This web page is for conference and course organizers who are interesting in booking Professor Evans to give a lecture. If you would like to download a handout from a recent lecture that Professor Evans has given then please select Lecture handouts.
For conference and course organisers, the following is a list of lecture titles that Bruce Evans has lectured about. Other topics might be appropriate and please contact info@cmt-optometrists.co.uk to discuss this.
Myopia
control: the effect of COVID-19, or
Myopia
control: making it happen for your next patient
For generations, optometrists have corrected refractive errors but have been largely impotent when it comes to trying to slow the progression of myopia. Like their patients, optometrists have been spectators who simply observe a patient’s myopia progressing until nature eventually decides that enough is enough and the myopia stabilises. Recent research has changed this perspective and has led to a paradigm shift in optometric practice. Today, optometrists can counsel myopic children and their parents and explain to them that their myopia progression can be slowed by 40-60%. It is realistic to expect that, on average, a child who was destined to become a -6.00D myope could end up as a -4.00D myope. In the future, even greater degrees of myopia control may be possible. This lecture will describe the interventions available, both in spectacle and contact lens modalities, and will review the scientific evidence. Fitting guidelines will be given to help community optometrists to transform from practitioners who correct to those who treat. The effect of COVID-19 on the myopia pandemic will be summarised. Practical tips will be provided to help clinicians make myopia control happen for their next patient.
The dreaded
solicitor’s letter: Avoidance and survival
Alternative title: Practising safely in a litigious world
Professor Evans has been involved as an expert witness in
over 90 cases over the last 25 years. These have included civil litigation,
complaints brought before the General Optical Council Disciplinary Committee, NHS
tribunals and fraud cases, and criminal litigation. He has taken instructions
from solicitors (for both prosecution and defence), the Association of
Optometrists, and from NHS organisations. In 2016 Professor Evans provided
expert advice on the first criminal prosecution involving an optometrist.
This presentation will give anonymised examples of cases to illustrate commonplace reasons why optometrists become the subject of GOC disciplinary cases or civil litigation. Professor Evans will give simple tips on steps every clinician can take to minimise the risk of receiving the dreaded solicitor’s letter. He will also give advice on how to deal with such letters, and with milder complaints. This will include advice on how to deal with solicitors and how to cope with the stress.
Non-tolerances:
how to minimise them and how to turn defeat into victory
All practising optometrists will occasionally experience a spectacle non-tolerance and, with Catherine Freeman, the author has been involved in research on this topic. This presentation will explain why non-tolerances occur and will discuss how to minimise the risk of a prescription causing problems for a patient. Research by business management experts on service excellence will be reviewed which highlights the fact that a patient complaint should be thought of as an opportunity. This research on what has been called the “recovery paradox” allows practitioners to view non-tolerances in a new, more positive, way and to appreciate that when handled correctly these represent an opportunity to turn what feels like defeat into victory.
Evidence-based optometry
Alternative title: What’s best for my patients? How to choose.
In the last half of the twentieth century there has been a quiet revolution in medicine as the philosophy of the "evidence-based approach" has evolved and become widely accepted. This approach uses simple scientific methodology to validate the work of healthcare professionals. The lecture explains this and applies the principles to the practice of optometry. Research jargon is avoided and some of the myths surrounding research and statistics are "stripped away". This far-reaching lecture touches on all aspects of optometric practice: from contact lenses to orthoptics, and from anti-reflection coatings to vision therapy.
Communication
skills for the optometrist: mind reading and time travel in the consulting room
The presentation will highlight how, when it comes to communication in the consulting room, optometrists are at an advantage because they know what anxieties and concerns most patients will have. The challenge is to remember to see the consultation through the patient’s eyes and tips for achieving this, even with child patients, will be provided. Common comments that patients make will be discussed in terms of what these tell us about the patient’s anxieties and needs. The importance of relaxing the patient by helping them fully express their concerns will be highlighted, emphasising when open and closed questions are appropriate and helpful to complete the eye examination in a timely way. The need to engage the patient’s trust will be noted, together with advice on how to achieve this through transparency and engaging mutual advocacy. The key requirement that will be stressed is to address any presenting complaint and to leave the patient appreciating that this has been addressed.
