What's in the News?

What's in the News?

We look beyond the Institute to provide you with regular news and analysis of key clinical and professional developments relevant to you and your practice

 What's in the News?

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*NEW* Optics at a Glance reveals latest data on the UK market

An average of 6% of sight tests carried out in the UK result in patients choosing to take up contact lenses, according to the latest edition of the Optical Confederation’s factsheet, Optics at a Glance.

The 2011 issue summarises statistics on sight tests, spectacle sales and contact lenses for England, Scotland, Wales and Northern Ireland. Among the findings are:

• There were 14.9m NHS sight tests and an estimated 6.2m private sight tests carried out in the year to 31 March 2011
• The average charge for a sight test was £21.67
• 62% of sight tests resulted in a changed or new prescription, 6% in contact lenses and 4% in referral to a GP or hospital
• The average interval between sight tests was 26 months
• The number of optometrists and dispensing opticians (DOs) increased in 2010
• Women optometrists and DOs outnumbered men in all four countriesCLICK HERE TO DOWNLOAD A COPY OF OPTICS AT A GLANCE

What we think: This useful factsheet, published for over 30 years, has a wealth of information on the UK optical market. It’s worth downloading as a reference source and can also be used to benchmark statistics against your own practice.

*NEW* 2012: The European Year of Active Ageing

2012 has been designated the European Year of Active Ageing and Solidarity between Generations by the European Commission. Launching the initiative, the EC said it provided the chance to reflect on how Europeans are living longer and staying healthier than ever before and to realise the opportunities that represents.
According to the EC, active ageing can give the baby-boom generation and tomorrow's older adults the opportunity to:

• Stay in the workforce and share their experience
• Keep playing an active role in society
• Live as healthy and fulfilling lives as possible

The European Council for Optometry and Optics highlighted the initiative in its newsletter and commented: ‘For ECOO members, this may be a good opportunity to present relevant activities linked to age-related visual impairment, preventable blindness, vision in the workforce, and vision and the information age.
‘It may also be an opportunity to share best practice examples and to raise awareness of the contribution that older people make to society and the importance of eyesight in this context.’CLICK HERE TO FIND OUT MORE ABOUT THE INITIATIVECLICK HERE FOR MORE INFORMATION ON ECOO AND ITS WORK

What we think: Living and working longer will present many new and different challenges to our patients’ eye health and vision. This European initiative highlights the need for us all to think about the ways that we assess and correct vision in these age groups, now and in the future.

 *NEW* College research points to poor quality of ready readers

Research commissioned by the College of Optometrists shows that many ready-made spectacles are not of appropriate quality to meet required standards.

Following the publication of a Which? report on ready-made reading glasses in October 2010, the College commissioned Professor David Elliott at Bradford University to carry out further research based on a much larger sample size.

Professor Elliot’s team assessed over 300 ready readers from a wide range of high-street stores, with costs ranging from £1 to £32. They examined how closely each pair met the advertised specifications, the positioning of the lenses in the frames and whether the centres of the lenses were likely to fall within the range for average pupillary distance (PD) in the UK population. They found that:

• Just over half of all ready-made spectacles in the study provided the optical standards required of them by the relevant British and European Standard
• Higher-powered spectacles (+3.50DS) were more likely to have errors
• The quality of ready-made spectacles could be easily improved by the use of more appropriate centration for the work they are intended for

A full report will be published in Optometry and Vision Science later this year.CLICK HERE FOR MORE DETAILS

What we think: The new research provides more evidence that the quality of ready readers is variable, especially in higher powers. Use the findings to discourage patients from buying these products, which can never be a substitute for properly prescribed and fitted spectacles.

 *NEW* College report reveals consumer attitudes to eye health

Consumers value their sight more than any other sense yet almost one in five have either never been for a sight test or not been for a sight test in the last five years.
These are among the findings of a report by the College of Optometrists, published in June 2011 to coincide with National Eye Health Week. Britain’s Eye Health in Focus: A study of consumer attitudes and behaviour towards eye health is a 40-page report on a survey of 4,004 adults in the UK aged 18-60. Among key findings are:

  • 86% value their sight more than any other sense.
  • 77% believe sight tests are more important to them than other regular medical tests (including preventative cancer checkups)
  • An estimated 1.3m adults in the UK have never been for a sight test
  • 40% use a computer for more than five hours a day
  • 10% see sunglasses purely as a fashion statement
  • 14% of parents say their children have never had a sight test
  • 30% of the population cannot say for certain whether their ethnicity puts them at higher risk of eye disease than others
  • 26% wish they had taken better care of their eyes when they were younger
  • 60% do not know that glaucoma can be inherited

A survey of a further 300 respondents of Asian and African-Caribbean descent found that 74% were uncertain whether they were more susceptible to eye diseases because of their ethnicity.

While most adults are generally aware of the potentially negative impact of the sun, smoking and their general lifestyle may have on their eyesight, many are less aware of the role that their family medical history or ethnicity could play on their pre-disposition to certain eye conditions, the College says.CLICK HERE FOR AN OVERVIEW OF THE COLLEGE REPORT CLICK HERE TO DOWNLOAD THE REPORT CLICK HERE TO ACCESS THE VISION CARE INSTITUTE™ REVIEW OF KEY PAPERS ON LIFESTYLE AND EYE HEALTH

What we think: While it’s reassuring that consumers value their eyesight above all other senses there is still work to be done in informing and educating the public about the importance of regular eye examinations. As the College observes, it’s encouraging that there is a growing understanding of the link between lifestyle and eye health. Read our key papers on this topic to provide accurate advice to patients.

*NEW* GOC highlights need for face-to-face learning

Attending peer review and clinical skills CET will soon be compulsory for UK-registered optometrists and contact lens opticians under changes to the UK’s continuing education and training scheme.

The General Optical Council is to introduce an enhanced CET scheme from the next three-year cycle starting January 2013. The main changes are:

  • A minimum of six points per year will be required towards the 36 general points needed per cycle
  • Peer review and clinical skills CET will carry more points than attendance at lectures or article-based CET
  • A limit to the proportion of points per cycle that can be obtained via article-based distance learning
  • Optometrists and contact lens opticians (CLOs) will need to undertake one peer review activity per cycle involving patient records and decision-making
  • Points must cover all competency units specified, including communication

The GOC says that almost all registrants (96%) met the minimum CET requirement for the last three-year cycle, but nearly 60% of total CET points awarded were from distance learning. Only about a quarter of points achieved (27%) were from lectures, and other face-to-face learning methods were much less commonly used.
CLICK HERE FOR FULL DETAILS OF THE NEW CET SCHEME

What we think: THE VISION CARE INSTITUTE™ is leading the way in face-to-face education by providing opportunities to learn via hands-on training and peer-to-peer interaction. Our state-of-the-art examination rooms and small-group facilities are ideal for helping eye care professionals to learn in this way. Our courses not only help develop clinical expertise but also cover topics such as communication and inter-personal skills.

*NEW* GOC issues advice on buying cosmetic contact lenses

The General Optical Council (GOC) has produced a new leaflet aimed at consumers wanting to buy cosmetic contact lenses to change the colour or appearance of their eyes.

The booklet, endorsed by the British Contact Lens Association, explains that consumers should only buy the lenses from a legal source, have them fitted by a professional and follow all advice about how to wear and look after the lenses.

In June 2011, the GOC published a new protocol explaining how it will deal with breaches of the Opticians Act, including selling zero-powered contact lenses illegally. These lenses can only be sold where a registered optometrist, dispensing optician or medical practitioner is on the premises.
 

David Howell, Director of Regulatory Services at the GOC, said: ‘We are aware of instances of them being illegally sold by outlets such as hairdressers, market stalls and novelty shops. The GOC is taking action against unregistered retailers selling the lenses illegally using its power to prosecute under the Opticians Act.’

GOC staff attended the Trading Standards Institute conference (21-23 June), to raise awareness of the Opticians Act among trading standards officers. The leaflet will also be distributed at events such as the Citizens Advice conferences, as well as through colleges and universities.
CLICK HERE FOR THE GOC’S ADVICE CLICK HERE TO ACCESS THE LEAFLET

What we think: This booklet is aimed at helping ensure safe use of cosmetic lenses and has useful advice for consumers. It points out that while these lenses can be effective for enhancing or changing the eye’s appearance, consumers need to take the same degree of care when buying and wearing them as with any other contact lenses.

*NEW* NICE publishes quality standard for glaucoma

The National Institute for Health and Clinical Excellence has published its quality standard for the care of people with chronic open-angle glaucoma (COAG), suspected COAG and ocular hypertension.

Quality standards set out for health and social care professionals, patients, NHS Trusts and commissioners the high-quality, cost-effective patient care expected. The quality standard on glaucoma (31 March 2011) comprises 12 statements, including:

  • People are referred to a consultant ophthalmologist for further assessment and definitive diagnosis if the optometrist or other healthcare professional suspects COAG. There are local agreements in place for referral refinement.
  • People with elevated IOP alone are referred to an appropriately qualified healthcare professional for further assessment on the basis of perceived risk of progression to COAG. There are agreements in place for repeat measures.
  • People referred for definitive diagnosis in the context of possible COAG or with OHT receive all relevant tests in accordance with NICE guidance.
  • People with COAG, suspected COAG or with OHT are diagnosed and have a management plan formulated by a suitably trained healthcare professional with competencies and experience in accordance with NICE guidance.

