired by ABDO CEO, Alistair Bridge, the webinar will enable participants to hear directly from current ABDO Board members, providing insight into what being a Board member involves – from the time commitment to supporting the delivery of the Association’s objectives.

"Board members play a key role in shaping ABDO’s strategy and overseeing the Association’s work," continued Daryl. "The webinar will help members find out more by hearing from current Board members and asking them questions. Members might want to hear about the kinds of issues the Board discusses – or find out about how Board members combine the role with family and work commitments. This is a great chance to learn more about these exciting roles."

Book a place on the 23 May webinar via the ABDO website Events page.

Members can submit their nominations by logging in to the ABDO website and visiting: www.abdo.org.uk/board-election-nomination-form.

The closing date for submissions is 14 June.

Should sufficient nominations be received, an election ballot will take place between 12 July and 27 August, and the results will be announced on 3 September. The successful candidates will take up their roles on 7 November for a term of three years – with the opportunity to stand for re-election for a further threeyear period.

NEWS

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ABDO plans hybrid autumn conference The 2024 ABDO clinical conference will take place on Sunday 6 and Monday 7 October at the National Resource Centre, Birmingham, providing two opportunities for members to attend.

This year, ABDO will be running webinars, online peer reviews and journal club sessions alongside the hands-on clinical conference.

The 2024 conference themes are: paediatric dispensing; myopia management; and acute eyecare for dispensing opticians.

Last year’s sold-out myopia

management conference was hailed "a huge success" with overwhelmingly positive feedback from delegates.

Alex Webster, ABDO head of CPD, said: “We are really excited to build on the success of last year’s conference and use a hybrid approach in 2024. This will enable even more ABDO members to benefit from the high quality and focused education that will be on offer to support their continuing professional development.”

Booking for the conference will open on Monday 1 July.

Celebrations in Canterbury Last month saw the newest cohort of dispensing opticians graduate at Canterbury Cathedral during the Association's prestigious Graduation and Prizegiving Ceremony.

ABDO president, Daryl Newsome, presented more than 200 FBDO diplomas, more than 50 FBDO CL certificates in contact lens practice along with 38 overseas FBDO diplomas. A total of 13 prizes were awarded to stand-out students, supported by industry sponsors.

Addressing the graduands during the ceremony on 24 April, Daryl urged them to consider the many roles that would now be open to them and to represent their professional body with pride.

Read a full report of the graduation in the June issue.

Building on last year's success

Speedy, stylish and smart Transitions Optical is preparing for the June launch of Transitions Gen S – with the S standing for Speed, Style and Smart.

Transitions Gen S Ruby

Described by the company "as the fastest dark lens in the clear to dark photochromic category", the lens is ultraresponsive to light, reaching category three levels of darkness in 25 seconds and fading back in less than two minutes.

The lens is available in eight colours, including a new addition: Transitions Gen S Ruby. All colours have been optimised to be true to tone at all stages, offering vibrant tints in any light.

The 'smart' element of the lens is its ability to provide 39 per cent faster vision recovery from intense bright lights versus clear lenses. During fade back, tests have shown a 39.5 per cent improvement in contrast sensitivity and 40 per cent faster vision recovery versus the previous generation.

The lens also blocks 100 per cent UVA and UVB rays and filtering up to 32 per cent of blue violet light in the clear state

and up to 85 per cent when activated.

Antonio Capra, Transitions brand consultant at EssilorLuxottica, said: “Patients deserve the best vision care we can offer, and light management is key.

To achieve its mission, Transitions Optical proposes a solution for comprehensive vision that goes beyond traditional correction. With Transitions Gen S, we combine science and technology in a revolutionary product that is intuitive and smart, reacting so fast to light that it adapts to your every move.

"On top of that, Transitions offers an elevated experience of complete pairing through a large colour palette that enables wearers to personalise their looks with vibrant colours to match any frame. Today we have a real opportunity to improve patients’ vision care and Transitions Gen S is set to become a key recommendation for ECPs," added Antonio.

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NEWS Scottish OCT taskforce set up

Spreading the word

Optometry Scotland (OS) has launched a short-life working group (SLWG) to investigate the need for investment in new technology to treat eye patients.

The taskforce, funded by OS, will explore the use of optical coherence tomography (OCT) in community practice to determine the benefits and value of additional investment – and the potential for expansion across Scotland. The findings will then be presented to the Scottish government.

While initial investment in retinal imaging technology was supported by the Scottish government via grant funding in 2008, these OCTs have become outdated with many practitioners now choosing to offer private OCT services.

The SLWG aims to determine the financial implications of universal implementation of EILIDH THOMSON OCT technology in the community, while providing research-based evidence to support the need for the service.

The group is expected to run for six months and will comprise of seven members, representing stakeholders across eyecare. These include Julie Mosgrove and Eilidh Thomson, OS chair and vice chair, as well as individuals from multiple and independent practices, NHS National Services Scotland, ophthalmology and the University of Aberdeen.

When asked, OS confirmed that dispensing opticians and contact lens opticians would be represented on the SLWG as part of the overall practice team.

Eilidh Thomson said: “We are incredibly fortunate to live in a day and age where technology can serve such a fundamental role in the healthcare process. However, this can only provide value to patients if access is equitable.”

The Body Doctor has appointed Emma Meeres as its new marketing manager. She joins the company from PPG Architectural Coatings.

“We’re really excited about Emma joining our team,” said Body Doctor sales and marketing director, Sam Wymer. “Emma has a huge amount of experience and some amazing ideas that match our ambitions for the future.”

Emma commented: “As marketing manager, I’ll be working to spread the word about the Body Doctor's innovative products, the Dry Eye Revolution and generally helping people think better, feel better and live better."

The company has recently partnered with MacuHealth to become its exclusive UK distributor of EMMA MEERES MacuPrime eye supplements and ReMind brain health supplements.

Also new from the company is the Eye Doctor Advanced Triple Action Eye Drops for dry eye.

Targeting all three layers of the tear film, the drops feature an advanced microemulsion lipid-based formula for treating and preventing symptoms of moderate to severe dry eye.

Footwear firm deal renewed Marcolin and Skechers have renewed their licensing agreement for the design, production and worldwide distribution of Skechers sunglasses, spectacles and children's eyewear.

The partnership, started in 2014, has been extended until 31 December 2030.

The Skechers optical and sunglass collections offer an array of unique, expressive accessories for adults and children in Skechers’ iconic looks and colours. From classic profiles to athletic-inspired designs, Skechers Eyewear features vivid prints and patterns, bright pops of colour and unique side treatments. The Skechers Kids collection sparkles with rhinestones, along with sporty, playful looks for active adventures.

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Skechers sports sunglasses

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NEWS Schools missing mark on hearing/sight loss In a recent poll of 510 educators, 92 per cent of respondents agreed that identifying pupils with mild to moderate hearing and/or sight loss was important for removing academic barriers, but more than 50 per cent didn't know how to.

SchoolScreener for Schools in action

The poll was conducted during a webinar for primary and secondary school educationalist, including those responsible for inclusion and welfare, focused on identifying and supporting pupils with mild to moderate hearing and sight loss as part of school inclusion and welfare programmes; and it included a Q&A with Thomson Screening’s clinical leadership.

At the beginning of the webinar, delegates were asked how they would rate their understanding of visual and

hearing impairment in children and young people, including the signs to look out for, the impact of these conditions on their educational and social development, and how students need to be supported in school.

Only 31 per cent rated their understanding as ‘good’ or ‘very good’. Almost half responded that their understanding was simply 'fair'.

A second poll asked delegates what the largest benefits to their school of checking pupils for vision and hearing deficits might be: 92 per cent said the largest benefit would be to “identify and remove academic barriers for students”.

Michael Ter-Berg, CEO of Thomson Screening, which developed SchoolScreener for Schools screening software, said: “The 92 per cent figure demonstrates the importance of checking children’s eyesight and hearing as they develop through key stages two and three.

"It also underscores the importance of research showing that children with vision and hearing loss are more likely to miss key stage two targets and underperform at GSCE, as well as other research in recent years identifying the impact of unidentified vision and hearing loss on social development and behavior.”

Missoni global licence to stay with Safilo The Safilo Group and Missoni have announced the renewal of their global licensing agreement for Missoni brand eyewear until the end of 2029.

Since the start of the relationship in 2020, Missoni has represented a significant brand in Safilo’s women’s luxury fashion portfolio thanks to its collections characterised by the innovative use of the fashion house’s iconic textiles and colours, giving them a distinctive identity.

“We are very proud to renew our partnership with Missoni," said Angelo Trocchia, CEO of the Safilo Group. "In only four years of collaboration, we have been able to strongly develop the eyewear category, in particular in the main European markets and in North America.

This renewal offers us a new and stimulating opportunity to consolidate and broaden our distribution, continuing to work together with the brand."

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Missoni eyewear on the catwalk

Nockolds retains OCCS contract Nockolds Solicitors has been retained as the chosen provider of the Optical Consumer Complaints Service (OCCS) following a competitive tender process.

The Hertfordshire-based firm has provided the GOC funded mediation service to resolve consumer complaints in the optical sector since 2014. It has been awarded a new threeyear contract with an optional oneyear extension.

The OCCS continues to deliver a resolution rate of 87 per cent of consumer complaints via mediation.

The General Optical Council, which funds the OCCS, said that this proven model of alternative dispute resolution (ADR) was contributing to increased patient JENNIE JONES satisfaction, lower costs per complaint and a reduction in cases being referred to Fitness to Practise proceedings.

Nockolds’ ADR team is headed up by partner, Jennie Jones, who has more than 20 years’ experience in clinical dispute resolution in a regulatory setting.

Jennie said: “We are thrilled to be continuing this established partnership. We’re looking forward to building upon our tried and tested work to date as well as implementing new plans. With eye health care and optical practices evolving, through AI, the transfer of more optical care to local and primary settings and technology with care pathways to improve and maintain patients' vision like never before, the consumer/optical practice relationship is a fundamental.

"As we enter into our 10th year in delivering the OCCS, we are keen to build on the work of the OCCS in supporting compassionate and confident interactions between consumers and optical professionals, and helping the sector to be fit for the future," she added.

Did you know... only 22% of presbyopic patients have ever tried multifocal contact lenses?1

Packshot images for illustration purposes only

Help them get their freedom back by talking to them about ACUVUE® Multifocal contact lenses

Visit our page to access tools, information and more

1. JJV Data on 昀le, 2021: Ageing Eye Quant Research. Markets included UK, US & Japan (N=1358 (UK n=450) ACUVUE® Contact Lenses are indicated for vision correction. For detailed product description and safety information, please consult the Instructions for Use www.e-IFU.com. © Johnson & Johnson Medical Ltd 2024. ACUVUE® and ACUVUE® OASYS MAX 1-Day MULTIFOCAL are registered trademarks of Johnson & Johnson. PP2023AMB7211

NEWS

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Luxury brands see eye to eye

New MD for Menicon

British luxury eyewear company Linda Farrow has struck a new deal with French fashion label Jacquemus to produce its sunglasses collection.