Orthoptics for
the busy optometrist: a user-friendly guide
Alternative title: Diagnosis of binocular anomalies
A simple, logical, step-by-step approach is taken to the diagnosis of orthoptic problems. A minimum of theory is used to aid understanding of the practical aspects, which are the main theme of this talk. The lecture includes an overview of treatment methods. Simple, consulting-room, techniques for the diagnosis of incomitancies are described. The diagnosis and treatment of heterophoria is covered in some detail.
The final part of the talk concentrates on strabismus & amblyopia. Clear guidelines are given on the cases which are most amenable to treatment by the optometrist and which require referral.
This lecture can be split into 3 talks (heterophoria, strabismus, incomitancy), each of which can be given as part of a series or in isolation.
The role of the optometrist in dyslexia
This lecture starts by summarising what dyslexia is (and what it isn't!). The lecture concentrates on the role of the optometrist, but places this within the framework of a multi-disciplinary team. A suggested optometric routine for the investigation of people with specific learning difficulties is described, based on recent research. Controversial issues such as the Dunlop test, behavioral optometry, low plus prescribing, eye movement training, and visual stress are discussed. Research on the use of precision tinted lenses is reviewed, highlighting the clinical implications. It is stressed that, although optometrists do not treat dyslexia, they can treat the visual problems that are particularly common in dyslexia. In this way they can make reading more comfortable.
Migraine &
other headaches: the role of the optometrist
Migraine affects about 10% of people and medical treatment is nowadays very successful. Optometrists can help detect and diagnose the condition, referring as appropriate. The lecture discusses controversial ideas, including the use of base in prism and Crookes alpha tints.
Visual stimuli (e.g., flicker, lighting, text) can be a trigger for some migraines. A recent randomised controlled trial is summarised. This found that precision tinted lenses, prescribed with the intuitive colorimeter, are an effective treatment for some cases. This research is summarised and its implications for the optometrist is discussed.
Computer
vision syndrome & digital eyestrain
This presentation starts with a brief review of the literature from 50 years ago, before computers, about what experts were saying about eyestrain, challenging occupational demands on vision, the need for accurate optometric correction of refractive error and ocular motor anomalies, etc. It will become clear that in most respects computers are just another example of demanding visual tasks and some of the problems they are said to cause are no different to problems that people in other generations have experienced. Nonetheless, the presentation will summarise the diagnosis and treatment of commonplace binocular vision and accommodative anomalies that can cause problems for computer users. It will also cover features of computer use that can be problematic in “new” ways. For example, flicker, repetitive patterns, excessive contrast, and strong colour contrasts. The presentation will touch on recent research about what makes some vision comfortable and some uncomfortable, cortical hyperexcitability, and visual stress. Some recent research on the demands and compromises of 3-D displays will also be summarised. The effect of COVID-19 on computer vision syndrome will be summarised.
Independent
optometry: strengths, weaknesses, opportunities, threats
A startling graph is presented showing the rapid increase in the number of optometrists per capita in the UK. 30 years ago, the author wrote an article predicting a polarisation within optometry, and evidence will be presented that this has happened. We have become a profession of two halves and this trend is destined to continue. Community optometrists are fortunate because their work requires engagement with two fascinating worlds; those of the clinician and of the businessman. It will be argued that clinical skills offer a huge business opportunity for optometrists that is under-utilised in the UK. The presentation demonstrates that developing a private clientele through evidence-based clinical care is not just an opportunity for ‘Harley Street’ locations but can be applied to most areas of the UK. Independent optometry is well-placed to provide excellent eyecare and this is a high priority for most patients. To be most successful in this endeavour, independent optometry need not be independent of the NHS (although this model is one option), but more often involves successfully building private eyecare alongside NHS eyecare. The presentation includes an entertaining tour of creative strategies to build a private practice, including mind-reading, time-travel, and seeking the clear blue waters of enlightenment.
The optometrists' guide to providing eyecare for young children
Alternative title: Paediatric optometry
The reasons why children can benefit from optometric care are summarised. The lecture provides a clinical overview of techniques for assessing ocular health, visual acuity, refractive error, binocular function, and accommodation in infants and young children. Common conditions to detect are summarised, together with prescribing criteria for refractive error at different ages. The importance of a child-friendly approach will be stressed as the best method to obtaining good quality data and making the eye exam fun for the child and the practitioner. A realistic approach will be taken, with advice on what to do when the child does not co-operate and a full set of results cannot be obtained.