The College of Optometrists endorsed the standard and said it was complemented by joint guidance issued with the Royal College of Ophthalmologists on the referral of glaucoma suspects by community optometrists, and supplementary guidance on supervision in relation to glaucoma-related care by optometrists.CLICK HERE FOR THE NICE QUALITY STANDARD ON GLAUCOMACLICK HERE FOR THE COLLEGE OF OPTOMETRISTS' COMMENTSCLICK HERE FOR THE JOINT GUIDANCE ON REFERRAL AND SUPERVISION

What we think: Clarification of the roles and responsibilities of optometrists in referring suspected glaucoma and ocular hypertension is welcome. This latest document from NICE sets out the standard of care that patients, professionals and providers can expect of the NHS.

*NEW* Public backs regular vision assessment for drivers

The public would support regular compulsory testing of all drivers’ vision if it were introduced in the UK, according to three surveys timed to coincide with consultation on government proposals for medical fitness to drive.

Research by the College of Optometrists revealed that one in five drivers (20%) admitted to having driven knowing their vision was not as good as it should be. Yet nearly four out of five (79%) would support regular compulsory vision tests. Asked how frequently tests should occur nearly half of drivers (46%) said every five years. The College is recommending that all UK drivers over the age of 40 have a vision check every five years, increasing to every two years for those aged 60 and over.

A survey by road safety research group the RAC Foundation found a similar level of support for regular testing of drivers; 79% of those questioned said not only did they back the move but they would also be prepared to pay for tests at 10-yearly intervals. Support was high among drivers and non-drivers alike.

National charity Brake also found strong public support for regular eyesight testing. Its survey showed 75% of drivers supported compulsory eyesight testing for drivers every five years. Brake is one of several road safety stakeholders campaigning for the number plate test to be replaced as well as for regular retesting of drivers’ vision.

Currently, the Driver and Vehicle Licensing Agency requires that drivers pass the number plate test on taking their driving test and then self-certify that they meet the medical standard for driving at the age of 70. DVLA consultation on proposals for drivers’ vision assessment closed on 28 April 2011.CLICK HERE FOR THE COLLEGE RESEARCH RESULTS AND COMMENTSCLICK HERE FOR DETAILS OF THE RAC FOUNDATION SURVEYCLICK HERE TO FIND OUT MORE ABOUT BRAKE’S CAMPAIGN

What we think: The government is consulting on changes to the eyesight requirements for drivers but its proposals do not include regular vision tests at intervals throughout the driving career. These surveys show high and consistent levels of support regular compulsory testing among drivers themselves.

*NEW* Profession welcomes funding for public health campaigns

Professional bodies have welcomed the publication of a White Paper announcing £4bn in funding to tackle issues such as smoking, obesity and alcohol abuse.
Published in November 2010, Healthy Lives, Healthy People sets out how funding from the overall NHS budget will be ring-fenced for spending on public health. Under the proposals:

  • Local authorities will take on new responsibilities for commissioning public health services
  • A central body, Public Health England, will organise national programmes such as immunisation and screening
  • During 2011, the Department of Health will publish documents that build on this approach, including on mental health, tobacco control, obesity, sexual health, pandemic flu preparedness and health protection

The College of Optometrists welcomed the proposals regarding the support for local innovation and health protection from Public Health England. There would be many issues such as obesity and smoking that would involve all health professionals, including optometrists, it said.

The Eye Health Alliance called on all those involved in public health including the Government, GP consortia, health care professionals and local authorities to work together to ensure that everyone in their local community was aware of the importance of eye health, and the need for regular sight tests and early diagnosis.CLICK HERE FOR THE WHITE PAPER, HEALTHY LIVES, HEALTHY PEOPLE CLICK HERE TO ACCESS THE VISION CARE INSTITUTE™ REVIEW OF KEY PAPERS ON LIFESTYLE AND EYE HEALTHCLICK HERE TO ACCESS OUR TIPS TO PROMOTE & PROTECT EYE HEALTH

What we think: There is growing understanding of the link between lifestyle and eye health. Eye care professionals have an important role to play in informing and educating their patients about the potential impact of smoking and other lifestyle issues based on published evidence.

*NEW* Government proposes lower vision standard for UK drivers

Drivers’ vision standards would be relaxed under changes set out in a consultation document published by the Department for Transport (DfT) and Driver and Vehicle Licensing Agency (DVLA). The proposals include:

  • Retaining the number plate test and reducing the distance at which it can be read for Group 1 drivers (cars and motorcycles) from 20m for the new-style number plate to 17.5m
  • Adopting EU standards for visual fields of Group 1 drivers when a ‘detailed eye examination’ takes place
  • Self-reporting of fitness to drive to continue, with no requirement for vision assessment throughout the driving career

Commenting on the proposals, Road Safety Minister Mike Penning said: ‘Britain has some of the safest roads in the world and licensing rules have an important role in maintaining this position. We must make sure that only those who are safe to drive are allowed on our roads, while at the same time avoiding placing unnecessary restrictions on people’s independence.’

The Optical Confederation, which has been campaigning to improve drivers’ vision assessment, expressed ‘serious concerns’ about the proposals: ‘In our opinion this is a distraction from the real debate which should be about [the number plate test’s] abolition, and replacement with an adequate assessment of VA and visual fields.’
The Confederation encouraged other stakeholders from the health, transport and road safety sectors to respond to the consultation, which ran until 28 April 2010. The consultation document also set out proposed changes to requirements for Group 2 drivers (buses and lorries).CLICK HERE FOR THE DfT/DVLA CONSULTATIONCLICK HERE FOR THE OPTICAL CONFEDERATION’S RESPONSECLICK HERE FOR MORE INFORMATION ON THE PROFESSION’S CAMPAIGN

What we think: The UK already lags behind most European countries in its requirements for testing drivers’ vision. Recent EU legislation offers an opportunity to bring us into line with our nearest neighbours and introduce regular compulsory testing as well as improved methods of assessment.

*NEW* Profession reacts to 3D safety concerns

The optical bodies have clarified the potential health issues with viewing 3D displays. The move follows concerns generated by a statement from game manufacturer Nintendo on its Japanese website that children aged six years and under should not play 3D games on its new 3DS console.
According to a report in the Wall Street Journal, Nintendo’s statement read: ‘Watching 3D images for an extended time could result in adverse effect on eyesight development in the case of children six years old and under, therefore we highly recommend a switch to 2D display.’ It also advised users to refrain from playing if they felt unwell.

Karen Sparrow, Education Advisor to the Association of Optometrists, commented that Nintendo was right to warn people about the potential risks: ‘This is not unique to the Nintendo 3DS as watching 3D images through other means, such as at the cinema or on a 3D television, could give rise to the same concerns.’ She added that there were additional factors when using the 3DS due to the close proximity of the device and its use for prolonged periods
Commenting on 3D displays in general, Optometric Adviser to the College of Optometrists Dr Susan Blakeney, said: 'Most people will be fine when watching 3D films or television and there is no evidence of any more long-term harm being caused after watching 3D displays than there is with 2D.'

Dr Peter Howarth of Loughborough University has published a review of the potential hazards of viewing 3D displays in Ophthalmic and Physiological Optics (March 2011). ‘Although people have reported experiencing symptoms when watching 3D content, specifically headaches and eyestrain, there have been no studies whatsoever which have detected any permanent damage,’ he said.

On 3D TV spectacles, the Association of British Dispensing Opticians advised its members to inform patients that these might not be suitable for everyone, adding: ‘They should only be used for the purpose they were specifically designed for and should not, under any circumstances, be used for general wear or other activities.’ CLICK HERE FOR THE WALL STREET JOURNAL REPORTCLICK HERE FOR THE AOP STATEMENTCLICK HERE FOR THE COLLEGE STATEMENTCLICK HERE FOR THE REVIEW ARTICLE IN OPO CLICK HERE FOR ABDO’S STATEMENT

What we think: With growing use of 3D displays, eye care professionals need to be familiar with any potential ocular hazards and to offer accurate, evidence-based advice. These sources offer useful information on which to base your recommendations and address your patients’ concerns. 

*NEW* University of Plymouth to launch new optometry course

The University of Plymouth has announced plans to introduce a new BSc (Hons) Optometry course via its School of Health Professions. The General Optical Council has granted provisional approval for up to 36 students to start the course in September 2011.

The three-year full-time course, run in collaboration with Exeter University in the Peninsula College of Medicine and Dentistry, will see optometry students learning alongside undergraduates from other health disciplines and also gaining clinical experience within optometric practices in the South West.

The new course is said to be in response to what the university describes as ‘continuing pressure on all health services in the region, including optometry, leading to an ongoing demand for graduates in health disciplines and the potential risk of unmet health needs resulting from workforce shortages’.

Commenting on the announcement, Head of School Professor Graham Sewell said: ‘The course development team is excited by the possibilities of delivering an optometry programme that both meets the General Optical Council requirements and draws on our considerable experience in other healthcare professional disciplines of utilising innovative teaching and learning strategies, including problem-based learning and professional placement learning.’

Dean of the Faculty of Health, Professor Richard Stephenson, added that the Faculty was delighted to support the development of optometry in the South West and valued the opportunity to work closely with partners across the sector.’CLICK HERE FOR THE UNIVERSITY’S STATEMENT CLICK HERE FOR INFORMATION ON COURSE CONTENT

What we think: The addition of a new optometry school, with an emphasis on clinical experience and cooperation with other health disciplines, is an interesting development. We look forward to hearing more about the curriculum and how the course will operate in practice.

