Apr 2016

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY
PO BOX 106 954, AUCKLAND CITY 1143
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APRIL 2016
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OTs tackle low vision
Collaboration
between the
occupational
therapy (OT) community
and an advocacy group
has resulted in several
public awareness
projects and a developing
curriculum for OT
students to specialise in
low vision care.
The development began
a few years ago when
Dr Mary Butler, Otago
Polytechnic principal
lecturer, put some
third-year students
in-touch with the Visual
Impairment Charitable
Trust Aotearoa (VICTA) to develop ideas for projects
to help that community. Around the same time
Associate Professor Gordon Sanderson from
Otago University encouraged Dr Butler to develop
a curriculum for postgraduate OT students to
concentrate on that area.
Occupational therapists are interested in
function and practical ways to improve lives,
says Dr Butler. Low vision is a central field in OT
practice overseas, but in New Zealand, there are
opportunities for OTs to become more involved in
helping low vision patients to navigate life in spite
of their visual problems and to work far more
closely with optometrists.
“I’m very much trying to create a space where
the profession will say, ‘we can do this’, and to
encourage OTs to work closely with optometrists.
I’m encountering too many old neighbours and
clients who are unnecessarily disabled by visual
impairment,” says Dr Butler.
“Too often they are told by their ophthalmologist
that there is nothing that can be done. This is
not true. There are many things that OTs can do
by problem solving everyday functions such as
cooking, community mobility and remaining active.
We tend to use the simplest equipment or none at
all to bring about these outcomes.”
Projects arising from student collaboration with
VICTA include the development of high visibility
canes and wristbands for low vision pedestrians to
make drivers aware of their presence on the street.
“The whole question of road safety was a big
issue from the time we started the group,” says Dr
Lynley Hood, founding trustee of VICTA.
The Trust actually began as the Dunedin Visually
Impairment group, a lively cadre of elderly people
diagnosed with various problems that will lead to
permanent sight loss. When it became clear their
issues were of national significance, particularly in
regard to the ageing population, Dr Hood and her
cohort established the Trust.
“If you’re no longer allowed to drive, even if
you get half-priced taxi fares with a disability
allowance, getting around becomes very
expensive. Buses are the better option,” says Dr
Hood. “But if you catch the bus, you still have to
cross the road. (Low vision people) don’t have
white canes or guide dogs, so motorists don’t
know that they can’t see them properly. So, one
of the first suggestions was high visibility walking
sticks. They are a hit with bus drivers.”
Still from video promoting the use of high visibility sticks and wristbands from OTs
collaboration with VICTA
VICTA worked with a local fabricator to develop
four high visibility walking sticks, made from
carbon fibre with high contrast colours sure to be
visible from blocks away. Go Bus and Richies now
train drivers to recognise high visibility canes and
wrist bands thanks to VICTA’s efforts. While one of
Dr Butler’s third year OT students, Keri McMullan,
helped produce a video promoting the service,
which VICTA intends to use to promote visibility
canes around the country for World Sight Day in
October.
McMullan was also responsible for a video
promoting the use of iPads among low vision
recipients and, according to Dr Butler, a third
video promoting safe use of mobility scooters is in
the works.
“I applied for a small amount of funding to help
promote what occupational therapy can do for
people with low vision,” says Dr Butler. “We have
been running student placements, making videos,
creating Facebook pages, setting up an equipment
library, running iPad classes for people with low
vision and workshops for OTs. Lynley and VICTA have
been very important in helping us to get traction
and the profession is now coming on board.”
A postgraduate paper in vision rehabilitation will
be rolled out at Otago Polytechnic in the second
semester of the 2016 academic year. Dr Butler says
this has been brewing for some time.
“It came about in a number different ways. My
main area is brain injury and a few years ago I had
a master’s student doing work on neurological
vision impairment. She was working for the Blind
Foundation, but she pointed out that people with
neurological vision impairment and other kinds of
low vision did not qualify for help from this service.
At about the same time, Lynley and Gordon were
setting up VICTA, which draws together 20-30 with
low vision every month who are passionate and
increasingly articulate about what they need. Put
that together with the figures from the Disability
Survey (2014), which found that that self-reported
visual impairment among adults increased an
astonishing 100% between 2001 and 2013 (from
81,500 to 163,000) and it all clearly points to an
area where we all have to do our bit; and we are
particularly keen to work closely with optometrists
both in practice and research about low vision”
To see more on of what Kiwi OTs are doing for low
vision patients check out: https://www.facebook.
com/Vision-Matters-OT-866464940127100. ▀
Celebration and a question of style
Our last month before going to press has been a
whirlwind of functions. The wonderful Macular
Degeneration Race Day was a chance to enjoy a
stunning day for a fabulous cause. Though my hat
played havoc from a picture-taking point of view,
it was a pure pleasure to be involved and Jai, our
new editor, got her first taste of what a wonderful
industry this is.
There were more celebrations at the upbeat
Excellence in Ophthalmology and Vision
Research Prize Evening, where some of our most
experienced professionals stepped up to support
and celebrate some of our budding newcomers;
at Auckland Eye, which was celebrating the
end of its refurbishment; and at the Summer
Students Research Symposium, covered by our
well-known editor-at-large, Maryanne—all
included in this month’s issue.
A question of style
We’ve tweaked a few things this month after
some of you were kind enough to provide
feedback on the magazine.
Thanks to all those who say you’re loving
the slightly fresher, more modern look of the
magazine; the content mix of news, views, and
celebrations; and the more national focus—
though we can always do with more stories from
around the country, so keep them coming.
We’ve also listened to those who weren’t quite
ready for the evolution (perhaps revolution) to
that doyen of journalism styles, the Associated
Press (AP), followed by most western publications.
The AP only use full titles on first mention and
thereafter simply refer to the person by their
surname. (Even President Barack Obama becomes
simply Obama). This ensures consistency, clarity,
accuracy and brevity—a constant challenge in
publishing as there are always more stories than
ads to support the publication of those stories.
AP’s style was also developed to avoid
stereotypes and upsetting anyone as it treats
everybody the same. Many women have a
problem with the “Ms”, “Mrs” or “Miss” honorifics,
which force them to reveal their married status,
compared with men’s simple “Mr”. Sweden even
EDITORIAL C ▀
introduced a gender neutral title “hen” to avoid
the problem. Some publications use first names
for students instead of surnames, but just how
much study, experience or age should a person
have before they can be referred to in the same
manner as their peers? Then there’s the question
of medical doctors versus PhDs—the latter given a
particularly bad rap by some honorary PhDs using
the title—with many publications deciding to
now only acknowledge someone’s PhD when it’s
relevant to the story and only use the title “Dr” for
medical practitioners.
Here at NZ Optics we are your industry
publication and though we can’t promise to do
everything you ask (as that could diminish the
editorial integrity of the publication, which is
something we hold in very high regard to ensure
all are treated fairly) we do care what you think
and so have reinstated professional honorifics—so
no Mr’s but lots of Dr’s.
We love your feedback, especially your praise,
and we do listen. This is your publication and the
next generation’s too and everyone should have
a voice, which is why we’re delighted to have an
article this month from Nikku Singh (no title yet),
the new president of the NZ Optometry Student
Society (NZOSS).
So enjoy this month’s issue, celebrating so many
wonderful things people in this industry have
achieved, and don’t be afraid to let us know what
you think—we can take it!
Lesley Springall, publisher, and Jai Breitnauer at the
MDNZ Race Day
NEW ZEALAND
University’s generous gift
Joan Ready, former Faculty of Medicine
and Health Sciences administrator with
the Department of Ophthalmology, has
donated $250,000 to her former department for
department head Professor Charles McGhee to
spend at his discretion.
Talking at the 2016 Excellence in Ophthalmology
and Vision Research Awards (see story p4), Professor
McGhee said he was both surprised and delighted at
Ready’s generous gift, which would be used to help a
number of young people reach their goals.
Ready worked at the Faculty for more than 35
years in various research and management roles,
including research technician and manager for
Physiology, Pathology, Clinical Sciences, School of
Nursing and the Rural Health Inter-professional
Immersion Programme. She joined Professor
McGhee when the Department of Ophthalmology
was in its infancy and stayed there for the last 17
years.
