Letters: March 30

Studying the solution (p32, March 2) sheds interesting light on the interaction of contact lens solutions with silicone hydrogel materials, but was surely incomplete. In common with several BCLA lectures I have attended on the subject, it failed to give the complete picture for a typical UK practitioner. 

As I understand it the UK’s best selling solutions, used by most of the national chains and regional groups, and many independent opticians, are from Sauflon. Sauflon solutions are repeatedly excluded from such research even though they are of great relevance to a substantial proportion of UK practitioners, especially as they are one of the few companies to produce a product specifically for use with silicone hydrogel lenses. 

For the record, my colleagues report that Sauflon Synergy is a considerable improvement on All-one-light for use with SiHy lenses, especially for J&J products, but let’s see some unbiased data. Alternatively, I will continue to draw my standard cynical conclusion when the usual suspects are not included in academic research:

? The research is funded by a global multinational
? The research proves that the excluded products are superior and hence omits them from the results.
And finally, it might be my age, but I did not appreciate the improbably small print on the all-important table of results.


Peter Black
Aughton, Ormskirk, Lancashire


Your anonymous correspondent (Letters, March 16) suggests doctors get a raw deal, but at least they are paid for extra work and can often get government to change its mind, which is more than we can. For the NHS to retain consultants, they are allowed lucrative private work often at £1,500 per hour, surely analogous to our subsidising inadequate NHS fees.

Government insistence on running the NHS on business lines has seen interesting consequences. A&E departments are flooded by time wasters who cannot obtain the desired GP appointment, and hospital infections abound. Also, unrestricted immigration has placed intolerable burdens on already demoralised staff.

Optically, I feel some small independents are financially stretched due to misguided reliance on shared care, diabetics now being routinely redirected to health centres. Government is constantly hosting new initiatives which quietly fizzle out.
Unless owning a trendy city centre practice, optometrists are hardly in a position to eschew the NHS (like dentists), as children and pensioners would be lost.
Cherry-picking patients may be forbidden, government might impose an ‘all or nothing’ rule.

Mike Cooper, Enfield


From giving Jamie Murray Wells a platform to spout his opinions on our profession, to then read the disproportionate ramblings of David Levy, last week’s Optician (March 23 2007) was by far the most anger inducing I have read for a long while.

I am a dispensing optician, and while I agree that to be in with a chance of success within the profession one must be able to sell, I do not believe that we should forget our medical and clinical knowledge. I did not put myself through three years of additional education to be wholly demoralised by somebody who chooses to call the people coming into his ‘shop’ his ‘customers’. Why not set up a stall down the market and call them punters?

I work in a ‘practice’, and I work for my ‘patients’. All of the ophthalmic opticians and optometrists that I work alongside, provide excellent assistance when the practice is busy, and are more than able to advise on the style of frames and the suitability of lenses. I do not have perfect knowledge of the procedures carried out in the testing room, but then my job is to dispense spectacles. I believe that this is the way it should be, and this is my role within the profession.

Because of this, I also have to wonder whether Mr Levy has ever driven a car wearing a pair of varifocal or bifocal lenses that are not correctly fitted? Or whether he has a prescription that would be a problem should the frame be ill-fitting? Maybe he is the reason why we have a continual stream of outside patients, unable to see and in need of nothing more than a proper fitting.

On a final note, and without trying to sound like I am rambling, what on earth are the organisers of ‘Independents Day’ thinking of when they put the likes of Murray Wells on a stage for another spot of free publicity? Rod for one’s own back springs to mind. The problem with this is that the back in question belongs to people like me, a professional who will have to deal with the subsequent fall-out and the profession’s demise which I fear is inevitable in years to come. We should all thank people like Levy and Murray Wells right now, before we have no collective voice to do that with at all.

Name and address supplied


I am pleased that my recent article (Viewpoint, February 9) has achieved its intended purpose of instigating a lively debate about the importance of dispensing opticians. It has had a huge response and I am very grateful for the numerous replies and comments I have received over the last few weeks.
I am concerned, however, with David Levy’s response to the article (Letters, March 23) and am confident that the General Optical Counsel’s fitness to practise committee would share these concerns.

While it is true most DOs work on the high street, the same is true of most dispensing pharmacists, but I have never considered them sales representatives! Indeed, just as pharmacists, DOs are highly trained professionals and, just as optometrists, require GOC registration and CET.
To suggest, ‘DOs must stop thinking that their duty is to detect subconjunctival haemorrhages and the like’ is worrying. I would like to take this opportunity to remind Levy that every registered dispensing optician has the same statutory duty as optometrists to refer patients that present with an apparent disease or injury of the eye. Perhaps Dr Little had a valid point when he discussed DOs managing apparent subconjunctival haemorrhages themselves (Letters, March 9), but if a patient presented with an anisocoria, for example, I would hope that a DO would understand that further investigation was necessary and not just neglect his or her observations. If an optometrist did not see the patient and the anisocoria went uninvestigated, the consequence could be life threatening and I am sure all registrants would agree public safety is paramount.
I was even more shocked to read, ‘what harm can anyone do’ when referring to incompetent dispensing. Only today, I had a four-year-old anisometropic patient with strabismic amblyopia caused by incorrectly dispensed lenses. I am sure the child’s parents would not agree with Levy’s sentiments.

I have recently learnt that the ABDO syllabus for DOs is dramatically different to when Levy and others qualified in the mid 1980s. Recently qualified DOs and optometrists generally find the two courses similar and while it could be argued that the DO course is now over-clinical, I still resent being called a salesman and strongly believe a good understanding of the complexities of the ocular system among other things is fundamental to the correct provision of spectacles.

DOs are specialists in dispensing with basic knowledge of optometry – I maintain that only qualified DOs should dispense spectacles just as only optometrists (specialists in refraction and ocular pathologies) should refract and perform eye examinations. Optometrists should not find this statement offensive and I am certainly not intending to ‘attack my optometric colleagues’. Rather, I believe both DOs and optometrists are essential in any optometric practice and, with professional parity, can be complementary and support each other to provide an even better level of service to the public.

Robert Longhurst
Rayleigh, Essex


The system of paying CET training money through PCTs and their contractors discriminates against locum optometrists who by definition are not assigned to any one contractor and so often miss out. I feel there should be a rethink on how these funds are distributed.

Perhaps it could be done centrally through the GOC or through Vantage who after all know who is completing CET, or perhaps it could be offset against yearly AOP subscriptions. There must be a better way that is fair to all.

Andrew Jarvis 
Stockport