Goldmann tonometry reduces glaucoma referrals

Optometric use of Goldmann applanation tonometry (GAT) has ‘huge potential’ to reduce unnecessary referrals to the Hospital Eye Service, according to a letter published in the British Journal of Ophthalmology.Researchers at the Royal Eye Infirmary, Plymouth carried out a pilot study with four local optometry practices to determine how many referrals under the 2009 National Institute for Clinical Excellence (NICE) guideline based solely on intraocular pressures (IOPs) >21mmHg would be avoided if GAT were offered to all patients. They found:

  • Of 3,295 patients examined over 5 months, 73 (2%) had IOPs of 22-25mmHg on non-contact tonometry (NCT) without any other signs of glaucoma
  • Of these 73 patients, 46 (63%) were found to have IOPs of 21mmHg or less when measurements were repeated on GAT, and did not require referral
  • Only 27 of the 73 patients had IOPs >21mmHg confirmed on GAT and were referred

The authors conclude that the large increase in new patient referrals for possible glaucoma resulting from the NICE guideline could be reduced if community optometrists used GAT, to the benefit of patients, Primary Care Trusts and the HES.Meanwhile NICE is consulting on draft quality standards for the care of people with glaucoma. The College of Optometrists and Royal College of Ophthalmologists (RCO) have convened a summit on quality and efficiency in glaucoma care ahead of the December deadline for consultation. The NICE standards are due to be published in June 2011CLICK HERE FOR THE BJO LETTERCLICK HERE FOR THE NICE GUIDANCE AND DRAFT STANDARDS 

What we think: The College of Optometrists and RCO point out that, when referring a patient on IOP grounds alone, Goldmann (or Perkins) tonometry offers greater accuracy. This new study suggests that nearly two-thirds of referrals under the NICE guideline could be avoided by using GAT, considered the ‘gold standard’ technique, rather than NCT. 

Which? highlights problems with ready readers

Consumer magazine Which? has warned that ready-reading glasses can cause eye problems, including eye strain and double vision.A Which? investigation employed an optometrist to check the quality of 14 pairs of low and high prescription ready readers from seven high-street stores and found potential problems with half of those tested. The more serious concerns were with higher prescriptions.The shops investigated were Poundland, Primark, Marks & Spencer, Boots the Chemist, Foster Grant at Superdrug, Sight Station and regional chain Tiger. Which? found that higher powered Poundland ready readers had the wrong prescription, an ‘over-large’ pupil distance and optical centres at different heights. Other ready readers tested were also likely to cause eye problems, it said.Which? expressed concern that nearly one in five of its members surveyed who wore ready readers did so for active tasks, such as decorating. The optometrist commented: 'For people with higher prescriptions, they're not suitable for walking or other mobile activities.'The College of Optometrists commented that, for optimum quality of vision and comfort, spectacles should be fitted by a qualified professional. ‘Everyone’s eyes are different and there is no “one size fits all” solution,’ it said.CLICK HERE FOR A SUMMARY OF THE WHICH? REPORT CLICK HERE FOR THE COLLEGE OF OPTOMETRISTS’ RESPONSE

What we think: Ready readers can never be a substitute for properly prescribed and fitted spectacles, and the importance of proper professional care cannot be over-emphasised. This brief report alerts consumers to potential problems with ready readers, especially in higher powers. Use it to advise patients against non-prescription spectacles and look out for those who wear them for active tasks. 

Optical bodies respond to White Paper consultation

The Government’s Health Service White Paper, Equity and Excellence: Liberating the NHS, gives eye care practitioners opportunities to widen their respective roles, professional organisations have claimed.Published by the Coalition Government in July 2010, the White Paper proposes that groups of GPs will be responsible for commissioning health care for their local communities. NHS sight testing will continue to be a nationally commissioned and negotiated service. The Department of Health has now received responses to the proposals from the Optical Confederation and other bodies.The Confederation said it was looking forward to working with GP consortia through Local Optometric Committees, and welcomed the possible publication of national quality standards or pathways for a range of conditions with the help of the new NHS Commissioning Board.Among other responses, the College of Optometrists said optometrists had the capability and capacity to increase their contribution to eye care and relieve pressure on hospital eye services, emergency departments and GPs. The Royal College of Ophthalmologists pointed to NHS Scotland as a system to aspire to, and the UK Vision Strategy argued for a greater role for commissioning enhanced services.CLICK HERE FOR AN OVERVIEW OF THE CONFEDERATION’S RESPONSE

What we think: The profession’s representatives broadly welcomed the White Paper when it was published and have now expanded their comments in response to consultation. Although the Confederation has concerns about some of the proposals, they do offer opportunities for an expanded role for eye care practitioners. It’s encouraging to see the profession working together in this way. 

Global attitudes and perceptions about vision care

Across cultures and national boundaries, people value sight as the most important of their five senses. Yet new research reveals that more than four in 10 people around the world share the misguided belief that seeing well translates to good eye health.This is just one of the insights gained from the Global Attitudes and Perceptions About Vision Care survey, conducted on behalf of THE VISION CARE INSTITUTE™ and published to mark 2010 World Sight Day (October 14).The survey was conducted in 13 countries (Australia, Brazil, China, France, Hong Kong, Italy, Japan, Korea, Russia, Singapore, Taiwan, the UK and US) and more than 6,500 adults aged 18-54 were interviewed in total.Among the findings are:

  • Globally, two in three adults (66%) and more than one in four children (28%) use some form of vision correction
  • 84% report having had an eye examination but incidence varies from 58% in China to 94% in Italy and Brazil
  • For only 54% has the eye examination been comprehensive
  • 62% say they are willing to pay more for a better examination
  • The ‘ideal’ age for a first eye examination is 5.5 years but the age this actually takes place is 16.9 years and 18.3 years for a comprehensive examination

This diversity of beliefs globally presents both challenges and opportunities for eye care practitioners. All practitioners have an important role to play in helping to change attitudes and perceptions in their own communities, and each and every patient visit is an opportunity to educate and influence.CLICK HERE TO READ MORE ABOUT THE SURVEY CLICK HERE FOR AN EXECUTIVE SUMMARY OF THE TVCI SURVEY RESULTS CLICK HERE FOR A POSTER REPORTING THE RESULTS

What we think: World Sight Day is an ideal time to reflect on vision care and eye health around the world but we should take particular note of attitudes closer to home. One striking finding is that use of vision correction among British children is less than half the global average or that of countries such as France and Italy. We need to take every opportunity to educate all our patients in the value of a regular eye examination and remind families of the importance of caring for children’s eyes. 

Eyecare Trust launches campaign on driving at night

The Eyecare Trust has produced a range of new resources designed to help practitioners highlight the importance of ensuring motorists’ vision is roadworthy. The campaign was launched to coincide with 2010 World Sight Day and in advance of the clocks changing.The Trust says all drivers have a legal responsibility to ensure their sight is fit to drive every time they get behind the wheel, yet roadside research conducted by the charity among 546 drivers at seven locations around the UK found more than half (53%) admit they had difficulty seeing clearly when driving at night.‘Poor vision can put motorists and other road users at increased risk after dark, so with the long nights beginning to draw in, now is the perfect time for drivers to MOT their eyes,’ the Trust says. Among its recommendations are:

  • Have regular sight tests to ensure your vision is clear and eyes are healthy
  • If you require prescription eyewear for driving make sure you wear it every time you get behind the wheel.
  • Never wear sunglasses or tinted lenses to reduce glare while driving at night
  • Keep your windscreen clean and smear free
  • Check you wiper blades for wear
  • Watch your speed

An online survey conducted in July by LV= car insurance among 2,490 drivers found about one in 10 (11%) of those prescribed spectacles or contact lenses for driving admitted they did not always wear them.CLICK HERE FOR DETAILS OF THE EYECARE TRUST CAMPAIGN CLICK HERE FOR MORE FINDINGS FROM THE LV= SURVEY

What we think: The optical and optometric professional bodies are working together on a wider campaign to raise awareness among all drivers of the need to look after their eyesight and ensure they have good vision when driving. They are also calling on the Government to implement a more systematic and scientific method of assessing drivers' vision. Watch out for increased interest and activity in this area as their campaign gathers momentum. 

GOC agrees proposals for CET and revalidation

Optometrists, dispensing opticians and contact lens opticians will soon be expected to take part in continuing education and training (CET) across all relevant competency areas and in a range of modalities.Under proposals agreed by the General Optical Council, the three-year CET cycle and 36-point requirement will remain but registrants will need to earn a minimum of six points per year. A wider scale of points will be introduced and interactive CET, such as peer review, and clinical skills CET will carry more points than attending lectures or text-based distance learning. Other main changes are:

  • Optometrists will be expected to complete one peer review activity per cycle involving patient records and decision making
  • Contact lens opticians can count their contact lens CET points within the overall requirement rather than additional to it but they must undertake one peer review activity per cycle
  • The number of points gained through text-based distance learning will be limited
  • Every six years, optometrists and contact lens opticians working in practice will have to demonstrate they have had a clinical skills assessment in ocular abnormalities and ocular examination

The GOC will now develop these proposals and the new scheme will be introduced in January 2013.CLICK HERE TO READ THE FULL PROPOSALS CLICK HERE FOR COURSES AT THE VISION CARE INSTITUTE™

What we think: The new scheme opens up exciting prospects for CET to be more relevant and practical, to the ultimate benefit of our patients. The unique facilities at THE VISION CARE INSTITUTE™ are ideally suited to delivering high quality, innovative education via a range of different learning formats and peer-to-peer interaction is central to all our CET activities. 