In the Faculty newsletter, Professor McGhee
said he was extremely grateful to have had “Joan
University vice-chancellor Professor Stuart McCutcheon and
Joan Ready (front) with Professor John Fraser, dean of Faculty of
Medical and Health Sciences, and Professor Charles McGhee (back)
as a great friend and colleague over the last 17
years” and that she played an integral part in
many of the department’s major developments in
ophthalmology.
He anticipates the Joan Ready Fund will help start
the careers of several future ophthalmologists and
clinician scientists in New Zealand, he said. ▀
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April 2016
11/03/2016 3:55:24 PM
NEW ZEALAND OPTICS
3

News
in brief
RANZCO WARNS AGAINST EYEBALL TATTOOS
The inclusion of eyeball tattooing in health legislation passed by
the NSW Labour government in February has effectively legalised
this experimental form of “body modification” in the state. RANZCO
responded by issuing a strong warning against the practice, which
involves injecting ink into the sclera to make it a solid or mix of
colour. “The eye is a very complex and sensitive organ and in no
way should anyone consider tattooing it if they wish to retain their
sight over the long-term,” said Associate Professor Mark Daniell, a
corneal specialist. Eyeball tattooing has been banned in some US
states due to a link to blindness and cancer.
SMART CONTACTS FROM CHINA
In a huge leap forward for next-generation wearable tech, a
Chinese research team have built an “invisible” circuit layer within
a contact lens for the first time. The team’s research, published in
the journal Advanced Materials in March, was led by Professor Song
Yanlin at the Chinese Academy of Sciences in Beijing. The built-in
electronic circuit is invisible to the naked eye because it measures
one micrometre in width, making it narrower than the average
bacterial cell. It could be used to measure glucose levels in the tears
of diabetic patients or become part of a layer of “invisible skin”
giving a sense of feeling back to patients with prosthetic limbs, the
authors said.
PENNY THE PIRATE CROWNED QUEEN
OPSM’s Penny the Pirate--an eye test turned into a book and an
associated app, designed to test kids’ eyes while reading with their
parents--has been crowned the world’s most successful marketing
campaign in the Warc 100 rankings, an annual report that judges
the world’s best marketing campaigns by business impact.
The campaign, created for OPSM by Saatchi & Saatchi Sydney with
the help of paediatric eye care specialists, resulted in thousands of
children having their eyes checked and increased the number of
eye tests conducted by OPSM by 22.6% year-on-year. The book is
now being used by not-for-profit organisation OneSight to help test
children’s eyes in remote and rural Australia.
ESSILOR AQUIRES UK ASSET, PUBLISHES STRONG RESULTS
Essilor International has acquired UK-based Vision Direct Group,
one of Europe’s leading online contact lens retailers, with
revenue of around £33 million ($71 million) in 2015. Essilor said
the acquisition strengthens its current position in Europe by
complementing existing activities. Fuelled by 19 new acquisitions
and partnerships, Essilor also published strong financial results for
2015, as the company continues to focus on its lens and optical
instrument divisions, innovation and consumer marketing. Revenue
was up 18.4% to €6,716 million ($11,205 million), while operating
profit increased 19.6% to €1,183 million ($1,974 million).
MORE MAORI SURGEONS PLEASE
The Royal Australasian College of Surgeons (RACS) has committed
to increasing the number of Maori surgeons in New Zealand as part
of a newly developed Maori Health Action Plan. “At present, there
are only a small number of surgeons in New Zealand who identify
as Maori,” said Dr Jonathan Koea, an Auckland-based hepatobiliary
and general surgeon and member of the Plan’s working group.
Dr Koea notes that while this programme will take a sustained
effort over years, it is a significant step forward for the College’s
commitment to Maori health. “Through the Action Plan, RACS
intends to increase the number of Maori in the surgical workforce,
embed cultural competency as a fundamental professional skill,
focus more surgical research into Maori Health and promote
initiatives that will decrease the disparities that currently exist for
Maori.”
BAYER OFFERS GRANTS
Bayer and the American Association for Cancer Research (AACR)
announced the availability of the “AACR-Bayer Innovation and
Discovery Grants”. The programme aims to promote the key tenets
of the Bayer Grants4Targets initiative with a focus on oncology
to provide new treatment options for cancers with high unmet
medical need, to encourage innovation and translation of ideas
from basic research into novel drugs and to foster collaborations
between academic groups and the pharmaceutical industry.
BIONIC EYES BECOMING A REALITY
Once the privilege
of TV’s Six Million
Dollar Man, bionic
vision is becoming
more commonplace
for the everyday
patient. Pixium
Vision have
launched the Iris II,
their first epiretinal
implant with 150
electrodes—more
than three times what is currently available—suitable for patients
who have lost their sight due to retinitis pigmentosa (RP). The
France-based research team, headed by Professor Michel Weber,
said early results with patients with RP are positive.
Meanwhile in the US, optics specialist Eric Tremblay unveiled a
unique contact lens that will provide the wearer with telescopic
vision. The lens is just 1.55 mm thick and features a thin, reflective
telescope that enables the user to zoom in and out via winking. ▀
Excellence in
ophthalmology
celebrated
The annual Excellence in
Ophthalmology and Vision Research
prize evening is an upbeat affair,
bringing together those at the beginning
of their careers with those who have more
experience to share.
This year event’s on March 1 was no
different, with a celebratory atmosphere
pervading the halls at the University of
Auckland. The event was well-attended
by members of the Ophthalmology
Department, senior staff from the School of
Medicine, donors, benefactors and friends
and family members of the prize winners.
Ophthalmologist and department head
Professor Charles McGhee presided,
explaining the evening was about
celebrating past and future potential
success. He reviewed the achievements of
the department since it was established
in 1999, including gaining more than $33
million in research funding, increasing
research fellows from one to 75, 700
research papers published or soon-to-be
published, 30 higher research degrees
awarded or submitted, and 18 PhD and MD
students currently enrolled. There has also
been a myriad of national and international
connections developed through the success
of past students, many of whom have gone
on to become leaders in their field both here
and overseas. Professor McGhee thanked
the department’s benefactors, those who’ve
been supporting the department from the
start such as Drs Bruce and Wendy Hadden
and the Ring family to the newest supporter,
former faculty administrator Joan Ready
(see story P3) who he says blew him away
with her generous retirement donation of
$250,000.
Doctoral candidate Yeri Kim provided
an outline of her PhD research into the
Development of connexin inhibitors for the
treatment of retinal diseases to understand
the mode of action of Peptagon and HCB1019
to potentially treat diabetic retinopathy and
macula oedema, and dry and wet AMD. Given
the initial success of Kim’s research, clinical
trials with Peptagon are expected to start this
year.
But the main reason for the evening was
to celebrate seven award winners: the noted
summer studentships and the winners of the
prestigious William MacKenzie Medal, Arthur
Thomas Paterson scholarship and Calvin Ring
Undergraduate awards:
Calvin Ring Undergraduate Prize in
Ophthalmology—Victoria Utley
Dr Peter Ring presented the Calvin Ring
Undergraduate Prize for the best allround
undergraduate student in clinical
ophthalmology to fifth year medical student
Victoria Utley.
In presenting the award, Dr Ring explained
that the award was given in honour of
his father, Dr Calvin Ring, who was at
the forefront of ophthalmology for his
generation, who spearheaded good practice
and the use of new IOLs in cataract surgery
and who was instrumental in bringing about
the Maurice Paykel Chair of Ophthalmology,
held by Professor McGhee.
Utley comes from a dynasty of surgeons in
Christchurch whose publications and research
showed a strong surgical bias, he said. Utley
said she was excited to receive the award, the
first since school, and though she was still
undecided which direction to follow she’d
always had an interest in ophthalmology. “I
enjoyed my ophthalmology placement last
year. I’ve always been interested in eyes, but
being able to see the research and being able
to understand that the eyes aren’t their own
separate entity, they are kind of a window to
what’s going on generally in the body, I found
fascinating.” Utley said how privileged she
felt to have won the award and to have met
the Ring family.
William MacKenzie Medal—Michael Wang
The William MacKenzie Medal is awarded
each year for “Early Excellence in Eye
Research.” It is a highly prized award
that recognises
the significant
contribution
made by a
medical student
or trainee intern
towards a research project, which reached
publication status during the year of the
award.
