New eyes for old: solving presbyopia

12 August 2003

Dr Arthur Ho

The recently established Vision Cooperative Research Centre is developing a strategy to replace the hardened lens of ageing eyesight and restore natural vision.

The eye's lens focuses by changing shape. When muscles in the eye relax, the lens is pulled flat to focus on distant objects. When the same muscles contract, the lens returns to a plumper shape, bringing closer objects into focus.

But as the eye ages, the lens hardens, preventing it reforming into its broader shape. The lenses of 40-year-old people have only a quarter of their capacity to change shape, or accommodate, as they did at birth. After the age of 45, most people will need glasses or bifocal contact lenses for reading. Rapid growth in the over-45 year age group means that presbyopia will soon affect over 40% of the population.

The Vision CRC has targeted presbyopia as a growing area of need. Dr Arthur Ho, director of the Vision CRC Presbyopia Program, is part of an international group of researchers developing a flexible gel lens to replace the older hardened lens, restoring the eye's ability to focus up close.

We see it being used initially as an improvement to current cataract surgery, Dr Ho said. But once it is shown to be safe and effective, we think that more and more younger people who are starting to need reading glasses will adopt it as well.

Implanting the gel would be similar to current cataract surgery, although the lens is not replaced. After making a small incision in the cornea, the surgeon would cut a tiny hole in the lens capsule and remove the contents. The gel, which has the consistency of thick oil, is pumped in and a burst of UV or visible light transforms it into a jelly. This could be a quick, 15-minute procedure, says Dr Ho.

8 Oct 2002

Scientists light up the brain to study eye diseases

UK scientists are using a new technique of lighting up the brain to investigate eye disease, aiming to better understand common eye problems and improve treatment for patients.

While brain scanning, or Magnetic Resonance Imagining (MRI), is routinely used to study brain function and to detect abnormalities such as tumours, eye specialists at the University of Leicester are using a new, more advanced method, called functional Magnetic Resonance Imagining, to find links between eye disease and brain function.

According to Professor Irene Gottlob, head of ophthalmology at the university, researchers usually use the advanced scanning method to study normal brain function and detect neurological disorders. So far it has only been used in the investigation of a handful of eye diseases.

The technique records the changes in blood flow in the brain that accompany brain activity, allowing scientists to see which areas light up, or become active, as people look at different pictures and patterns.

Prof Gottlob said a greater understanding of the link between eye problems and the brain would help patients who have a range of conditions.

There are many common disorders of the visual system, where we don't understand how the brain has changed, she said.

If people have missing parts of their peripheral vision (enlarged ‘blind spots’), for example, due to glaucoma, they are not aware of the missing information. She says that in these cases the brain fills in the missing information so the patient sees a complete picture.

The team will also study the eye movement disorder nystagmus where the eyes continually wobble.

Some patients report a continually moving world, whereas to others the world seems perfectly normal and stationary, said Prof Gottlob. The team will investigate how the brain and eye interact to cause the condition.

© HMG Worldwide Ltd 2002

24 Aug 2002

Researchers at University of Manchester Institute of Science and Technology (UMIST) beleive that they may have new evidence that diet can increase pigment density and therefore reduce the risk of developing Age Related Macular Degeneartion(ARMD).

A growing body of evidence supports the theory that people are at risk of developing ARMD if the density of of their macular pigment is low.

The Manchester based team has developed a new device for measuring the Macular pigment Optical density. Patients who are already experiencing early stages of ARMD may be able to delay or prevent its progress through dietry intervention.

Dr Murray and his colleage Hui Haiang Koh presented their latest findings to the Association of Research in Vision and Ophthalmology in Florida USA..

We will keep you posted on any advances in this technology.

From a report in The Optician (UK)

20 August 2002

Eye 2 Eye Opticians in Manchester England, one of our associated Practices, launch new Laser and Cataract Operations referral Service.

We are pleased to be associated with the I-Care Medical Services team in offering a Practice referral service for potential Laser (lasik) eye correction, Cataract and Glaucoma Operations. The Service offered is that of pre- screening and onward referral to a team of Highly regarded Ophthalmic surgeons based in Calais France.

All Operations will be carried out at a Private Practice in France following Consultations with the Ophthalmologists and specialists, whenever possible in England. Following the initial Consultation, Patients who are then regarded as suitable for any operations will be invited to attend the Clinics in Calais where the Operation will be conducted.