Founded in 2009, Jacquemus is known for its play with proportions and eye-catching accessories such as its signature Le Chiquito bag.

Inspired by influences from art and his home in the South of France, the French designer Simon Porte Jacquemus brings a sense of fun with colour to his collection.

The new sunglasses collection, produced by Linda Farrow, features three styles – Pilota, Ovalo and Gala – each one emblazoned with the Jacquemus logo on the sides and signature gold end tips.

Linda Farrow creative director and CEO, Simon Jablon, said: “We are delighted to announce working with Jacquemus to produce their eyewear collection. We expect this to be a long-term partnership that continues to grow and evolve each season.”

Kevin Mitchell is stepping down as managing director of Menicon after 36 years in the role. He will be succeeded by Gaynor Williamson, who joined the company last year as commercial director.

The company stated: "Kevin has been a cornerstone of Menicon since its days as David Thomas, before being acquired by Menicon in 2009.

Throughout his tenure, Kevin has demonstrated unwavering dedication and exceptional leadership, fostering growth and steering the company through pivotal transformations."

GAYNOR WILLIAMSON The company expressed its "sincere appreciation for his longstanding service and wishes him well in his next chapter" – adding that "the appointment of Gaynor Williamson as the new managing director signifies a commitment to continued growth and success for Menicon".

Prior to joining Menicon, Gaynor spent three years with Alcon as head of key accounts and, before, that 11 years with Johnson & Johnson Vision – latterly as commercial business manager.

Jacquemus Ovalo

by Linda Farrow

Hollywood walk of frame Grammy Award-winning musician and actor, Lenny Kravitz, has teamed up with EssilorLuxottica to launch a limited edition gold-plated, gold-mirrored Ray-Ban Reverse Aviator style with his signature etched on the lens.

A hero piece in the Ray-Ban Reverse collection of Aviator, Wayfarer, Caravan and Boyfriend, Kravitz showcased the frames whilst attending his recent Hollywood Walk of Fame Ceremony. Each pair comes with limited edition packaging and a case signed by Kravitz. Only 1,000 pairs have been made available worldwide.

Thanks to innovative astigmatic, prismatic and resolving powers, the concave lenses of Ray-Ban Reverse are said to offer uncompromised optical precision. Materials used include bio-based nylon lenses with a 41 per cent biobased carbon content, bio-based acetate frames with a 67 per cent bio-based carbon content, and 100 per cent recycled packaging, card and cleaning cloth.

Lennie Kravitz wears Ray-Ban Reverse limited edition

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Gender identity to be kept off-register Registered eyecare professionals will no longer have their gender information recorded on the General Optical Council (GOC) public registers.

The GOC has approved a proposal to remove this information from the public register following a consultation, which drew a higher than typical response.

During a recent meeting, council members commented that providing information about a registrant’s gender "did not hold a public protection purpose and removing it would better align the GOC’s register with other health and care regulators".

The council also noted that no other protected characteristics were recorded on the register and that "providing this type of information without a public protection purpose could lead to concerns around personal privacy".

The council heard that some consultation respondents suggested that its removal could also prevent potential unconscious biases against female optical professionals.

The GOC will continue to collect registrants' gender information for internal monitoring purposes.

STEPPER (UK) Limited sales@stepper.co.uk steppereyewear.com For UK frame availability, please consult website.

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NEWS FOCUS NICKY COLLINSON

Accredited CLOs ideally placed to offer ocular biotherapy A sutureless amniotic membrane patch (Omnigen) held on to the cornea by a custom bandage contact lens (OmniLenz) is rapidly expanding as an out-patient application to treat corneal trauma and ocular surface disease – with accredited contact lens opticians (CLOs) ideally placed to offer this treatment.

Omnigen and OmniLenz are the result of ground-breaking research by scientific, clinical and industry experts at Nottinghambased biotech company, NuVision Biotherapies.

Formed in 2015, NuVision pioneered the production of human amniotic membrane (or amnion) patches for use in ophthalmology. Its technology is based on

amniotic membrane into a sterile, stable dry therapy. The amnion has a natural ability to prevent the growth of bloodvessels; limits inflammation, reduces scarring and has anti-microbial properties, all of which help to preserve sight while the surface of the eye repairs itself.

Since 2021, the amnion has been supplied in partnership with the Anthony Nolan Trust's Cell and Gene Therapy Services through consented voluntary c-section patient donations from hospitals in Leicester.

Approved for NHS use, Omnigen quickly rehydrates upon application, supporting tissue repair in numerous ways. It serves as a unique, long-storage

NuVision Biotherapies' Omnigen uses amnion to heal the cornea

research led by Dr Andrew Hopkinson and Professor Harminder Dua, who developed a new method of preserving the amnion. This resulted in Omnigen – flexible amnion patches that can be stored for long periods at room temperature.

NATURAL HEALING PROPERTIES A patented dry preparation of amnion, Omnigen can be applied in a suture-free out-patient setting, or surgically – as a permanent graft supporting the structure and re-growth of natural tissue, or a temporary patch acting as a biological dressing to protect the wound, physically prevent inflammation and adhesion development, and support pain management whilst facilitating tissue recovery.

Developed at the University of Nottingham’s Academic Ophthalmology Department, NuVision’s Tereo manufacturing process transforms the

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'off-the-shelf' healing product, benefiting patients with ocular surface disease.

Manufactured exclusively for NuVision

by Menicon UK, OmniLenz is a high water content custom bandage contact lens created to hold Omnigen on the ocular surface without the need for sutures or surgery – in just a four to six-minute outpatient procedure. The daily wear, non-prescription lens can be applied for the treatment of various ocular surface diseases – including severe dry eye and epithelial erosion.

Speaking with ABDO at 100% Optical in February, NuVision CEO, Andy Hill, said: "These ocular surface diseases and conditions can clearly be managed in High Street eyecare practice rather than via referral to the hospital eye service. With the necessary training and education on the product and its use, this is certainly within the accredited contact lens optician's scope of practice."

Due to the 'Covid effect', which drove patients to practices rather than to hospitals, some 80 per cent of use is now with the OmniLenz contact lens.

"Out-patient application of Omnigen is not just about convenience,” continues Andy, “it allows unscheduled and emergency, suture-free intervention to facilitate management of ocular damage that could cause visual impairment. It enables successful management of refractory conditions, and offers an efficient and effective care pathway, greater access to treatment and a reduction in healthcare costs and resources."

GREAT STEP FORWARDS The company has to date treated more than 10,000 patients with donated amnion, and trained more than 40 eyecare professionals to apply the lens in practice.

The training programme and certification process takes around 45 minutes, with three now actively practising with the product.

Andy added that the company was currently reviewing its structure to meet expanding demand for OmniLenz.

The NuVision team is also in discussions with ABDO to investigate the delivery of OmniLenz training and education for CLO members at the National Resource Centre (NRC).

Max Halford, ABDO clinical lead, said: "This new option for the management of suitable patients with conditions such as acute dry eye or corneal abrasions is a great step forward for practitioners within High Street practice.

“We are working with the NuVision team to see how this treatment can be delivered by accredited CLOs – and to ensure that training will allow this to become part of a CLO’s scope of practice. We hope to offer training at the NRC as soon as possible.”

Ed Fox, ABDO head of membership services, confirmed that NuVision trained members delivering these types of treatment, and who are part of the Association’s professional indemnity insurance scheme, would be fully covered.

Max added: “We continue to recommend CLOs to undertake the extended services training to enhance their ability to appropriately manage patients who present with anterior eye concerns, and expect all CLOs to carefully consider their personal scope of practice dependent on their training and confidence to support individual patient needs.”

Act early to help slow the worsening of a child’s myopia (short-sightedness)1 The world’s only myopia management contact lens supported by a 7-year clinical trial2,3,4

Myopia can worsen rapidly particularly in younger children5

MiSight® 1 day cuts the worsening of myopia by half1†

MiSight® 1 day benefits are proven to last after treatment has ended4,6‡

†Using measured and modeled data, pooled across ages (8-17), MiSight® 1 day slowed myopia progression by an average of approximately 50%. ‡12 months post-treatment, evidence indicates that no accumulated myopia control benefits were lost following 3 or 6-years of MiSight® 1 day wear (on average, for children aged 8-15 at start of wear). Instead, eye growth reverted to expected, age-normal rates.

1. Arumugam B et al. Modelling Age Effects of Myopia Progression for the MiSight 1 day Clinical Trial. Invest. Ophthalmol Vis Sci. 2021; 62(8): 2333. 2. Chamberlain P et al.

A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci. 2019; 96(8): 556-567. 3. Chamberlain P et al. Long-term Effect of Dual-focus Contact Lenses on Myopia Progression in Children: A 6-year Multicenter Clinical Trial. Optom Vis Sci. 2022; 99(3): 204-212. 4. Chamberlain P et al. Myopia progression on cessation of Dual-Focus contact lens wear: MiSight 1 day 7-year findings. Optom Vis Sci. 2021; 98(E-abstract): 210049. 5. Zadnik K et al. Factors Associated with Rapid Myopia Progression in School-aged Children. Invest. Ophthalmol. Vis. Sci. 2004; 45(13): 2306. 6. Hammond D, Arumugam B, et al. Myopia Control Treatment Gains are Retained after Termination of Dual-focus Contact Lens Wear with no Evidence of a Rebound Effect. Optom Vis Sci. 2021; 98(E-abstract): 215130. © 2024 CooperVision. CooperVision® and MiSight® are registered trademarks of The Cooper Companies, Inc. and its subsidiaries.

CVGY122291-1

MiSight® 1 day

PRODUCT SPOTLIGHT - EYEWEAR

New Upside from Orgreen Optics

Vibrant duo steer into harbour Ørgreen Optics has unveiled the Runaway and Upside as key highlights of its vibrant Havn (Harbour) stainless steel collection. The collection’s name draws inspiration from the tranquil harbours and intricate canal networks surrounding the company's Copenhagen HQ, with a vivid colour scheme reflecting the rich palette of hues found in the houses nearby.

Runaway is a masculine Hexapantos shape with a subtle top bar and tonal colour palette, while Upside is a classic pillow rectangle inspired by the vintage Clubmaster shape. Upside also features a tactile texture on the stainless steel front and the beginnings of the sides engraved in subtle geometric vertical lines.

From East to West Inspired by an icon

Yalea x Frida Khalo model Beautiful

De Rigo house brand Yalea has launched the Yalea x Frida Khalo collection celebrating the iconic artist who left her mark on the world.