This year’s winner, Michael Wang, a fifth
year undergraduate medical student,
received his award from Associate Professor
Jennifer Craig who said Wang’s academic
achievement, dedication toward research and
enthusiastic approach was commended by
a number of staff members. She explained
how Wang had done an exceptional job
working on a number of different projects
in her department looking at some of the
treatments for dry eye, mostly in the area of
ocular surface disease. He has published two
papers and submitted a third on the work
he’s been doing and has at least two more in
the pipeline. He now has eight papers to his
name and six in preparation, she said.
Award winners (L to R) Michael Wang, Eileen Song, Clare Wu, Victoria Utley, Andy
Kim, Benjamin Wright and Dr Leo Sheck. Picture by Godfrey Boehnke (GB)
Arthur Thomas Paterson Scholarship—Dr Leo
Sheck
Auckland Eye’s Dr Sarah Welch, the current
clinical director of ophthalmology at
Greenlane Clinical Centre, specialising in
medical and surgical retina, presented the
Arthur Thomas Paterson Postgraduate
Scholarship to Dr Leo Sheck. The
scholarship supports a vocational trainee
in ophthalmology to pursue a fellowship
overseas.
In presenting the award Dr Welch said it
was a pleasure having Dr Sheck as a registrar
in the department and that he’s been a
great asset. Dr Sheck is going to Moorfields
Eye Hospital in London to study genetic eye
diseases, in particular retinal dystrophies and
electrophysiology and diagnostics. All areas
of great need in the country and within the
Auckland district, said Dr Welch.
In his citation, Dr Sheck said at Moorfields
he’d be working with Professor Graham
Holder, a well-recognised international expert
in electrodiagnostics, while his supervisor
will be Professor Michel Michaelides, an
international expert in retinal dystrophies.
Eye Institute Summer Studentship—Andy
Kim
Eye Institute ophthalmologist and patron of
the Buchanan Ocular Therapeutics Unit at
Auckland Unversity Dr Trevor Gray, presented
the Eye Institute Summer Studentship award
to third year medical student Andy Kim.
Kim conducted a comprehensive literature
review over the summer on Demodex
blepharitis under the supervision of Associate
Professors Jennifer Craig and Trevor Sherwin.
The aim of his project was to review the
current knowledge on Demodex mites and
Demodex blepharitis with the intention
of identifying molecules which could be
uniquely and readily expressed by Demodex
mites. It was also a pre-cursor to Kim’s
honours project to develop a diagnostic test
for ocular demodicosis.
Retina New Zealand Summer Studentship—
Benjamin Wright
Frazer Alexander, president of Retina New
Zealand, presented the Retina NZ Summer
Studentship award to fifth year medical
student Benji Wright.
Wright undertook a summer studentship
Characterising Cystic Maculopathy in
Inherited Retinal Disease, funded through
Retina New Zealand and supervised by
Retina Specialists’ ophthalmologist Dr
Andrea Vincent, who he worked with in the
Greenlane Clinicical Centre.
During the summer studentship Wright
determined the incidence of cystic
maculopathy in a number of inherited
retinal diseases, identified from the NZ
Database of Inherited Retinal Disease. He
reported on the differing incidences of cystic
changes between autosomal dominant,
autosomal recessive and x-linked retinitis
PhD research presenter Yeri Kim and Professor
McGhee entertain the audience. Picture by GB
Naveed Yasin, Raul Ayala and Priyanka Agarwal
Clare Wu and Dr Bruce Hadden share a laugh
during the prize giving. Picture by GB
pigmentosa. He also investigated the rates
of response to carbonic anhydrase inhibitor
treatment in patients who have developed
cystic maculopathy, and correlated this with
their genetic cause, in order to ascertain the
likelihood of successful treatment.
Tom Cat Trust Summer Studentship—Clare
Wu
Associate Professor Bruce Hadden presented
the Tom Cat Trust Summer Studentship award
to third-year medical student Clare Wu.
Supervised by Associate Professor Trevor
Sherwin and Jane McGhee, Wu researched
stem cell proliferation, migration and
differentiation of excised limbal tissue verses
neurospheres. The cell sources were seeded
onto amniotic membranes then placed on
donated human cornea for varying time
periods. She found neurospheres proliferated
and migrated more favourably than their
limbal tissue explant counterparts, informing
future treatment options for patients with
limbal stem cell deficiency.
Ombler Trust Summer Studentship—Eileen
Song
Dr Andrea Vincent presented the final
Summer Studentship Award, the Ombler
Trust Award, to third-year medical student
Eileen Song.
Under Dr Vincent’s supervision, Song
characterised the nature and spectrum of
X-linked inherited retinal disease within
New Zealand. Using the Inherited Retinal
Disease Database, she identified individuals
with X-linked disease and investigated the
correlation between their clinical features,
disease in females and the genetic test
results. Results from her project show
9.26% of patients from the Inherited Retinal
disease Database harbour a diseasecausing
mutation in a retinal gene on the X
chromosome. The population studied also
contained several families where the obligate
female carriers were as severely affected
phenotypically as the affected male family
members, challenging the conventional
concept that female carriers have a later
onset and a milder course of disease than
affected males. The study highlighted the
importance of local knowledge in order to
optimise management and treatment, said
Dr Vincent. ▀
4 NEW ZEALAND OPTICS April 2016

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April 2016
NEW ZEALAND OPTICS
5

New 3 point test
for teachers
Albany optometrist Stuart
Warren has developed a 3
Point Check Test for school
teachers to administer to determine
if near vision problems may be
contributing to learning difficulties.
Warren, an advocate for students
with dyslexia, developed the test
from his experience treating young
patients whose vision problems
were causing difficulties at school.
“If a child has a learning problem, but passes the school screening
test, teachers assume their vision is fine. But in reality there may
still be a near vision problem. Over the past 10 years there have
been quite a few studies to support the idea that the prevalence
of near-vision problems is quite high especially if there is a
background of learning difficulties.”
Warren’s 3 Point Check Test assesses if a child’s near vision is
clear, single and steady, which Warren refers to as the “near visual
platform”. It measures amplitudes of accommodation, convergence
and asks students if letters appear to be “jumping or moving” on
the page--an indicator of visual stress. This latter symptom can be
assessed with tinted lenses based on those used in controlled trials
by the Dyslexia Research Trust at Oxford University.
Warren says he is planning to sell his test as a kit for teachers, but
is also making it available to optometrists. “I’m currently working
with a small handful of schools. I was invited to speak to a group
of teachers at the end of last year and I discussed the 3 Point Check
Test and they were very positive about it. Some of the teachers
were surprised because they never considered that near-vision
could be a problem.”
Warren says one school he worked with arranged for a dozen
students with known learning difficulties to be screened and found
that four of them had previously unidentified near-vision problems.
The test is designed for children aged seven to 17 and can be
conducted by a trained teacher in less than a minute.
Children with near-vision problems may have difficulties
with reading accuracy and fluency or they may have difficulty
concentrating in class. Warren says he frequently uses a
questionnaire that he sends out to parents and teachers to identify
any correlation between vision and learning. A common symptom
that appears in the questionnaire is a child’s inability to keep their
place in a text. “They’re not able to allocate attention to the task of
learning,” he says.
Warren’s interest in behavioural optometry and helping patients
with learning difficulties, led him to develop the kit. But one
particular patient he saw in early 2015 was instrumental in creating
the test: an eight-year-old boy who was on reading recovery for 18
months and was even taken to a psychologist to determine other
reasons for his reading difficulty. “When I tested the patient, I found
he couldn’t converge at all, which really surprised the parents. These
kinds of problems are all too common, so it makes sense to have a
near screening test out there. It could solve a lot of problems.”
After selling his practice, Warren is now working at Albany
Optometrists and is building a number of tools for schools and
optometrists to help students with learning problems including
a video to demonstrate the 3 Point Check Test. For more visit his
website at http://icept.co.nz. ▀
See the light,
not the UV
Australian
researchers
have developed
a nanoscale device
that is able to filter
specific colours from
light. Researchers
at RMIT University
and the University
of Adelaide have developed a stretchable material able to
manipulate light while remaining transparent. Using artificial
crystals known as dielectric resonators that are just 100 nm to
200 nm in size, the material could be used to make contact lenses
that prevent harmful rays—such as UV light—from penetrating
the eye.