In the case of Laser (lasik) surgery, most operations are completed within the day, usually on a Saturday or Sunday, and no overnight stays are required. It is recommended that Patients be accompanied by a relative or friend to assist in the postoperative recovery and homeward return journey.

In the case of cataract surgery, the operations usually require at least one overnight stay following the operation, and it is recommended that the patient should be accompanied by a relative or friend to assist in the homeward return journey.

For Glaucoma type Operations, the Operations usually require one or two night stays, and again it is recommended that patients should be accompanied.

The prices Quoted for Surgery includes the initial Consultation with the surgeon, the operation itself, and final consultation following the operation. The Patient will be responsible for travel to and from the initial consultation, travel to Calais, by either Ferry or Eurotunnel at specially arranged discounted fares, and any overnight accommodation, which can be pre-arranged by the I-Care at special rates in Local Hotels in Calais.

For our International Clients we at Eye 2 Eye can assist in arranging all of the required Consultations with the surgeons in Calais France.

For Further Details of these services please call Mr Geoff Lord on (UK) 0161 655 3105

22/feb/2002

LASIK EYE SURGERY PROBLEMS REVEALED

New research claims that as many as 1 in 4 of those who have undergone Lasik Laser Surgery are experiencing problems with night vision long after the surgery took place.

The research was conducted in the USA in which 605 people who had undergone Lasik Eye Surgery reported that they were still suffering from one or more problems with night vision after six months. However 97 per cent of respondents said they would recommend the treatment to a friend.

The reported problems regarding night vision ranged from seeing halos, starbursts and other disturbing glare around light sources, which persist long after surgery.

The study, which was carried out at the Ohio State University, said the symptoms were linked to those having had surgery repeated. “Patients who had undergone surgery again were generally less happy with the outcome than those who had only had surgery once” and Ophthalmologists stated that it generally takes about six months before patient’s prescriptions stabilise. The researchers also found that those with flatter corneas were more likely to see starbursts surrounding light sources.


9 Jan 2002

VAT (value Added Tax)(uk) CASE IS WON BY THE UK OPTICAL PROFESSION

FODO (Federation of Ophthalmic and Dispensing Opticians) announced that in the Case recently fought out at a VAT tribubal between Customs and Excise(UK) and Vision Plus opticians, that Dr Brice, the Chairman of the tribunal, has ruled in favour of the Vision Plus Practice of Southport.

As this case was accepted throughout as being the representative test case, it is applicable to all opticians.

It is a triumph for the profession and our patients

Although Customs & Excise may yet appeal to a higher court, the fact is that the profession, and our patients have won a crucial victory.

FODO sought unity behind a representative test case, and engaged the best advice available
This strategy gave us victory for the whole profession



21/Dec/ 2001

NO NEW VAT ON SPECTACLES (UK ONLY)

The Customs and Excise Office in the UK have again lost a claim to have VAT (Value Adde Tax) added to the cost of Spectacles in the UK. This is the third time that the Customs and Excise Office have lost battles in the courts regarding the controversial imposition of VAT on spectacles. The recent Court Battle came about because of a recent ruling in the House Of Lords, which made Credit Card Transactions relating to certain Goods a single Transaction. The Customs and Excise Office then mounted a claim against Opticians who are eligible for Partial exemption of VAT on Spectacles because the Dispensing Element of Sale of spectacles is VAT Exempt.
The Customs and Excise office are to decide over the next few weeks whether the mount an appeal, However VAT experts say this is unlikely due the History of the Office losing the same Battle three times previously.

21/DEC/2001

SUNGLASS HUT RENEWS LINKS WITH LUXOTTICA

Luxottica and Oakley have made an agreement to distribute Oakley Sunglasses through the Luxottica Owned Retail outlets Sunglass Huts.

The Agreement was made following the initial purchase of The Sunglass Hut Chain of Retail Outlets by Luxottica earlier this Year when Luxottica stocked the outlets with substantial volumes of stock from their own sunglass ranges at the expense of Oakley Stock.

20 Dec/2001

Public avoid Opticians because of Cost Fears

It is estimated that More than 3 Million people have not visited their Optician for more than three years because they believe routine checks are too costly, according to a recent survey carried out on behalf of Healthcare provider HAS.

One in five of those questioned said that they had put off making appointments due to the perceived high cost of any possible treatment or the need for new spectacles.