Treating
orthoptic anomalies in optometric practice.
A secret to success in orthoptic treatment is to choose the
cases to be treated carefully, and clear guidelines are given on this.
Treatment methods that are discussed include refractive modification, prismatic
lenses, and eye exercises. Simple methods, which can be used in typical
optometric practices and are appropriate for children, are emphasised. The
lecture draws upon the literature from disciplines ranging from traditional
optometric orthoptics and hospital orthoptics to more controversial approaches
such as behavioral optometry.
Double vision: what do I do?
Alternative title: The investigation of diplopia in optometric
practice
The diplopic patient can present a major challenge to the
optometrist. The main causes of diplopia, both binocular and monocular, are
summarised. The lecture emphasises simple methods of investigation, diagnosis,
and treatment.
Kids 4
contacts: developing a successful paediatric contact lens practice
Contact lenses can make a big difference to a child’s life and the main motivating factors are similar to those for adults: cosmesis, sport, and improved visual function. But each of these factors is more likely to apply to a child than to an adult. In particular, the word ‘cosmesis’ underestimates the impact that contact lenses can have on children’s self-image and confidence. The requirements for successful contact lens wear are also similar to those for adults: ensuring motivation, good patient education, and minimising the risk of complications. These factors will be covered in the presentation so that practitioners can fully engage their patients and parents in informed consent.
There are several visual conditions which are better managed with contact lenses than spectacles. These conditions will be discussed, particularly anisometropic amblyopia. Types of contact lenses for this and other conditions, including myopia control will be covered. The presentation will emphasise clinical relevance. In particular, throughout the talk the content will be related to the practitioner in the consulting room with the patient. Tips will be given for handling the child patient, and explaining the benefits of contact lenses and the essentials for safe wear to both child and parent.
Monovision:
when, how, & why
Monovision is still one of the most successful methods of correcting presbyopia with contact lenses, and studies of the success rate of monovision are discussed. Research on ocular dominance suggests that the traditional sighting method of determining the eye to have the reading lens is inappropriate and suggestions are made for a more meaningful approach. The effect of monovision on binocularity is reviewed and the orthoptic contraindications for monovision are listed. Monovision is contrasted with multifocal contact lenses and the limitations of multifocal contact lenses and an explanation will be provided for why monovision in some cases performs better than multifocal contact lenses. Tips will be provided for selecting ideal patients and detecting patients where monovision should be avoided.
Orthoptic
indications for contact lenses
Binocular vision anomalies affect at least 5% of patients consulting optometrists. For many binocular anomalies, contact lenses are the best mode of refractive correction. These conditions are listed, with illustrative examples. The rare cases where contact lenses are contraindicated will also be discussed. Anisometropia emerges as a key motivation for fitting contact lenses, but other topics including strabismus and incomitancy will be discussed within the context of contact lenses.
Review of
recent research at the Institute of Optometry
A summary of recent research in topics including myopia
control, glaucoma, accommodation, optometric decision-making in referrals, OCT,
orthoptics, contact lenses, dyslexia, and migraine. Only studies which are
relevant to practising optometrists are included, and a
"practitioner-friendly" style is adopted, stressing clinical
implications.
Sensory sensibilities: How we adapt to binocular anomalies
Alternative title: Sensory adaptations to binocular vision anomalies
The sensory adaptations that young people make to orthoptic anomalies are explained in a straightforward way, stressing the implications for the management of binocular anomalies in optometric practice. The lecture covers: sensory fusion, stereopsis, foveal suppression in 'phoria, amblyopia, HARC, and strabismic suppression.
Please note, the above are samples of lecture topics.
Other subjects include, diagnosing incomitancies, starting a practice, &
practice development. Please ask for more details.
Professor Evans provides lectures through his company, Evans Optometric Consultancy Ltd. The fees below cover presentation and preparation of a handout which will be available for download from ResearchGate. Additional charges for preparation may also be applicable, so please ask for a quote.
full day: £735
half day: £390
evening: £190 if London or Essex, £250 if within one hour of London, half day rate if further
tutorials: £95
per hour, if the student(s) can come to Brentwood, Essex.
The hourly rate is the same for one or more students, so it is most cost
effective if a small group of students attend together and divide the cost
between them.
consultancy: £95 per hour
Travelling expenses
1st class rail/air fare + taxi; or car at 45p per mile
Updated February
2023