Right now, dielectric resonators only work with specific colours,
but because the scientists were able to build the material to be
elastic, they were able to control the properties of the surface and
filter out more colours. When combined with other advances in
technology, the result could be a smart contact lens that protects
the eye while gathering and transmitting live data—like a tiny
version of Google Glass.
“With this technology, we now have the ability to develop
light weight wearable optical components, which also allow for
the creation of futuristic devices such as smart contact lenses
or flexible ultrathin smartphone cameras,” said lead author and
RMIT researcher Dr Philipp Gutruf.
The paper, Mechanically tunable dielectric resonator
metasurfaces at visible frequencies, was published in the journal
ACS Nano. ▀
A review of ocular coherence
tomography angiography
BY DR SHANU SUBBIAH AND DR
PETER HADDEN*
Optical coherence tomography (OCT)
has evolved over the past decade as
one of the most important ancillary
tests in ophthalmic practice. The technology
was first developed in 1991 and the first
clinical application reported in 1994 for the
investigation of macular disease. 1, 2
The first iteration time-domain OCT had
both speed and sensitivity issues that
limited its accuracy, reliability, and efficiency.
These limitations were supplanted by the
introduction of spectral-domain OCT (SD-OCT)
systems, which used spectral interferometry
and Fourier analysis. This allowed image
acquisition 50 to 100 times faster than timedomain
technology with a subsequent and
dramatic improvement in quality.
Optical coherence tomography angiography
(OCTA) is a new non-invasive approach to
diagnostic imaging in retinal disease. It
identifies blood vessels because the blood
flowing through them causes the reflected
OCT signal to vary slightly on consecutive
scans, since it is moving and altering rather
than staying still like the rest of the eye,
and can generate angiographic images in a
matter of seconds. 3, 4 It is a new technique
that enables us to image yet another
anatomic structure of the eye with OCT, this
time the vasculature.
Previously the “gold standard” investigation
for diagnosis of retinal vascular disease has
been “injected dye” angiography. Standard
angiography allows for dynamic visualisation
of blood flow with a wide field of view.
Patterns of dye leakage, pooling, and staining
can be appreciated, thus allowing diagnosis
of pathology. Fluorescein angiography (FA)
and indocyanine green angiography (ICGA)
are, however, invasive tests that require
intravenous administration of dye and
imaging of 10–30 minutes.
Standard angiography does of course have
limitations; retinal pathology can be obscured
by leakage, hemorrhage and media opacities.
Also, the images provided are also twodimensional,
hence one cannot distinguish
between blood vessels at different depths
within the retina. FA and ICGA have other
drawbacks that can limit their widespread
use. They are invasive, relatively expensive,
and time-consuming, consequently they are
not ideally suited for use on a regular basis
in a busy clinical setting. Although very safe,
the dyes pose risks ranging from nausea to
allergic reactions, including anaphylaxis in
rare instances. 5 Indocyanine green dye is also
contraindicated in pregnancy and kidney
disease.
OCTA, in comparison, is a non-invasive
technique that acquires volumetric
angiographic information without the use of
dye. Each three-dimensional scan set takes
approximately six seconds to obtain. Enface
images (OCT angiograms) can then be
scrolled outward from the internal limiting
membrane (ILM) to the choroid to visualise
the individual vascular plexus and segment
the inner retina, outer retina, choriocapillaris
or other area of interest. In fact the 3 × 3 mm
OCT angiograms appear to be of equivalent
if not a higher resolution than the currently
available FA/ICGA images. 6
Exact delineation and size measurements
can be performed for pathology such as
choroidal neovascularisation (CNV) in “wet”
age-related macular degeneration (AMD).
OCTA also demonstrates changes in the
choriocapillaris surrounding CNV lesions.
Some of these changes are thought to occur
prior to CNV development, which means that
we may be able to identify patients who are at
risk of developing wet AMD. 7
OCTA has been used to assess optic nerve
head perfusion in glaucoma. OCTA of
glaucomatous optic nerves demonstrated a
significant decrease in blood flow compared
with controls. A correlation between blood
flow in the disc and visual field pattern
standard deviation was observed, implying an
association between decreased perfusion of
the optic disc and glaucoma severity. 8
As well as AMD and glaucoma, OCTA
reveals the vascular changes (impaired
capillary perfusion, microaneurysm turnover,
and quantification of blood flow) seen in
conditions such as diabetic retinopathy, retinal
vein occlusions and macular telangiectasia.
Of course there are some limitations to
OCTA. The area visualised is much smaller
than with angiography, typically commercially
available machines visualise a 6 x 6 mm
area compared to the 200 degree imaging
now available with wide angle FA and the
leakage of dye is not appreciable making
conditions such as chronic central serous
chorioretinopathy difficult to diagnose.
Conclusion
We have been fortunate enough to have
the AngioPlex OCT angiography upgrade on
the Zeiss Cirrus HD-OCT at Eye Institute for
the last two months. The technology has
been incredibly useful for the assessment
and treatment of patients with retinal
Eye Institute appoints CEO
Eye Institute has appointed a chief
executive officer to spearhead the
company’s future.
Dr David Fitzpatrick-Cockram brings
both the knowledge and expertise to
take Eye Institute to the next chapter of
its development as the practice has now
reached a size where it will benefit from
being professionally led, said Dr Peter Ring,
one of Eye Institute’s original co-founding
ophthalmologists. “It’s an exciting step. He
will be able to bring a wealth of personal
experience in the health care world to help
Eye Institute to continue to stand out as an
ever-improving provider of exceptional eye
care.”
In Auckland, as well as its flagship premises
in Remuera, Eye Institute runs fullyfunctioning
surgical and clinical facilities in
Manukau and North Shore, with satellite
clinics in New Lynn and St. Heliers.
“We were seeking someone with
exceptional qualities. We have found that
in David. He will be able to help guide us
Fig 1. This OCTA image shows
ischaemia superior to the
fovea in a superotemporal
branch retinal vein occlusion.
No amount of avastin will
be able to bring the vision
back in this ischaemic area
Fig 2. Telangiectatic vessels
can be seen temporal to the
fovea in this patient with
juxtafoveal telangiectasis
Fig 3. A choroidal neovascular
membrane can be
identified in this image,
colour coded by depth
disease. Importantly
OCTA has minimal,
if any, impact on the
amount of time that
the patient spends in
the clinic and reduces
the need for further
appointments for
FA and ICG. We have
access to immediate
imaging that can
be used for disease
management.
We realise this technology is still in its
infancy, especially with regards to image
interpretation, so in the present at least
OCTA is not going to replace FA and ICG
entirely, but it will decrease the need for
these tests and will also allow us to provide
a more accurate diagnosis in cases where the
risk and inconvenience of FA or ICG makes
us reluctant to use those techniques. The
illustrated cases show that it is turning out
to be a very valuable and frequently used
adjunct for Eye Institute. ▀
References
1. Huang D, Swanson EA, Lin CP, et al. Optical coherence
tomography. Science. 1991;254 (5035):1178-1181
2. Imaging of macular diseases with optical coherence
tomography. Puliafito CA, Hee MR, Lin CP, Reichel
E, Schuman JS, Duker JS, Izatt JA, Swanson EA,
Fujimoto JG. Ophthalmology. 1995 Feb;102(2):217-29
3. Kim DY, Fingler J, Zawadzki RJ, Park SS, Morse
LS, Schwartz DM, et al. Optical Imaging of the
chorioretinal vasculature in the living human eye.
Proc Natl Acad Sci. 2013;110:14354–9
4. Spaide RF, Klancnik JM, Cooney MJ. Retinal Vascular
Layers Imaged by Fluorescein Angiography and
Optical Coherence Tomography Angiography. JAMA
Ophthalmol. 2014; E1-6.
5. Kwiterovich KA, Maquire MG, Murphy RP, Schachat
AP, Bressler NM, Bressler SB, et al. Frequency
of adverse systemic reactions after fluorescein
angiography. Results of a prospective study.
Ophthalmology. 1991;98:1139–42
6. Matsunaga D, Puliafito CA, Kashani AH. OCT
Angiography in Healthy Human Subjects.
Ophthalmic Surg Lasers Imaging Retina.
2014;45(6):510–5
7. Jia Y, Bailey ST, Wilson DJ, Tan O, Klein ML, Flaxel CJ,
et al. Quantitative Optical Coherence Tomography
Angiography of Choroidal Neovascularization in
Age-Related Macular Degeneration. Ophthalmology.