Of those, Interviewed 49 percent said they had not spent any money on themselves or their families eye care needs in the last 12 Months.

18/Dec/2001

DYSLEXIA AND VISION EXPLAINED

A book has been published with the aim of de-mystifying the controversial subject of dyslexia.

Dyslexia and Vision is written by Professor Bruce Evans, a researcher and clinician in this specialist field for many years. He says the book has been written for clarity and has tried to avoid technical terms and is aimed at teachers, psychologists and parents. The book covers topics from vision training to the use of tinted lenses.

Professor Evans says that the book would be useful for Optical Practitioners to pass on to their patients where dyslexia is suspected in members of the family.

Dyslexia and Vision is Published By Whurr Publishers (ISBN 1-781861 562425) priced at
£19.50 from Whurr Publishers (UK) 020 7359 5979


Combination drug wins European union's OK

report date: 22/10/2001 as reported from opticiansnet.com

Pharmacia Corporation's new combination glaucoma drug, Xalacom, has obtained regulatory approval for marketing in the European Union.

Clinical trials of the eye drop, which combines the prostaglandin-analog latanoprost with the more commonly prescribed beta blocker, timolol, have shown that it lowers intraocular pressure far better than either drug if used alone.

Member states of the European Union grant mutual regulatory approval of a drug if it first obtains approval in another of the member countries. Union member Sweden were the first to take the step of approving the new drug.

The U.S. Food and Drug Administration are at the moment, reviewing Pharmacia's new drug application for Xalcom. The drug, taken once daily, is designed for patients with glaucoma or ocula hypertension whose current treatment regime fails to control the intraocular pressure.



Millions of Britons cannot read small print

By Martin Hickman

LONDON (Reuters) - Twelve millions Britons could be eating food past its sell-by date or taking the wrong medicine because they can't read read small print, according to the Royal National Institute for the Blind (RNIB).


Saying Britain was suffering an information famine, the RNIB said on Tuesday that new research showed one in five of the UK's 59 million citizens could not decipher vital information on labels and bottles.


To discover the extent of the problem, the RNIB carried out its largest ever in-depth research among people with sight problems as well as a national sample of the general public.


More than 1,000 people with sight problems varying from total blindness to inability to pass the driving sight test were interviewed by the Office for National Statistics. Pollsters Taylor Nelson Sofres surveyed a general sample of 2,000 adults.


Extrapolating the findings, the RNIB said 21 per cent of the adult population struggled to read instructions on bottles of medicine or letters from their doctor.


A quarter of the general population and 73 per cent of people with sight problems could be eating food past its usable date because they could not read food labels, the institute said.


While 14 per cent of the general public had difficulty reading captions on TV, one in 10 adults was thought to be unlikely to be able to read the number of an approaching bus in time to hail it.


BIG PROBLEM


Small print is a big problem for significant numbers of people, said Ian Bruce, an RNIB director. The dangers inherent in this information famine are clear.


It is not only people with sight problems who face the potential danger and daily frustration of taking the wrong dose of medicine or eating food long past its sell-by date.


A surprisingly large proportion of the general population, particularly older people, also struggle because they can't easily read small print.


Everyday household equipment was becoming more difficult to operate because of the growing use of hard-to-read electronic displays, the RNIB said.


The institute, which represents Britain's two million people with sight problems, singled out the internet as a particular problem because of the thoughtless ways websites are designed.


To improve readability, the RNIB recommended publishers use a plain typeface with a minimum type size of 14 point with the use of semi-bold and bold. It added that text should be well-spaced, but without italics or clutter.


GLARE CONTROL FOR LOW VISON PATIENTS

31 AUG 2001

Glare control lenses, as supplied by Low Vision Supplies of Billingham Cleveland, have recently been introduced in to the UK. The Special Glare Control Lenses are Photochromic lenses with a special blue filter for sensitive eyes, and were developed by Lens Manufacturer Corning.

There is a range of six different lens filters from CPF 450 to CPF 550 (Corning Photochromic Filter) including the “sunglass Look”. The number refers to the cut of point of the filter (i.e. 450nm cuts out the range of light at 450 NM) The lenses use corning Photochromic filter technology to maximize vision and eye comfort for indoor and outdoor use. The lenses can also be used for sufferers with associated eye conditions such as macular degeneration, macular dystrophy, retinitus pigmentosa, and even lens opacities.

