DISPENSING OPTICS JULY 2020 - ABDO
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NEWS, INFORMATION AND EDUCATION FOR OPTICIANS JULY 2020 DISPENSING OPTICS
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JULY 2020
contents
features
16. CET C-75570
Exploring depth perception
By Mark Hickton
22. CET MCAs C-74109
Triaging: reassurance, CLO, optometrist
or ophthalmologist?
By Suzanne Dunn
23. NRC update
Preparing for a safe return
15.
24. In practice
How to increase your fashion focus
by Antonia Chitty
26. Report
WHO, what, how? after Covid-19
by Elaine Grisdale
regulars
5. DO Dispatches
6. A DO and proud of it
28. 6. News
14. Product spotlight
28. Region update
29. Business Bites | Eyecare FAQ |
12. 24. Competition Corner
30. Jobs & Notices
26.
FC – Image from stock
JULY 2020 DISPENSING OPTICS 3
Value is found in everything you love
DISPENSING OPTICS
The Professional Journal of the
Association of British Dispensing Opticians
Volume 35 No 7 DO Dispatches
EDITORIAL STAFF
Publisher Sir Anthony Garrett CBE HonFBDO MOVING ONWARDS
Editor Nicky Collinson BA (Hons)
Email ncollinson@abdo.uk.com
AND UPWARDS
Assistant Editor Jane Burnand As I write this month’s column, most
Email jburnand@abdolondon.org.uk
Design and Production Rosslyn Argent BA (Hons) optical practices will have reopened or
Email rargent@abdo.uk.com made the necessary preparations to do
Admin. Manager Deanne Gray HonFBDO
Email dgray@abdo.uk.com so. We are living in a strange new world in practice, with
personal protective equipment and all the other
EDITORIAL/ADVERTISING constraints that Covid-19 has placed upon us – and yet
Telephone 0781 2734717
Email ncollinson@abdo.uk.com
there remains amongst many the hope and expectation
Website www.abdo.org.uk that things will continue to improve.
SUBSCRIPTIONS I have been hugely impressed by the sheer determination of
UK £150 so many people across the sector – and especially ABDO
Overseas £175, including postage
members – to get back to providing the professional care
Apply to: Edward Fox FBDO and service that patients need. The past three months have
Association of British Dispensing Opticians
Godmersham Park, Godmersham, been unimaginably difficult for everyone and the ABDO
Kent, CT4 7DT team has been doing everything it can to provide
Telephone 01227 733911 information, help and support to members.
Email efox@abdo.org.uk
Website www.abdo.org.uk
Clearly, it will be some time before the full impact of the
ABDO CET pandemic is understood. It may well be that some things
Head of CET Alexandra Webster MSc PGDipE FBDO CL FHEA FBCLA never return to how they used to be. However, we have a
ABDO CET, 5 Kingsford Business Centre, duty to seek to promote the profession and seize whatever
Layer Road, Kingsford, Colchester new opportunities arise.
Essex, CO2 0HT
Telephone 01206 734155 Enhanced training will be at the centre of this, whether it be
Email abdocet@abdo.org.uk for the provision of minor eye conditions services,
CONTINUING EDUCATION REVIEW PANEL management training or low vision – and so now is the time
Joanne Abbott BSc(Hons) FBDO SMC(Tech) to take the initiative. Do visit the ABDO College website to
Josie Barlow FBDO CL
Keith Cavaye FBDO(Hons)CL FBCLA
see all the training courses available, as well as the ABDO
Andrew Cripps FBDO PG Cert HE FHEA Business Support Hub for details of the next management
Kim Devlin FBDO(Hons)CL
and leadership course that you can enrol on.
Stephen Freeman BSc(Hons) MCOptom FBDO(Hons) Cert Ed
Claire McDonnell FAOI
Angela McNamee BSc(Hons) MCOptom FBDO(Hons)CL FBCLA Cert Ed
We are here to assist your professional development in any
Alex Webster MSc PGDipE FBDO CL FHEA FBCLA way we can. Let’s make sure that we get something positive
Gaynor Whitehouse FBDO (Hons) LVA
out of such a torrid time.
EDITORIAL COMMITTEE
Sir Anthony Garrett
Nicky Collinson BA (Hons)
Antonia Chitty MA MCOptom MCIPR ABDO general secretary
Alex Webster MSc PGDipE FBDO CL FHEA FBCLA
Max Halford FBDO CL
Debbie McGill BA (Hons)
Sir Anthony Garrett CBE HonFBDO
Jo Holmes FBDO
DISPENSING OPTICS IS PUBLISHED BY
ABDO, 199 Gloucester Terrace, London W2 6LD
© 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: 9,239 copies (January to December 2019)
ABDO Board certification
JULY 2020 DISPENSING OPTICS 5
OUR MONTHLY COLUMN FROM THE ABDO PRESIDENT
JO HOLMES FBDO
A DO and proud of it
e are gradually months. It will continue online through clinical negligence in or out of the
W emerging from one of
the most life changing
situations that has
happened in my
lifetime, taking stock on a personal,
business and organisational level.
Just like many members, ABDO has
this period: you can get up-to-the-minute
optical news along with the monthly
magazine via the website.