2014;121:1435–44
8. Jia Y, Wei E, Wang X, et al. Optical coherence
tomography angiography of optic disc perfusion in
glaucoma. Ophthalmology. 2014;121(7):1322-1332
ABOUT THE AUTHORS
* Dr Shanu Subbiah is a refractive cataract surgeon,
with dual fellowship training in both retinal and
corneal disease. He’s involved in clinical research
into macular degeneration and retinal disease and is
actively involved in teaching.
Dr Peter Hadden is a refractive-cataract and retinal
surgery specialist and a clinical senior lecturer in
ophthalmology at the University of Auckland. He’s
involved in several research programmes and has
published more than six papers.
Both are consultant ophthalmologists with Eye
Institute.
Dr Trevor Gray, Barbara Hare and Dr Peter Ring
welcome new CEO Dr David Fitzpatrick-Cockram
(second from left)
to provide a level of service and excellence
in eye care that’s unmatched by others,”
said Dr Trevor Gray. “David’s experience as
both a provider and a procurer of healthcare
services gives him a unique insight into
healthcare management.”
Dr Fitzpatrick-Cockram has more than 25
years of clinical training and experience,
including qualifications in healthcare
leadership from Yale University and post
graduate qualifications in strategy and
innovation from the University of Oxford.
Prior to coming to New Zealand in 2013, the
South African-born Dr Fitzpatrick-Cockram
was director of innovation, director of mental
health and professional lead for clinical
psychology for the NHS in the UK. More
recently he was the senior clinical lead at
Southern Cross Health Society.
Dr Fitzpatrick-Cockram said he was both
delighted to have returned to the warmth of
the Southern hemisphere and to be joining
a leading ophthalmological practice like
Eye Institute. “I have a passion for patientcentred
excellence in healthcare and Eye
Institute is the perfect place for me to
contribute to New Zealand ophthalmology
with such an amazing group of surgeons and
the fantastic team that supports them.”
Eye Institute general manager Barbara Hare
will be assisting Dr Fitzpatrick-Cockram with
the running of the practice and with project
management under the new title of chief
operating officer. ▀
6 NEW ZEALAND OPTICS April 2016

Making the revolutionary, routine.
CIRRUS HD-OCT with AngioPlex
// ANGIOPLEX
MADE BY ZEISS
NEW
ZEISS AngioPlex OCT Angiography
Introducting All-New Technology
Ultra-clear visualisation of microvascular blood flow using non-invasive CIRRUS OCT Angiography
New vascular information
• Ultra-clear 3D microvascular visualisations powered by OMAG C
• OMAG C - the proprietary processing technique that detects motion of red-blood
cells within sequential OCT B-scans performed repeatedly at the same location
• Depth of retinal vasculature colour coded for ease of visual assessment
Enhanced workflow
• Ideal non-invasive, dye-free angiography
• Single-Scan simplicity: capture OCT angiography with just one scan
• Real-time tracking with FastTrac ensures artifact-free scans and precise
location identification during follow-up visits
ZEISS
Ph: 1800 882 041 (AU)
Ph: 0508 765 271 (NZ)
med.au@zeiss.com
April 2016
NEW ZEALAND OPTICS
7

Auckland Eye celebrates new look
Auckland Eye celebrated the complete
refurbishment, expansion and
modernisation of its headquarters at the
end of February.
Auckland Eye doctors and new chief executive
Dr David Pendergrast, Arrow’s Mario Cross, Tracey Molloy,
John Kelsey and Nia Stonex
Peter Stoute with Drs Brian Kent-Smith and Hussain Patel
Visionz
With just over six months to go
before New Zealand’s Premier Optical
Event, Visionz 2016 opens its doors, it’s
time to get organised and plan your visit.
We hope 60 exhibitors will commit to Visionz
2016 which is being held in Auckland October
14th - 16th October.
WHERE
Ellerslie Events Centre Ellerslie Auckland.
Newmarket & Pakuranga Hunt Club Rooms
WHEN
Friday 14th October - 9.00am -6.00pm
Saturday 15th October - 9.00am – 6.00pm
Sunday 16th October - 9.30am -1.00pm
2016
2014
CONFERENCE PROGRAMME
Education is one of the foundation elements of any good industry
exhibition and at Visionz 2016 delegates have the opportunity to earn
CPD and general points. Further details to follow.
FREE ENTRY
There is no charge for admission for all optical practitioners, practice
managers, optical staff or students from the Auckland school of
Optometry to the trade exhibition.
For more Information, please contact: Gary Edgar at nzowa@live.com
Registration details to follow.
GRAND OPENING – 23 SEPT. 2016
Deb Boyd, and the organisation’s former CEO
Moira McInerney—who started the destruction
and construction process, were joined by others
involved in the project, including representatives
from architects Jasmax and construction company
Arrow, a host of optometrists, eye care company
representatives and other special guests. All
were invited to raise a glass to the new building
and celebrate the end of the “noise, dust and
disturbance” of the past several months.
Dr Stephen Best and Dr David Pendergrast
thanked attendees for their patience with their
patients and support during the process, as
the practice moved its clinic from one part of
the building to another to maintain services
throughout the duration of the project.
Today the practice is larger and lighter, with more
consulting rooms, waiting rooms and staff areas; a
better flow between areas; no more leaky building
concerns; and a whole new “less clinical” look and
feel, explained Dr Pendergrast. What was two quite
distinct buildings have now been joined into one,
unified in their design, and related to Auckland Eye’s
Oasis Surgical building, with the same external
cladding, gable angles and through the use of
external metal screens, which modify light entry
and give the building a contemporary design. Dr
Pendergrast joked there had been some arguments
as to what the screens’ design represented. “They
are endothelial cells from my point of view, but
others say they are retinal epithelial cells, but we
are decided they are cells of the eye.”
Silmo Sydney
partners
with NRA
New Australasian optical fair
Silmo Sydney announced it will
include an Independent Retailers
Conference, which will be organised in
partnership with the Australian National
Retail Association (NRA).
“The most successful trade shows are
those which meet the needs of buyers and
match them to sellers. The key is to present
the right mix aligned to a common goal;
it’s all about the balance,” said Gary Fitz-
Roy, managing director of Silmo Sydney
exhibition organisers Expertise Events.
The Independent Retailers Conference
programme will enable practitioners
to pick up valuable retailing ideas that
can have real impact and would not
normally be available to them, said
Fitz-Roy. “Quite often the industry is
so focused on their practices that the
behind-the-scenes every day running
of the business doesn’t get the focus it
should and it’s these aspects that can
greatly affect profitability, such as leases,
law and specific retailing training such as
merchandising.
“Our programme will run on the show
floor and be made up of small concise
sessions and visitors will have the
opportunity to sit one-on-one with NRA
specialists to discuss specifics.”
Phillippa Pitcher, Naomi Meltzer and Dr Sarah Welch
The newly refurbished building is also sustainably
future-proofed with tanks for rainwater collection,
the facility to add solar panels, room to grow and
the ability for the practice to be flexible about how
it uses its new, naturally-lit spaces. “The move to
the reduced paper practice is accelerating, so we
have made sure we have the IT infrastructure to
support this,” said Dr Pendergrast.
The refurbishment also allows space for the
continued growth of Auckland Eye’s research
department, headed by Dr Dean Corbett, while
the increasing number of retinal specialists in the
practice has allowed it to incorporate a dedicated
retinal wing, including a small procedure room.
“Tonight we wanted to say publicly that we are
done and finished and back in business full speed,”
summarised Dr Pendergrast. “And we have got to
the finish line of what I think is an excellent
result.” ▀
In the same announcement, Silmo Sydney
also announced that its official charity will
be the Australian Royal Institute for Deaf
and Blind Children (RIDBC). Funds will be
donated to them from the exhibition and
the organisation will have a presence at
the show. “Children are our future and this
is an extremely worthy cause. More than
1 in 2,500 children in Australia have vision
loss, there has been a 100% increase in
vision-impaired children enrolled in RIDBC
programmes in the last seven years,” said
Fitz-Roy.
“We promised to push the boundaries
and create a world class event that
unites the key market players and adds
value to buyers. The involvement of NRA
certainly adds real value and clout to the
overall event; we are excited by what we
have announced so far, but expect more
exciting announcements soon. We have
only just begun outlining our plans for
SILMO Sydney.”
