Features

I write in response to Alan Gilbert who feels he has been hoodwinked by optometrists using Colourimetry, and equates that to behavioural optometry. However, Colourimetry is not behavioural optometry. Some behavioural OOs use a Colourimeter, as do some non-behavioural OOs, some orthoptists, and NHS eye departments.

The behavioural model is based on the neurology of the visual pathways - 80 per cent of the retinal fibres pass to the visual cortex giving sight, 18 per cent of the retinal fibres pass to the superior colliculus in the retino-tectal pathway, and the other 2 per cent pass to the hippocampus and amygdala giving visual input to spatial awareness, memory and emotion. At the superior colliculus the visual information is integrated with sensory information from the vestibular, proprioceptive, auditory and tactile systems. The brain uses all the sensory information together with previous experience, to create vision, which takes place in at least 36 areas of the brain.

As a self-styled average practising optometrist, Mr Gilbert works with sight. As a behavioural optometrist, I work with sight and vision.

Caroline Hurst, Chairman BABO

I read Richard Carswell's letter (Optician, August 15) with mounting incredulity as it is clear the AOP has completely misunderstood Richard Llewellyn's concerns (August 8). Why is itwondering whether a PCT could prevent records being sold to another contractor (they certainly cannot) when Mr Llewellyn was worried about what happens to his GOS patients' records when and if he opts out of GOS?

I don't understand why the AOP isseeking advice as to who owns the records, when itswebsite gives the answer: the optician owns them. We are advised to keep our records for as long as possible and for a minimum of 10 years after the patient's most recent visit. Clearly then the question is not who owns the records, but whether the PCT can demand the practitioner hands them over when the contract terminates.

If a PCT asks for those records, a practitioner should in fact refuse, notwithstanding the fact that he signed a contract witha clause apparently giving PCTs the right to possession. This aspect is unenforceable. Further, the records areprotected by the Data Protection Act 1998, sothe patient must give their consent before even a copy of their record is passed on to a thirdparty, let alone the original record card!

So, even if a practitioner wished to comply, he is going to have to contact his patientsfortheir consent to disclose their record. WillPCTs reimburse the optician for this cost and that of providing a copy of every GOS patient's record?There is nothing a PCT can do if the patient does not reply or refuses to give their consent or do PCTs believe every patient will be happy to be 'transferred' from their existing optician to someone else just because theoptician has now opted out of providing GOS?

Why does a PCT even need a copy of the GOS records in these circumstances?When people change their optician, most do so without ever having their details forwarded.If and when a patient contacts the 'departing' optician for an appointment, he can then advise that he no longer provides 'NHS' eye tests andthe patient can then decide what to do.

The AOP isina tangle over who owns the records when these contracts could not possibly have changed the existing position. While this new system is an improvement on the 'grandfathering' fiasco, I hope anyone involved in organising it does not haveanything to do with London 2012!

David Levy, Radlett

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