ECOO highlights benefits of contact lenses for children

The European Council of Optometry and Optics, the organisation that promotes eye health across Europe, has highlighted a new study that shows myopic children as young as eight years can benefit from wearing contact lenses.Published in the August 2010 issue of Optometry and Vision Science, the research involved almost 500 moderately myopic children, between the ages of 8 and 12 at five sites across North America. Children in the study enjoyed the same benefits of contact lens wear as teenagers, and ranked especially highly the same improvements in quality of life as other older lens wearers do, namely:

  • Their ability to participate in activities, such as sport and dancing
  • Their appearance
  • Their satisfaction with their vision correction

ECOO observes that this study is the first to concentrate on children’s vision-related quality of life and shows that young children have the same concerns over their method of vision correction as the rest of us. Another interesting and unexpected finding is that children find contact lenses easier to handle than spectacles, it adds.CLICK HERE FOR THE ECOO STATEMENT CLICK HERE FOR THE ABSTRACT IN OVS CLICK HERE FOR NEW FINDINGS ON CONTACT LENSES FOR CHILDREN AND TEENS

What we think: We welcome the fact that ECOO has drawn attention to this important study. This latest research from the ACHIEVE group is one of a series of studies showing the benefits of contact lenses for children and teenagers. Freedom from glasses can boost children’s self-confidence, as well as allowing them to participate fully at school, at sports and at play. 

Survey reveals gender differences in the workplace

Women in the profession are as satisfied as men with their chosen career even though they earn less in real terms and are less likely to hold managerial positions. These are among the findings of a new survey into working practices of women practitioners and their attitudes to their jobs and career.Conducted between July and September, the Women of Vision 2010 survey involved 808 optometrists and dispensing opticians of whom just over half (54%) were women. The survey reveals many significant gender differences, such as:

  • Almost nine in 10 women (86%) are satisfied with their chosen careers and women are at least as satisfied as men with their work/life balance.
  • Overall, women respondents earn less on average than men both in actual salaries and pro rata when working hours are taken into account
  • Women are less likely to be a practice owner or director than men (14% vs 34%)
  • Women with children are more likely than their male counterparts to take primary responsibility for childcare in the family while they are at work
  • Flexibility of working days and hours is more important to women practitioners than men yet very few women, or men, work half days or school hours, and none of those taking part in the survey had term-time contracts

For women, contact lens work is considered the most enjoyable part of their work, followed by paediatrics and dispensing, while men favour dispensing, contact lenses and managing the business.CLICK HERE FOR MORE RESULTS FROM THE SURVEY CLICK HERE FOR FINDINGS ON JOB SATISFACTION AND CAREER PLANS CLICK HERE TO FIND OUT ABOUT OUR RETURNING TO WORK COURSES

What we think: THE VISION CARE INSTITUTE™ recognises the challenges that we can face following a career break and that returning to work after taking time off to spend with your family can be daunting. Our innovative two-day course, ‘Returning to Work – Confident & Refreshed’, is designed for all those returning to practice for whatever reason. It’s delivered in a relaxed and friendly environment by fellow practitioners and tutors who have been through career breaks themselves. Book your place now for dates from February to June 2011! 

‘Could glasses soon be history?’ asks BBC

Scientists from research centres around the world including King’s College London (KCL) have uncovered a gene associated with myopia. Their findings are published online in the journal Nature Genetics.A feature in BBC News Magazine (14 September 2010) headed ‘Could glasses soon be history?’ claimed the discovery could pave the way for treatment to prevent myopia. Dr Chris Hammond of KCL said that in about 10 years, myopia could be ‘cured through eye drops’. ‘We've known for many years that the most important risk factor to short-sightedness as you get older is family history. But until now, we hadn't identified any genes responsible for that susceptibility.’In a 12-year study which looked at 4,000 twins, researchers at KCL's Department of Twin Research identified the RASGRF1 gene as one which had variations shared by people with myopia. They replicated this association in six adult cohorts of European ancestry with 13,414 individuals in total.A separate study in the Netherlands has found a second gene which also governs short sight, and Dr Hammond believes multiple genes are probably responsible.
‘So it's not THE myopic gene we've found but it's certainly an important step on the path to understanding how the eye does become short-sighted.’But he added that some people that had rarer genes would still be short-sighted. ‘So to say we will eliminate glasses may be overstating it. We're never going to stop myopia in everyone, but we hope to have some impact on the majority.’CLICK HERE FOR THE BBC FEATURE CLICK HERE FOR THE ABSTRACT IN NATURE GENETICS

What we think: While these findings are exciting, they represent just one approach to understanding and controlling myopia. Dr Hammond acknowledges that any prospect of myopia treatment may be 10 years in the future but major advances in spectacle and contact lens technology are already available today. 

College announces first OSCE results

Nearly eight out of 10 candidates (78%) passed the College of Optometrists’ first Objective Structured Clinical Examination (OSCE), which replaces the Final Assessment for the Scheme for Registration, and can now enter the Opticians’ Register.A total of 310 candidates sat the OSCE held at the Royal College of General Practitioners Conference Centre in July 2010. These candidates were also the first to complete the new Stage 2 Work-based Assessment.Commenting on the first OSCE, Dr Cindy Tromans, President of the College of Optometrists commented: ‘I am delighted with the results from the new-style work-based and final assessments. Employers and the public can be confident that the 241 successful trainees will begin their careers able to use their knowledge and skills to make appropriate clinical decisions for patients across the whole range of clinical presentations.’The introduction of the OSCE marks the end of a period of extensive development for the College’s Scheme for Registration since the 10-part Professional Qualifying Examination was replaced and work-based assessment introduced in 2005.CLICK HERE FOR MORE INFORMATION ON THE OSCE AND SCHEME FOR REGISTRATION CLICK HERE TO FIND OUT MORE ABOUT TVCI’S OSCE PREPARATION COURSES

What we think: Congratulations to all those candidates who were successful in the College’s first OSCE. More than 120 pre-registration optometrists have gained valuable hands-on experience for their Final Assessment by attending THE VISION CARE INSTITUTE™ one-day OSCE Preparation Course, which includes one-to-one feedback with experienced College of Optometrists’ examiners and assessors following a comprehensive following a ‘mock’ examination. Look out for 2011 course dates to be announced soon. 

Optical bodies call for better assessment of drivers' vision

The Optical Confederation and Eye Health Alliance are calling on the Government to replace the number plate test with a more systematic and scientific method of assessing drivers' vision.European Directives on driving licences introduce a number of measures to harmonise laws relating to the testing and licensing of drivers across Europe. The basic requirements for eyesight were amended in 2009 in Directive 2009/113/EC and require that drivers meet minimum standards for visual acuity and visual fields. The Directive also stipulates that all applicants will 'undergo an appropriate investigation' to ensure that they have adequate visual acuity.The Optical Confederation is calling for the current system of vision screening for professional drivers to be extended to all drivers and to replace the number plate test. It is also working with the optical organisations across Europe to ensure Members of the European Parliament and the European Commission are aware of the UK position on improving the system for checking drivers' eyesight.The Eye Health Alliance described the number plate test as ineffective and unfair and said the current system placed too much responsibility on the driver to self-report problems with their vision to the Driver and Vehicle Licensing Agency (DVLA).The UK Government has until January 2011 to bring in legislation to extend the current system of vision screening for professional drivers to all car and motorbike drivers. A public consultation on the proposals is expected later this year.CLICK HERE FOR THE OPTICAL BODIES’ STATEMENT CLICK HERE FOR EUROPEAN DIRECTIVE 2009/113/EC CLICK HERE TO FIND OUT MORE ABOUT THE CAMPAIGN

What we think: A review of the current system for testing drivers’ vision is long overdue. The Directive presents an opportunity for the profession to make its case for bringing the UK in line with other European countries. Look out for more activity in this area in the coming months. 

First results with biosynthetic cornea show promise

Scientists in Sweden and Canada have developed a biosynthetic corneal implant that may help overcome the worldwide shortage of donor corneas for transplantation.Researchers at Linköping University (LiU) implanted biosynthetic corneas made from synthetic cross-linked collagen in 10 patients with significant vision loss due to advanced keratoconus or central corneal scarring. The aim was to facilitate tissue regeneration without the use of human donor tissue. They found:

  • Implants remained stably integrated and avascular 24 months after surgery
  • Cells and nerves from the patients’ own corneas grew into the implant, resulting in a ‘regenerated’ cornea that resembled normal, healthy tissue
  • No rejection reaction and no long-term immune suppression needed
  • Biosynthetic corneas became sensitive to touch and tear film was restored
  • Vision improved in six of the 10 patients and, after contact lens fitting, was comparable to conventional transplantation

‘This study is important because it is the first to show that an artificially fabricated cornea can integrate with the human eye and stimulate regeneration,’ said senior author Dr May Griffith. ‘With further research, this approach could help restore sight to millions of people who are waiting for a donated human cornea for transplantation.’CLICK HERE FOR THE ABSTRACT CLICK HERE FOR LiU COMMENTS AND VIDEO FOOTAGE OF A PROCEDURE

What we think: This is one of a number of approaches to artificial or synthetic corneas. Various prosthetic corneas (keratoprostheses) made from plastic are already in use. The authors stress that this is only an initial clinical study on 10 people but are optimistic about the potential for this new approach once further clinical trials have been carried out. 