Two ophthalmic and two sunglass styles, named Beautiful, Rebel, Unique and Strong, reflect the distinctive traits of the artist. Stylistic motifs are flower patterns on the sides, and end tips shaped like a paintbrush. Colours are intense and bold, with black and red, purple and pink, in a balance of colour-blocks and transparancies. Acetate sunglass Beautiful comes in a W version with a flower on the side and an iconic unibrow symbol on the front.

Two-in-one protection

Invu's new chidlren's clip-on collection

The new Invu optical frame and magnetic clip children’s collection from Swiss Eyewear Group enables eyecare professionals to address the important need for UV protection.

The vibrant frames are crafted in comfortable, ultraflexible Swiss TR90 material. With a simple click, children can convert their prescription spectacles into sunglasses.

The matching ultra-polarised clips are anchored to the frame with four hidden magnets to ensure they stay firmly in place.

Everything’s just peachy Founded in 1880 in the Jura region of France, Morel Lunettes has a 140-year history of eyewear craftsmanship and innovation.

As the design world embraces Pantone Colour of the Year – Peach Fuzz – the company has included peach tones in its 2024 collection. Described by Leatrice Eiseman, executive director of Pantone, as "embodying feelings of compassion and conviviality with a harmonious, warm sensation", peach shades appear in bold collages in the acetate Lisa range (pictured).

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Morel model Lisa in peach hues

PRODUCT SPOTLIGHT - EYEWEAR Peak colouration craft

Blackfin One model Palau

New styles in the Blackfin One titanium collection are the result of extensive R&D in colour to obtain chromatic results – such as gradient, metalised, matte, antiqued and multicolour – to accentuate the frames' graphic aspect.

Models Fiji, Samoa and Palau are the 'peak' manifestation of the company's new concept in design and colour. Thanks to innovative bi-layer processing of a single sheet of titanium, the front is given a unique geometric camouflage effect – highlighted by contrasting colours.

Ready-to-wear kimono style A colour palette inspired by Japanese gardens permeates the new Face à Face Japan Now collection – from yuzu green to indigo blue and azalea pink.

Continuing the brand’s exploration of the kimono aesthetic, model Haori (pictured) conjures the iconic Japanese garment. The width of the sleeves is reflected in the volumes, combined with a slender waistband detail on the frame and along the side. The colour palette is inspired by kimono prints with smoky gradients enhanced by solid colour dots and graphic floral patterns.

Haori from the Face à Face Japan Now collection

Summer Games face on Oakley’s latest releases – Sphaera and BiSphaera – are set to make a statement at the Summer Olympic Games.

Sphaera will offer Team Oakley essential features for peak performance. It features Prizm Lens Technology for detail, a lightweight O-Matter frame, a front vent for enhanced airflow, and secure Unobtainium nose pads and molded-in ear socks.

BiSphaera are designed with a similar brow and stem to Sphaera, and offer the same lightweight and flexible comfort but with the option of Prizm Lens Technology or Oakley Authentic Prescription lens options.

US athlete Fred Kerley wears Oakley Sphaera

Ace eyewear partnership

Federer models style Ryegrass in pewter and forest

Oliver People's and Roger Federer have announced a new four-collection partnership featuring the brand's first-ever eye shield styles.

The RF | Oliver Peoples partnership begins with four sunglasses and two shields. Custom colour enhancement, polarised and mirrored lenses feature alongside adjustable rubber grip nose pads and end tips.

A number 8 plaque represents Federer's birthdate (8.8.81) as well as the number of his Wimbledon titles, while a corewire pattern reflects the threading patterns of the strings found on vintage tennis racquets. An octagonal RF metal logo piece at the end tip resembles the end of a tennis racquet.

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CPD

LEARNING DOMAINS

Shedding light on cataracts: causes, symptoms, diagnosis, treatment and prevention

PROFESSIONAL GROUPS

By Lisa Farrell MScOptom

C CPD CODE: C-108143 MCQs AVAILABLE ONLINE: Wednesday 1 May 2024 CLOSING DATE: 7 August 2024 ANSWERS PUBLISHED: September issue 2024

This CPD session is open to all FBDO members and associate member optometrists. Successful completion of this CPD session will provide you with a certificate of completion of one non-interactive CPD point. The multiple-choice questions (MCQs) are available online from Wednesday 1 May 2024. Visit www.abdo.org.uk After member login, scroll down and you will find CPD Online within your personalised dashboard. Six questions will be presented in a random order.

Please ensure that your email address and GOC number are up-to-date.

The pass mark is 60 per cent.

CPD CODE: C-108143 18

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ataract is classed as one of the world’s primary causes of blindness1-3 with the prevalence of cataracts growing with age. Understanding cataracts, including their causes, symptoms, diagnosis, treatment options and prevention strategies, is crucial for supporting the maintenance of ocular health and the patient’s quality of life.

Due to the natural crystalline lens’s avascular structure, it is transparent by nature. It is encased by a basement membrane known as the capsule and is biconvex in shape. The loss of lens transparency, whether from a congenital or an acquired cause is known as a cataract4. Cataracts are a common but treatable eye condition that can impact upon quality of life.

The main reason to undergo cataract surgery is predominantly for visual enhancement – especially in cases where the individual is having problems in carrying out everyday essential functions, such as driving or for specific occupational duties.

Other indications to have cataract treatment is to improve the clarity of the media to allow monitoring of retinal pathologies, such as diabetic retinopathy and/or for cosmetic indications, i.e. to restore a black pupil. The patient will primarily have the decision on whether they wish to be referred for treatment and ultimately the suitability to undergo surgery will rest with the ophthalmologist5.

RISK FACTORS AND AETIOLOGY Multiple risk factors are associated with the formation of cataracts4,6,7,9,10.

Understanding these risk factors is essential for identifying individuals who may be at higher risk of developing cataracts. First and foremost, older age is the most common association. As people age, the proteins in the lens of the eye breakdown, leading to the formation of lens opacities.

Genetics play a significant role in predisposing individuals to cataracts4,7,1.

Certain medical conditions can also increase the risk of cataracts. These include diabetes, hypertension, obesity and metabolic syndrome. Individuals with these conditions may be more prone to developing cataracts due to oxidative stress and inflammation.

Several lifestyle factors have been linked with an increased risk of cataracts.

Smoking, excessive alcohol consumption, poor nutrition, ultraviolet exposure (UV) or the long-term use of steroids increase the risk of lens opacities. Other factors associated with cataract formation are ocular trauma, radiation exposure and therapy from X-rays or cancer treatment9,10.

At first, the visual symptoms caused by a cataract may affect only a small portion of the crystalline lens and the patient may be unaware of any visual disturbance or loss. As the cataract matures, it distorts the light passing through the lens resulting in an increased cloudiness to the vision, leading to more noticeable symptoms4,8.

Cataracts often develop slowly, however, as the condition progresses, individuals may experience blurred or faint vision with an increased sensitivity to glare, particularly when driving at night, which results in spoking of headlights. A difficulty seeing in low-light conditions is commonly reported and extra lighting is required, especially for near tasks. A reduction in contrast and brightness of colours, monocular diplopia and frequent changes in refractive correction are commonly encountered.

The types of refractive changes noted are a myopic shift, an increase in astigmatism or an anisometropia7,12.

Factors that can help reduce the risk of cataracts are keeping systemic conditions in check, such as blood sugar levels and blood pressure, protecting from UV rays, changing lifestyle; by maintaining a healthy weight, reducing alcohol consumption and ceasing smoking. Being proactive and having regular eye examinations can help keep the patient informed of the cataract progression and when treatment is required4,17,18.

CLASSIFICATION OF CATARACTS CONGENITAL CATARACTS Cataracts are classified as either congenital or acquired. Congenital cataracts are a less common form of cataract compared to age-related cataracts. They are present at birth or develop within the first year of life4,14. The incidence of congenital cataract is approximately 3:10.0004. Twothirds of cases are bilateral. Unilateral congenital cataracts are typically sporadic as they occur without the presence of systemic disease or family history. In around only 10 per cent of cases the cause can be ascertained4,14.

In the case of bilateral congenital cataracts, autosomal dominant (AD) is the most common genetic mutation that gives rise to their formation4,14. Rubella infection, chromosomal anomalies such as Down syndrome and metabolic disorders such as galactosaemia are other causes linked with congenital cataracts forming. Aniridia can also be linked with the development of congenital cataract4.

When treating congenital cataracts, an intraocular lens (IOL) is not implanted

FIGURE 1. Cortical cataract

immediately. Regular check-ups are required to monitor visual acuity and if it is developing normally, no surgery is required. In cases where visual development is not progressing normally, surgical intervention is necessary.

Congenital cataracts, when visually significant are operated on within the first six to eight weeks of life to prevent amblyopia15.

ACQUIRED CATARACTS Acquired cataracts can be sub-divided based on where and how they develop in the eye4. Nuclear sclerotic, cortical, subcapsular and Christmas tree cataracts are all age-related opacities. Nuclear sclerotic cataracts form in the middle of the lens, resulting in the nucleus taking on a distinguishing yellow appearance. This occurs due to the deposition of urochrome pigment. As it progresses, the colour deepens to a brown hue known as brunescence4,12,13.

Brunescent cataracts are harder which is surgically relevant as they can be more challenging to treat resulting in longer surgical times4,12,13. As the refractive index of the nucleus increases, an increase in spherical aberrations occurs resulting in a myopic shift. This is commonly known as the second sight of the aged, as some elderly patients are able to read again without spectacles4.

Nuclear sclerotic cataracts can be best

observed with oblique slit lamp biomicroscopy4.

Cortical cataract (Figure 1) can form on the anterior, posterior or equatorial cortex. In between the lens fibres, clefts and vacuoles begin to form, progressing to the characterised radial spoke-like opacities around the nucleus’ perimeter. They usually begin in the infero-nasal quadrant. Due to the light scatter from cortical opacities, patients typically report glare as their most problematic symptom4,12,13.

Subcapsular cataract can be either anterior or posterior. From fibrous metaplasia of the lens epithelium, an anterior subcapsular cataract forms directly under the lens capsule4,11,13.

Posterior subcapsular opacities form in front of the posterior capsule (Figure 2 next page). They appear vacuolated or plaque like when viewed by oblique slit lamp biomicroscopy or black on observed by retroillumination4.

Posterior subcapsular cataracts result in more notable visual effects than those reported by nuclear or cortical cataracts due to their location. Near vision tends to be more affected than distance vision4,16. In miotic conditions, such as in direct sunlight or from oncoming headlights, patients are most symptomatic. Posterior capsular opacities also develop faster than other types of cataracts16.

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CPD

FIGURE 2: Posterior subcapsular cataract

The rarest form of cataract is the Christmas tree cataract. Classic presentation is needle-like deposits in the deep cortex and nucleus. They are nonuniform and multi-coloured. The opacities result from elevated calcium levels causing an accelerated breakdown of membraneassociated denatured proteins. Blurred vision, reduced night vision, glare and diplopia are the symptoms reported10.