Another hard decision has been to
suspend the 2021 ABDO diary. We know
how much members look forward to
receiving this, but this change allows us to
practice. All members have access to a
legal helpline for advice. Access to
selected British Standards, business
support, advice and guidelines and
Ophthalmic Lens Availability Online are all
on the website. CET is provided without
charge through regular webinars.
been looking at ways to tighten the belt. We reallocate funds to where members really And lastly there is a range of discounts
have furloughed as many staff as possible. need them. Many more members have and savings, including cashback on
Meetings staff and board members would needed to call upon our membership everyday shopping and fuel. The average
have attended have been postponed or team for support. As well as offering a potential saving for a member who uses
moved online. Communicating through listening ear, the team directs members the discounts on offer is £479.70, which
video conference facilities saves money, to the counselling service included in more than covers your membership fees.
has helped the team develop new ways of membership, assists members in extreme Over the past several months, we
working, and will continue to be useful into financial hardship with membership fee have had to consider our priorities. Please
the future. holidays, and the Benevolent Fund. be assured you, our members, are at the
Difficult decisions have had to be ABDO membership still gives forefront of our thoughts and will continue
made. ABDO is suspending print issues excellent value for money. Professional to be as we emerge into a new world.
of Dispensing Optics magazine for six indemnity insurance covers you for any #ADOANDPROUD
NEWS JULY 2020
GOC issues new dispensing opticians and optometrists to
be fit for the future, with the right skills,
mindful of the “enormous impact the
Covid-19 pandemic is having on our
ESR statement behaviour and knowledge required for members and the education sector – and
contemporary practice. of the need for consultees to have
The General Optical Council (GOC) has “Updating our education and training adequate information in order to make an
issued a new statement on its Education requirements will do this, ensuring the informed response”.
Strategic Review (ESR) following two professions remain relevant, meet Read the full version of this story on DO
comments made by ABDO general patient and service user needs, foster Online. ABDO will provide an update for
secretary, Tony Garrett, in last month’s innovation and offer an attractive career members on the ESR in next month’s issue.
Dispatches column. option in an increasingly competitive
The statement explains the purpose higher and further education recruitment NEW FLIP-THROUGH OPTION
of the ESR and the action the GOC is landscape.” Members will now be able to read
taking to ensure everyone can contribute Tony Garrett responded by welcoming Dispensing Optics (DO) as a flip-through
“at a pace they are comfortable with”, said the potential of the ESR “to enhance the experience via digital publishing
GOC director of education, Leonie Milliner. ability of dispensing opticians and platform, Issuu.
Addressing concerns over the velocity contact lens opticians [CLOs] to develop “As DO goes digital-only for the next
of the ESR during the current climate, the their roles for the benefit of patients”. six months, we wanted to continue to
GOC stated the Covid-19 pandemic had However, he expressed disappointment offer members a ‘turn page’ experience
“sharpened the need” for requirements that the papers submitted to the GOC’s in addition to being able to download the
for approved qualifications to remain up- council meeting in July did not include journal as a PDF,” said DO editor, Nicky
to-date as the “future accelerates any proposed new education outcomes Collinson.
towards us”. for CLOs. Members will receive an Issuu link as
The statement went on: “Patients and He said he hoped that in working each publication goes live. To flip through
service users, as well as employers and towards a further public consultation in the June issue, visit Dispensing Optics
commissioners, expect student late July, the GOC would continue to be June 2020 on Issuu.
6 DISPENSING OPTICS JULY 2020
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NEWS
Revised CET proposals “a positive step”
ABDO has described the proposals essential role as a healthcare professional
contained in the General Optical Council’s in the many different settings of optical
latest CET consultation as “a positive practice,” she said. “I would like to see the
step”, and is encouraging all members to GOC recognise now is the time to have an
respond by the deadline of 20 August. equal approach to continuing professional
The review proposals, which can be education for DOs.
found on the GOC Consultation Hub, are “The original mandatory approach to
based on feedback from the GOC’s 2018 peer review for optometrists and contact
public consultation: ‘Fit for the Future: A lens opticians was based on professional
lifelong learning review’ and include: COMPETENCIES TO BE REPLACED practice risk. However, this form of case-
replacing the current competencies of based learning is considered a highly
the scheme so that they are more flexible; other healthcare professions and reduce effective form of education across
allowing registrants more control over barriers to inter-professional working. healthcare professions and would be
their learning and development and the “Following the coronavirus pandemic, equally beneficial for dispensing opticians
ability to tailor it; enhancing requirements eyecare in the UK will never be the same to help develop their patient care.
for registrants to reflect on their practice; again as we expect to see rapid “The GOC has shown that the
and changing the name from CET to CPD developments in more hospital services overwhelming majority of dispensing
(continuing professional development). within primary care. Having a professional opticians already take part in this form of
ABDO head of CET, Alex Webster, education scheme that can be easily learning and as there is now the
commented: “The changes proposed in recognised should be one aspect of a possibility of the GOC allowing a broader
the GOC CET consultation are overall a swifter approach to these changes.” approach to online learning post Covid-
positive step towards building a broader However, Alex added that she was 19, access issues to peer review could be
approach to life-long learning for GOC “disappointed” that peer review was not much less of a concern for those
registrants. Changing the scheme name being considered mandatory for all dispensing opticians who have yet to take
to CPD will align optical professionals with registrants. “Dispensing opticians fulfil an part in peer review,” Alex concluded.
Conscious coupling for eyewear line
In the spirit of its new Eco Conscious collection, Eyespace has pledged to plant a tree
for every frame purchased in partnership with the One Tree Planted charity.
The collection is made up of 18 styles for men and women, designed in non-toxic
bio-based acetate. Model Hemlock (pictured) is a retro style for men available in black and
blonde tortoiseshell.
Each frame comes with biodegradable demonstration lenses and plastic-free
FSC-certified packaging, which is fully recyclable and biodegradable.
ECO CONSCIOUS MODEL HEMLOCK
www.eyespace-eyewear.co.uk
Future funding Ongoing funding, argued the OFNC,
was required to manage the transition, by
discussions continuing to provide remote consultation
ongoing due to reduced capacity, prioritise face-
to-face care, and to help cover the extra
As DO went to press, discussions on the costs of PPE and other IPC measures.
future funding of general ophthalmic Ministers and NHS England have
services (GOS) were continuing between responded to the OFNC’s concerns, and
NHS England and the Optometric Fees ROUTINE GOS BACK IN ENGLAND further acknowledged the additional
Negotiating Committee (OFNC). challenges and costs that domiciliary
A resumption of the full range of GOS routine GOS work in England, but providers face. These include
work in England, subject to appropriate highlighted the challenges in terms of operationalising three weeks’ notice
infection prevention and control (IPC) infection risk, reduced capacity and requirements, additional IPC measures
measures and appropriate personal income, and the wider impact on patients, and the increased challenges of gaining
protective equipment (PPE), was finally the NHS and public health. access to care homes to provide eye
given the green light on 17 June when NHS The OFNC wrote to ministers on health care during the pandemic.
