100% for all
OT ’s Olivia Wannan and Emily McCormick share some of the educational highlights from 100% Optical 2016, which was held at London’s ExCeL Exhibition Centre (6–8 February)
As over 7000 people flocked through the doors of 100% Optical, a diverse education programme that was packed with sought-after speakers, alongside an exhibition of 160-plus companies, pointed to the event’s success.
From talks by Alistair Burt MP, Minister of State for Community and Social Care, and Specsavers’ co-founder Doug Perkins, to academic Professor Kovin Naidoo, the majority of the education on offer during the three-day show was sold out.
Myopia main stage
Making a flying pit stop between Columbia and Mexico to open the show as keynote speaker, CEO of the Brien Holden Vision Institute, Professor Naidoo, addressed a full theatre from the main stage about myopia.
"If individual practitioners do not change their clinical practice, do not change their health promotion strategies and do not change their discourse with patients, in 2050 this world will be in a crisis in terms of eye care"
“This, in turn, will place an increased burden on our healthcare system in the future, especially the eye health system,” he said.
Looking to potential preventatives, Professor Naidoo explained that most people agree that if a child spends more than two hours outdoors daily, this risk will decrease. “We need to spread that message,” he stressed.
For long-term prevention to be effective, Professor Naidoo believes governments and the private sector need to “get on board.”
“We need to get governments involved in spreading that message and making it an integral part of the school system,” he said.
Professor Naidoo stressed that individual practitioners need to take responsibility too as “no amount of donor funds is going to be able to address these challenges that we face.”
Encouraging practitioners to take action, he said: “Many of us are observing the enormity of this problem and saying that there is not much that we can do about it, but, on the contrary, I believe that we can achieve a lot if we work together.”
The Brien Holden Vision Institute is already working to address the increasing issue and has launched its Our Children’s Vision campaign as a result. The initiative, Professor Naidoo explained, recognises that 90 million children worldwide are vision impaired, and 90–95% of that number are so due to myopia.
Through this involvement, he estimates that eye care services can be provided to 50 million children by 2020.
In closing, Professor Naidoo stressed: “Every individual practitioner can make a difference. No matter what organisations and professional bodies do, if individual practitioners do not change their clinical practice, do not change their health promotion strategies and do not change their discourse with patients, in 2050 this world will be in a crisis in terms of eye care.”
Extended services for Perkins
Settled back into life in the UK, having spent much time establishing Specsavers in Australia and New Zealand, Mr Perkins' new focus is on extended optical services, he told delegates at 100% Optical.
“There are opportunities ahead in optics,” Mr Perkins said, adding: “People must get it into their hearts and minds that they need to engage in extended optical services."
“It won’t happen overnight, but I hope [through this talk] that you will be encouraged to begin that journey,” he added.
Discussing why he thinks change is afoot, Mr Perkins informed delegates: “Optics hasn’t changed much in the last few decades in terms of its clinical offering.”
"The NHS is slow-moving, but the fact that it is moving slowly doesn't mean that we need to sit back. We can be more proactive and get our key messages and training ready for the revolution that is inevitable"
Expanding on this, the optometrist acknowledged that the retail side of optics has changed “immensely,” but highlighted that “in the clinical environment, what most aim to do is exactly the same.”
During the talk, Mr Perkins identified the emergence of optometrists with specialties as a sign that change is certainly on the way. “If there are already people with specialties in the sector, which there are, the clinical world is already beginning to change and it is going to be significantly different in the future,” he stressed.
Touching on the drivers for change, Mr Perkins highlighted the ageing population and stretched eye departments as key factors. “Eye departments are the third biggest overhead in the NHS and clinical commissioning groups (CCGs) have got to do something about that,” he said.
Emphasising the importance of the sector working together to advance and achieve this revolution, Mr Perkins said: “As a sector we must work together with complete transparency.”
He added: “We are not competing with independents or other multiples. If they are effective that helps us because the industry needs to demonstrate to the health service that there is a job and an opportunity to expand optometry. The risk if we don’t do it is the commoditisation of our business and competing with the internet, which is not a pleasant experience.”
Mr Perkins identified the work being carried out in Wales as something that the whole profession should aspire to and added: “Our message is to start thinking about training and education in a systematic way; work with all of the schemes that are available to you.”
Encouraging the profession to begin to act now, Mr Perkins said: “The NHS is slow-moving, but the fact that it is moving slowly doesn’t mean that we need to sit back. We can be more proactive and get our key messages and training ready for the revolution that is inevitable.
He continued: “The more that we can encourage the health service that we are ready, the more likely it is to respond and appraise the opportunities that are there for us. If we don’t step up, there are ophthalmology groups and medical groups standing by to take advantage of community eye care. They are doing other things in the Five Year Forward View, so why not step into our territory?”
Displaying an unfaltering passion for driving the profession forward, Mr Perkins said: “This is my focus now and I will not move on until I can see the required collaboration taking place.”
Attending 100% Optical on day one of the show (6 February), Mr Burt's address was the first he had given to an exclusively optical audience.
Speaking to a full theatre as part of the Unleashing local energies session, which also featured managing director of the LOC Support Unit, Katrina Venerus and chief executive of Pharmacy Voice, Rob Darracott, Mr Burt told practitioners that, of course, patients should not see GPs for every medical ailment. Instead the MP invited CCGs to utilise the skills of a whole range of health professionals to innovate the delivery of healthcare.
Having already expressed his support for the optical sector during a meeting with key representatives of the Optical Confederation last December, Mr Burt expressed a determination to ensure that developments in primary care do not revolve solely around GPs and general practice.