Myotonic dystrophy has been linked with Christmas tree cataract formation. In this case, it is classed as a secondary type cataract4,11.

Secondary cataracts are caused by systemic or ocular disease and can result from certain types of medications, trauma or from surgery. Myotonic dystrophy, diabetes mellitus, hypertension, glaucoma, dermatitis and uveitis are commonly linked with the formation of secondary cataracts with chronic anterior uveitis being the primary cause4.

The chance of developing a cataract increases with chronic anterior uveitis due to the duration of intraocular inflammation17. The prolonged use of steroids to treat this condition can typically accelerate a cataract’s development16,26. In the nascent, at the posterior pole of the lens a multi-coloured opacity can be observed. If the inflammation can be stopped, this opacity may not progress but if it persists, posterior and anterior cataracts

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develop16. In the presence of posterior synechiae, cataract formation is more likely4.

Steroid based medications can be associated with the formation of subcapsular cataracts. They firstly affect posteriorly and can mature to affect the anterior capsule4,16. Other medications related to the development of cataracts are chlorpromazine, busulphan and gold4.

For chlorpromazine, which treats psychotic disorders, stellate lens opacities can develop on the anterior capsule27.

Blunt trauma can result in lens opacification due to damage to the lens fibres. Posterior subcapsular opacities are most likely to form in a rosette or stellate shape. After trauma, a cataract can take years to form, and remain stable or progress to maturity. In cases where cataract surgery is required, good visual outcome is probable in circumstances without global rupture4,24.

Cataracts can also be surgically induced. Most commonly after pars plana vitrectomy (PPV). Nuclear sclerotic cataracts occur in approximately 80 per cent of cases within two years of the operation20,22,23. Post localised, ocular radiation treatment, posterior subcapsular cataracts can present9.

Iridescent, cortical opacities present in the third decade of circa 90 per cent of people with myotonic dystrophy. It is not until the fifth decade that they progress to

radial, posterior subcapsular cataracts that are visually impacting.

With regards to diabetes mellitus, in the presence of hyperglycaemia, a raised glucose level also occurs in the aqueous humour, which diffuses into the lens4,12.

Snowflake cortical opacities are the typical presentation of a diabetic cataract. Age-related cataract occurs earlier in diabetics. Nuclear opacities are common and tend to progress rapidly.

For the young diabetic, snowflake cortical cataracts can resolve naturally or mature rapidly depending on the control of their blood sugars. Cataract formation is four times more likely in individuals who have both diabetes and hypertension18,19.

Approximately 10 per cent of patients with severe atopic dermatitis develop bilateral cataracts between their second and forth decades4. Typically, a dense, anterior subcapsular plaque can be seen which puckers the anterior capsule.

Posterior subcapsular opacities may also form20.

Nuclear sclerotic and posterior subcapsular cataracts can be linked with patients who have high myopia. This is due to the increased axial length and nutrients having further to travel through the vitreous to the crystalline lens. In the presence of nuclear sclerosis, a further increase in myopia occurs25.

In individuals with hereditary retinal dystrophies, posterior subcapsular cataracts are associated; Stickler syndrome, retinitis pigmentosa, Leber congenital amaurosis and gyrate atrophy are some the dystrophies correlated with cataract formation4.

HOW TO MANAGE CATARACTS AND WHEN TO REFER When optical correction with spectacles or contact lenses no longer gives optimal visual correction, cataract surgery will be required. Optimal vision for each patient will vary depending on lifestyle and their everyday tasks. The level of visual acuity recorded in the testing room does not always reflect how it impacts upon the patient’s day to day visual capabilities.

Within the referral letter; visual acuity, pupillary responses, ocular motility and ocular health should be recorded. Visual acuity is best measured using LogMAR and, if possible, measure contrast sensitivity as these give a better understanding of the quality of vision.

Normal contrast sensitivity for patients over 60 years of age range, from 1.52-1.76 log contrast sensitivity units.

For individuals under 60 years of age, 1.72-1.92 log contrast sensitivity units is typical28.

When contrast sensitivity is reduced, it can be enhanced through the use of yellow filter lenses and the patient may be advised on extra lighting to enhance the contrast. Disability glare is often a symptom reported by patients with cataracts, and brightness acuity testing gives a useful indication of how this is impacting the patient4.

Pupillary responses should be noted as a pupillary anomaly such as an afferent pupillary defect implies ocular pathology, which may affect post-operative visual outcome. If performing a dilation prior to referral, note how well the pupils dilate as a poorly dilating pupil can increase the difficulty of performing cataract surgery such as in diabetic cases.

Assessing ocular motility, and noting if any strabismus is present, is important information to include on a referral letter as post-operatively, decompensation can occur subsequently causing diplopia as a result from the improvement in sight. The health of the ocular adnexa should be recorded as any anomalies can predispose to endopthalmitis. Such examples that may require pre-operative treatment are tear film deficiencies, blepharitis, conjunctivitis, dacryocystitis, ptosis, ectropion or entropion4.

Depth of the anterior chamber is important to note as shallow depth can make cataract surgery more complex.

Pseudoexfoliation can also cause complications during surgery as it can be evidence of a weak zonule4. Ocular pathology, such as macular degeneration, should be mentioned as this can impact upon the visual outcome post treatment.

Cataract surgery is typically carried out on one eye at a time in case a complication arises during surgery, and thus there is a second eye to rely on.

The eye with the weaker vision will be operated on first. There are instances where bilateral phacoemulsification will be carried out. This can happen when a patient requires general anaesthetic to undergo treatment, and can be coincided with another treatment when under sedation. Bilateral cataract surgery may be carried out on the same day if the

ophthalmologist deems the patient at a low risk of complications arising29.

There are multiple referral pathways that the patient can opt for. Under the NHS, patients can be referred via their GP to their local hospital or via other healthcare providers such as NewMedica, SpaMedica or ACES. The latter accept NHS patients and have shorter waiting times. These health care clinics also carry out private treatments, which gives the patient more choice regarding the type of intraocular lens (IOL) implanted.

Under the NHS, single-focus IOLs are used but, privately, various options are discussed with the patient, from single vision, monovision to multifocal IOLs (Figure 3). Multifocal and accommodating IOLs can give a good level of vision but there are instances where patients will need optimal visual correction for their lifestyle and hence require glasses. These can be for either distance or near30.

After studying optometry at the Ulster University Coleraine, LISA FARRELL graduated in 2010. She then practised in various clinical settings from High Street independent practice, to hospital and domiciliary eye health care.

In 2017, Lisa returned to study and completed her Masters in cataract and refractive surgeries.

Currently, she works for the committees of CORU, Ireland's multi-profession health regulator, and as a locum optometrist between the UK and Ireland.

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

LEARNING OUTCOMES FOR THIS CPD ARTICLE DOMAIN: Communication

FIGURE 3: Multifocal intraocular lens

In the case of NHS treatments, if a patient has previously had monovision correction – either naturally occurring or through contact lens correction – the surgeon may implement this in the IOL calculation29. Typically, emmetropia is the aim for long distance and the patient will only require near vision glasses. This, however, is not always the outcome, especially in cases of high astigmatism.

Where each eye is being treated separately, the time gap between the second eye treatment will vary depending upon the outcome of the first eye – and if the patient wishes to undergo treatment for the second eye. Usually, a gap of eight to 12 weeks is given between treatments.

This can vary depending upon waiting times. However, four to six weeks postcataract treatment, a refraction and new spectacles can be dispensed29.

1.3, 1.7, 2.2: Communicate effectively with patients who present with signs and or symptoms of cataract and enable them to understand their condition including referral pathways and treatment options.

DOMAIN: Clinical Practice 5.3, 7.5: Demonstrate an understanding of patient risk factors for cataract, how cataracts are classified and managed and patient options for referral and treatment.

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MCAs

Multiple choice answers

Young adult myopia

By Kathryn Webber BSc (Hons) MOptom DipTP IP (Higher Cert) CL MCOptom FHEA and Dr Matthew Cufflin BSc (Hons) PhD MCOptom FHEA CPD CODE: C-107280 Published January 2024

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

Axial length is defined as the distance from the anterior surface of the cornea to? a. The retinal pigment epithelium at the back of the eye b. The posterior of the crystalline lens c. The plane of the spectacle lenses d. Where the patient holds their reading material a is the correct answer. Axial length is the distance from the anterior surface of the cornea to the retinal pigment epithelium at the back of the eye.

Myopia management contact lenses and spectacle lenses are licensed up to what age? a. Fifteen years of age b. Eighteen years of age c. Twenty-one years of age d. No age limit is applied b is the correct answer. MiSight contact lenses and the spectacle lens options are licensed up to the age of 18 years.

Most myopia is due to what? a. Axial length b. Refractive index of the eye c. Corneal curvature d. Lens thickness a is the correct answer. Most myopia is axial in nature and each 0.1mm of extra axial growth equates to 0.25-0.30D of myopia.

The College of Optometrists states that products can be used off-label for myopia management under what circumstances? a. None: the College of Optometrists states that products cannot be used ‘off-label’ b. If there isn’t a licensed alternative and the parent/carer requests the product c. If the patient requests the product and there is clinical rationale the treatment will work d. If there isn’t a licensed alternative and there is a clinical rationale the treatment will work d is the correct answer. The myopia management guidance published by the College of Optometrists in August 2022 states that products can be used off-label if there isn’t a licensed alternative – and we have good reason to think that the treatment will work through suitable evidence and/or clinical rationale.

Juvenile onset myopia most commonly begins between the ages? a. Zero to four years b. Five to seven years c. Eight to 13 years d. Fourteen to 18 years c is the correct answer. The majority of myopia is classed as juvenile onset and this most commonly begins between the ages of eight and 13 years. The average age of stabilisation was found to be 15.6 years (+/-4.2 years) in the COMET study in 2013.

Percentage with stable myopia 100.0 90.0

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80.0 70.0

% of cohort

According to the COMET study, what percentage of myopes were still progressing at age 21? a. Fifty per cent b. Twenty-three per cent c. Ten per cent d. 3.8 per cent c is the correct answer. The COMET study found that 23 per cent of myopes were still progressing at age 18 and 10 per cent at age 21 – showing that a significant minority of these juvenile myopes continue their progression into adulthood.

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Data redrawn from the COMET study12 showing the percentage of myopes that were stable across age groups

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In their 2023 retrospective analysis, how much did Khan et al find being in a ‘high learning environment’ change the odds of myopia progression? a. The risk is approximately 10 times greater b. The risk is approximately doubled c. There is likely no increased risk d. The risk is approximately halved b is the correct answer. Being in a ‘high learning environment’ increased the odds of myopia progression by more than two times according to the recent Australian retrospective practice study, which compared those in a high learning environment including both students and academics, with the general population (see: Khan HA et al. Myopia progression in adults: a retrospective analysis.

Optometry and Vision Science. 2023; 100(8): 537-542).