England issued new guidance and an 12 June, urging them to put in place further Stay tuned to the ABDO Covid-19
updated standard operating procedure. transitional funding arrangements for guidance page, and DO Online, for all the
The OFNC welcomed the return to primary eyecare beyond the end of June. latest news and updates.
8 DISPENSING OPTICS JULY 2020
DISPENSING OPTICS I JUL2020
industry body positions, education and the
New leading role wider profession within the UK, Europe and
at Alcon Asia,” said Antoine Delgrange.
Cheryl Donnelly has joined Alcon as “With her leadership and passion for
international head, professional affairs. the industry, Cheryl will be crucial to
A registered contact lens optician, connecting our vision care innovation
Cheryl will work closely with Carla Mack, agenda and portfolio of products to the
head of global professional affairs, to needs of Alcon’s customers.”
drive Alcon’s international priorities. Prior to joining Alcon, Cheryl spent
“As a highly respected member of the five years as CEO of the British Contact
international vision care community, Cheryl Lens Association. She previously worked
brings her extensive experience gained in at Bausch + Lomb in professional services
CHERYL DONNELLY
independent and large chain practices, and medical affairs.
Capsule of colours
The Guess and musician J Balvin
partnership has returned with a second
Colores capsule collection.
The capsule features a three-piece
eyewear collection available in a wide range
of vibrant colours, such as havana blue
acetate and orange crystal acetate, havana
green acetate and green crystal acetate,
havana amber and light crystal acetate.
The geometric and cat-eye shapes
are inspired by J Balvin’s album Colores,
incorporating red, yellow, green, blue and
J BALVIN WITH MODEL SARAH ORREGO
purple tones, and is available from Marcolin.
NEWS
Senior OA course
launched
ABDO College has opened applications
for its new Senior Optical Assistant
course, aimed at those looking to
become senior optical assistants and
future dispensing opticians.
The course now lasts a year, rather
than two, and the content has been OA course students at a workshop
refined and updated to make it more with an existing working knowledge of
relevant to the tasks a senior OA would optical practice would be very useful.
ALAN PITCHER do in practice. Students work through “Students who complete this, or our
weekly assignments with the support of introductory Optical Assistant course, will
ABDO College webinars and advice and be accepted onto the FBDO programme.
In the driving seat guidance from a personal tutor. Students For students who want to enhance their
Essilor has appointed a new commercial should allow six to eight hours a week for skills in smaller steps, following the OA
director to drive business solutions and study, and will receive all course reading course with the Senior OA course as a one-
growth for independent practices. materials as part of each unit. year programme provides a great solution.”
Alan Pitcher joins Essilor with a ABDO College head of operations, The course costs £950, and the
background in the health sector, most Steve Hertz, said: “Student and employer application deadline is 28 August for a
recently in orthopaedic medical devices. feedback is a key driver in how we September start. For further information
He said: “Much will undoubtedly develop courses and it was clear that a and to apply for this and other courses,
change in this industry in the coming one-year course to develop candidates visit www.abdocollege.org.uk
years, but I’m driven to see lens volumes
return to pre-crisis levels and see key
brands return to monthly growth before
year end.”
Clarification on testing rules
Tim Precious, managing director at The Association for Independent Optometrists and Dispensing Opticians (AIO) has
Essilor, added: “Alan is a solid addition to issued a statement, reviewed by the General Optical Council (GOC), which it says makes
the team and will undoubtedly drive the clear that “no routine eye examinations or sight tests should have been conducted
business forward and support ECP growth between the period 23 March 2020 and 15 June 2020 – and that any practice breaching
the rules should therefore be subject to GOC fitness to practise (FTP) proceedings”.
as part of our promise to be their best
The statement has been published on the AIO website following a meeting between
business partner.”
the AIO and GOC CEO, Lesley Longstone. In a separate statement the AIO is inviting
anyone aware of any breaches to get in contact with either itself or the GOC “in order that
fitness to practise proceedings can be commenced in each case”.
AIO chairman, Christian French, commented: “Whilst we are aware of, and fully
understand, the motivation of the Change.Org petition that has been circulating [see
News page 12], our focus is on ensuring clarity regarding the statements issued by our
regulator, whilst bringing to account those who have broken those rules and denigrated
our profession in such a blatant manner.”
BULGET KIDS EYEWEAR
Bookshop back up and running
The ABDO College bookshop is now open again for all orders of books and optical
equipment.
Showing their The ABDO College bookshop offers an extensive selection of books relating to
colourful side optics, contact lens practice, ophthalmology and more, alongside competitive prices
on a range of optical equipment.
The latest Bulget Kids collection from Go The bookshop closed temporarily while staff were furloughed, but has now
Eyewear comprises of six new ophthalmic reopened to allow students from all institutions to purchase the titles they need as
styles and three sunglasses, all available they prepare for their studies resuming in September.
in four colors. ABDO College head of operations, Steve Hertz, said: “I’m really pleased to be able
Designed for children aged from four to get the bookshop service back up and running. As practice reopening starts to gain
to eight years, Bulget Kids eyewear momentum, we are here to help support colleagues in any way we can, be it extra or
combines crystalline with opaque colours spare rulers and gauges to help with hygiene routines or the new reference books
for a grown-up look. The sunwear styles students will become well acquainted with over the coming academic year.”
come with polarised lenses. Visit the ABDO College bookshop to browse items and place orders.