Proper fitting and care is key in contact lenses for children

The American Academy of Optometry (AAO) has emphasised the benefits of contact lenses for children and the need to regularly review lens care and hygiene, following a report that more than one in five emergency department cases in children in the US are linked to contact lens injuries.The US Food and Drug Administration study published in the journal Pediatrics (July 26) reviewed 144,799 medical records of patients from birth to 21 years old visiting emergency departments at 100 hospitals between 2004 and 2005. The study found:

  • An estimated 33,779 (23%) medical device-associated adverse events a year were due to contact lens injury (corneal abrasion, ulceration, conjunctivitis)
  • A majority of these contact lens injuries occurred among teenagers aged 16- 21, followed by children aged 11-15 years
  • The injuries were generally superficial and did not require hospitalisation
  • 6% of adverse events were caused by eyeglasses (lacerations to face or eye) and 3% by eye protection devices (corneal abrasion from device earpiece, foreign object in eye, photokeratitis)

In response, the AAO said that contact lens wear had many benefits among children, including improved self-perception and unobstructed peripheral vision. By maintaining regular appointments and reviewing lens replacement, lens care and hygiene at every visit, both children and adults could be happy, healthy, and safe contact lens wearers.CLICK HERE TO READ THE AAO STATEMENT CLICK HERE FOR THE PAPER IN PEDIATRICS CLICK HERE FOR THE LATEST STUDIES ON CONTACT LENSES FOR CHILDREN AND TEENS

What we think: The most common risk factors in this study were alteration of the recommended wearing or replacement schedules and non-compliance with lens wear and care regimens, underlining the need to involve parents during the fitting and aftercare process, and to reinforce compliance at every opportunity. 

Survey reveals low awareness of UV risk

British people are concerned about protecting their skin from harmful ultraviolet (UV) rays, yet more than 90% are still unaware of the need to protect their eyes.The fifth annual Healthy Sight Survey commissioned by Transitions Optical to monitor consumer awareness about eye health issues was carried out by independent market research company Ipsos on a representative sample of 1,028 men and women aged 18 years and over. Among the findings were:

  • 62% of people are disturbed by sun glare, 44% are disturbed by bright light and 41% of people feel sensitive to light
  • While 79% of people associate UV rays with tumours and the risk of cancer, only 9% are worried about eye damage
  • 15% of people do nothing to protect their eyes from UV damage
  • Only 20% of people wear spectacle lenses that automatically darken outdoors when exposed to sunlight and block UV
  • On average, people spend 28h outdoors during the week, and 41% of people spend more than 15h outdoors per week.

Karen Sparrow, education adviser to the Association of Optometrists, commented, ‘UV-blocking eye protection is crucial to prevent long-term harm, and we need to remember to protect our eyes all year round, not just during the summer months.’CLICK HERE FOR THE LATEST INFORMATION ON UV AND THE EYE CLICK HERE FOR NEW RESEARCH INTO THE BENEFITS OF UV EYE PROTECTION

What we think: Eye care professionals have an essential role to play in informing and educating the public about the risk from harmful UV, and providing appropriate protection. A brimmed hat, wraparound sun glasses and UV blocking protection in prescription spectacle and contact lenses should all be discussed. UV protection for eyes is as important as sunscreen for skin. While summer isn’t the only time of year when eye protection may be needed, it offers the opportunity to highlight the importance of this eye health issue to your patients. 

TVCI celebrates a successful year

THE VISION CARE INSTITUTE™ marked its first anniversary with an interview in Optician with Dr Kamlesh Chauhan. The feature describes TVCI’s achievements over the past year and the unique facilities at the Pinewood campus. It also details how delegate feedback on courses is being used to review and enhance the TVCI offer.Kamlesh explains that the Institute’s courses are constantly evolving, making them more effective: ‘If we don’t fulfil patient satisfaction by getting people to use these skills in practice, we’ve not achieved our purpose.’Future developments will include installing new instrumentation, including OCT, video keratoscopes and a wavefront analyser, as well as working with other education providers and adding new presenters.Kamlesh joined the Institute in August 2009 and brings more than 20 years of experience in optometric training to his role as head of TVCI. In April, he was elected Vice President of the College of Optometrists, and as past Vice Chair of its Education Committee he is closely involved with the new Objective Structured Clinical Examinations (OSCEs).CLICK HERE TO READ THE INTERVIEW IN OPTICIAN CLICK HERE TO REGISTER FOR TVCI COURSES

What we think: The past year has been a busy one for TVCI, with many successes. Back-to-work courses, the first Optometry Reunited event and developing the TVCI website are among notable achievements, alongside our regular hands-on courses providing peer-to-peer education. If you haven’t yet visited TVCI, enrol now for your first course and experience for yourself a uniquely different way of leaning! 

Ingredient in red wine may help prevent some eye diseases

Resveratrol, found in red wine, grapes, blueberries and peanuts, stops abnormal blood vessel growth in the eye, according to US researchers at Washington University School of Medicine.The discovery has implications for preserving vision in blinding eye diseases such as diabetic retinopathy and age-related macular degeneration, they say.The formation of new blood vessels, angiogenesis, also plays a key role in certain cancers and in atherosclerosis. Conducting experiments in mouse retinas, the researchers found that resveratrol can inhibit angiogenesis.‘A great deal of research has identified resveratrol as an anti-ageing compound, and given our interest in age-related eye disease, we wanted to find out whether there was a link,’ says retina specialist Dr Rajendra Apte, the study's senior investigator. ‘There were reports on resveratrol's effects on blood vessels in other parts of the body, but there was no evidence that it had any effects within the eye.’The investigators studied mice that develop abnormal blood vessels in the retina after laser treatment. They found that when the mice were given resveratrol, the vessels began to disappear.CLICK HERE FOR THE ABSTRACT CLICK HERE FOR TVCI’S REVIEW OF DIET AND ALCOHOL ON EYE HEALTH

What we think: These findings in an animal model are interesting but should be treated with caution. Other studies have suggested moderate alcohol consumption might have a protective effect on eye health but heavy drinking should be avoided for eye and general health reasons, especially when combined with smoking or poor diet. The consensus is that eating a healthy, balanced diet will provide all of the nutrients required to keep the body healthy and may help maintain eye health. 

Promoting the importance of children’s eye care

The Optical Confederation has sent out more than 23,000 letters to primary school head teachers in the UK to highlight the importance of sight tests for children from a young age. The mailing is part of a wider national Children’s Eye Care Initiative by the optical professional bodies.Optometrist Polly Dulley, chairman of the campaign, said: ‘We want to ensure that all children starting school this September are encouraged to see their local optician for a free NHS sight test. Poor eyesight can have a significant effect on children’s ability to learn and on their behaviour, yet often goes unrecognised by teachers, parents and the children themselves.’THE VISION CARE INSTITUTE™ Vice President Ian Davies told delegates at the 2010 European Academy of Optometry and Optics meeting in Copenhagen in May that 53% of children in the UK have had any kind of vision test, compared to 75% of children in Italy and 88% of children in Russia.THE VISION CARE INSTITUTE™ Global Attitudes and Perceptions about Vision Care Survey also found that, across the world, 28% of children wear vision correction, compared to just 13% of children in the UK.CLICK HERE FOR A SHORT FILM EXPLAINING THE BENEFITS OF CHILDREN HAVING THEIR SIGHT TESTED FROM AN EARLY AGE CLICK HERE FOR AN EXECUTIVE SUMMARY OF THE TVCI SURVEY RESULTS

What we think: We all have a part to play in promoting the importance of regular eye examinations for people of all ages but the profession’s current emphasis on children’s vision is welcome. The TVCI survey reveals just how far the UK has fallen behind other countries in the provision of children’s eye care and vision correction. Why not get involved at a local level by offering to give a talk to schoolchildren, or perhaps by holding an open day for teachers to visit your practice. 

How long should an eye examination take?

Optometrists say they need 29 minutes to conduct an eye examination to an acceptable standard, rather than the ‘industry standard’ of 20 minutes, according to the results of a new survey published in Optometry Today (2 July 2010).Hampshire-based optometrist Christian Dutton received 600 responses to the online survey and included 555 in the final analysis, representing nearly 5% of UK registered optometrists. Practitioners who allocated over 40 minutes per eye examination, those unable to separate pre-screening time from overall eye examination duration and those working to the NHS Scotland model were excluded. Results include:

  • 92% of practitioners say the 'industry standard' 20-minute allocation is insufficient to conduct an eye examination to the standard described in College of Optometrists’ guidance
  • The mean requirement among respondents is 29 minutes for each eye examination (excluding pre-screening)
  • They say a safe upper limit is 16 eye examinations in an 8-hour working day.
  • An additional 36 minutes is required each day to undertake essential non-eye examinations and administrative tasks

The author calls for evidence-based research to determine an updated industry standard for eye examination duration: ‘This should ensure that practitioners are allocated sufficient time to complete their professional obligations, patients should be satisfied by receiving optometric care which is accurate and of good quality, and ultimately the profile of UK optometry could be raised.’CLICK HERE TO READ MORE COMMENTS ON THE SURVEY

What we think: Eye examination times have long been the subject of heated debate. The advent of new clinical techniques and pre-screening tests mean that the content of the eye examination is changing rapidly and this latest survey of practitioner opinions is therefore timely. We await with interest more research that would take the discussion further. 

