PRESS & MEDIA

"Sasha Rodoy, a campaigner seeking tighter regulation of laser eye surgery, said the leaked document confirmed all her fears about the industry's priorities. "These 'hard sell' techniques may not be illegal, but they are totally inappropriate for a medical procedure and they should be illegal.""



www.theguardian.com/society/2014/sep/20/...cs-laser-eye-surgery

'Sunday Business Post' today:



"With thousands of laser and lens replacement surgeries taking place in Ireland every year, not everyone is getting the life-enhancing results they wanted.

A British campaigner for tighter regulation of eye surgery claims to have been contacted by hundreds of unhappy patients from Ireland who have undergone these procedures, mainly at high street chains.

Sasha Rodoy, who had laser eye surgery in 2011, runs two websites offering disgruntled patients a platform to tell their stories and to warn others of the risks of undergoing surgery at certain clinics.

She has been in contact with thousands of patients in Britain and a growing number from Ireland.

Rodoy - who subsequently settled with the company involved and is, therefore, precluded from speaking publicly about her own experience - began by blogging about her own situation. She was soon inundated with comments from others.

''People are being told that they were just unlucky. If that's the case, why are there thousands out there in the UK and Ireland? she said.

Providers of eye surgery in Ireland include consultants working in private practice in hospitals, independent private clinics and the high street chains.

Most of the online ire is directed against high street chains.

The market

Optical Express is the main player in Ireland, with a network of five clinics here. The firm has been unhappy over a website which is critical of laser eye surgery, and is one of those run by Rodoy.

But the company recently lost a legal battle in Britain to have the website closed down.

Lawyers for Optical Express claimed that the critical website was being funded by a rival firm. This was dismissed by the expert panel examining the case, which said that allegations made by Optical Express had been designed to ''impugn the honesty and integrity of Rodoy, who was named as the respondent in the case.

High street chains such as Optical Express typically advertise incentives to attract business. They partner with other companies that try to win customers with the chance to win free laser eye surgery, or ''two eyes for the price of one.

The advertising is a source of concern to Rodoy, but she said she was more worried about aggressive sales techniques used by clinics.

''The main issue is the hard sell. A number of clinics pay optometrists and so-called refractive technicians' a commission based on the number of people they get to go ahead with surgery. Or else they are on target-based salaries, said Rodoy.

The Sunday Business Post obtained a copy of the guide given to staff by Optical Express.

The ten-page confidential document contains sales techniques to be used by sales staff.

Suggested actions and behaviours are marked in black. Suggested words and phrases are marked in blue, while their recommended best practice phrases and guidance are in red.

Optical Express advises bookers to:

• Take payment in full (if not possible take deposit - the larger the deposit, the less chance of cancellation).

This is all occurring before the patient has seen a surgeon. In another section the manual advises staff to:

• Use statements like: ''What price can you put on your eyesight?, ''Remember you do this for the rest of your life ie Lifetime investment

• Alter the deposit to make the finance options work for the patient

• Compare finance payments to monthly, weekly or daily spend.

• Remind of benefits, ie, if sports player put them in that situation

Recommendations published internationally regarding any elective surgical procedure dictate that informed consent from patients is assured in advance. A cooling off period is recommended between the initial assessment and the decision to proceed with surgery.

Optical Express said this document was no longer in use and had been updated with new training materials.

''The purpose of a consultation is to allow the patient to understand the benefits and risks of their procedure, and every effort is made to ensure this is done in a balanced manner that allows them to make an informed decision, it said.

One patient in Ireland, who has taken a High Court case against Optical Express, spoke to this newspaper. ''I have been in constant pain since. Invasive surgery should not be a business.

''I was offered surgery, at a reduced price - but had to avail of it within two weeks, said the patient, who added that ''these sales techniques are okay for window glazing, not surgery.

This patient's legal case is one of 19 that have been taken against Optical Express since 2009.

The company said in a statement: ''Optical Express is aware of a small number of cases currently under review in Ireland, but for legal reasons cannot comment on them.

Cases

Dublin-based consultant ophthalmologist Professor Michael O'Keeffe said that a typical surgeon might expect to have one or two cases taken against them over a lifetime.