“I want to acknowledge the importance of eye health,” he said, adding that primary care and its role in developing future services is critical. He noted it is also “vitally important that this includes eye care professionals who can shape eye care services so that they meet the growing demand for the future.”
He added: “Radical change is required to realise our objectives for health and wellbeing, quality and efficiency, and for us to be able to meet the challenges that we will face as part of a growing population, and its increasing vision needs.”
Concluding his talk, Mr Burt called on practitioners to help drive reform locally and to strive for an increased focus on eye care among commissioners. “I would like to urge you to continue to use your influences with local commissioners to ensure that eye health is high on local agendas.”
The education programme provided the opportunity for many UK academics to share details of their latest findings on a range of areas, from ocular allergies, optical coherence tonometry and the management of age-related macular degeneration, to drug delivery, dry eye and sports vision.
Bringing delegates’ minds back to the hot topic of myopia, Aston University optometry lecturer, Dr Janis Orr, spoke to practitioners about how slowing – rather than simply correcting – myopia progression is vital for patient health.
Dr Orr emphasised during her talk, Does the solution to myopia progression come in a bottle?, that myopia is a major risk factor for developing more serious eye conditions, such as retinal detachment and that: “[Treating myopia] is going to reduce the lifetime risk of other ocular conditions.”
Dr Orr’s talk referred to a new international meta-analysis study that compared 16 treatments from specialist lenses to pharmaceuticals. The paper concluded that atropine and pirenzepine held the most potential as myopia treatments. However, with this low-dose atropine concentration unavailable in the UK, the best alternative for British patients is orthokeratology, the researcher said.
Dr Orr similarly concluded in her talk that atropine has shown the most promise as a medicinal treatment, explaining: “We don’t know why it works at all but we know it works … The most likely site of action is the retina.”$youtube("PathToYouTubeURL")
ggest that their myopic patients, of any age, try orthokeratology.
The rebound effect of ortho-k lenses was not well-known, she told conference attendees, adding: “We can’t get that sort of data – kids won’t stop wearing them.”
She noted that the twice-a-day dosage required for pirenzepine – as opposed to atropine’s once-a-day – had seen the push for the drug to be used in myopia treatment decline.
The future is microbots
Moving from the selection of drugs to their delivery, University College London biomedical engineering lecturer, Dr Christos Bergeles, told delegates how tiny drug-dispensing robots moving in a patient’s eye could be the new revolution in AMD treatment.
Through his research, Dr Bergeles has successfully created such a robot at the micrometer scale that is able to be directed to a specific, desired area within the eye.
The devices are steered using electromagnetic fields, and the specific electromagnetic forces and fields applied by another machine outside the body allow the magnet to be moved exactly where it is wanted – for example, to the optic disc, he said.
Once the drugs are delivered, the device could then be removed using a similar needle – a necessary move as leaving it in could result in inflammation, Dr Bergeles continued.
"Instead of needing a very, very skilled surgeon to go and directly deliver something to the vein, could we not have a small device with no strings attached, and it could dock itself at a particular vessel and then deliver the drug?"
“There are two billion myopes in the world right now, but by 2050 there will be five billion,” he warned, adding: “That represents 50% of the world’s population.”
Identifying myopia as potentially the “biggest future public health challenge that the profession of optometry has ever faced,” Professor Naidoo discussed the growing global prevalence of the condition, as well as the interventions that are available and how myopia can be addressed by the profession.
He highlighted that if the estimated rise in myopia occurs, people will also be at an increased risk of developing myopic macular conditions, including cataracts, glaucoma and other retinal issues.
The microbot technology could help to solve the issues of optical drug delivery, especially in cases where drops do not reach the affected area, Dr Bergeles said.
“Instead of needing a very, very skilled surgeon to go and directly deliver something to the vein, could we not have a small device with no strings attached, and it could dock itself at a particular vessel and then deliver the drug?”
Dr Bergeles thought that a range of surgical micro-robots would become standard for many ophthalmologists in the next few years, as these technologies offer tremor-free precision, mistake-correction capabilities, and micro-scale surgical abilities.
“We are now approaching the limit of what the clinicians in ophthalmology can do … But we can enable interventions that are currently not just hard but inconceivable [with] the type of tools we are trying to make,” he concluded.
From engineering to how we are engineered as people, the University of Bradford’s Professor Brendan Barrett shared details of his research, which aims to answer if we could some day prime sports stars’ sight to boost their potential, or if their vision is already what gives them the elite edge.
While Professor Barrett is currently testing the abilities of the English women’s cricket team, to gauge how their sight compares to those with normal vision, he informed attendees that different sports have a multitude of different visual requirements, explaining: “You’ve got to start somewhere, picking one element of one sport. Catching in cricket is our test case.”
Slip fielders in particular face a difficult visual challenge: getting their hands to the speeding cricket ball in less than half a second, he explained.
Dr Barrett emphasised that what allowed a professional cricketer to make a one-handed catch that an ordinary person might miss could be due to better eyesight or an ability to ‘read’ the field better.
Using special sight-restricting goggles and body sensors, Professor Barrett planned to measure the cricketers’ catching ability in response to changes in the visual information they get.
He highlighted that, already, professional athletes have demonstrated they have an edge in a sight test where they must count the number of random dots flashing on a screen for 150 microseconds.
100% Optical 2017 will be held on 4–6 February at the ExCel Exhibition Centre, London.
Image credit: Media 10