The Company have produced a leaflet which is available on request from the company at :- Crown Buildings, Queensway, Billingham Cleveland TS23 2LP or by telephone at 01642 530801 or details can be obtained at their website at www.visionsupplies.co.uk

Blue Light regulates the body clock

24 August 2001

According to an article in the journal of Physiology the human eye is sensitive to short wave blue light and transmits information to the so-called “body clock.” This new research from the University of Surrey indicates the possibility that this type of light could be used to adjust the body clocks of shift workers, Long haul travelers, and those effected by Seasonal Affective Disorder (SAD).

The report goes on to say that exposure to this blue light seems to suppress melatonin levels, which cannot be explained by the activity of photoreceptors. Dr. Debra Skene, who led the University research team says “our findings have exiting implications for the future, some sections of the population have a particular need to adjust and manipulate their body clocks in order to function effectively during the hours of the night, when our body responses are trying to tell us to go to sleep.

The full article can be found at www.jphysiol.org/cgi/content/abstract/535/1/261



10 August 2001

Does the Eye control the Body Clock ??



Source: Thomas Jefferson University (http://www.tju.edu/)


Date: Posted 8/10/2001

Jefferson Neuroscientists Uncover Novel Receptor In The Human Eye To Control Body's Biological Clock

Neuroscientists at Jefferson Medical College have clarified how the human eye uses light to regulate melatonin production, and in turn, the body's biological clock.
They have discovered what appears to be a fifth human photoreceptor, and which is the main one to regulate the biological - and non-visual - effects of light on the body. They have identified a novel photopigment in the human eye responsible for reacting to light and controlling the production of melatonin, which plays an important role in the body's circadian rhythms.

They also discovered that wavelengths of light in the blue region of the visible spectrum are the most effective in controlling melatonin production.
This discovery will have an immediate impact on the therapeutic use of light for treating winter depression and circadian disorders, says George Brainard, Ph.D., professor of neurology at Jefferson Medical College of Thomas Jefferson University in Philadelphia, who led the work. Some makers of light therapy equipment are developing prototypes with enhanced blue light stimuli.

In the long range, we think this will shape all artificial lighting, whether it's used for therapeutic purposes, or for normal illumination of workplaces, hospitals or homes - this is where the impact will be, he says. Broad changes in general architectural lighting may take years, but the groundwork has been laid.

Dr. Brainard and his co-workers at Jefferson and at the Uniformed Services University of Health Sciences in Bethesda, Md., report their work August 15 in the Journal of Neuroscience.

We have strong evidence for a novel, fifth photoreceptor and it appears to be independent of the classic photoreceptor for vision, he says. It influences the biological effects of light. It regulates circadian rhythms and hormones in the body. We've also shown the fingerprint of wavelength sensitivity for the regulation of the hormone melatonin, he says.

Four cells in the human retina capture light and form the visual system. One type, rod cells, regulates night vision. The other three types, called cone cells, control color vision.

It's known that exposure to light at night can disrupt the body's production of melatonin, which is produced by the pineal gland in the brain and plays a vital role in resetting the body's daily biological clock.

Earlier this year, Dr. Brainard and his group showed that the combined three-cone system didn't control the biological effects of light, at least not for melatonin regulation. But subsequent work led to the surprising discovery that a novel receptor was responsible for the effect.

We didn't anticipate this at all, he says. In the study, they looked at the effects of different wavelengths of light on 72 healthy volunteers, exposing them to nine different wavelengths, from indigo to orange.

Subjects were brought into the laboratory at midnight, when melatonin is highest. The subjects' pupils were dilated and then they were blindfolded for two hours. Blood samples were drawn. Next, each person was exposed to a specific dose of photons of one light for 90 minutes, and then another blood sample was drawn. Wavelengths of blue light had the highest potency in causing changes in melatonin levels, he explains.

In theory, he says, If a clinician wants to use light therapeutically, the blue wavelengths may be more effective. If you wanted built-in illumination that would enhance circadian regulation, you might want this wavelength region emphasized. In contrast, if you wanted something that doesn't produce biological stimulation, you might steer the light more toward the red wavelengths. But controlled clinical trials will be needed, he adds.

Next, Dr. Brainard's team would like to study the next step in how light regulates not just melatonin, but all of the body's circadian rhythms, including body temperature, cortisol and performance rhythms.