10 DISPENSING OPTICS JULY 2020DISPENSING OPTICS I JUL2020
New insights into
Guidance for eyecare access
domiciliary Being a woman, disabled or poor means
eyecare you have less access to eyecare – new
research from international charity
The Optical Confederation’s
Sightsavers has found. WOMEN MORE AFFECTED
Domiciliary Eyecare Committee
Women and those from a lower
(DEC) has issued guidance to support
socio-economic background were often of visual impairment across locations in
the provision of eyecare to adults
disproportionally affected by issues India, Pakistan and Tanzania.
who are ‘extremely clinically
involved in eye problems – in one case, Lead author, Emma Jolley from
vulnerable’ and ‘clinically vulnerable’, people with additional, non-visual Sightsavers, said: “These results add
as well as those who are unable to disabilities were 10 times as likely to be extra layers to our understanding of who
leave home owing to physical or blind or have severe visual impairment has visual impairment, which is important
mental ill-health or disability. than those without. if we’re going to be efficient and effective
Gordon Ilett, co-chair of the DEC, The study, carried out by UK-based in supporting them.
said: “Vision and healthy eyes are Sightsavers and partners in three The full study has been published in the
critical to people who cannot leave countries, uniquely recorded disability journal Opthalmic Epidemiology and can be
home, may have other long-term and socio-economic status in five surveys found on the Sightsavers research centre.
conditions or who are isolating. Eye
disease is insidious and can be
catastrophic. We must not fail the ABDO board elections to open soon
most vulnerable in society by denying ABDO members will soon be asked to cast their votes in this year’s ABDO board elections.
them the eyecare they need to stay With nominations closing on 19 June, four members have been formally proposed to
fit and well.” fill two places. The members standing for election are: Saima Begum, Kevin Gutsell, John
Read more on this and find a link Hardman and Les Thomas.
to the guidance via DO Online news. Ballot Papers will be distributed by Electoral Reform Services on 17 July. Voting will
close on 1 September and the result will be announced on 4 September.
JULY 2020 DISPENSING OPTICS 11NEWS
GOC revises * A Change.org petition, calling on
the Professional Standards Authority
practice re-opening (PSA) to investigate the GOC for “conflict
statement of interest”, had received more than 7,000
signatures at the time of going to press.
The General Optical Council (GOC) has The PSA stated on 19 June that it was
revised its statement on the re-opening seeking information about the matters
of optical practices based on feedback it raised from the GOC, and that it would
has received. make a further statement in response to
The changes also incorporate new the petition within the next three weeks.
guidance from the governments and/or The GOC issued its own response to
the NHS across the four nations regarding the petition last week, outlining its
EQUIPPING NHS WORKERS
the resumption of optical services. position on the issues raised. The
The regulator said it had worked regulator refutes claims that it changed
Hospital lens closely with the College of Optometrists
to ensure that its statement and their
its position between its statement on 23
March 2020 on the provision of essential
cleaner drop guidance were aligned. eye services in England, and the one on
Glasklar UK has donated hundreds Read the revised statement on the 12 June 2020 regarding the re-opening of
of bottles of its refillable spectacle GOC website here. optical practices.
lens cleaner to frontline NHS
doctors and nurses at nearby
Hastings, Bexhill & Eastbourne Stepping back into
Hospitals. the future
Ellie Jarman, Glasklar UK
Stepper has set out to customers how it
marketing coordinator, said: “Several
plans to support independent practices in
of our Glasklar stockists have been
“the new normal”.
providing free bottles of cleaner and
In a recent communication, managing
free refills to essential workers, so
director, Peter Reeve, writes: “Independent
the idea grew from there. We heard of Extra support measures in place
opticians are in a unique position to
a local ICU consultant who cleaned reconsider their business to meet the new website with improved frame image viewing,
his spectacles using a high alcohol challenges and opportunities. With a scale, catalogue search and online ordering.
anti-bac wipe and damaged the a freedom of thinking and the ability to Other measures to support stock flow
surface coating as a result, rendering react to local needs, these challenging include no minimum order quantities, no
his glasses unusable.” times can be viewed as an opportunity.” volume contracts, a next-day delivery
The company said it would be To help practices resume business as service and an ‘on approval’ facility.
implementing several other support safely and successfully as possible, the “As a great optician, you can add value
initiatives enabling its UK stockist company has introduced a range of new to your community and Stepper can add
network to also support their NHS initiatives. These include new virtual ways of value to your business. As business begins
keyworkers locally. connecting with Stepper’s business again, step by step we will learn how the
development managers, and a new-look future evolves,” Peter concludes.
Preparing for “Since the lifting of lockdown has been
unfolding smoothly throughout Europe,
looking 2020 edition rich in innovative
content and friendly, inspiring encounters.”
Paris return we are very optimistic and are more Get the latest show updates at
Silmo Paris is “all hands on deck” to determined than ever to propose a forward- https://en.silmoparis.com
welcome visitors back to its 2020 show
from 2-5 October at the Paris Nord
Villepinte.
Some 700 companies have confirmed
their registration, for an exhibitor
attendance rate of 80 per cent, said the
organisers.
Amélie Morel, chairman of Silmo
Paris, said: “Silmo Paris continues to work
on a daily basis to protect and enhance
the industry. Resolutely positive and
enthusiastic, our team is ‘all hands on
deck’ to prepare the next edition of the
SHOW REMAINS SLATED FOR OCTOBER
trade fair.
12 DISPENSING OPTICS JULY 2020DISPENSING OPTICS I JUL2020
Rising to the R&D
challenge
CooperVision has repurposed part of
its R&D and production facilities in
Hampshire to enable it to produce bottles
of hand sanitiser.
Following a re-design of a laboratory NEW PRODUCTION LINE
COVID-19 COMMS SUPPORT in order to be able to handle the
chemicals involved in the production of Mathieson, senior vice president of
Design service hand sanitiser, the project team European manufacturing.
repurposed machinery and composed “Whilst we are unable to supply
offered new operating procedures. unlimited volume, we hope that we have
Charmant Europe is offering customers a “As a manufacturing organisation been able to release some of the burden
free graphic design service for Covid-19 with an innovative in-house design team, on the frontline local organisations who
related communications. we were keen to take on this challenge we have been able to support.”