Fitz-Roy said currently stand bookings
are strong and Expertise Events was
looking forward to hosting the Silmo Paris
organising team in early April when they
come to conduct a site visit of the new
Darling Harbour Centre.
Silmo Sydney is set to take place from
March 9-11. ▀
ACBO runs
basics seminar
Optometrists from around New Zealand
attended a seminar to learn about
integrating behavioural optometry
methods within their existing practice.
Workshop leader Adrian Bell with ABCO member Keith
Miller and CR Surfacing’s Steph Court and Lynton Dodge
The Australian College of Behavioural
Optometrists Kickstarter Seminar on February 21
featured presentations and workshops by Adrian
Bell, a Sunshine Coast-based optometrist with 30
years’ experience in the field.
The course was designed for new ACBO
members or others getting started in Behavioural
Optometry. In addition to a dinner, sponsored by
CR Surfacing, attendees were taken on a step-bystep
look at behavioural examinations, testing,
decision-making and prescribing. It was also a reintroduction
to near retinoscopy, an under-utilised
tool, according to organisers.
“This course is enough to make people start
thinking and prescribing in different ways,” said
Keith Miller, ACBO’s New Zealand director. “It’s
using the tests they’re already doing but looking
at the results in a slightly different manner.
They’re learning new ways and getting a better
understanding of using the retinoscope for
investigating what a person is doing with their
visual system when they’re, say, reading.”
Bell took the group through an afternoon session
that ended in a workshop on the retinoscope.
“Retinoscopy is one of those things that some
people think we don’t need any more. But I will
encourage you to get your ret out, charge it, blow
off the dust, because it’s a great way of observing
vision, in a dynamic sense.”
Bell said the retinoscope provides a dynamic view,
over time, of where patients are focusing and even if
they are paying attention. He also discussed methods
for using the retinoscope with younger patients.
“Remember your refraction is a subjective
test. Retinoscopy is much more objective. You’re
directing attention to a particular place, but you’re
more in control. It’s objective, real-time and it’s
dynamic. The focus moves, the eyes move, the
reflex moves.”
Feedback from the 27 attendees was positive,
said Miller. If optometrists wanted to pursue
behavioural optometry and earn certification,
they can attend additional seminars offered over
the year. March’s Practical Vision Therapy NZ -
Workshop 1 with New Zealand optometrist Evan
Brown was sold out.
“There really are not enough behavioural
optometrists in New Zealand,” Miller said. “With
one-in-five children suffering a vision-related
problem that can interfere with their learning,
there’s a lot that could be done. But if all those
children came to a behavioural optometrist for
examination and vision care, we couldn’t cope.
But [they] aren’t seeking help because they don’t
know; nobody is offering them the appropriate
levels of care.” ▀
REINVENTING BUSINESS.
23> 26 SEPT. 2016
PARIS NORD VILLEPINTE
Conception : CARLIN
SILMOPARIS.COM
Neuro-ophthalmology evening from CVRT
BY DR JESSE GALE*
The first Capital Vision Research
Trust (CVRT) education event for
2016 was themed around neuroophthalmology.
Many optometrists and
ophthalmologists feel less confident dealing
with neuro-ophthalmic complaints because
the cause of the problem is not usually visible
with the slit lamp. The presenters were fellow
Wellington neuro-ophthalmologist Dr Neil
Aburn and myself.
I started with a talk on abnormalities
of the pupil, where I discussed various
physiological and pathological aspects from
the interesting melanopsin ganglion cells,
to tips on examining pupils and measuring
a relative afferent pupil defect (RAPD),
causes of light-near dissociation, and a
number of cases of anisocoria.
Dr Aburn presented on optic neuropathies
with a great range of varied cases to
demonstrate the crucial principles about
how the history guides the differential
diagnosis and investigation. Among
the interesting cases were both the
common and bizarre, from urgent medical
emergencies to gradual inherited problems.
Our sponsor OptiMed made a brief
presentation on the scanning laser
ophthalmoscope called Eidon, which takes
wide-field retinal images without dilation.
I then presented another talk on diplopia,
with cases to illustrate several important
principles and some of the important
patterns to recognise. Cases of monocular
diplopia, cranial nerve palsies, myasthenia
and orbital disease were covered, with
emphasis on red flags. Both Dr Aburn and
I tried to use plenty of case studies and
questions to stimulate thought and draw
feedback from the participants and to
highlight the underlying principles and safety
issues of these challenging presentations.
Other CVRT education event dates for
Wellington in 2016 are: Wednesday April
25, Wednesday August 24 and Thursday
December 1. For more information, please
visit www.capitalvision.org.nz or email
info@capitalvision.org.nz. ▀
ABOUT THE AUTHOR
* Dr Jesse Gale is an ophthalmologist with Capital &
Coast District Health Board and Capital Eye Specialists
in Wellington. He is a new board member at Capital
Vision Research.
8 NEW ZEALAND OPTICS April 2016

A NEW LOOK FOR AUCKLAND EYE
After nearly two years of building,
refurbishment, expansion and
modernisation, Auckland Eye is delighted
to announce the completion of our new
and improved St Marks Road site.
Welcome to the future of ophthalmic care
Now finished, our new development reinforces
Auckland Eye’s position as a state-of-the-art
consulting facility, allowing us to accommodate
future technological developments as they arise, in this
highly specialised and fast-moving field.
A better working environment
We hope patients will enjoy the new look clinic as much as
our doctors and staff do. With more consulting rooms, new
examination equipment and allocated space for dedicated
services like our research department headed by Dr Dean
Corbett, it’s a win-win for everyone concerned.
A new vision for all
We believe everyone will benefit from what has been a
ground-up refurbishment. Our patients remain our first
priority. They will enjoy the welcoming atmosphere, the
new and modernised waiting areas and facilities, enhanced
by the use of natural light throughout the practice –
designed to provide a better overall patient experience.
Our doctors and support staff will continue to provide
their expertise and perform their vital roles as ever, in
a centre purposely designed for ophthalmology in the
21st century.
Design with focus
The new clinic design unifies the two previously very
different parts of the building and integrates us perfectly
with our premier day-stay centre, Oasis Surgical.
The new front site houses our dedicated retinal suite, designed
to allow the team to provide the specialised care that patients
with medical and surgical retinal problems require. The previous
Auckland Eye building has been extended to cater for all eye
care needs, with all areas benefitting from a modernised look
and feel. Exterior cladding and external screens blend the two
parts of the practice together seamlessly.
Sustainability and
future-proofing
Wherever possible, we have incorporated sustainable
technology into our new design. This includes tanks for
rainwater re-use, high performance insulation, double-glazing
and the facility to add solar panels in the near future.
See our lives change
So here’s to the new look Auckland Eye. We’d like to say
thank you to everyone involved in the refurbishment – not
least our patients who have been very understanding with the
disruptions; our development partners who have done such
an outstanding job and of course to you, our referrers, who
have continued to support us throughout.
With the move towards a paper-reduced practice accelerating,
we have also made sure we have the IT infrastructure in place
to support this, including dedicated server rooms, UPS, data
cabling and upgradeable and expandable hardware.
www.aucklandeye.co.nz
April 2016
NEW ZEALAND OPTICS
9

Photo by ACBO’s Kickstarter Seminar keynote, optometrist Adrian Bell
Great day for MDNZ
Macular Degeneration NZ hosted the
third annual charity race day on
February 20. The summer sun shone,
360 guests filled the Guineas Ballroom at the
Ellerslie Racecourse in Auckland—dressed in
their “race day best”—and everyone had a
wonderful time.
“We are very grateful for the ongoing support
from New Zealand’s ‘eye world’ for this annual
event as without them there simply would be
no event,” said Philippa Pitcher, MDNZ general
manager.
In her welcoming address Dr Dianne
Sharp, MDNZ chair and Retina Specialists’
ophthalmologist, told race day guests of
the revolution over the last few years in the
treatment of macular degeneration, even for
the most severe cases, and the ability today to
deliver amazing results for people who would
otherwise experience significant troubles and
hardship. Timing is critical, she said, and MDNZ
is working to seize this opportunity to save sight
by raising awareness and ensuring good access
to treatment for everyone across the country.
Race day guests were treated to a superb
buffet lunch, a great day of racing and a brilliant
selection of goodies in the auctions and raffles.