Which one of these techniques is most sensitive when trying to detect changes in myopic progression? a. Autorefraction b. Subjective refraction c. Optical biometry d. Pupillometry c is the correct answer. Axial length (when measured by optical biometry) is a much more accurate and repeatable measure than objective or subjective refraction and can detect smaller changes. This makes it an ideal measurement to be used in research studies looking at myopia progression.

What is the average axial length for an emmetropic adult? a. 30mm b. 25.99mm c. 24mm d. 23.75mm d is the correct answer. The average axial length for an emmetropic adult is 23.75mm.

IMAGE: Topcon Healthcare, Japan

A biometer (MYAH, Topcon Healthcare) which can measure axial length

ABDO CPD REGIONAL EVENTS 2024 ALL EVENTS OFFER • Six interactive CPD points including peer review • Refreshments and light buffet • Interaction time with sponsors All events start at 6:30pm and finish at 9:30pm unless otherwise specified

Wednesday 15 MAY

WORCESTER

Worcestershire Wildlife Trust, Lower Smite Farm, Hindlip, WR3 8SZ

Thursday 13 JUNE

LEEDS

Village Hotel Leeds North, 186 Otley Road, Headingley, Leeds, LS16 5PR

Tuesday 9 JULY

DERBY

Derby Leisure and Events Venue, The Pavillion, Moor Lane, DE24 9HY

Wednesday 18 SEPTEMBER

TRURO

Truro Rugby Club, St Clements Hill, Truro, TR1 1NY

Thursday 26 SEPTEMBER

LONDON

Governor’s Hall, St Thomas’ Hospital, Westminster Bridge Rd, SE1 7EH

Tuesday 1 OCTOBER

WASHINGTON

Holiday Inn Washington, A1 Junction 64, Emmerson Road, NE37 1LB

Monday 4 NOVEMBER

CAMBRIDGE

Cambridge Rugby Club, Volac Park, Granchester Road, CB3 9ED

All events will open for booking on the ABDO website Events page approximately six weeks prior to the event start date. Visit www.abdo.org.uk

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T EC H CO R NER

TECH CORNER – FREEFORM LENSES TONY CALVO

FREEFORM SINGLE VISION: why bother?

In the constantly evolving world of lens technology, dispensing opticians (DOs) hold the key to unlocking optimal visual experiences for their patients. A critical decision in this journey lies in choosing between conventional lenses and freeform single vision designed lenses.

This article aims to provide a greater understanding of the advantages of freeform single vision lenses, enabling the DO to navigate the decision-making process and provide patients with eyewear that goes beyond the ordinary.

Navigating the digital age

conditions. Through sophisticated algorithms, freeform technology optimises the lens design to minimise these aberrations. The result is clearer, sharper and more natural vision – all of which you can emphasise to patients during the dispense.

Seamless peripheral vision Conventional lenses often fall short when it comes to peripheral distortions, leading to discomfort and disorientation,

In a world dominated by digital devices, freeform goes one step further by incorporating features like an anti-fatigue boost, which uses the wearer’s own accommodation to optimise the lens for a range of focal distances. Providing this level of flexibility ensures the lenses cater to the evolving needs of patients immersed in prolonged screen time, making them a practical choice for the modern lifestyle.

Technological genius

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The advent of freeform lens technology has revolutionised the vision correction landscape. At the core of this revolution lies advanced digital mapping and surfacing, which customises optics based on an individual's unique prescription and eye measurements. This leap ensures a level of precision that goes beyond the capabilities of conventional manufacturing methods. Understanding the intricacies of this technology allows you to communicate effectively with patients, emphasising the substantial benefits of precise and personalised vision correction.

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Precision advantage When guiding patients through the lens selection process, attention often falls on the precision mapping afforded by freeform lens design. Unlike conventional lenses that offer a standardised approach, freeform lenses consider refractive errors as well as peripheral aberrations. Imagine a lens made not just for basic vision correction but also tailored to address those subtle imperfections that can impact visual clarity. This precision mapping allows for customisation that results in lenses that provide a more natural and distortion-free field of vision.

Tackling oblique aberrations One of the standout features of freeform lenses is their ability to correct oblique aberrations, including spherical aberrations and astigmatism. These aberrations can cause blur, glare and halos – especially in challenging lighting

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Visual acuity maps using LogMAR scale demonstrating the clarity of vision in a single vision lens manufactured: conventionally (1); using entry level freeform calculations (2); and using advanced freeform calculations (3)

commonly referred to as the 'swim effect'.

Freeform lenses address this issue by optimising the prescription across the entire lens surface, ensuring a more consistent and comfortable viewing experience – especially in the periphery.

DOs can explain how freeform lenses enhance peripheral vision, making the transition between different visual zones seamless – a feature that significantly contributes to wearer satisfaction.

Comfort and aesthetics We understand that comfort is not just about good vision; it's also about how spectacles feel and look. Freeform lenses excel in providing a more comfortable visual experience. By incorporating parameters into the design, such as pantoscopic tilt, face form angle, back vertex distance and lens base curve along with a freeform aspheric back surface, the lenses are optimised to deliver a reduction in thickness. This level of customisation enhances visual comfort whilst contributing to the overall aesthetic appeal of the spectacles.

Summary The choice between conventional and freeform single vision lenses is a decision the DO can guide patients through with confidence. By understanding all the great innovations that come with freeform lenses, you can effectively communicate their substantial benefits to your patients. Ultimately, it's about more than just choosing a great lens; it's about using the relationship with your lab, and the knowledge they hold, to gain advice on all the different lens designs available. Armed with this wisdom, you can lead patients towards eyewear that not only meets their expectations – but exceeds it.

TONY CALVO SMC (Tech) has more than 15 years' experience in the ophthalmic industry. He began his career in practice, initially working in the lab and progressing through various management positions. As operations manager for Optimum Rx Lens Specialists, he oversees all aspects of production.

OPTICAL SUPPLIERS ASSOCIATION MEET THE MEMBER

The Body Doctor: Levelling up dry eye knowledge Dry eye and lid hygiene appointments create more contact opportunities with patients and builds closer bonds, believes the team at the Body Doctor, which has stepped up its offering of products in this growing sector of eyecare.

Ross Bailey, optical director, explains that the 12-yearold Yorkshire business has expanded Body Doctor optical rapidly to director, Ross Bailey keep up with demand from independent practices for its in-practice treatments for dry eye.

“Most people know us as an eye

compress business, but we have grown our offering enormously and are now a onestop-shop for dry eye disease and blepharitis treatments. We provide all the tools and treatments for practices to really differentiate themselves in this increasingly important sector.”

For a membership fee, the Body Doctor can help a practice set itself up as a dry eye clinic, with the ability to image the patient’s condition, show lids and lash improvement during the treatment period, and supply a recommended at-home or in-practice treatment plan.

“Engaging the patient and showing the objective results really helps with compliance," Ross says. "We all know this is a disease that needs to be managed, and lid hygiene appointments are now becoming routine in many practices. Practices are intercepting and treating asymptomatic patients before any issues trouble the patient. These points of contact build trust,

leading on to further eye examinations and new spectacles, or perhaps opening up the opportunity to return to contact lenses.”

The Body Doctor’s aim is to set up 100 dry eye clinics in independent practices around the UK and to push forward with its CPD offering, delivered through webinars and at events around the country.

“We are on a mission to level up knowledge of dry eye disease amongst both clinicians and patients and bring innovative treatments to both the practice and at home." explains Ross.

A new member of the OSA, the business particularly values the regulatory insights provided by the professional team which keeps in touch with often changing UK, EU and international regulation.

“I am also a networker at heart, so I enjoy the contact at the OSA and finding out about the early stages of industry trends, and opportunities to collaborate with other businesses," concludes Ross.

PROFESSIONAL CERTIFICATE in PAEDIATRIC EYECARE Providing skills to develop and further your career ABDO will soon launch a new professional certificate in paediatric eyecare that will enable eyecare practitioners to develop advanced skills and knowledge in relation to many different aspects of paediatric eyecare.

Participants will draw on groundbreaking research by eminent academics and specialist clinicians from a varied range of disciplines.

For any dispensing optician wanting to develop advanced skills in paediatric eyecare, this programme has everything.

The flexible course consists of nine units delivered online by leading academics as recorded lectures plus a training and assessment day at the ABDO NRC in Birmingham, which will be offered four times a year.

COURSE AND EXAM FEE ABDO members - £1,500 Non members - £1,850 Each theoretical unit will have an MCQ assessment and be CPD accredited.

COMING SOON!

To register your interest please visit www.abdo.org.uk/paediatric-eyecare-course/

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IN PRACTICE – SUSTAINABILITY KAYE MCINTOSH

Small

T

things matter

he drive to pursue social, ethical and environmental objectives has become ever-more important for the optical industry and profession – and practices are approaching this in very different ways. But does doing the right thing have to eat into your profits? We spoke to three practice owners about how they are driving change without it costing the earth.

The course “challenged you to think about your own business and the three pillars of sustainability,” Sukie adds. “It’s not just about energy savings and recycling but about giving back to your community, buying local and understanding where your waste goes. If you don't wash out a margarine pot, then it won't get recycled because it's contaminated.”

It’s a common problem: a 2022 survey by climate change NGO WRAP found that 84 per cent of households were STARTING FROM SCRATCH contaminating their recycling through A series of paintings incorporating well-intentioned ‘wish cycling’ – putting discarded plastics from local beaches items that can’t be processed into the inspired Sukie Woodhouse to pursue recycling bin. social, ethical and environmental topics at Sukie approached the council to ask Woodhouse Opticians in Blackpool. They if Woodhouse’s cardboard could be were works from her last exhibition before collected separately from general waste. she joined the practice full-time five years “They practically laughed at me,” she ago, after two decades as a director. recalls. Her own research led her to Green Oak Recycling, which supplies roll cages to store waste cardboard and charges a small fee to collect each one when it’s full.

Sukie then began to think about single use plastics. “Nobody seemed to want to recycle dummy lenses," she continues. "I asked Wolf Eyewear if we Eco-inspired art by Suki Woodhouse on display could display their frames without the lenses and whether they “We didn’t know anything about would accept returns without them. They sustainability so we looked for training and were prepared to give it a go. found free courses online from the Skills “So we had a little mini trial and asked Network,” says Sukie. Governmentour patients if it made any difference to funded, the Level 2 qualification in them trying on the frame without lenses. understanding sustainability was at no They unanimously said no. But it was cost, as long as students completed the impossible to persuade any of the other course. The whole five-strong team companies to supply dummy frames took part. without lenses.”

“We did an energy audit of the practice Sukie’s been through several different and found that we could make changes options for frame recycling, with varying quite easily, like blocking any gaps where costs for collection. She now uses Bird cold air could get in, and making sure that Eyewear, which make frames from wood the windows were securely closed and and recycled aluminium. “They offered me that we turned off all the lights when we a free collection box with my own logo on. left,” Sukie explains. The practice also My patients’ old frames get recycled into switched to sustainable light bulbs instead spectacle cases so it’s a circular journey.” of strip lighting.