Warning issued on ‘vodka eyeballing’

Ophthalmologists in the US have warned that ‘vodka eyeballing’ could lead to permanent vision damage.The American Academy of Ophthalmologists (AAO) issued a statement after the drinking game was widely featured on You Tube, on social networking sites and in the media. The statement said ‘People need to be aware that anyone who pours vodka directly into his eye risks damaging the surface epithelial cells – often causing pain and infection.‘More seriously, "eyeballing" can also lead to permanent vision damage by killing endothelial cells in deeper layers of the eye's cornea. This is unlikely, but possible.‘Depending on the amount of alcohol and length of time it is in contact with the eye, epithelial cell loss could result in corneal ulcers or scarring, not to mention a great deal of pain. And if endothelial cells die off, vision recovery would be uncertain.’The AAO strongly advised the public not to engage in the practice and added that ‘eyeballers’ did not even get a ‘quick high’ as claimed, because the volume of vodka absorbed by the conjunctiva and cornea was too small to have that effect.In the UK, The Daily Mail (15 May 2010) was among those warning of the risks of the practice, which it said was common among students at British universities. The report described the case of a student left with permanent scarring, pain and blurred vision from vodka eyeballing.CLICK HERE TO READ THE DAILY MAIL REPORT

What we think: While it may seem hard to believe that anyone would inflict this on their eyes, there are hundreds of clips on You Tube showing just that. Be alert to any unexplained signs or symptoms of ocular damage and use the AAO’s advice to discourage this practice. 

Two-yearly eye tests avoid sight loss, says College

Nearly nine out of 10 of the UK population fear losing their sight above all other senses yet almost one in five have not had an eye examination in the last five years.The research for 2010 National Eye Health Week (June 14-20) was carried out on behalf of The College of Optometrists in April and May among more than 4,000 respondents. Findings revealed:

  • 86% value their sight more than any other sense
  • 18% have not had an eye test in the last five years
  • 35% are aware they should visit their optician optometrist every two years.
  • 40% have not had an eye test because they have no symptoms
  • 31% are unaware that not all eye conditions show symptoms
  • 24% do not think it is necessary to have an eye test
  • 18% are worried about the cost

Source: Future SightDavid Scott-Ralphs, Chair of National Eye Health Week said: ‘This week is a call for everyone to have a regular eye examination as a crucial part of their healthcare routine, just like going to the dentist.‘The survey findings released today are astonishing when you consider that more than half of the 1.8 million people in the UK living with some degree of sight loss, could be helped with an eye examination or a new glasses prescription, yet many don’t give their eye health enough importance.‘From today, our aim is to ensure that more people are aware just how much their vision matters,’ he added.CLICK HERE FOR MORE COMMENT ON THE COLLEGE SURVEY CLICK HERE FOR INFORMATION ON NATIONAL EYE HEALTH WEEK

What we think: These findings reveal just how much work the profession needs to do to educate the public about the importance of eye health and the need for regular eye examinations. Make sure you, your practice and your practice team communicate these messages at every possible opportunity. 

Risk factors for MK in daily disposable contact lens wear

Young contact lens wearers using daily disposable (DD) soft lenses are less at risk from microbial keratitis (MK) than older wearers, according to findings presented by Stapleton and co-workers at the annual meeting of ARVO (Association for Research in Vision and Ophthalmology) in May 2010.The incidence of severe MK in DD lens use is lower than for other daily-wear soft lenses but the overall incidence is similar. The study investigated risk factors for MK in DD wearers attending Moorfields Eye Hospital with MK from 2003-2005 and those reported through a one-year surveillance study in Australia and New Zealand (2003-2004). Both were matched with DD-wearing controls. A total of 68 cases of MK (36 severe) and 372 controls were analysed. Independent risk factors were:

  • Wearing lenses every day compared with less frequent use (odds ratio 6.0x)
  • Overnight wear compared with daily use (OR 1.2x)
  • Less frequent hand washing (OR 3.2x)
  • Smoking (OR 1.7x)
  • More than 1 year since the last aftercare (OR 1.8x)
  • Certain DD types (OR 0.2x)
  • Youth (OR 0.2x).

Consistent with previous findings in other daily wear modalities, overnight wear, frequent use, smoking and poor hand hygiene are significant risk factors for MK with daily disposables. In contrast, younger age and more frequent check-ups are protective. As risk varied with contact lens type, material properties and design may play a role in the aetiology of MK in DD wear.CLICK HERE TO ACCESS THE ABSTRACT CLICK HERE FOR THE VISION CARE INSITUTE™ POSTER ON HANDWASHING CLICK HERE FOR MORE INFORMATION ON SMOKING AND EYE HEALTH

What we think: These important findings from two major studies provide further evidence of modifiable risk factors in contact lens wear. It’s encouraging to note that young daily disposable lens wearers are at lower risk than older wearers, since concerns about safety may be a perceived barrier to children and teens wearing contact lenses. 

Seasonal advice for allergy sufferers

As the peak allergy season approaches, eye care professionals (ECP) have an important role to play in providing patients with practical advice on how to prevent and treat ocular symptoms, as well as prescribing the best vision correction options available to manage their condition.According to a survey by the Asthma & Allergy Foundation of America (AAFA), supported by Johnson & Johnson Vision Care, nearly half (45%) of contact lens wearers say that eye-related allergy problems often prevent them from wearing their contact lenses, and one in 10 (12%) admits to having dropped out of contact lens wear because of their allergies.Surprisingly, almost three in four respondents (74%) say their ECP has never suggested daily disposable contact lenses as an option for them to continue wearing contact lenses comfortably during the allergy season.Daily disposable lenses can be a healthy and more comfortable option for many people with eye allergies. Putting in a clean, fresh lens every day minimises the potential for accumulation of allergens and irritants. Daily disposables also eliminate the need for lens care solutions, and hence eliminate exposure to additional irritants.With the advent of new toric daily disposable lenses in a wider range of parameters, more contact lens wearers can benefit from this modality, especially during the peak season for allergies.Here’s a round-up of management strategies to help optimise contact lens wear for the allergy sufferer:ALLERGEN AVOIDANCE or EXPOSURE REDUCTION

  • Help sufferers identify causative allergen(s)
  • Discuss avoidance strategies where practical
  • Advise on environmental control tactics
  • Prescribe daily disposable contact lenses

TO ALLEVIATE SYMPTOMS

  • Introduce cold compresses and lid massage
  • Add re-wetting drops during lens wear (single dose/non-preserved preferred)
  • Use anti-allergy eye drops pre and post daily wear, prior to and during the allergy season

CLICK HERE FOR THE JOHNSON & JOHNSON VISION CARE EYE HEALTH ADVISOR™ MAGAZINE’S SPECIAL EDITION ON ALLERGY

What we think: Many allergy sufferers are also contact lens wearers who may experience discomfort and symptoms when wearing their lenses. However, with careful management and regular monitoring, most of these patients can continue with contact lens wear, even during the peak season for allergies. Daily disposable lenses are an effective option in these patients. 

Low risk of ocular events for child contact lens wearers

Relative to teens and young adults, contact lens wearers under 14 years old present with fewer interruptions in lens wear, according to a new study presented at the annual ARVO (Association for Research and Vision in Ophthalmology) meeting, held in Florida in May.The CLAY (Contact Lenses and Youth) group conducted the study into age as an independent risk factor for ocular events that interrupt soft contact lens (SCL) wear in youth. The retrospective review of 3,549 soft lens wearers aged 8-33 years from 14,327 visits at six academic centres in the US between 2006 and 2009 found:

  • 522 events which interrupted contact lens wear among 426 wearers.
  • The percentage of visits with an event was less than 3% at each end of the age distribution (8-13 year olds and 30-33 year olds)
  • Among the 14-25 year olds, there was an event at approximately 5% of visits with the maximum risk among 20-22 year olds
  • Lens replacement schedule was significant, with lowest risk for daily disposable lenses

These results suggest the risk of events that interrupt SCL wear peaks in adolescence and early adulthood. Relative to teens and young adults, patients under 14 years old presented with fewer interruptions in lens wear.The CLAY group also looked at risk factors for significant and serious events in the same cohort of soft lens wearers. There were 187 events in 159 wearers, including eight cases of microbial keratitis. Soft lens use in young patients aged 8-13 years was associated with a low risk of corneal infiltrative events or infections compared to teens and young adults.CLICK HERE FOR THE STUDY ON INTERRUPTIONS IN LENS WEAR CLICK HERE FOR THE RESULTS ON RISK FACTORS

What we think: Attitudinal surveys have shown that parents are concerned about the safety of contact lens wear and that this may be a barrier to their children wearing contact lenses. It’s useful to have results of these large studies at hand to reassure parents that problems with contact lenses are rare among this age group. 

IOLs outperform Lasik for moderate to high myopia

Phakic intraocular lenses (IOLs) are safer than excimer laser surgical correction for moderate to high myopia and are preferred by patients, according to the findings of a Cochrane Review.Researchers at Moorfields Eye Hospital in London reviewed three randomised controlled trials with a total of 228 eyes including patients with -6.00D to -20.00D of myopia and up to 4.00D of myopic astigmatism.The percentage of eyes with uncorrected visual acuity of 20/20 or better 12 months after surgery was not significantly different between the two groups. Phakic IOL surgery was safer than excimer laser surgery for moderate to high myopia, with significantly less loss of best spectacle corrected visual acuity after 12 months. IOLs also scored more highly for patient satisfaction/preference.The authors say that while phakic IOL surgery might be accepted clinical practice for higher levels of myopia, it may be worth considering for more moderate levels of myopia (7.00D of myopic spherical equivalent or less, with or without astigmatism).CLICK HERE TO READ THE ABSTRACT

What we think: This analysis involved only three studies and 228 eyes but the results were widely reported in the lay media. Although Lasik is the most commonly offered refractive surgery in the UK, phakic IOLs are among the procedures that are rapidly gaining ground. Eye care professionals need to be familiar with the relative merits of the latest procedures to provide accurate information for their patients. 