The company has created various and contribute to supporting not only our The company has also provided 3,000
templates, such as displays, posters and own requirements for hand sanitiser, but face masks to Southampton General
stickers, that can be used free of charge. also see if we could support the Hospital and contributed to the hospital’s
As an additional service, customers can community in some way,” said Steve staff welfare fund.
personalise the materials, for example, by
inserting a practice logo, adjusting layout
size, or including individual hygiene rules.
The company will provide layouts ready
for use, and can arrange the production Business campaign supports homeless
of bespoke elements at cost. Details can The National Eyecare Group (NEG) Business Club has launched its latest campaign –
be found in the log-in area of the company’s ‘It’s time for some one-to-one’ – to support independent practices.
website, or via the sales team.
Available as a 30-second animated video, conventional print and electronic media,
the video can be tailored to feature members’ practice logo and phone number at the
end, and is delivered in HD square format optimised for social media. All proceeds from
each sale will fund a sight test and a pair of glasses for a homeless person in
partnership with Vision Care for Homeless People.
Log into the NEG Business Club at www.practicebuilding.co.uk/neg to access this
and other campaigns and resources.
Evidence-led
myopia education
The British Contact Lens Association
FABRIZIO CURCI (BCLA) is inviting members to take up
its new certificate course in myopia
Italian job management.
The online course features six
Fabrizio Curci has been named as the new recorded lectures and will include the
CEO and general manager of the Marcolin latest evidence-based research, delivered
Group. by field experts including Gillian Bruce, Dr
Group chairman, Vittorio Levi, said: Nicola Logan and Professors Pauline Cho,
“We are very happy that Fabrizio is joining Ian Flitcroft and Kathryn Saunders.
Marcolin to lead our business into its new Contact lens optician and former
phase of development. He is a seasoned BCLA president, Keith Tempany,
executive with a vast and impressive spearheaded the new certificate course.
international track-record in several He said: “This programme will create an DR NICOLA LOGAN
industries.” understanding of myopia and the
Fabrizio Curci was previously CEO and principles of different management “The evidence base from cutting
general manager of Fiera Milano. He said: strategies that can reduce the potential edge research is translated into practical
“I am pleased and proud to lead the ocular health risks that our young and guidelines and advice on how to
management team of Marcolin Group and emerging myopes could experience later introduce myopia management into your
to step into this amazing industry.” on in life. own practice,” Keith added.
JULY 2020 DISPENSING OPTICS 13PRODUCT SPOTLIGHT
Review Recall
COVID19 Recall Manager
Patient Details Key Indicators
Recall prioritisation made simple
Xeyex has launched a new feature called Covid19 Recall Manager to help
Held Recall Items
Patient ID GL10187PRACTICE MANAGEMENT SOFTWARE
To go alongside its validated catalogue of contact lenses, the
company is now finalising its new catalogue service for ophthalmic
lenses. This will enable practices to download lens information and
apply their mark-up, reducing time spent creating lens catalogues.
Protection of profits by payment plan
Orasis PMS’s monthly subscription payment plan is described as ideal
for those practices looking to set up an eyecare plan.
“Our client base is now much more accustomed to paying monthly
direct debits – and the benefit to your business is the steady monthly
income which will help enormously with cashflow,” said director,
Linus Mason.
The reward and loyalty programme enables the practice to set its
own prices and promote the benefits of individual plans, such as regular Premium, tailor-made service for patients
and continuous eyecare, optical coherence tomography, priority with Orasis
appointments, free servicing and repairs, events, discounts, free
delivery and so on.
Kris Coleman, dusiness development manager of Pabari Opticians in
Birmingham, is an Orasis founder member practice from 1994. He said:
“We offer a value-for-money personal eyecare plan. It’s convenient for
us and has been great for cashflow, particularly during Covid-19.”
Putting the flex into PMS
Optinet Flex is designed to help practices adapt to life post-pandemic
in two key ways – via eRecall and online appointment booking.
“Letter recalls are expensive and place a workload on practice staff,”
said Chris Smith, Optinet business development manager. “Switch to
email and SMS reminders and you will save money, fill your practice
diary more quickly and reach your patients no matter where they are. At
the click of a button, Flex can send all your email, SMS and letter recalls,
while the option to send letters via Docmail is also fully integrated.”
Regards the benefits of online appointment booking, Chris
explained: “Traditionally after receiving their recall, a patient would
either phone or pop in to the practice to make an appointment.
However, giving your patients a live view of the practice diary, and the
ability to book their own appointments, will reduce the number of calls Controlling the appointments flow
and visitors to the practice. with Optinet Flex
“The Flex online diary lets you control which appointment times are
available, the appointment reasons that can be selected, and it even
allows bespoke information prompts to appear during the booking
process,” Chris added.
Relaxed payment and module options
WinIpro has launched a new payment plan for practices, with rental and
one-off price options.
The new Relax contract includes the appointment, referral, recall
SMS and email, dispensing, contact lens and remote support modules.
Pointing out the benefits of the system not being cloud-based,
Carlton Plaatjes, head of Ipro UK, said: “When the internet goes down,
practices can just carry on working. It also makes it a very valuable
option for those who do home visits, or who work in remote areas of
the UK.”
The software can be integrated with diagnostic technology, while its
hearing aid management system integrates with Noah, the de facto
standard for hearing devices.
Alan Verrinder, dispensing optician owner of his eponymous
practice in Tewkesbury, has been using WinIpro for 18 years. He said:
“The workshop module works very well with our own lab, and we utilise
ordering, cash system, EPOS, appointments and document
management. The reminders module is also very good, and we do a few
each day so that we never have a great surge.”