From a report from the Jefferson University.

27 MARCH 2001

THE GREAT VAT BATTLE BEGINS

The Optical profession is to submit a claim the European courts requesting the EEC to institute legal proceedings against the UK Government. They believe that the UK Government is acting illegally in imposing VAT on the Dispensing element of the Sale of Spectacles from the 1 June 2001.

The professional Bodies also claim that they will not absorb the cost of the increase as the VAT officers have suggested. One prominent Optician has stated that he intends to give each of his patients a letter explaining that the increase of 10% in the price is due solely to the imposition of the new VAT, and suggestion that they write their respective MPs asking them to refund the VAT which they believe has been collected illegally.

USA TO START NEW TREATMENT FOR GLAUCOMA SUFFERERS

Glaucoma sufferers in the USA will benefit from the use of two new drugs. In a recent report in the USA from the Associated Press the report goes on to say that the 2 new drugs, Travatan and Lumigan work by raining the fluid build up within the eye which is one of the main causes of Glaucoma. Travatan has been shown to work well in particularly in for Black Patients.

DRIVING RESTRICTIONS FOR THE OVER 50,S IN UK !!

The Ministry of Transport denies rumours that drivers in the age groups over 50 in the UK will have restrictions placed on them. Speculation started recently when a leaked European council document stated that it was considering introducing restrictions on driving licences.

10 March 2001

Web site of the Year Awards

The Hot news for us is that our sister web site, (www.eye2eye-opticians.co)on which this web site is based, has just been placed in the ROLL OF HONOUR in the finals of the Practice web site of the year awards. The judging was carried out recently by a panel of 4 judges who were judging the web sites for, ease of location, visual appearance, ease of use, Quality of the information, and speed of response. The final judging will take place over the next few weeks and the winners will announced at the Eye Care Awards Of the Year on the 22nd April. We will keep you posted..

9 MARCH 01

QUESTIONS IN THE HOUSE ON BUDGET DAY

The Conservative Party leader Wm Haigh asked Tony Blair and the chancellor, in the House of Commons following the budget announcements, why he had not advised the press and public about the new proposed 10% stealth tax to be imposed on the supply of spectacles, which will take effect from 1st. June. He (Mr Haigh) accused the chancellor and the Prime Minister of deliberately hiding the fact that this new tax was coming into force, and that it would virtually wipe out many of the gains made by poorer people claiming benefits in the budget, and in the case of the over sixties, who 2 years ago were given the right to a Free sight Tests, would now effectively have to give the money back when they purchased new Spectacles.

1 March 01

THE BIG SHOCK FOR OPTICIANS

It came as a great shock to most Opticians that Customs & Excise have decided that as of the 1st June 2001 all previously agreed methods of calculating VAT on spectacle dispensing in the UK will be terminated and that the Dispensing of Spectacles will attract the FULL rate of VAT at 17.5%. This will effectively mean that for every pair of spectacles dispensed in the UK an increase in price to the public of about 10% will result.

The History of VAT and spectacle dispensing in the UK has been a long and hard battle with Customs and Excise, won by the Optical profession on several occasion, much to the annoyance of VAT inspectors. The Optical Profession won the previous battles by proving that a part of the sale of Prescription Spectacles was a professional dispensing function, which are deemed as VAT exempt. This meant that only the actual supply of the frame and lenses was eligible for VAT. In most cases this resulted in patients only paying approximately 10% VAT instead of the full 17.5%.

The New rules are the result of a recent judgment in the UK House of Lords, where it was claimed by a credit card company, that credit card sales of spectacles were a single supply and not a composite of two elements (Goods and Dispensing).

The Optical groups and associations in the UK have advised their members not to take any individual actions against this move as they (the associations) intend to mount a united defence against the moves by the Customs and Excise Office.


23 Feb. 01

CATARACT CURE !!!

An American Company “Worldbrain” claims to have developed a new Homeopathic remedy for Cataracts. In the report it claims that the new treatment, called Catavue, has achieved a reduction of 80 – 100 per cent in cataract size within 90 days. It is claimed that the long waits for cataract surgery may be a thing of the past, and they intend to introduce this Product on to the UK market soon through a select group of suitably qualified candidates for assessment and trials. We will keep you posted!!!