Revised guidance on decontaminating trial contact lenses

The Government has issued new guidance on decontamination of trial contact lenses and other contact devices.Advice was first issued amid fears that Creutzfeldt-Jakob Disease (CJD) and variant CJD (vCJD), the human form of bovine spongiform encephalopathy, could be transmitted from person to person by this route. The risk of infectivity of the cornea and ocular surface is now thought to be low.Under the new guidance, the lens or device should be:

  • Decontaminated immediately after contact with the eye surface
  • Rinsed in Water for Irrigation BP (not tap water) for not less than 30 seconds
  • Cleaned with liquid soap or detergent, then rinsed in Water for Irrigation BP (or normal saline) for 30 seconds
  • Immersed in a freshly-prepared solution of sodium hypochlorite providing 10,000ppm of available chlorine for 10 minutes
  • Rinsed in three changes of Water for Irrigation BP for 10 minutes or more
  • Shaken to remove excess water, dried with a tissue, and stored dry
  • Any further measure (such as autoclaving) can then be carried out if necessary; otherwise, the lens or device is ready for re-use.

CLICK HERE FOR THE FULL GUIDANCE FROM THE DEPARTMENT OF HEALTH CLICK HERE FOR THE COLLEGE OF OPTOMETRISTS’ AND ABDO GUIDANCE

What we think: While it’s reassuring that the risk of transmission of CJD and vCJD by this route is minimal, it is necessary to take appropriate precautions and follow the latest advice. Disposable trial lenses and contact devices are preferred to re-used items wherever feasible. 

Colleges publish new advice on glaucoma referrals

The Joint Group on NICE Glaucoma Guideline has published guidance on the referral of glaucoma suspects by community optometrists in the UK.In May 2009 NICE (National Institute for Health and Clinical Excellence) released clinical guidelines on diagnosing and managing glaucoma and ocular hypertension. The latest advice from the College of Optometrists and Royal College of Ophthalmologists relates to asymptomatic patients suspected of having glaucoma and may be summarised as follows:Tests conducted should be according to the patient’s clinical need

  • If referring on IOP alone, Goldmann (or Perkins) tonometry is more accurate
  • Refer if one or more of the following is identified (in either eye):
  • Optic disc signs consistent with glaucoma
  • Mean of four IOP readings >21mmHg (some exceptions for older patients)
  • Visual field defect consistent with glaucoma
  • Narrow anterior angle consistent with risk of acute angle closure
  • Signs associated with glaucoma

The Colleges also provide advice on referral letters, procedures for non-contact tonometry and specific scenarios in which practitioners may consider not referring.CLICK HERE TO ACCESS THE COLLEGE GUIDANCE CLICK HERE FOR THE ORIGINAL GUIDELINE FROM NICE

What we think: The NICE guidelines caused controversy when first released and concern that the number of referrals would rise steeply. The Colleges’ latest advice, endorsed by other professional bodies, clarifies the current position. Practitioners need to be familiar with the guidance and apply the recommended referral criteria. 

BCLA adds patient leaflet on ‘Looking after contact lenses’

The British Contact Lens Association has produced a new leaflet to help contact lens wearers get the best from their lenses. ‘Looking after contact lenses’ is an eight-page leaflet of common Q&As, Dos and Don’ts of lens care.The leaflet highlights the importance of looking after lenses and informs patients of the care procedures that are crucial to successful contact lens wear, including:

  • Wash and dry hands before touching lenses
  • Rub and rinse re-usable lenses with solution before and after each wear
  • Empty the lens case after each use, clean and air dry, and replace it regularly
  • Never use tap water to store, clean or rinse lenses or case
  • Check the eyes feel good, look good and see well each time lenses are worn

‘Looking after contact lenses’ is the second patient information leaflet from the BCLA. ‘Buying contact lenses’ explains the law relating to contact lens sale and supply and provides advice on precautions wearers should take when buying lenses.CLICK HERE TO ACCESS THESE LEAFLETS

What we think: Designed to supplement and reinforce instructions given by the practitioner rather than replace them, this leaflet reflects current thinking on issues such as rub and rinse, case care and overnight wear. It’s a useful reminder to patients, and practitioners, of the importance of lens hygiene. 

Contact lens event of the year: weathering the recession

The contact lens industry remained healthy in 2009, despite the global economic downturn, and further growth in business is predicted for 2010, according to the US journal Contact Lens Spectrum.In the January issue, Editor Dr Jason Nicols says that 2009 was a challenging year that saw the worst financial crisis since the Great Depression of the 1930s. But as Spectrum’s Annual Report in the same issue indicates, the contact lens field is performing well.Dr Nicols points out that, in the US, the ophthalmic sector as a whole was up 44% year-to-date going into the fourth quarter of 2009, far above many other economic indices. The contact lens market also was expected to see modest growth in 2010. ‘The fact that our industry has maintained itself with signs of growth is truly remarkable—so remarkable that it is our Contact Lens Event of 2009,’ he says.CLICK HERE FOR THE EDITORIAL CLICK HERE FOR THE ANNUAL REPORT ON THE MARKET

What we think: It’s encouraging to see this upbeat assessment of the US market which supports the contention that eye care is less affected by economic recession than other sectors. With the outlook optimistic for 2010, now is the time to be reviewing your business and capitalising on the opportunities that lie ahead 

Simple eye test may detect Alzheimer’s

Eye care professionals could soon have a role in detecting neurodegenerative disorders such as Alzheimer’s disease, according to a paper published in the journal Cell Death and Disease.A research team at University College London has developed a technique that uses fluorescent markers to detect and quantify cell death in the retina. Imaging the different phases of nerve cell death over time can give an early indication of brain cell death, and monitor disease progression and treatment efficacy.Although the technology used in their studies has been adapted for use in animal models, researchers say the instruments are essentially the same as those currently used in hospitals and clinics around the world. The system incorporates a customised confocal scanning laser ophthalmoscope.Lead author Professor Francesca Cordeiro told BBC News, ‘It is entirely possible that in the future a visit to a high-street optician to check on your eyesight will also be a check on the state of your brain. I hope that screening for Alzheimer’s will be available on the high street within five years.’ The first patient trials to assess the technique will begin later this year.CLICK HERE FOR THE FULL TEXT OF THE PAPER CLICK HERE FOR THE BBC NEWS REPORT

What we think: While this technology is in its early stages, if successful it has the potential to transform the diagnosis and monitoring of Alzheimer’s and other degenerative diseases, including glaucoma. It’s encouraging that eye care professionals have been identified as having a role in screening for these disorders. 

3D films reveal binocular vision problems

3D films such as the box-office hit Avatar may be increasingly popular but not with the significant minority of film-goers who suffer from binocular vision problems.According to a feature in The Daily Telegraph, more than 3m people in the UK have eye conditions that impair stereoscopic vision, making it difficult, or impossible, for them to experience 3D films. The technology used to create the illusion of 3D could also cause more extreme physical reactions, such as dizziness and nausea, it claimed.Writing in Optician, clinical editor Bill Harvey explained how the latest 3D spectacles work and the likely effects on those with abnormal binocular function. ‘It may be appropriate for eye care practitioners to warn those without comfortable binocular vision that they may either risk some headache or visual stress, or simply not appreciate any 3D effect,’ he said.The UK Film Council says there are now 400 3D screens in Britain and studios are also producing more films in 3D. Next-generation television sets enhanced with stereoscopic capability are among developments in prospect for the near future.CLICK HERE FOR THE DAILY TELEGRAPH FEATURE

What we think: Renewed interest in 3D technology, and advances such as high-definition television, present an opportunity for ECPs to educate their patients on eye care and eyewear issues. With growing numbers of children’s films available in 3D, an unexpected spin-off may be early detection of binocular vision problems. 

National Eye Week highlights link between lifestyle and eye health

Only one in 12 adults in the UK associates obesity with sight loss, although weight is a major risk factor in many sight-threatening eye conditions.Results of the ‘See the benefit’ poll, released by The Eyecare Trust to mark National Eye Week, also show:

  • More than four in five of those surveyed (82 per cent) believe a man of 6ft weighing 13st 3lb is healthy, when in fact he is overweight
  • Those with a body mass index (BMI) over 25 are most likely to believe their eyes are in ‘good’ or ‘very good’ health
  • Obese people are the group least likely to visit their optician

With more than half of all adults in the UK above their recommended weight and nearly one in four classed as obese, The Eyecare Trust warns that these people are putting themselves at risk of poor vision. Regular eye examinations are vital in the early diagnosis and treatment of eye conditions linked to unhealthy lifestyles, it says.The first National Eye Health Week will run from June 14-18, 2010 and aims to raise awareness of the importance of eye health and increase uptake of eye examinations.CLICK HERE TO ACCESS THE VISION CARE INSTITUTE’S REVIEW OF KEY PAPERS ON LIFESTYLE AND EYE HEALTH CLICK HERE FOT THE EYECARE TRUST’S GUIDE TO HEALTHY SIGHT

What we think: Obesity has been linked to increased risk of various eye diseases, although not all these associations are consistent. It is certainly a significant public health issue, as well increasing the risk of many health conditions with ocular effects, such as hypertension and diabetes. Eye care professionals need to be aware of the latest thinking on lifestyle and eye health to provide accurate advice to patients. 