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Bird Eyewear is certified as B Corp, verified on meeting high standards for social, ethical and environmental impact, and balancing purpose with profit.

Suki has also received additional help from the local Chamber of Commerce.

Its advisor on sustainability has provided Suki Woodhouse: driving spreadsheets changes in practice and training to undertake at the next audit.

“Eventually, I will be off-setting our carbon footprint but I’m not that far on the journey yet,” she says.

The Level 2 course made the practice team think about what they do in the community. Sukie is now a school governor and the team is part of a local business group that plants trees: “Our parks have fallen into disrepair, so we go out with other local businesses, weeding and replanting.”

Using optical resources, the practice also works with schools.

“We've bought a range from Waterhaul, which produces its frames from abandoned fishing gear – known as ‘ghost gear’.

Waterhaul produces The frames eyewear from ‘ghost gear’ aren't polished, so you can still see the texture of the original plastic.

“Waterhaul also provides bags and tools for collecting litter. We are planning to do a beach litter pick with schools. It’ll be fun – you get something back from seeing the children and the joy that they have in understanding their local environment," Sukie concludes.

I N P R ACT I C E

BRINGING PATIENTS ON THE SUSTAINABILITY JOURNEY Dr Scott Mackie says saving money isn’t the main driver. “Your priority should be sustainability. But becoming more environmentally friendly may well save you money in the long term.”

The owner of Mackie Opticians in Bothwell, near Glasgow, Scott says you need to think beyond your own building and supplies. “One of the biggest carbon footprints is created by patients travelling to see us. So we started thinking about how we can reduce journeys.”

The practice gives people appointments covering several services so they only have to come in once. “They get their sight test, contact lens check and pick up their reading glasses on the same day, or we can post out glasses or contact lenses to them.”

Environmental action doesn’t have to be drastic, he adds. Small things matter: for instance, spectacle cleaning spray is offered in refillable bottles, reducing plastic waste.

“We give all our staff refillable water bottles," says Scott. "We don’t want to ban single-use plastic but give people alternatives. It’s a way of looking out for

their health as well. Staff feel valued and part of a great team that collectively is trying to make a difference. It saves people money too."

Going further in tackling plastic waste from contact lenses than merely recycling them isn’t expensive either, says Scott. “We’re really trying to promote fortnightly or monthly lenses to patients wearing lenses Collecting pre-loved full-time. For frames at Mackie Opticians most patients, if there is no difference in comfort or vision they could be paying less, saving the planet more and my profit is the same so we let them choose.”

The practice collects old spectacles for re-use through its own charity, which offers eyecare to people in need in the Punjab.

ALL IN IT TOGETHER Jonathan Partridge Optometrists in Welshpool, Powys, won two awards in 2023: Sustainable Practice of the Year at the SightCare Conference and Green Practice of the Year from Optometry Wales.

Co-founder and dispensing optician, Beverley Partridge, says: “We have a big advantage in one way because we relocated in 2015 into a building that we literally took apart and rebuilt.

Everything's been done to save energy.

When you walk into a room, the light comes on automatically; when you walk out, the light goes out. The building is essentially purpose-built so it's easier to look after, to heat and maintain.”

The little things are important, says Beverley. “Every night we turn all our computers and monitors off. We're a team of six people and whoever is the last person to leave checks everything. Many of the things that we do were intended to save money. We have never bought a Jiffy bag or a box ever, in our 34 years. We keep the boxes suppliers use. Clean them, store them and then re-use them.”

Beverley started monitoring the

Beverley Partridge receives her 2023 SightCare award from sponsor Jack Carter

heating due to the energy crisis in winter 2020/21. “When electricity prices went through the roof, ours increased by £200 pounds a month. We're a small business and we couldn’t sustain that.”

Just being careful about energy use and keeping the heating down saved £150 a month in the early days of the crisis.

“Even now, our latest bill was cheaper than the month before.”

They involved the whole team of six.

“We sat down and looked at our usage and asked everyone for their ideas. How can we do better? What can we improve on?

Because everyone is involved, everyone looks out for sustainability. Everyone monitors the temperature control and

Prisoners in HMP Barlinnie sort them and any that can’t be re-used go to Bird Eyewear, which smelts the metal down for re-use and recycles the plastic.

Staff are encouraged to suggest patients keep the same frames when they need a new prescription. “We make it clear in staff meetings that if someone re-uses their own frames, we don’t see it as ‘you’ve lost a sale’. We are going to say ‘well done’," explains Scott.

Patients don’t have to wait to send their existing frames away to be re-glazed. The practice has a scanner, from Hoya, which measures the frames and the lenses are made remotely.

The whole practice ethos is “about providing the best service”. Because the offer is so broad, including smoking cessation, diabetic and glaucoma clinics, spectacle sales are only one element. And sustainability is a key goal. As we speak, Scott is packing for a trip with his charity to run eye camps in India. It’s all part of the same vision – sustainability, environment and ethics writ large.

energy usage. People understand why, they're not doing it because I tell them to.”

The practice has moved from recycling printer toner cartridges to refillables, buying bottles of ink. The practice uses an independent waste service but keeps costs down by working with another business. “We’ve joined forces with our neighbour next door to share our bin, so we’re much more mindful about what we put in," explains Beverley.

The ABDO SEE Hub has a range of resources to help with waste and carbon foot-printing, including a sustainability policy template for your practice. A range of case studies highlights optical companies taking action.

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

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RESEARCH REVIEW – PART 3 DR NEEMA GHORBANI MOJARRAD

Virtual reality, AI and more Welcome to Research Review Part 3, designed to support dispensing opticians (DOs) and contact lens opticians (CLOs) in keeping up-to-date with relevant research – and learning how to apply evidence-based practice techniques and approaches in day-to-day practice.

F

ive papers have been selected this month, focusing on myopia and refractive error, paediatric vision, and contact lenses and the anterior eye.

Alongside a summary of each paper is a short discussion about how the study might be relevant to DOs and CLOs in practice. Full references are included to ensure readers can make their own professional judgements on the findings.

MYOPIA CONTROL AND REBOUND STUDY: Sánchez-Tena MÁ et al.

Assessing the rebound phenomenon in different myopia control treatments: A systematic review1 As there is now a range of different myopia management interventions available, debate has ensued on which are more effective than others. There is also discussion as to the occurrence of any rebound effects, i.e. where ceasing the use of a myopia intervention induces increased myopia progression.

The presence of a myopia management rebound effect may lead to the child developing a level of myopia similar to that if left untreated, thus it is important to bear in mind when considering the options. A commitment to the therapy may be even more important to consider in the long term.

The authors of this paper conducted a systematic review of the studies published to see if there was an answer to the possible rebound effect for the different interventions available. A total of 11 studies were included, looking at changes in axial length and spherical equivalent of refraction changes. These studies included a mixture of optical and non-optical myopia management interventions (such as light therapy and atropine).

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atropine and myopia management spectacles seemed to be the interventions growing in recent search popularity more than other interventions. The authors went on to advise that these results may help in public messaging, and facilitate better patient and practitioner education.

The average rebound effects for optical treatments were 0.04 ± 0.04mm VR AND PAEDIATRIC VISION for axial length, and -0.13 ± 0.07D for refractive changes, over an average STUDY: Bexson C et al. Safety of virtual evaluation of 10 months. The authors reality use in children: a systematic indicated that although optical review3 treatments showed lower rebound effects As digital technology evolves, patients compared to pharmacological and red may find themselves increasingly worried light therapies, these treatments seemed to report greater myopia control effects.

It’s worth noting that the average age of the participants, and the length of intervention used in these studies, varied considerably, and this may have an impact on the results found. For instance, the rebound observed after six years of wear or at 15+ years of age may not be the same as after a year of use or at nine years of age.

Is VR safe for children?

STUDY: Nagra M et al. Using big data to understand interest in myopia2 Do you tend to use the term 'myopia control' or 'myopia management'?

Although considered interchangeable, patients may understand these differently, and be more familiar with one term over the other.

In this study, the authors used Google Trends to look at people’s search patterns for interest in refractive errors and myopia.

They found that the term 'myopia' was a more popular search term than 'nearsightedness' or 'short-sightedness', indicating that explaining 'myopia' once is enough for patients to understand the term; in fact, 'myopia' made up more than 50 per cent of the search interest volume in comparison to other refractive terms such as 'astigmatism' and 'hyperopia’. The authors also found that the term 'myopia control' was more widely used and searched for than 'myopia management'.

The study also revealed that the use of

about its impact on their children. This can include typical concerns such as excessive use of digital devices and whether this will cause their children to become myopic – or even more myopic.

However, one area which has been less investigated for its’ visual and other side effects is virtual reality (VR). You might find yourself, for example, being asked about the possible negative impact of VR headsets on children's vision.

In this study, the authors looked at the evidence regarding safety and potential adverse events reported for children when using VR. They identified 26 studies that would meet their inclusion criteria, but advised that (generally) research data about safe VR use in children was limited.

The authors found that while VR could cause 'cybersickness' symptoms in children, such as oculomotor issues, disorientation and nausea, this wasn’t significant enough to cause participants to want to stop using it. Children with

RESEARCH REVIEW amblyopia may suffer from double vision, but this was reported to quickly disappear once they stopped VR use. Generally, however, adverse events were not reported, and were poorly defined and categorised.

The authors advised, therefore, that there wasn't enough evidence to fully evaluate the safety of VR use in children under the age of 14 years. Data on repeated or prolonged exposure was also lacking, and therefore more data was necessary.

It’s worth pointing out that this study did not evaluate whether the use of optical correction, such as spectacles, was taken into consideration, or would be important to consider for safety. For now, most VR manufacturers recommend that spectacles are worn during VR immersion in order to see clearly. Whether this provides a potential increased risk is currently unknown.

CONTACT LENSES AND CHATBOTS STUDY: García-Porta N et al. Are artificial intelligence chatbots a reliable source of information about contact lenses?4 Many of you are likely to be familiar with artificial intelligence (AI) chatbots, and may even have used them. AI software can be used to seek answers to a range of questions, possibly as an alternative to search engines such as Google, as it can be quicker to evaluate search results and information. This led the authors of this study to analyse three openly available AI chatbots: ChatGPT 3.5, Perplexity, and Open Assistant.

They found that the answers the chatbots gave to 10 common contact lens questions varied in accuracy, with ChatGPT being most accurate when used

References 1. Sánchez-Tena MÁ, Ballesteros-Sánchez A, Martinez-Perez C, Alvarez-Peregrina C, De-Hita-Cantalejo C, SánchezGonzález MC et al. Assessing the rebound phenomenon in different myopia control treatments: A systematic review. Ophthalmic and Physiological Optics 2024;44(2):270-9.

