Geraint Griffiths - In The Hot Seat

An interview with Geraint Griffiths, MSc, MCOptom launches our new regular post, In the Hot Seat where we interview prominent members of the profession to find out their news, views and idiosyncrasies.

Geraint talks candidly to Jane Macnaughton on his view of Sportvision, preparation for 2012 and playing the violin.

Tell us a bit about Sport Vision; the concept and your interest in this area?

Sportvision is the optimising of safe and efficient vision in sport and it is strange that the same cannot be said about Optometry in general. For instance Optometry is the optimising of safe and efficient vision in occupation sounds very mundane and uninspiring.

It sounds much more grand to say Optometry is the identification of treatment of ocular morbidity. The uncomfortable truth is that at most only 20% of the population have anything wrong with their eyes, the rest have occupations for which vision is essential. This 80% also pay our bills.

What are you currently working on at the moment?

A startling and almost accidental finding from Sportvision is that visual and occupational performance are directly linked. This of course is intuitively obvious and the continued practice of optometry depends on it, but it has never been proved scientifically.

The evidence of this is that performance in two of the most important occupations driving and reading, is not measured. The driving standard has no scientific basis and reading speed is not measured effectively or taught at undergraduate level. Science confuses the measurement of visual performance with an understanding of its effects on occupation.

This has lead to a problem, which is peculiar to optometry that the solution is taught before the problem has been understood. The problem optometry has is not the measurement of vision but the effect vision has on occupation.

The protection and correction of vision in sport and other occupations has always been a concern from which government lead interest with ocular therapeutics, is leading us away. Optometrists make very good, highly trained and cheap assistants to the Hospital Eye Service (glaucoma shared care, diabetic screening, minor secondary eye care), their high street trading allows them to subsidise this work or even give it for free. The recent GOC instigated changes to the Professional Qualifying Exams, down play the importance of occupational optics and binocular vision, because ophthalmology is not generally concerned with what the eyes are used for or how they work together (unless there is manifest pathology). Orthoptists are generally unaware of the subtleties of fixation disparity because only large angles of deviation need to measured prior to a squint operation and the treatment of amblyopia is largely patching, which pays scant regard to binocular function.

What are the main objectives of this project?

80% of what we know is directly or indirectly related to eye-sight. In normally sighted individuals sight is by far the most important sense. The effect of visual deficiency can be profound and could have a far greater effect on morbidity, ocular and general than has ever been considered.

Optometry is perfectly placed to understand this connection and prevent many of the degenerative diseases and psychological problems that are currently crippling the National Health Service.

The overriding objective is to show a profession, which is convinced that medicine and the treatment of disease is its highest ideal that Optometry has a unique role to play in the prevention of ocular and systemic disease. And that a simple corollary of this is that selling specs and regular eye tests will actually increase life expectancy.

The missing links in our understanding of visual function and its relation to occupation are simple and robust and perhaps that is why we are so reluctant to accept them.

1. There are two dominance types, who are physiologically different
    a. Type 1 – Right eye dominant right hand and right foot dominant
    b. Type 2 – any left tendency
2. The primary occupational (and sporting) visual skills are
    a. Aiming
    b. Anticipation based on depth perception
3. The 6 diagnostic elements of visual performance are
    a. Refraction
    b. High and low contrast logMAR vision
    c. Eye dominance
    d. Muscle balance
    e. Fixation Disparity
    f. Colour preference and light sensitivity

With this information all individuals and their relationship to a given occupation can be analysed. This protocol is derived from the laws of sport vision which are proposed in the original publication in Optometry Today. Download a copy of the article, Eye Dominance in Sport here.

As a direct result of this research dyslexia and its related disabilities are shown to be primarily a dysfunction of binocular vision and problems with light sensitivity. Psychological signs are secondary to the original visual deficiency. The tragedy of our schools vision screening service, where it still exists, is that visual performance is measured only at 6 metres with a Snellen chart and that reading performance at the near point is disregarded.

The Laws of Sportvision predict that the primary visual skill in reading is aiming (which needs well established eye dominance) and it should be measured at the near point not at 6 metres.

Another key objective is now to convince the College of Optometrists that this research and the consequential school research needs to be supported. Scientist who vet grant applications tend to be steeped in the measurement of visual performance and academia. The evidence for this profound change in understanding is contained in the records of high street optometrists who do not have the academic skill or time to publish results in the peer reviewed journals. A plea for help can be stifled by a narrow view of scientific protocols. This applies to both College vehicles, Optometry in Practice and iPRO research, which are supposed to facilitate and encourage practicing optometrists to do research. A deep irony is that the mindless adherence to rules and rote is an anathema to the dyslexic.

How do you think Sportvision will progress in the next 10 years?

Sportvision will change the face of Optometry. It will give the profession back its identity and provide a role for Optometrists and Dispensers working together, which will revolutionise the health care industry.

The College may take on board the ideas generated by Sportvision, if it doesn’t a new course will be founded possibly in conjunction with one of the sporting Universities Like Loughborough. Sportvision is a completely new science and will generate lots of funding from industry, sporting and optical to support post-graduate research and a chair in optics.

Do you think that 2012 will have an impact upon how optometrists view sportvision?