THE VISION CARE INSTITUTE™ keeps an ‘Eye on the Future’

The Eye on the Future Survey, commissioned by The Vision Care Institute™, provides some fascinating insights into the value that consumers place on eye care professionals (ECPs) and the services they provide.The survey involved interviews with 500 optometrists and dispensing opticians, and with 1,000 adult consumers, in February this year. The findings were first released at the BCLA 2009 Clinical Conference.The full results of the survey are published. Among the conclusions are:

  • The public has a higher opinion of the profession and its role than ECPs think
  • Consumers trust and respect ECPs and value their advice
  • Consumers recognise the importance of eye health and want to learn more
  • The public has a good understanding of the need for continuing education and training (CET) and is more likely to visit a practitioner who participates
  • ECPs want more hands-on training and ongoing support

CLICK HERE TO READ THE FULL RESULTS ON PUBLIC PERCEPTIONS OF THE PROFESSIONS ROLE CLICK HERE FOR ATTITUDES TO CONTINUING EDUCATION

What we think: The Eye on the Future Survey reveals a very positive picture of how the public views the profession. Our research also highlights the opportunity to educate and inform the public on the importance of eye health, and to demonstrate to patients that you keep your professional skills and knowledge up to date. 

See yourself as a contact lens practitioner?

The British Contact Lens Association and Association of British Dispensing Opticians have produced a new leaflet encouraging more optometrists and dispensing opticians to specialise in contact lenses.‘See yourself as a contact lens practitioner?’ describes the many valuable benefits to fitting contact lenses, from increased job satisfaction to greater career prospects. Aimed primarily at students and the newly qualified, the leaflet provides:

  • Guidance on who fits contact lenses in the UK and how to get started
  • Information on how to gain skills and experience in contact lens fitting
  • The requirements for contact lens continuing education and training (CET)
  • Details of courses and qualifications available to recognise your expertise

BCLA Council member Brian Tompkins commented: ‘What we really want to get over to new recruits to the profession is how much fun it is to fit contact lenses - how rewarding contact lenses are to us as practitioners and how life-changing they can be for our patients.’CLICK HERE TO CONTACT THE BCLA FOR A COPY OF THE LEAFLET

What we think: Do you have a trainee, pre-reg or newly qualified colleague who may be interested in specialising in contact lenses? Would you like to have formal recognition for your own expertise through additional qualifications? This useful leaflet and accompanying feature have the information you need to get started. 

Efron breaks down barriers to contact lens fitting

Professor Nathan Efron has urged practitioners to embrace contact lens fitting and proactively recommend contact lenses to patients.Posing the question ‘Why fit contact lenses?’ in an article in Optician, Professor Efron explores concerns that practitioners may still have about contact lens fitting and counters them with facts from the latest research findings.His ‘10 reasons to fit contact lenses’ are:

  • Adaptation to contact lenses is rapid and trouble-free
  • Contact lenses are convenient and expand lifestyle choices
  • Silicone hydrogel lenses minimise ocular complications
  • Daily disposable lenses are especially suited to 'part-time' wear
  • Numerous systems are available to facilitate convenient lens supply
  • Numerous contact lens options exist for the correction of astigmatism
  • Presbyopia can be corrected with bifocal designs or monovision
  • Contact lenses offer a safe, effective, stable, and reversible alternative to refractive surgery
  • Vision with contact lenses can be as good or better than with spectacles
  • Improved materials and solutions help alleviate lens-related dry eye

CLICK HERE TO ACCESS THE FULL TEXT OF PROFESSOR EFRON'S ARTICLE

What we think: This article sets out compelling clinical reasons for fitting contact lenses and shows how advances in material, design and manufacture have made lenses available to correct virtually any refractive error. Why not use it to re-examine your own approach to contact lens recommendation and to convey a positive message to patients about the many benefits of contact lens wear. 

RNIB report maps out future impact of sight loss

Targeting minority ethnic groups is the most cost-effective strategy for preventing and treating sight loss, according to a new study funded by the Royal National Institute of Blind People (RNIB).The Future Sight Loss UK study, presented at the recent Vision UK 2009 conference in London, looked at the prevalence and costs of sight loss in Britain. Of 1.8m people with partial sight and blindness in 2008, just over half (53%) was due to refractive error, followed by age-related macular degeneration (17%), cataract (14%), glaucoma (5%). Between 2010 and 2020, the prevalence of sight loss in adults would increase due to:

  • AMD by 31%
  • Cataract by 20%
  • Diabetic retinopathy by 16%
  • Glaucoma by 25%

However, among people of African-Caribbean origin, sight loss due to glaucoma was predicted to rise by 57% over the decade.The study also found that the most cost-effective intervention for preventing and treating sight loss is likely to be one targeting minority ethnic groups, who are expected to have lower access to eye care services than the general population and more severe cases of undetected eye disease.CLICK HERE TO ACCESS THE FULL RNIB REPORT

What we think: Be aware that people of African and Caribbean origin are more at risk of chronic glaucoma and may suffer at a younger age, as well as the condition being more severe. Make sure that your practice procedures reflect this higher risk. You might want to consider local PR activities to promote the importance of regular eye examinations to these groups. 

THE VISION CARE INSTITUTE™ shows patients value profession’s skills

Patients trust and respect their eye care practitioner and recognise the importance of continuing education and training, according to new research for THE VISION CARE INSTITUTE™The Institute’s ‘Eyes on the future’ survey questioned 1,000 adult eye care patients and 500 optometrists and dispensing opticians. Among the key findings were:

  • Patients place a much higher value on eye care practitioners’ expertise than practitioners themselves expect
  • 91% are more likely to visit a practitioner who regularly takes part in CET
    86% would like to see evidence of CET participation
  • Practitioners want improved CET with more hands-on training (80%), peer to peer interaction (89%) and ongoing support (70%)

Presenting the results at the 2009 BCLA Clinical Conference, the Institute’s Vice President Ian Davies said that patients had a good understanding of eye care issues and urged practitioners not to underestimate how much patients value what we do.What we think: Our survey provides a fascinating insight into consumer attitudes to you and your work. Why not talk to your patients about your expertise, tell them that you’re constantly improving your skills, and display your certificates and qualifications in your practice. 

Practitioner advice is key to weathering the recession

Are your patients taking risks with their contact lenses in order to save money during the recession?A BCLA/GOC online survey of 2,000 UK adults, of whom 240 wore contact lenses, found some wearers would consider cutting costs by:

  • Switching to a cheaper brand of lens (38%) or solution (21%)
  • Wearing lenses for longer than recommended (21%)
  • Having less frequent checkups (11%)

Yet most would continue to follow their eye care practitioner’s advice. Almost all (93%) would not consider switching to a cheaper lens brand without consulting their optician, or cut down on lens cleaning (96%).CLICK HERE FOR THE BCLA/GOC SURVEY RESULTS

What we think: Eye care practitioners should be well placed to weather the recession, given that patients clearly value professional advice. Research from IBM among 10,000 consumers recently showed the economy has had less effect on Health & Beauty expenditure than on other retail sectors, with 65% of consumers in this category maintaining or increasing category spend. Each aftercare appointment offers an opportunity talk to patients about wear and care habits, reinforce good practice, address any areas of concern and stress the importance of regular checkups. Payment schemes and reminders can also encourage compliance. 

Consumers receptive to UV protection message

People in the UK are aware of the need for sun protection for their skin but less likely to protect their eyes from UV, according to the latest survey from Transitions Optical.Market researcher Ipsos interviewed 1,000 UK adults in the 4th annual Healthy Sight Survey commissioned by the ophthalmic lens manufacturer. Among findings were:

  • Only 7% of consumers are spontaneously aware that extended UV exposure can cause eye damage but awareness increases to 75% when prompted
  • Almost nine in 10 (87%) say that UV rays are likely to be most harmful to the eyes in summer, although eye damage is a concern throughout the year, whatever the weather

Commenting on educating patients about UV, Transitions Optical said: "It’s a topic which eye care professionals must continue to bring to the fore when discussing their patients’ lifestyle and lens requirements. Most patients will want to protect their eyes with lenses that block 100% UV rays, they just need to be reminded.CLICK HERE FOR NEW RESEARCH INTO THE BENEFITS OF UV EYE PROTECTION

What we think: Patients are increasingly receptive to advice on health-related issues. As health care professionals, we should recommend UV and glare protection to all our patients. Wearing UV-blocking contact lenses in association with other forms of eye protection offers the maximum protection from damaging UV rays. 

FDA and contact lens summit highlight need for ‘rub and rinse’

New guidelines on best practice in contact lens care have highlighted the importance of the ‘rub and rinse’ step to maintaining eye health.In June 2009, The US Food and Drug Administration (FDA) issued new advice to consumers on storing and cleaning contact lenses. Among the FDA’s recommendations were:

  • Use a rub and rinse method
  • Empty the solution out of the contact lens case after each use
  • Do not top-off or re-use solution
  • Avoid exposing lenses or cases to any type of water or other non-sterile solutions.

CLICK HERE FOR THE FDA’S ADVICE

Professor Deborah Sweeney and co-workers published a review of the Asia Pacific Contact Lens Care Summit held in Singapore in 2007. Published in Clinical and Experimental Optometry in March 2009, the review summarises current thinking on contact lens hygiene and sets out guidelines for the safe and effective use of contact lenses. The guidelines include:

  • Safety is enhanced significantly by rubbing and rinsing contact lenses both prior to and following storage

These authors also stress the need for lens case hygiene and the avoidance of tap water and other high-risk situations.CLICK HERE FOR THE REVIEW AND GUIDELINES

What we think: Patients show low awareness of the contribution of the rub and rinse step to avoiding eye infection – make sure they are aware of this and other potential risk factors. Ask patients to demonstrate their cleaning and lens handling technique, and ensure that you reinforce care procedures at each visit.

 

Last modified: February 6, 2012