2. Nagra M, Wolffsohn JS, GhorbaniMojarrad N. Using big data to understand interest in myopia.

Optometry and Vision Science.

2024;101(1):37-43.

in both Spain and the UK (written in Spanish and English). Interestingly, for questions that would be related to specific country legislation, the AI chatbots were poor at providing correct answers, and could potentially provide inaccurate information about local contact lens legislation.

Should patients be taking advice from chatbots?

The authors concluded, therefore, that AI chatbots may be able to give answers for general contact lens questions, but they cannot provide the nuance and context that an eyecare professional in the 'real world' would.

AMD TREATMENT AND DRY EYE STUDY: Gao M et al. Influence of serial intravitreal injections on measures of dry eye: a systemic review and metaanalysis5 Many of us will see patients suffering from eye conditions such as wet agerelated macular degeneration (AMD) or even myopic maculopathy. The treatments for these conditions usually require intravitreal injections. Although the primary considerations in evaluating outcomes related to such treatments are around retention/improvement of vision 3. Bexson C, Oldham G, Wray J. Safety of virtual reality use in children: a systematic review. European Journal of Pediatrics 2024.

Mar 11.

4. García-Porta N, Vaughan M, RendoGonzález S, Gómez-Varela AI, O'Donnell A, de-Moura J et al. Are artificial intelligence chatbots a reliable source of information about contact lenses? Contact Lens and Anterior Eye 2024;47(2):102130.

5. Gao M, Xia F, Wang P, Feng Z, Wang X. Influence of serial intravitreal injections on measures of dry eye: A systemic review and meta-analysis. Contact Lens and Anterior Eye 2024 Feb 12:102127.

and integrity of the macula area, patients may also complain of symptoms that are not investigated.

Dry eye is more commonly reported in older female patients – the same demographic are likely to have wet AMD intravitreal injections. Therefore, this study aimed to investigate the long-term effects of these injections on dry eye signs and symptoms.

In the meta-analysis for their study, the authors included four studies with 259 participants. They noted that after the injections, dry eye symptoms significantly increased. A higher score was reported in the ocular surface disease index (OSDI) questionnaire, with a mean difference of 10. The only visible measure difference reported was that of tear film osmolarity (with a mean difference of four). Measures of tear break-up time, with and without fluorescein, and Schirmer tests all showed no significant difference.

Therefore, the authors suggested that although repeated use of anti-vascular endothelial growth factor injections may increase dry eye symptomology, and that intravitreal injections may have some detrimental effect on ocular surface comfort, the ocular surface may partially recover over time.

It may then be worth advising patients about possible discomfort and dry eye sensations prior to their attendance for any intravitreal injections, and monitoring them for dry eye symptoms as they undergo continual treatment. Further research to understand the mechanisms involved may be beneficial.

The author would like to thank Bausch + Lomb, Professor James Wolffsohn and Dr Amy Sheppard for sharing their monthly research update, which has helped to support the preparation of this article. It is partly adapted from this content, alongside a review of data from other sources.

Dr Neema Ghorbani Mojarrad PhD, BSc (Hons), MCOptom, FBCLA, FIACLE, Prof. Cert. Glaucoma and Low Vision Dip. SV, FHEA is an assistant professor at the University of Bradford and a locum optometrist.

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TAKE 5 – WITH DR MONICA JONG NICKY COLLINSON

Myopia management MYTHS, TOOLS AND TECHNIQUES

F

resh from the Main Stage at 100% Optical, Dr Monica Jong, global professional lead in professional education at Johnson & Johnson (J&J), sat down with Dispensing Optics editor, Nicky Collinson, to expand on the nuances of her presentation: 'A new approach to myopia management'.

A highly esteemed researcher and educator, Dr Jong gained her optometry degree and PhD from the University of Melbourne. She co-founded the International Myopia Institute, co-created the first global online education programme in myopia at the Brien Holden Vision Institute, and co-authored the WHO report on the Impact of Myopia and High Myopia.

She leads practitioner education initiatives around the world to support evidence-based myopia management, and mentors graduate students from developing DR MONICA JONG and developed countries.

NC: WHY IS MYOPIA MANAGEMENT NOW HIGH ON J&J’S AGENDA? DR JONG: J&J has been conducting research and development in the myopia field for the past 15 years.

We believe myopia management is a compelling and worthy solution to address this global eye health issue.

We also believe in working in partnership with optometrists, and dispensing opticians (DOs) and contact lens opticians (CLOs) especially, by empowering them through advocacy and leadership in education and training.

I spent time working at the Brien Holden Vision Institute, where our teams conducted the initial research and advocacy work in raising awareness of the myopia epidemic. This experience and the work we did on the Holden et al Study, coupled with my strong professional background in clinical research, education and seeing patients, has shown me the extraordinary potential in how we can mitigate the impact of the forecasted longer-term myopia-related vision impairment in our communities.

It is estimated that the prevalence of myopia will reach 50 per cent globally by 2050. I remain committed to driving the development of myopia management in order to help provide patients with the most innovative treatments available.

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NC: WHAT COMMON MYOPIA MANAGEMENT MISCONCEPTIONS MIGHT DOS AND CLOS NOT BE AWARE OF? DR JONG: Myopia management can be perceived as complex – but you don't require specialist equipment to get started. There really is no entry barrier to offering patients myopia management options, and an accurate refraction with your existing practice instruments is all you need. It’s not essential to be able to measure axial length, however, it directly measures eye growth, which is a useful and accurate method for measuring the success of myopia management treatment.

It’s worth noting, however, that peer-reviewed myopia control clinical trials demonstrate a strong correlation between axial length and refraction change.

Of course, in some treatments like low-dose atropine and orthokeratology, measuring axial length is useful given the refractive change may be masked.

In the UK, already 50 per cent of adults in 2006 and 23 per cent of teens had myopia. And the proportion of children with myopia has more than doubled in the past 50 years according to the NICER study in Northern Ireland.

Once a child has myopia they will likely progress, so we should manage immediately. I strongly feel that commencing myopia management is within all optometrists’ and DOs' grasp, because we have all the tools in practice already. High quality education exists online and face-to-face for both DOs and CLOs, produced by experts like Myopia Profile in collaboration with companies like J&J. Because patient education is an important part of the myopia management equation, we have also started developing materials that support the eyecare practitioner in making those conversations easier. Even a conversation mentioning the 20/20/2 rule is a great way to engage patients and parents, while keeping the message easy to understand.

NC: WHY IS EARLY INTERVENTION SO IMPORTANT? DR JONG: Early intervention is critical, as age is the biggest risk factor for myopia progression. The younger the child, the faster the rate of progression. This leads to an increased risk of vision problems in the future.

Therefore, practitioners shouldn't wait for myopia progression to begin myopia management, as evidence shows that once a child develops myopia, they are highly likely to increase. Children showing signs of being premyopic should also be monitored.

The environment plays a huge role too. We know outdoor sunlight has the ability to reduce the incidence of myopia and somewhat slow axial elongation. Intense

TA K E 5

OBITUARY

OBITUARY:

John Hockney 1948-2024 "A visionary in manufacturing optics"

Dr Jong presenting on myopia management at 100% Optical

education is also being linked to causing myopia in a number of recent studies. Therefore, there are multifactorial elements to myopia development, and as patients’ first port of call, we as eyecare professionals can play a key role in educating our patients, and their parents, about myopia early on, along with regular follow-up and early management.

NC: SPECIFICALLY, HOW DOES J&J VIEW THE ROLE OF THE DO AND CLO IN SUPPORTING THE MANAGEMENT OF MYOPIA FOR CHILDREN? DR JONG: DOs and CLOs have an important role in helping to provide early intervention and access to the latest products, education and management tools. They can support myopia awareness by talking to patients about lifestyle and existing treatments, playing a big part in the solution and the follow-up.

We believe strongly in the multi-disciplinary team where everybody is involved in reinforcing the message that myopia can be managed beyond providing a correction only. We also aim to support practitioners’ learning journey through education and CPD. NC: CAN YOU TELL ME MORE ABOUT ACUVUE ABILITI 1-DAY SOFT THERAPEUTIC CONTACT LENSES – AND ABILITI OVERNIGHT THERAPEUTIC CONTACT LENSES FOR MYOPIA MANAGEMENT – AND WHETHER WE WILL SEE THEM LAUNCHED IN THE UK SOON? DR JONG: We were delighted to receive CE mark 2797 in 2023 for Acuvue Abiliti 1-Day Soft Therapeutic Lenses for Myopia Management. J&J plans to launch Abiliti 1-Day lenses in a portfolio with Acuvue Abiliti Overnight Therapeutic Lenses. These lenses will be available in France in the coming months, and we will share details on further launches in due course. We are excited to see how our Abiliti products will help address patient needs in this region in the future.

It is with regret we inform the profession and industry of the death of John Hockney – founder of Cambridge Optical and former chairman of the Federation of Manufacturing Opticians (FMO).

“I think it is fair to say that John was 'Mr Optrafair' for many years and devoted an enormous amount of his time to ensure it was a financial success for the FMO,” said Kingsley Sleep, former vice chairman of the trade organisation that went on to become the Optical Suppliers Association.

“He was the founder and owner of Cambridge Optical, which grew into the Cambridge Optical Group following the acquisition of many long-established optical companies during the 1980s," continued Kinglsley. I worked with John from 1981 to 1991, which was a time of rapid expansion, and The late John Hockney there was never a dull moment.

“John was an extraordinary character: extrovert, ebullient, clever and shrewd all at the same time. He was also a visionary in the world of manufacturing optics, and changed the face of the sector in many ways. We shared a sense of humour and enjoyed a strong friendship. That never changed in subsequent years and I shall miss him.”

Another contemporary, Bob Hutchinson, agreed: “John was one of a number of highly respected manufacturing opticians during the 1970s and 1980s. Starting his career in the spectacle frame business in London, his talents at running a business soon came to the fore when he opened a small unit for lens glazing in Histon, Cambridgeshire.

Through long hours, and dedication to his customers, this business, like those to follow, grew and the business moved to Bar Hill, a new village in Cambridgeshire.

“The purpose-built premises were filled with state-ofthe-art glazing machinery and it seemed a huge leap of faith. But with John’s guidance the building was later doubled in size and the new entity was opened with a large celebration for all John’s customers and friends by no less than Eric Morecambe, the UK’s favourite comedian.

“John had a large personality and was constantly filling the old print magazines with PR and stories about Cambridge Optical. His success was in understanding what the public wanted in frame design, as well as quality lens production, and in the care he took for every one of his customers.

“As chair of the FMO for two years, he oversaw TV advertising on eyecare issues, paid for by the lens manufacturers. Creating some of the largest stands at Optrafair, he also brought clothes designer Jeff Banks and a catwalk to the show,” added Bob.