Next month’s Product Spotlight is on spectacle lens products. Ipro UK head, Carlton Plaatjes
JULY 2020 DISPENSING OPTICS 15CET
COMPETENCIES COVERED
DISPENSING OPTICIANS
Communication, Standards of
Practice, Refractive Management,
Exploring
Paediatric Dispensing
OPTOMETRISTS
Communication, Standards of
depth perception
Practice, Binocular Vision
By Mark Hickton BSc (Hons) Cert Ed FBDO FHEA
hen we take photos of sensor, in a similar process to the
W amazing landscapes
or scenery and then
review the images at a
later date, it is often
the case that the photos ‘do not do the
scene justice’; something seems to be
missing. Of course, we are trying to
biological lens system of the eye creating
an image on the retina. From a light
receptive point of view, the retina is a
two-dimensional sensor, very much like
the camera sensor. Unlike a camera,
which produces two-dimensional images,
we view the world as a three-dimensional
compare a two-dimensional scene to a perceptual model. How do we manage to
three-dimensional memory, and thus achieve this from the two-dimensional
our perception of depth is not fully sensor array?
utilised and images can look flat. Ophthalmic dispensing students are
Photographers and artists will often continuously advised by the author that
This CET has been approved for 1 point by use techniques to help enhance the ‘you see with your brain’; the retina is a
the GOC. It is open to all FBDO members, illusion of depth in an image, and this can light-gathering structure that transmutes
and associate member optometrists. The help ‘bring the image to life’. Some of photon-induced chemical changes into
multiple-choice questions (MCQs) for this these techniques are comparable to electrical nerve impulses. These signals
month’s CET are available online only, to monocular depth cues exploited by our travel to various areas of the neural visual
comply with the GOC’s Good Practice
visual system to aid in our perception of system and the brain ‘interprets’ the
Guidance for this type of CET. Insert your
depth. This article will explore not only signal patterns to construct a probable
answers to the six MCQs online at
the various visual cues that help form our three-dimensional perceptual model. It is
www.abdo.org.uk. After member login, go
into the secure membership portal and rich three-dimensional experience of the within this neural processing that our
CET Online will be found on the L menu. world around us, but also pathologies that perception of depth is formed1.
Questions will be presented in random can impact on our perception of depth.
order. Please ensure that your email STEREOPSIS
address and GOC number are up-to-date. SEEING ‘WITH YOUR BRAIN’ One of the most obvious mechanisms for
The pass mark is 60 per cent. The There are comparisons between the depth perception is stereopsis. The
answers will appear in the November 2020 human eye and the camera; modern majority of humans have good correctable
issue of Dispensing Optics. The closing camera lens systems focus light onto a vision from two eyes, with each eye
date is 9 October 2020.
C-75570 Approved for 1 CET Point Figure 1: Stereoscopic images with disparity. To view this image in 3D, stare beyond
these images to form a ‘3rd’ image in the centre
16 DISPENSING OPTICS JULY 2020depth perception, it does not mean to
say that patients restricted to monocular
vision (due to amblyopia or enucleation,
for example) have no depth perception at
all. If you possess good binocular vision
and cover one eye, the world around you
does not reduce to a two-dimensional
photograph; this is due to monocular depth
cues that the visual system uses to help
augment the perceptual internal model11.
OCCLUSION
Occlusion is perhaps one of the most
Figure 2: (a) possible occlusion; (b) mis-leading occlusion
apparent monocular depth cues (Figure
2a). Here we can see that the red circle is
receiving a slightly different image. The is present after the critical period, there
occluding some of the blue square and
disparity between these two images is are some studies which suggest that a
thus it is logical to assume that the circle
translated by the visual system to help form level of stereopsis, mostly in relation to
is in front of the square. This assumption,
three-dimensional vision2,3. Stereoscopic anisometropic amblyopia, can be
however, is based on the guess that the
photography simulates this mechanism by regained through perceptual training9.
blue object is a square, and not shaped,
producing two slightly disparate photos As well as stereopsis, physiological
as in Figure 2b.
that can be fused together by the viewer oculomotor cues, such as convergence
In this example, the visual system is
to create a three-dimensional experience and accommodation, reinforce our
using ‘best guesses’, or heuristics, when
(Figure 1). Whilst this stereoscopic perception of depth8,10. The action of
deciphering the image, and many of
mechanism works well for depth perception these mechanisms generate muscular
these heuristics are formed from visual
at close ranges, stereopsis becomes less responses that allow us to decide whether
experience.
informative when viewing more distant we are viewing an object close up or at
Another experiential depth cue is the
targets with very small disparities in the distance2. Accommodation also alters our
relative size of objects. Figure 3 shows
individual retinal images4. plane of focus; when viewing close objects,
two ‘objects’; if the objects were quite
The neural pathways relating to depth distant objects will go out of focus. This
abstract in nature, then it would be
perception, as with the majority of visual effect can be duplicated in photography
difficult to discern the relative depth of
processes, develop as we grow. The (and by artists and computer imagery) by
the objects. However, we know by
processing of stereopsis begins in the the use of the bokeh effect; the taking of
experience that children are bigger than
primary visual cortex (sometimes an image with a narrow focal plane.
footballs and therefore deduce that the
referred to as the striate cortex, V1), but Although stereoscopic vision and
football is closer.
many extrastriate neural areas are also convergence cues significantly aid with
involved in the processing of disparity to
create our perception of depth5,6. If these
areas of the neural visual system are not
adequately stimulated in our early years,
problems with stereopsis will arise.
If strabismus is present (i.e. a squint
in which the eyes are misaligned during
fixation), or if there is a significant level
of anisometropia, the visual system will
struggle to combine the visual outputs
from the eyes into a single percept; if left
untreated within the critical period,
patients will develop amblyopia. Studies
suggest that between two to three per
cent of the population are amblyopic1,7,
showing a significant reduction in visual
acuity and contrast sensitivity in one eye.