MAIL ORDER CONTACT LENS SUPPLY COMES UNDER FIRE IN THE US

A report in “Contact Lens Spectrum” claims that in study in the US by a group of three Doctors, found that inappropriate advice and information was being given to members of the public and customers by sales staff of Internet and direct sales companies. The Doctors Asked Questions relating to lens specifications and the use of alternative cleaning and sterilisation solutions, and were given false or misleading information by sales Staff. The Doctors Claim that filling a prescription improperly, or giving incorrect contact lens advice has potential clinical and Legal ramifications for both patient and Practitioners.


16 Feb 2001

Cricket Umpires Sight Tests

The International Cricket Council Proposes that all cricket umpires at International Test Cricket Matches should undergo a Sight Examination and Hearing Test. The moves are designed to promote a more Professional image of the sport and to establish a minimum requirement in relation to vision and hearing for Umpires.

17 Feb. 01

Uveitis linked to Rheumatic disease

According to a report issued by a Finnish study, and reported in “The Journal of Rheumatology,” It is claimed that up to 22per cent of uveitis sufferers also suffer from rheumatic diseases. Uveitis is the cause of 5% of all cases of blindness yet the real cause of the disease is still not fully understood. A full report can be found on the society web site at www.ivanhoe.com.

1 FEB 2001

The Government has introduced new rules for claimants of Benefits of help at Opticians. With effect from the 19th of February Evidence of entitlement will be asked for when attending your Opticians for a NHS Sight Test and/or help towards the cost of spectacles. You will need to take evidence of age if you are between 13 and 19 and claiming for child entitlements, or if you are over 60 and claiming age related Free Sight Tests. If you receive benifits of any kind and are claiming Help towards the cost of your spectacles and Sight Test then you will need to take along with you your benifits book or the letters which were sent to you by the DHSS when you Qualified for benifits. All Opticians have been advised that where no evidence can be produced at the time of the test then the claimant will still be able have the sight test and claim the relevant help so no one will be turned away at the point of service. The new procedures will be introduced on a National basis and is designed to cut down on false claims by the public.

Sept 2000

PARENTS OFTEN LAX OVER AMBLYOPIA TREATMENT

According to a report in this Months “British Journal of Ophthalmology” that in research on 57 children with “lazy eye” found that parents needed to be better educated as to the benefits of occlusion therapy, where a patch is worn over the normal eye to encourage use of the “lazy eye”. The report goes on to say that 54% of parents were said to be lax about the treatment because they did not fully understand the importance of the occlusion therapy in preventing permanent vision problems.

Almost 7 out of 10 (68%) of the parents involved in the study blamed poor knowledge for failing to keep their children on the therapy. The report goes on to say that it is essential that Parents should be better advised as to the benefits of the therapy when their children are first placed on to a course of occlusion therapy.

Oct 2000

LIB DEMS PLEDGE TO RESTORE FREE EYE TESTS

The Liberal Democrat Party, in its pre-manifesto document, has repeated its long-standing commitment to restoring the universally Free Sight Test. The aim is to “reduce ill health by spotting problems earlier by scrapping charges for eye tests and dental checks. The funding of the move will be by introducing an increase of 10p on to a pack of cigarettes”. The manifesto goes on to say that “these preventative measures need to come into force”. The document also contains a commitment to recruit an extra 5,000 doctors and 20,000 nurses and further investment in hospitals.

24 Nov. 2000

Contact Lens supply rules are soon to change.

The General Optical Council has submitted new rules for Government approval to allow Contact Lenses to be supplied by sources other than by the Optician who conducts the original contact lens Sight Test. The Testing Optician must supply the Patient with sufficient information to allow others to supply the contact lenses. The Contact Lenses supplier however must work under the supervision of another registered Contact lens Practitioner. This means that anyone can buy contact lenses direct from other suppliers, including Internet suppliers, providing that the supply is controlled by or under the supervision of, Qualified Practitioners.

However, a word of warning !! are those on line lenses really that cheap ?? consider the fact that you may need aftercare !!! who will provide it if you have bought lenses on the Internet!! The Optician who conducted the sight test will be entitled to charge you for any follow up visits or advice, so beware !!! and also remember it is always easy to get things cheap, but if you need any aftercare is it going to make the bottom line price any cheaper than if you had bought the complete package including after care from the Optician who conducted your Test.

So buyer beware !!! Be aware of the TOTAL price you may have to pay......


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