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QUESTIONS & ANSWERS AMY SEAMAN

How do I join my LOC? QUESTION I am interested in joining my local optical committee (LOC), but am not sure what’s involved or how to go about it?

It’s possible to attend LOC meetings as a ‘guest’ initially

DO YOU HAVE A QUESTION on a topic that's relevant to everyday practice? Send your Q&As to the editor at ncollinson@abdo.org.uk

AMY SEAMAN FBDO CL was the first DO to be appointed as a director of the Central LOC Fund in March 2024, covering the North East region. ABDO regional lead for the North and Midlands, Amy is a member of Sheffield LOC, is a minor eye conditions services accredited contact lens optician, an ABDO examiner and former lecturer.

Email aseaman@abdo.org.uk

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Held at regular intervals throughout the year, LOC meetings are open to all and so a dispensing optician (DO) can attend as a 'guest' – even if they are not a member.

I attended LOC meetings for almost a year before becoming a member.

During my time as an 'observer', I learnt how the meetings were organised, came to understand the topics arising on the agenda, and got to know the current members and what their LOC roles were.

The first thing I would do is contact your LOC's secretary to ask for the details of the next meeting and request permission to attend as a guest. Very occasionally, there may be matters on an LOC meeting agenda that are private, or not yet in the public domain. This would mean guests stepping out of the meeting for a few minutes whilst this is being discussed. Of course, guests are not able to take part in any voting but can listen to debates.

The agenda for an LOC meeting will vary but may include discussions and updates about any new referral pathways being proposed, or changes to the method of communication between optical practices and others involved in patient care. They may discuss issues with local waiting lists and provision of sight testing in their area; it’s often a very broad range of subjects covered that changes at each meeting.

LOC members will have various roles and there will be time for members to update the committee on what they may have been following up on since the last committee meeting. These roles are determined and assigned by the committee and can differ from LOC to LOC depending on what is relevant to their local area. I am one of the CPD leads on my LOC. All LOC websites should detail how to contact the secretary or administrator. If you can't find this information, contact your ABDO regional lead for help. LOC websites also have information about how to join the LOC mailing list. It is good to join this list even if you decide not to attend meetings or become a member. LOCs send out notifications, usually via email, about relevant items such as local pathway and referral changes and CPD events.

LOC websites vary in content but it is worth browsing through the one you are considering joining as they will showcase what the committee is involved in – and often list its members. You may be also be able to access the minutes of previous meetings.

You can continue to attend LOC meetings as an observer or you may wish to join as a member. Members are voted onto their LOC during the LOC’s annual general meeting (AGM). Applications open at least a month before the AGM. The process for announcing nominations and voting may vary in different areas, so check this with your LOC. It may be done prior to, or at, the AGM, online or in person.

Elected members serve for three years. All contractors and performers in that area are invited to attend LOC AGMs and so your practice should be informed about this meeting. You do not have to own a business as a contractor or have an NHS performers number to attend or to be part of your LOC; either you can stand for election or, as a DO, the LOC may co-opt you onto its committee.

Join your LOC's mailing list to ensure you are directly informed of the AGM. LOCs must have a minimum of six elected members, usually with a chair, vice chair, treasurer and secretary, in addition to other members. A typical LOC has between eight and 15 members. At the present time, a consultation is being undertaken by the LOC Support Unit to look at the LOC constitution, which sets the rules for all LOCs across England.

Find a link to the LOC in your area at www.loc-online.co.uk

DO’ING SOMETHING DIFFERENT SEEING LIFE THROUGH A DIFFERENT LENS

A

mbitious plans to set up new Vison Care for Homeless People (VCHP) clinics to provide a full dispensing optician (DO) service throughout the UK is top of the agenda – and leading that drive in the north is DO, Lorraine Bleasdale.

Lorraine brings a wealth of experience as a practice manager to her new role as VCHP clinic development manager for the north. The position also dovetails well with her continuing work in private practice and as a member of the ABDO Board.

“My experience as a dispensing optician and practice manager is particularly useful, especially with my lens and frame knowledge," says Lorraine. "This new role is showing me skills that I didn’t know I had, but in a good way. I really want to make a difference after 30 years in optics.

LORRAINE BLEASDALE, VCHP CLINIC DEVELOPMENT MANAGER

“It is very upsetting that people can get to such a low stage in life, and to feel intimidated about coming into an optical practice," Lorraine continues. "It is all about building trust, and providing a warm and welcoming environment in the clinics. Everyone deserves to have the same eye health care.”

Highlighting the first VCHP clinic to open in Scotland within the Crisis Skylight Centre in Edinburgh, thanks to sponsorship from Specsavers and others, Lorrraine says: “The first stage in establishing a new clinic is to work with local outreach groups to identify communities that we can help. We then find a location and source the equipment, from our amazing supporters. Building a team around the clinic, with a range of management, clinical and fundraising skills is vital to the clinic’s success."

Lorraine, who works in Cumbria, has well developed insights to seeing life from different perspectives and the importance of safeguarding, having worked as a foster mother for several years.

OA CORNER PART 41

EYECARE FAQ

FIRST SPECTACLES COLLECTION

SOCIAL MEDIA TIPS:

When a patient collects their first pair of spectacles, they may look to the optical assistant (OA) for advice.

In this month's OA Corner, dispensing optician Sue Deal considers what should be discussed upon collection, assessing any adaptation issues, and what advice and guidance should be provided to the patient before they leave the practice. This includes how to clean them – and what to do if any adaptation issues do not improve.

Read OA Corner in full on DO Online.

n May EyecareFAQ focuses on keratoconus, myopia and sun protection. Use Sun Awareness Week on 3-9 May to promote sunglasses to patients.

Some suggested social media posts include: 'Sunglasses protect your eyes from the harmful effects of UV light – and they can look great too'; 'Do my children need to wear sunglasses too? Children need to protect their eyes from UV just as much as adults do'; and 'Did you know sunglasses can be made to your normal optical prescription? Ask our dispensing optician for more information'.

Find Q&As on all these topics and in the EyecareFAQ section of the ABDO website and graphics in the EyecareFAQ resources for members section. Find EyecareFAQ on the ABDO website, Facebook, Twitter, Pinterest and Instagram.

HERE COMES THE SUN

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HELPING PATIENTS ADAPT TO THEIR FIRST PAIR OF SPECTACLES

M AY 2 0 2 4 D I S P E N S I N G O P T I C S

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NOTICES

ABDO BOARD ELECTIONS 2024 Notice is given of the election of Directors to the Board of the Association of British Dispensing Opticians (ABDO).

There will be five ABDO Board places open for election in 2024. Two seats are currently held by members entitled to seek re-election: Julie Lees and Andrew Symons.

words in which they are asked to detail any relevant experience they can bring to the Board and outline their aspirations for the future of the Association.

Nominations are sought from fully qualified members of the Association who wish to make a meaningful contribution to the future of the profession. ABDO is committed to being fair and inclusive, and promoting equality of opportunity. We want to ensure that the Board is representative of the Association’s membership and so particularly encourage members who are currently underrepresented to stand for election. This includes people from Black, Asian and minority ethnic backgrounds, disabled people and LGBTQ+ people.

ABDO members who may have a conflict of interest as a result of, for example, holding a board or senior management position with another optical body, may not be eligible for election.

ABDO Board members are required to attend four Board meetings per year, and attend at least two nationally organised meetings a year, including the ABDO Annual Meeting. In addition, Board members may be expected to attend a range of committee meetings both within ABDO and externally. The role is unpaid although Board members can claim reasonable expenses.

If there are more valid nominations than seats vacant then a ballot will be conducted by an independent organisation: CIVICA Election Services, London N8 0NW. Ballot papers will be dispatched on Friday 12 July 2024, voting will close at 12 noon on Tuesday 27 August 2024.

All candidates will be asked for a submission of up to 250

The nomination form can be found at www.abdo.org.uk/abdo-elections

Any person seeking election should complete the candidate form and include details of their six nominators. Nominators should then individually complete and sign the separate nomination form.

Members elected will take up their duties on Thursday 7 November 2024. Their period of office will be for three years with the opportunity to stand for a further three-year term.

The closing date for nominations is 5.00pm on Friday 14 June 2024.

Members who have any queries about the process or eligibility to stand should contact Jane Burnand. Email jburnand@abdo.org.uk or call her on 07939936827

ALWAYS READY FOR BUSINESS The ABDO National Resource Centre is ready and waiting to help your business.

Set in the heart of Birmingham the NRC is the perfect venue for your event. We have spaces and facilities to host small meetings, training courses, conferences and seminars.

THE NRC OFFERS YOU: • Flexible facilities offering meeting space from 4 to 160 delegates.

• Customisable room layouts • Catering facilities include water dispensers, ‘bean to cup’ coffee and artisan flavoured teas • FREE car parking • Superfast FREE WiFi • Dedicated host for your event

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D I S P E N S I N G O P T I C S M AY 2 0 2 4

abdo COLLEGE BOOKSHOP

Books and Equipment from ABDO College Make ABDO College your first choice for competitively priced: • Rules, gauges and charts • Dispensing, optometry, ophthalmology, contact lens books • Essential packs of books for student DOs • Useful study guides • Spread payments with PayPal Credit. eBooks now available for a range of key texts.

Order online at abdocollege.org.uk/bookshop/ Items not listed on the website can be sourced for you.

Email jhall@abdocollege.org.uk or call 01227 733904

KEEPING EXCELLENCE IN YOUR SIGHTS

. p i h s r e b m e m r . u s t Yo fi e n e b r You NETWORKING AND EDUCATION

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

PROFESSIONAL SERVICES

ABDO MEMBER BENEFITS INCLUDE: • Professional indemnity insurance • Personal accident cover • Counselling helpline - FREE 24-hour service • CPD • Dispensing Optics

BENEFIT SPOTLIGHT Eyecare FAQ EyecareFAQ is an ABDO initiative that has been promoting eyecare and eyewear directly to the public for 10 years. As an ABDO member, you have access to Eyecare FAQ resources and promotional material to use on your practice social media. Tips on using social media are also available in Dispensing Optics every month, so look up EyecareFAQ on Facebook, Twitter and Instagram today; then follow, like and share!

PROFESSIONAL SERVICES

Go to www.abdo.org.uk/dashboard/

• DO Online • Access to selected British Standards • FREE legal helpline • Discounts on everyday purchases • Member benefit plans with HMCA • Access to over 3,000 + health clubs, gyms and leisure centres • Mobile phones on the best rates available from EE • Savings on all your travel needs • Totum Pro card powered by NUS Extra • Save on travel insurance policies • Savings on Apple products

* Terms and conditions apply to all benefits. Some ABDO Membership benefits are arranged and managed through Parliament Hill and some are arranged through ABDO, please see website for details. The ABDO membership benefits web page is managed and run on behalf of ABDO by Parliament Hill Ltd. Offers are subject to change without notice. All offers correct at time of going to print.

• Advice and Guidelines