As a result, amblyopia is one of the
major inhibitors of stereopsis; this
pathology can cause a significant
reduction in depth perception6-8,
especially in relation to strabismic
amblyopia9. Though stereoscopic vision is
permanently disadvantaged if amblyopia Figure 3: Relative size tells us that the ball must be closer to us than the child
JULY 2020 DISPENSING OPTICS 17CET
environment can also offer monocular
depth indications to the visual system,
and involve cues such as atmospheric
perspective and texture gradient2. Light
from very distant objects will need to
pass through more airborne particles;
due to atmospheric conditions causing
light to scatter, distant objects will tend
to present poorer visual contrast to the
observer and to appear more hazy than
closer objects13.
Also, as short wavelength light is
scattered more than long wavelength
light, the colour of more distant objects
may shift towards the blue end of the
spectrum12 (Figure 5). Distant objects
also subtend smaller visual angles, so our
ability to resolve fine detail, such as the
texture and detail of an object, is
diminished as an object gets further away.
Lighting and shadows also give clues
to depth within our visual field.
Figure 4: Converging lines reinforcing depth perception Photographers often discuss the ‘golden
hour’ after sunrise and before sunset as
PERSPECTIVE CONVERGENCE Perceptual analysis of landscape an ideal time to undertake landscape
One of the most effective means of scenes can utilise perspective photography. With the sun low on the
establishing depth in art and photography convergence in relation to determining horizon, shadows become more
is by the use of converging lines that probable object depths; as the stimuli prominent and longer in length. The
converge to a point in the distance3. This appear further above or further below enhancement of shadows in this way can
perspective convergence is also used as a the horizon line, the more likely they are augment the perception of texture and
depth cue in monocular vision2,12 (Figure 4). to be closer. Consider observing clouds in features, and aid our perceptual systems
Whilst this depth cue is reliable for the sky when looking into the horizon; with the assessment of depth and shape
the majority of the time, nearby clouds appear higher in the visual of objects2,4.
misinterpretation of perspective scene (and have a larger visual angle from Two-dimensional images can be given
convergence by the visual system can the primary gaze position), whereas more the illusion of depth by taking advantage
sometimes confuse the visual system distant clouds appear closer to the of lighting heuristics adopted in visual
and lead to illusionary perceptions. The horizon (with a smaller visual angle from processing; the brain assumes light
Ponzo illusion is a strong example of the horizon). generally comes from above3,14, and this
this2, and is demonstrated in Figure 9 (we can give rise to the false perception of
will discuss the suggested cause of this MONOCULAR DEPTH INDICATIONS depth, as shown in Figure 6.
illusion later). The visual quality of the perceived When viewing Figure 6 upright, the
majority of viewers will perceive the
Figure 6: Illusionary depth due to
Figure 5: Atmospheric perspective lighting interpretation15
18 DISPENSING OPTICS JULY 2020diagonal ‘spheres’ tend to stand out the
page, following the ‘light-from-above’
heuristic, with the other features looking
like depressions14,15. When the figure is
turned upside down, we generally
perceive a reversal of depth, with the
diagonal features turning into
depressions in the image. Interestingly,
this illusionary depth is more difficult to
perceive when viewing the figure from
the side, as the light-from-above rule has
less relevance.
MOTION PARALLAX
Motion can also contribute significantly
to our perception of depth. Motion
parallax is a monocular depth cue in
which closer objects move more quickly
in the field of view compared to more
distant objects as the observer moves
through the environment4,11,16. This
effect can easily be observed when
Figure 7: Motion parallax observed on a train
travelling in a car or train; closer objects
in the foreground will pass by more of the card to double if its distance is of the object, regardless of distance; this
rapidly, whereas features in the far halved, but this is not what is is known as size constancy2,3,18.
distance barely seem to move (Figure 7). experienced. Instead our brain alters the To see through this neural illusion,
As well as augmenting the perception perception of size so that we hold two playing cards at the above
of depth with humans, parallax is thought approximately perceive the ‘natural’ size different distances and look at them both
to be essential for depth perception in
many prey animals, such as pigeons, in
0-2 2-20 ABOVE
which the eyes are laterally positioned DEPTH CUE
METRES METRES 20 METRES
with little overlap (and thus little
stereopsis)17.
Occlusion
In a similar way to static occlusion,
objects can pass in and out of view as the
observer moves through their Deletion and accretion
environment. When more distant objects
move out-of-view behind another object Relative height
(deletion), or when further objects are
revealed behind closer objects
Atmospheric perspective
(accretion), these act as further relative
depth cues to help augment our depth
Table 1a: Cues that indicate relative depth
perception of the observed environment
(see Tables 1a and 1b).
0-2 2-20 ABOVE
DEPTH CUE
METRES METRES 20 METRES
APPARENT DEPTH PERCEPTION
As discussed earlier, we can deduce the
depth of an object in space relative to
Relative size
other familiar objects of the same size,
with further objects appearing smaller. Texture gradients
Our perception of size, however, is also
influenced and altered by the apparent Motion parallax
depth of an object.
Consider this (and try at home): if you
hold a playing card at 60cm, and then
Accommodation
move it to 30cm, by simple geometry and
similar triangles, the retinal image will Convergence
now be twice the size. From this, we
would expect our perception of the size Table 1b: Cues that contribute to determination of actual depth
JULY 2020 DISPENSING OPTICS 19CET
PATHOLOGIES AFFECTING Chronic degenerative conditions,
DEPTH PERCEPTION such as posterior cortical atrophy (PCA,
We have seen from these discussions sometimes referred to as visual
that refractive and strabismic amblyopia Alzheimer’s), can affect the posterior
has a detrimental effect on stereoscopic lobes of the brain, and therefore the
depth perception, although any processing of depth information. PCA
pathology that affects binocular fixation can be difficult to diagnose as, although it
of the eyes, including disease and is considered an atypical variant of
trauma19, can lead to a breakdown of Alzheimer’s, patients tend to initially
binocular vision and impact on depth have relatively intact memories and
perception. Whilst such conditions affect cognitive processes; instead, this
the eye or oculomotor muscles condition initially affects the occipital
controlling fixation, there are other cortex and the dorsal and ventral
pathologies that can affect the visual processing streams. Symptoms tend to
processing of depth in the visual cortex manifest with visual problems, including
or extrastriate areas of the visual system. the loss of depth perception and the
As significant disparity comparison ability to cognitively identify objects6,20,21.