Many also took up the opportunity to get even
closer to the action through the exciting race
day experiences. People went home very happy
whether they won or lost, said Pitcher, with
many enjoying the additional compensation of a
surprise bottle of wine to take home when their
“losing ticket” was drawn and became a winner
after all.
MDNZ Ambassadors Sir Colin Meads, John
Adshead and Viv Jones joined guests on the day,
while others were there in spirit if not person
(due to other commitments) by providing
exciting auction items, securing tables of ten or
making other forms of donations. Once again
Sir Colin produced two signed rugby balls to
add to the auction proceeds.
“The day was a great success, raising $45,000
for MDNZ to continue its sight saving work for
which we are very grateful,” said Pitcher. ▀
The 2016 MDNZ 1600 race supporters group
OIC’s Tim Way with Karen and Alan Saks
Richard and Joy Goddard, Kumuda Setty, Chris Aldous and Barbara and Darren Savage
with the winner of the Essilor 1200, Kinagat, and his jockey Chris Johnson
Dr Sarah Welch, Yvonne New, Philip Walsh, Janet Wigmore, Tracey Molloy, Dr Archie McGeorge, Dr Kathryn
Philipson, Lahiru Gunasena and Bethan Rajwer supporting the Auckland Eye Avondale Guineas
NZ Optics’ designer Kirsten Newton with her
wonderful hat and new ed. Jai Breitnauer
MDNZ’s fascinator brigade: Sandy Grant, Julie Worsley,
Viv Jones, Sandra Budd and Phillippa Pitcher
OptiMed’s Mokta and Chris Simonson, Kerry and Craig
Norman, and Robert and Karen Nyenkamp
Dr Dianne Sharp, Vicki Lindsay, Julianne Horgan, Zanelle and Neville Angelo
and Drs Narme Deva, Andrea Vincent and Rachel Barnes
Julie Worsley, Dr Ian Elliott and Glenda
Bostwick
Auctioneer Michael Boulgaris, Di Goldsworthy and
“best dressed lady” Paula Farrar
10 NEW ZEALAND OPTICS April 2016
Hamilton Eye’s Selma Matloob, Monika Pradhan, Marina Nasmith, Joanna Hood, Sally
Rosenberg and Jena Youdif, backing the Hamilton Eye Clinic 1600
The team from Blackmores, including country manager Deva Dhar (left of banner) with
Saint Emilion, winner of the opening MDNZ 1500 race and the horse’s trainers and owners

oDocs goes commercial,
seeks investment
Innovative New Zealand startup and social
enterprise oDocs Eye Care is rolling out its first
commercial products in April.
oDocs (short for OphthalmicDocs) is the
brainchild of registrar Dr Sheng Chiong Hong
and Dr Benjamin O’Keeffe, senior house officer
of ophthalmology at Wellington Eye Clinic. Its
fundamental initiative was the development of
an inexpensive system combining smartphones
with 3D printable attachments to allow accurate,
mobile visual acuity tests, slit-lamp examinations
and retinal imaging with a lens that gives a 50
degree field of view into the back of the eye. Sales
of oDocs’ commercial products will help underwrite
efforts to provide devices to health services in
under-served and remote areas, especially in the
developing world.
To this end the company has launched visoScope,
an upgraded version of its original Fundus product,
and visoClip, a tool for viewing the anterior segment.
“We’ve reduced the Fundus to a simplified form
with a stronger structure and less parts, making it
ultimately more efficient to build, and we’ve evolved
it using better suited manufacturing techniques for
higher quality. The lenses will be included so it will
be ready to go out of the box,” says Hanna Eastvold-
Edwins, oDocs chief executive officer.
Keeping its social ideals at the forefront of the
commercial part of the operation, oDocs is running
a pre-order campaign, where half of the profits
generated will go into research, education and
supply of equipment to those regions most in
need, says Dr Hong.
oDocs will market visoScope and visoClip to
ophthalmologists and optometrists. The products
work with an app that currently runs on iOS
tablets and handsets only. Eastvold-Edwins says
the company will develop an Android app in the
near future.
The commercial products will be targeted at the
New Zealand market first, while the company seeks
approval for commercial sales in overseas markets,
oDocs’ Dr Sheng Chiong Hong accepting a highly
commended award at NZ Innovators 2016 in February
from former Prime Minister Jim Bolger
oDoc’s new visoScope and visoClip
particularly Europe and the Americas. oDocs will
begin to raise investment capital following the
commercial rollout, says Eastvold-Edwins.
“We are self-funded up to this point, but we will
be actively seeking investment. We are hoping to
attract an investor who understands how these
innovations could impact eye health, not just for
developed markets, but also emerging ones who
really embrace mobile health technology.
“At our core, we are an innovative technical team
working on a medical hardware product with the
potential to go global.”
Eastvold-Edwins says oDocs aims to sell 1,000 kits
this year. The units will be sold online with delivery
expected by third quarter 2016. Once the company
achieves sustainability, it will develop more
advanced iterations of the product, she says.
To find out more go to www.odocs-tech.com. ▀
New doctor for Christchurch Eye
Christchurch Eye Surgery announced that
Dr Logan Robinson has joined its team
as an experienced cataract surgeon with
subspecialty training in vitreoretinal surgery and
diseases of the retina and macula.
Dr Robinson joins Drs Jim Borthwick and Sean
Every to complete Christchurch Eye Surgery’s
surgical retinal team at the only private facility in
Christchurch with a vitreoretinal surgical suite.
Graduating from the University of Otago, Dr
Robinson undertook his ophthalmology training in
Wellington and Christchurch. He then completed
vitreoretinal surgery fellowships in Wellington and
at Manchester Royal Eye Hospital in the United
Kingdom, where he learned the latest techniques
in vitreoretinal and cataract surgery.
He took up a position as a consultant
ophthalmologist at Christchurch Hospital in 2015,
where he is involved in the training of junior
ophthalmologists as well as educational sessions
for GPs and optometrists. He also joined the team
at Southern Eye Specialists.
Dr Robinson says he believes it is important
to communicate clearly with his patients so
they have a good
understanding of
their condition and
can make informed
decisions about
their treatment.
“When I returned
to Christchurch I
wanted to operate
in a modern, wellequipped
facility so
Dr Logan Robinson
I could provide the highest quality of surgical care
for my patients. Christchurch Eye Surgery more
than meets my expectations. It has state-of-the art
surgical equipment and technology, together with
experienced and friendly staff and a beautifullydesigned
building. This combination makes for the
best experience possible for the patient.”
Away from ophthalmology, Dr Robinson is an avid
sports fan and enjoys mountain-biking, golf and
fishing when he isn’t spending time with his wife
and young son.
Christchurch Eye Surgery opened its doors in
June 2014. ▀
Christchurch education day
Around 60 optometrists gathered for a daylong
seminar in Christchurch in February,
the third consecutive year for this event.
Drs Zainah Asagloff, Antony Bedggood, David
Kent, Ainsley Morris and Logan Robinson gave
presentations this year.
Dr Morris said she really enjoys the annual day
spent with the optometrists—both local and
from around the country. “It is a chance to learn
together, build on the importance of collaboration,
especially in the therapy and treatment of patients,
as well as having a great day with nice people.”
Dr Morris, in her first presentation, discussed
pseudophakic macular oedema. The essentials of
recognition and diagnosis were detailed and the
importance of appropriate treatment and advice
to patients emphasised. While in Glaucoma—to
treat or not to treat, Dr Morris discussed conditions
which can mimic glaucoma, aren’t pathological,
but which have high pressures and the important
fact that not all patients who develop glaucoma
will lose sight over their lifetime.
Dr Kent presented on corneal collagen cross
linking with riboflavin (CXL)—indications,
techniques and post-operative management. He
covered the physicochemical changes that occur
in the cornea during CXL, the original Dresden
protocol and what the published studies of CXL
show. The primary indication for CXL is progressive
corneal ectasia including keratoconus and post-
LASIK keratectasia. He discussed accelerated CXL
and whether it may or may not be as effective as
the original protocol and he covered post-operative
management and expected clinical course.
Dr Kent’s second talk was on multifocal and
extended-depth-of-focus IOLs. He discussed both
bifocal and trifocal diffractive multifocal IOLs and
that the trifocal IOLs, such as Zeiss and FineVision,
have now superseded the older bifocal IOLs. He
also discussed the pros and cons of the different
types of extended-depth-of-focus IOLs.