When the London Olympics was announced I knew exactly what we would be doing for the next 7 years. Because of our collaboration with Johnson and Johnson and Adidas, both board members of SportvisionUK (with r+h and NatWest Bank), the Beijing Olympics is already changing the profession’s view of Sportvision. This is ahead of schedule. By the time of the London Olympics, Ophthalmic Optics will be an integral part of the support team for our athletes. Vision is the single most important consideration in the preparation for competitive sport

Have you have much interest from the Multiples?

Our leading brand, Specsavers have shown great interest by supporting the attendance at the diploma courses of their directors and inviting me to present at their PAC conference.

Specsavers are a special example of corporate identity but in general the multiples may only see the narrow commercial potential of sport vision. Sportvision is a bespoke service and doesn’t fit easily into the corporate model, which is driven by accounting advice from non-optometric directors. Independent practice is much better suited to the requirements of the individual patient and thrives on the long established and hard won expertise of dispensing and optometric colleagues; colleagues who are often driven from corporate employment by inflexible and inexpertly applied rules.

Sport vision and its future derivatives will be a premium service sold on clinical benefits which patients and athletes will be more than happy to pay for. The greatest disservice to clinical expertise is to offer free eye tests and two for the price of one. The laws of Sportvision clinically justify the dispensing and associate this with occupational and sporting performance and ultimately a longer life. This enormously increases the commercial potential of our profession.

What challenges do you look for in the future of optometry?

Optometrists may become the GP’s of the future with their ability to prevent disease and a judicious understanding of alternative medicine and nutrition, to release the strangle hold of the drugs companies. Their understanding of the behavioural effects of vision and ability to diagnose and refer manifest physiological and psychiatric disease will make them first point of reference in primary health care. Ultimately the Royal College of Optometrists will stand proudly side by side with our other famous Royal Colleges.

What prompted to do study optometry?

Dad (who was an optometrist) said don’t do optometry son, so I did engineering. When I found I couldn’t do that I had to find a means of escape. Optometry provided all the answers education, fascinating subject, deals with people, engineering content, sport, escape, drama, student life, so I applied to do Dentistry. Dad said, “for goodness sake don’t do dentistry,� so I put UMIST down as an afterthought. The interview at Birmingham dental school was traumatic and life changing, couldn’t answer the question “how I would feel about looking into peoples mouths all day.� Instantly felt at home at UMIST who offered me an unconditional place, it was the luckiest and best day of my life.

Where did you study and train?

Spent 7 years in Manchester; 3 doing Mechanical engineering, 3 doing Optometry and then another year doing an MSc in Optometry at UMIST. Stayed in the same hall of residence.

What is your overriding memory of your pre-registration year?

The moment when I realised I would never be a four test-a-day man after jumping up from two tests a day

When you qualified what did you do next?

Went to America and hitched from New York to Los Angeles and back.

What was one of your greatest challenges?

Leaving the original Sports Vision Association of which I was a founder member at the invitation of Don Loran, who started it all in this country; this lead to the formation of the Association of Sportvision Practitioners and SportvisionUK and the instigation of the Diploma in Sportvision practice. SportvisionUK now has over 60 members and will be taking an active role in preparing our Olympians for Beijing. The commercial engine for this project is our company Sportvision Ltd. This challenge continues even now but is beginning to show signs of success after 7 long and hard years.

What role has been the most rewarding?

Undoubtedly opening Optical3 this is the fulfilment of everything that has gone before in Sportvision and many years in corporate employment. We still have a long way to go but every day is a joy.

What do you think has been your greatest accomplishment?

Breaking the British Masters high jump record and holding it for 11 years
The least expected and one of which I am extremely proud was to be elected by my peers at UMIST to be their year’s president.

How do you evaluate success?

Success can be the smallest thing. It’s not money or cars or status, it doesn’t come from greed for success. It’s an inner contentment, which shines from some people and fills everyone them meet with happiness. It is what a group of people like this can achieve without rules or regulations targets or tellings off.

What is your greatest weakness?

Dyslexia - it is also my greatest strength. I am the proud owner of a de-compensated hypo-phoria in my left dominant eye, which I now know is the cause of my dyslexia.

Where is ‘home?’

Home is where my beautiful daughter, Josephine aged 8, is. Sometimes this is at our lovely new practice Optical3. Unfortunately her mother left me, partly due to my obsession with Sport Vision.

What do you do to relax?

Swim, run, stretch, go to the theatre, concerts, But most of all and most often, lunch with the Daily Mail in little upstairs cafes with wooden seats and tables and old fashioned service by ladies and gents who realise that a meal is a gift of love.
What are you listening to on your ipod at the moment?

Haven’t had time to find out how it works

Do you have any interesting hidden talents?

I play the violin. My second career could have been in the theatre, just finished playing John Malcolm in separate tables by Terrance Rattigan. Loved high board diving.

How would your friends describe you?

A bit of a div, always late.

If you had to live your life over again, what one thing would you change?

Whenever I have tried to change anything I get battered back on to the beaten path. This often causes great pain and anger but invariably teaches something, which is a key to the next step on the journey. I really believe in destiny and every day thank God for the opportunity I have been given.

Post your questions to Geraint.

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