Cases have also been taken against individual surgeons. Doctors must register with the Medical Council in order to practise in Ireland, but EU law means poorly trained surgeons who trained in EU countries with lower standards can register with the Medical Council.

O'Keeffe said many of the patients he sees who received laser eye surgery in eye laser chains claimed they were not alerted to the risks, or potential complications, in advance of getting the surgery.

A spokesperson for Optical Express in Ireland said: ''While we cannot comment on the standards offered by other clinics in Ireland, as a leading provider Optical Express strives relentlessly to have every patient we treat satisfied with the care we provide and to have excellent vision, surpassing their expectations.

''Every patient who seeks laser eye surgery with Optical Express must first attend a highly detailed refractive consultation to determine if they are suitable candidates for treatment.

''As patient care is our number one priority, we also ensure that everyone we treat is fully informed and suitable for the type of surgery selected. For example, we now provide all patients with a comprehensive video that contains details of risks, benefits and alternatives to surgery as part of the consent process.

''It is important to point out that not everyone who is assessed is suitable for surgery. Over the past five years we have declined to treat more than 150,000 patients across the group on clinical grounds. Patients who are considered unsuitable will be offered alternative optical solutions instead.

Industry

Complications that can arise from laser eye surgery include severely dry eyes and varying level of pain. Some patients can end up with worse sight, while a complication called corneal ectasia can result in a patient needing a transplanted cornea, or an implant.

Similarly, some patients are not regarded as suitable for surgery. For example, many surgeons believe that particularly large pupils pose an increased risk.

Rodoy said she has spoken to patients who were accepted for surgery by some chains, yet later found out that they were totally unsuitable candidates.

''I've heard from people with rheumatoid arthritis; people with large pupils; people with severe dry eyes; and even people with degenerative eye disorders getting surgery. They should never have been operated on, she said.

O'Keeffe said that clinics, which had started out doing laser eye surgery, were now beginning to do even more radical procedures such as clear lens extraction (see panel).

The Irish College of Ophthalmologists (ICO) - which is the recognised training and professional body for eye doctors in Ireland - said it was concerned that direct patient advertising is ''being increasingly used to promote certain elective surgical procedures, with special offers and little mention of the potential risks.

Mark Cahill, consultant eye surgeon and spokesperson for the ICO, said it had made a number of complaints to the Advertising Standards Authority, but that they had not been upheld. The ICO complained that Ticketmaster, a ticket sales and distribution company, was offering customers the chance to win free laser eye surgery as an incentive to buy tickets for events.

Cahill stressed that the ICO was not questioning the standard of surgical care at some clinics - just the advertising.

Earlier this month, the consumer magazine Which? published a report after sending an undercover reporter to a number of big-name high street clinics in Britain.

The report concluded that some clinics were not giving customers ''clear and accurate verbal information about risks.

There is a push to better regulate the sector in Britain, although progress is slow.

The College of Ophthalmology has invited members of the Oireachtas Health Committee, which is chaired by Fine Gael TD Jerry Buttimer, to a policy meeting on these issues on September 24."

'The Big Partnership', PR company representing Optical Express, considerately provided a significant amount of docs to journalist Susan Mitchell, in an attempt to prove that OE are good guys - including statistics showing Specsavers optician employees are their biggest fans!

NB: Info about Specsavers' financial partnership with a corporate eye surgery provider will be published at a later date.

No more can Specsavers - "the UK's most trusted opticians" - expect anyone to take their famous slogan seriously!

BBC London News tonight @ 6.30pm - WATCH IT!

For those out of the region and unable to get it on iPlayer, fear not, it'll be available online later this evening

Re Which? report as covered by Mail Online:
www.dailymail.co.uk/news/article-2727404...g-risks-surgery.html

This morning I've received messages from a significant number of people who say they've left comments under the feature but the Mail are not publishing them!

I tried myself, and sure enough - my low key comment was not published!

This is blatant bias, so I called the Mail Online office. I spoke with Lucy Kearney and asked her for an explanation of their actions.

She said that if I put my complaint in writing they would look at it!!!!

I bit my tongue and told her I am far too busy to waste my time writing to the Mail and suggested she simply look at the OERML Facebook page for details!

Meanwhile, Mail Online are allowing countless positive posts which are so obviously written by Optical Express!

30 June 2014: Interview with John McDonnell MP