begins in the primary visual cortex (V1), Stereoscopic impact should also be
Figure 8: Overcoming size constancy and any lesions or pathology in this area is considered with refractive correction.
perceiving the size of identical objects likely to impact on depth perception; Monovision correction is used within
based on their retinal image size
impact on depth perception from various spheres of ophthalmic practice,
damage to this area is difficult to assess, including contact lenses, intraocular lens
with one eye (Figure 8); you will see that
however, as lesions in V1 generally tend (IOL) implants, and refractive surgery.
the furthest playing card will be half the
to lead to cortical blindness due to the Whilst this method of visual correction
size in relation to the closest.
primary processing of most visual allows presbyopic patients to experience
Size-distance scaling relates the
functions6. distance and near vision regardless of the
perceived size of an object (S) with the
As sensory information is processed viewing angle, there is potential for
perceived depth (D), and the retinal
beyond V1, monocular depth cues are disruption of stereoscopic vision which
image size (R) by the formula2:
combined with disparity information to may impact on the processing of depth in
build up our overall perception of the visual field22,23.
S=K(R×D) (where K is a scaling constant)
depth8,14,16. Extrastriate areas of the Patients should be informed of
brain, forming the dorsal and ventral potential binocular vision issues relating
Since K is a constant, we can see as that
visual processing pathways, also have to monovision correction; whilst contact
as D increases and R decreases, the
roles in processing visual depth lens patients could be prescribed a
perceived size (S) stays the same.
perception4,5,11, and therefore any acute monovision correction on a trial basis,
Whilst this neural modification allows
lesions or trauma of these areas can monovision IOL surgical treatments may
us to perceive objects in the world with a
impact on the perception of depth6,19. be more difficult to amend.
relatively constant size regardless of
their distance, our visual system can be
deceived when the illusion of depth is
present; this brings us back to the Ponzo
illusion (Figure 9).
Both spheres in the image are the
same size, however, the majority will
perceive the top sphere being larger than
the bottom. Although the figure is a flat
two-dimensional image, the converging
lines fool the brain into thinking that the
higher sphere is further away than the
lower sphere2,18. The retinal image size is
the same; however, the perceived
distance of the higher sphere is judged
to be further away due to perspective
convergence.
Thus, from size-distance scaling, R
would remain the same but the value for
D will increase; this will increase the
perceived size of the image, S, exactly
what we experience when viewing
this illusion. Figure 9: The Ponzo illusion: which sphere is bigger?
20 DISPENSING OPTICS JULY 2020Despite the possible stereoscopic REFERENCES Psychology, and Ecology. 3rd ed. Hove:
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experience any depth perception Neuroscience 2007;8(5):379-391. Fundamentals of Cognition. 3rd ed.
deficit24; however, such issues may need 2. Goldstein EB and Brockmole JR. Abingdon: Routledge, 2018.
to be factored in when considering Sensation and Perception. 10th ed. 16. Kim HR, Angelaki DE and DeAngelis GC.
certain occupations that demand a high Boston: Cengage Learning, 2016. The neural basis of depth perception
level of stereoacuity22. 3. Gregory RL. Eye and Brain: The from motion parallax. Philosophical
As well as contact lens and IOL Psychology of Seeing. 5th ed. Oxford: Transactions of the Royal Society B:
refractive corrections, it is also Princeton University Press, 2015 Biological Sciences 2016;371(1697):
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stereopsis12,25 with unequal retinal Technology, 2012. Physiology A 2007;193(12):1177-1183.
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This article highlights the Perception. Oxford Research Rabinovici GD, Rossor MN and Fox NC.
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importance of prompt optometric and Stereopsis and amblyopia: a mini- and Refraction. London: Elsevier, 2007.
orthoptic treatments of amblyopia. With review. Vision Research 2015;114:17-30. 23. Smith CE, Allison RS, Wilkinson F and
a significant proportion of the brain 10. Proffitt DR. Distance perception. Wilcox LM. Monovision: consequences
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we are constantly rewarded with the rich Science 2006;15(3):131-135. disparities. Experimental Eye Research
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12. Tunnacliffe AH. Introduction to Visual 25. Jimenez JR, Ponce A, Del Barco LJ,
ACKNOWLEDGEMENTS Optics. 4th ed. Canterbury: ABDO, 2004. Diaz JA and Perez-Ocon F. Impact of
Photography for Figures 1, 3, 4 and 9 by 13. O’Shea RP, Blackburn SG and Ono H. induced aniseikonia on stereopsis with
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Tables reproduced with kind permission Research 1994;34(12):1595-1604. and Vision Science 2002;79(2):121-125.
of Professor Goldstein (Sensation & 14. Bruce V, Green PR and Georgeson 26. Eagleman D. The Brain: The Story of You.
Perception)2. MA. Visual Perception: Physiology, Edinburgh: Canongate Books, 2016.
MARK HICKTON has been a lecturer in
ophthalmic dispensing at Bradford
PLAN YOUR CET TODAY College for more than 12 years, and is a
For all the latest CET available from ABDO visit the Events section of the ABDO practising dispensing optician with over
website. Here you will able to see the latest online interactive CET sessions 22 years of experience. Mark is the
available for booking. Online sessions include discussion-based workshops, a module leader for the Optics and
great way to learn in a small group of your peers. Online discussion sessions are Ophthalmic Lenses modules, and his
available for all professional roles and are approved for three CET points. New college scholarly activity revolves
sessions will be added regularly. Additionally, we continue to host our monthly around the area of visual perception.
CET webinar series featuring a range of topics and speakers. Each CET webinar Mark is a Fellow of ABDO and a Fellow of
will be approved for one interactive CET point. the Higher Education Academy.
JULY 2020 DISPENSING OPTICS 21You can also read
