Optician meets Professor Lyndon Jones before a Coopervision organised event in Birmingham. As one of the most in demand contact lens educators in the world, Jones clocks up as many as 180,000 air miles in a year touring the world.
‘On this particular tour I was in Stockholm on Sunday, then the Netherlands yesterday, Birmingham today, then two nights in London followed by Warsaw on Saturday. When I return to the UK for the BCLA later in the year I’ll be stopping off in Prague beforehand and then onto Budapest and Paris after. I’ve just been to Japan and will be in Singapore later in the year. The lectures are just as much a chance for me to learn from the audience and I find it fascinating to get insights into how practitioners’ views differ around the world while away from home.’
Home for Jones, a proud Welshman, is Canada where he is director of the Centre for Ocular Research & Education (CORE) at the University of Waterloo. So how did his prestigious career begin?
Entrance to optics
‘I studied optometry in Cardiff and then moved to London in 1985 to do my pre-registration year at what at the time was called the London Refraction Hospital and is now known as the Institute of Optometry. I was given an opportunity to stay on part-time to work in the contact lens and the paediatric clinics, which were the two areas that I was most interested in.’
Not long after finishing his pre-reg year, Jones began working for a pair of practices in a role solely focused on contact lenses.
‘As that side of the business grew, the owners gave myself and my wife the opportunity to buy into the practices. So, in 1991, we actually ended up buying those two practices in south-east London along with one of the owner’s sons.
The practices were highly successful and won several Optician Awards over the next few years.
‘When we bought the practices in 1991, we completely revamped and refitted them. We basically bought every toy going. We were quite unusual for the time, in that we had a corneal topographer, because we were doing orthokeratology. We had a video slit lamp and full slit lamp imaging systems. At the time there were no commercially available digital slit lamp systems so we ended up getting one customised for us. We won Contact Lens Practice of the Year a couple of times as well as Independent Practice of the Year and Marketing Practice of the Year too.’
Jones attributes the wins in the Contact Lens Practice of the Year category to heavy involvement with companies doing in-practice clinical trials. ‘At any one time we typically would have four or five clinical trials ongoing. So that meant that our patients had the opportunities to try some new innovations coming into the practice.’
The clinical trials would prove to be a crucial bridge for Jones into the world of research.
‘One of the first things that we wrote up for the BCLA Journal was a situation where we looked at the difference between being proactive, versus reactive, in terms of contact lens fitting. We took 80 patients that hadn’t worn lenses before, and we waited for them to ask us about a contact lens trial. From memory about nine patients asked us for a contact lens trial and we eventually ended up with six new contact lens patients. Then for another 80 patients we actively offered a free contact lens trial, with the proviso that the patients would pay a full professional fee if they kept on with contact lenses after the trial ended. With that method 46 people took the trial and we ended up with 38 new contact lens users.’
In the early 1990s frequent replacement lenses were relatively new and Jones took the gap in knowledge about them as an opportunity for a PhD.
‘People really had no idea how often we should be replacing these lenses. High water content soft lenses came out in the late 1980s and we knew that frequent replacement was a good idea, but how often? Will three months be good? Will one month? What about a week? So I approached Johnson & Johnson and got funding for some studies in the practise and analysis of the lenses in terms of deposits from the tear film. So I was actually able to approach Aston University for the PhD with the funding in place.
‘I ended up actually doing my PhD part-time at Aston University. So I spent two days a week in Aston, three-and-a-half days a week working in the practice, and finished the PhD in 1997.’
At that point Jones and wife Deborah took stock of their situation with a view to making a decision about their future.
‘The practices were getting bigger and bigger so just continuing as we were was an option. The alternative was to pursue opportunities in research. At the time Debbie worked one day a week in the local eye hospital seeing basically all of their paediatric patients. So she has a real interest in paediatric optometry. In the end we sent our CVs around the world, and the first place that offered us two positions, was the University of Waterloo in Canada. So we went thinking that we’d stay for a couple of years, and then we’ll come back. That was 20 years ago, it was one of those fortuitous things that works out really well.’
Beginning his career as associate professor, Jones was charged with teaching the contact lens course and, on the research side, worked with Desmond Fonn in the Centre for Contact Lens Research (CCLR). ‘During my PhD I had worked in a biological science lab so they asked me to set up biological sciences for CCLR, which had no lab based components at the time,’ says Jones.
‘We started with one room with one masters graduate student, and I grew that over the years. Now we have six labs, we’ve got over 20 people and typically have six grad students and a couple of post docs. It’s probably responsible for about half of the income that now comes into, what is no longer the CCLR, but is now our new organisation called CORE, which is the Centre for Ocular Research and Education.’
Over the years, Jones has taught the external eye disease course along with pharmacology course. Due to his administrative duties as director of CORE, Jones teaches less than in the past, but still retains responsibility for delivering the contact lens course along with supervising students in the contact lens clinic one day per week.
‘I’m still in clinic, because I have a full therapeutic licence. In order to maintain the licence, you have to have a certain number of hours of patient contact. So that’s why I’m still in clinic one day a week. At universities education, administration and research are the three things expected of you. I enjoy education the most so it is nice to do things like this Coopervision event. Educating students is very different to doing continuing education, or research type talks to qualified clinicians. Here it is more of an interchange between myself and the audience. It’s very rare that I won’t learn something myself when I’m out talking to an audience, whether it be how they’ve integrated some of the research that we’ve done into practice or how sometimes they struggle to understand the relevance of the stuff that we’re doing. It keeps me grounded in how things can actually be applied in practice.’
CORE Online Educational Resources
Contact Lens Update, contactlensupdate.com
Evolving out of siliconehydrogels.org, the current resource, contactlensupdate.com has been running since 2011. Now in its ninth year, contact lens update continues to maintain the principles on which it was founded: to deliver evidence-based information on the latest topics related to contact lenses and the anterior eye. It is a collaborative project that is managed, curated and edited by CORE. Its strength comes from the input it receives from contributors around the world. The key focus is to translate new research into actionable advice for eye care professionals to use in practice.
Six editions are produced per year, each comprising four sections: guest editorial, feature article, conference highlight and clinical insight. By joining the mailing list via a form on the homepage, subscribers are informed as each new issue goes live.
A full back catalogue of issues is available, along with free to download practice tools and patient handouts. The initiative is supported by educational grants from industry.
Contact Lens Management, clmanagement.com
The current version of contact lens management was launched in 2018. It is a freely accessible resource for eye care practitioners to use to help support the differential diagnosis and management of a wide variety of contact lens-related complications.
The new version of the website saw the addition of a search function to help aid diagnosis based on signs and symptoms. New content directed to optometry students and newly qualified practitioners was also added, which demonstrates slit lamp techniques and the ocular structures and pathologies which are best viewed with them. This initiative is also supported by an educational grant from industry.
Contact Lens Compendium, contactlensupdate.com/compendium/ca/
Evolving out of a long-running publication produced for optometry students and faculty, the contact lens compendium is currently a well-used and valuable resource for eye care practitioners. It is a comprehensive, searchable database of all the contact lenses and care solutions available in Canada.
The site is freely accessible to all, and much of the information is of course relevant to practitioners worldwide. A dedicated US version in planned to launch during 2019.