His third talk was on post-LASIK keratectasia
where he discussed his own cases and reviewed
the risk factors and how they have been managed.
He emphasised that any post-LASIK patient who
develops increasing astigmatism needs corneal
topography to exclude keratectasia and that CXL
should be done earlier before it progresses. Dr
Kent’s final talk was on the history of LASIK.
Dr Robinson discussed the new OCT-based
classification system for vitreomacular adhesion,
vitreomacular traction, full-thickness macular
holes and lamellar macular holes. He also spoke on
how to differentiate papilloedema from pseudopapilloedema,
with the most important message
being to consider the entire clinical picture when
assessing an elevated disc, and he gave tips on how
to use OCT to differentiate between disc drusen
and papilloedema. Dr Robinson’s final talk was
on pigmented lesions of the retina and choroid,
and in particular how to differentiate between a
choroidal nevus and choroidal melanoma using
the mnemonic: “To Find Small Ocular Melanoma
Using Helpful Hints Daily”. Using this will prompt
timely referral for high risk lesions, allowing earlier
diagnosis, he said.
In Eye diseases in South East Asia, Dr Asagloff
made the following points:
••
Asians are more prone to endophthalmitis
from blepharitis
••
Asian eyelids can have epicanthal folds/
epiblepharon
••
In thyroid orbital inflammation, optic nerve
compression is more common
••
In a submacula bleed, look out for PCV
••
Giant cell arteritis is most uncommon
Speakers: Drs Zainah Asagloff, Logan Robinson, Antony
Bedggood, Ainsley Morris and David Kent
Dr Ainsley Morris (second from left) and optometrists
Gavin Lim, Suney Cheung, Rochelle van Eysden and
Michaella Dolling
••
In a bilateral panuveitis, VKH is a common cause
••
Angle-closure glaucoma is more common
In angle-closure glaucoma, optometrists can play
a vital role in detecting patients who have narrow
angles before they progress to glaucoma, she said.
“It is vital to detect shallow anterior chambers.
And this should lead to examination of the angles,
via Gonioscopy or Imaging.” Imaging modalities
include the eyeCam, Scheimpflug photography,
UBM and AS-OCT.
Dr Asagloff went on to discuss the diagnosis
of dry eyes, which can be diagnosed by simple
clinical means using tests such as TBUT, Schirmer’s,
staining or meniscus level. Optometrists should
look for the treatable underlying cause, she said,
and refer to an ophthalmologist if the dry eye
is moderate to severe and if there is a definite
underlying cause to treat.
Dr Bedggood explained how paediatric
ophthalmology is challenging, with potentially
sight or life-threatening diseases presenting few
or no symptoms. Fortunately there are some
quite specific patterns and ‘mantras’ that can be
followed.
Causes of red eye in children were discussed
and, apart from the rare and serious causes of
retinoblastoma or rhabdomyosarcoma, they
are mainly corneal and anterior segment diseases,
often chronic and more aggressive than in adults.
Corneal opacities and vascularisation due to
staphylococcus/blepharitis is one of these, he said.
Glaucoma in children and young adults is rare
and universally has high IOP, so a large disc, big cup
and normal IOP need not be a ‘suspect’ in someone
less than 35, said Dr Bedggood, while genetic
causes related to the Myocillin gene predominate.
Children from five years of age presenting with
bilaterally reduced vision, often mild at first, need
to be “robustly followed up” and sometimes tested
for retinal dystrophies, he added. “Subtle macular
signs, OCT changes, retinal flecks and family history
are key findings.”
Finally Dr Bedggood discussed the care of children
with low vision. “Providing excellent services
and communicating between ophthalmologist,
optometrist, BLENNZ and parents is an important
priority for all of us.”
Seminar organised by Fendalton Eye Clinic. Words
supplied by speakers. ▀
Opportunity for Community Optometrists
A fantastic opportunity for optometrists who are motivated to upskill in the assessment, diagnosis and treatment
of glaucoma is offered by the Department of Ophthalmology, The University of Auckland. We have established a
collaborative glaucoma clinic with the Department of Ophthalmology Auckland District Health Board. The long
term vision of this clinic is as a gateway to providing community based glaucoma care in the future.
For further information about this clinic and associated cost please contact:
Sue Raynel
Department of Ophthalmology
The University of Auckland
Ph: (09) 923-6337 or e-mail: s.raynel@auckland.ac.nz
April 2016
NEW ZEALAND OPTICS
11

with
Prof Charles McGhee
& A/Prof Dipika Patel
Series Editors
The ABCs of OCT in glaucoma
Background
BY HANNAH KERSTEN*
AND PROFESSOR HELEN DANESH-MEYER
Glaucoma is a multifactorial optic neuropathy characterised by
slowly progressive degeneration of the retinal ganglion cells and
their axons. Unfortunately, there is not yet one single test that can
discriminate glaucomatous eyes from normal eyes; the diagnosis
of glaucoma is made based on a specific pattern of structural and
functional changes. In the past, the retinal nerve fibre layer (RNFL)
was only able to be assessed subjectively by slit-lamp examination
and retinal photography, providing qualitative data. Optical
coherence tomography (OCT) was first described by Huang and
colleagues in 1991 1 . OCT, as used to acquire high resolution, crosssectional
images of the ocular structures, utilises low-coherence
near infrared light (800-1400 nm) generated by a super-luminescent
diode, which passes through the pupil to the posterior structures
of the eye 1 . It is analogous to B-scan ultrasound except that it uses
light instead of sound. Over the past 10 to 15 years, OCT has become
an invaluable tool and is in widespread use in both optometry
and ophthalmology. OCT is used in the diagnosis and longitudinal
analysis of a multitude of ophthalmic disorders that affect the optic
nerve and macula, including glaucoma. Newer spectral-domain OCT
has increased resolution (approximately 3 – 5 µm) and faster scan
acquisition time than older time-domain OCT technology. Common
spectral-domain OCT models include the Zeiss Cirrus and the
Heidelberg Spectralis.
Peripapillary Retinal Nerve Fibre Layer Measurements
Measurement of the peripapillary RNFL thickness using OCT
is now a routine component of the comprehensive glaucoma
assessment. In healthy eyes, the RNFL is generally thickest in
the in the inferior quadrant, followed by the superior, nasal and
temporal quadrants (the “ISNT” rule). There is, however, a large
degree of RNFL variability in “normal” eyes, and there is some
overlap in the structural characteristics of normal eyes and eyes
with early optic nerve damage due to glaucoma 2 . Many patients
will have anomalous structural features that may confound
the interpretation of OCT measurements, and the eye may be
incorrectly classified as “abnormal”. In patients with perimetric
glaucoma, the location of the RNFL thinning should correlate
with the visual field defect. In those with pre-perimetric disease,
it is important to compare the peripapillary RNFL thickness in the
individual quadrants with the appearance of the optic nerve head
on clinical examination.
The ability to detect and measure structural change is essential
in the diagnosis and management of glaucoma. Progression
analysis software, included with some OCT models, is able to
track the progression of RNFL thinning over time (figures 1 and 2).
It is necessary to review the RNFL overview at each visit, as well
as the progression scans, as these overview scans will give more
comprehensive information regarding RNFL thickness in each eye
(as well as the differences between the two eyes). It is important
to discriminate true disease-related changes from measurement
variability and normal age-related change. When a scan is accurate
and well-centred, the 95% tolerance for average RNFL thickness
is approximately 4 µm 2 . Spectral-domain OCT is more sensitive at
detecting glaucoma progression than time-domain OCT 3 .
Fig 1. Guided progression analysis on Zeiss Cirrus OCT. This shows progression of left RNFL
thinning. The first two exams are used as baseline measurements, with subsequent scans
compared to baseline. The signal strength is good in all scans however the first baseline shows
an area nasal to the optic disc with an incomplete scan, hence the reason for the lower average
RNFL thickness in Baseline 1 compared with Baseline 2. Over time, there has been a significant
reduction in RNFL thickness in both the superior and inferior quadrants.
Fig 2. Guided progression analysis on Zeiss Cirrus OCT. This shows stable RNFL thickness over
six consecutive OCT scans. There is marked RNFL thinning, particularly in the superior and
inferior quadrants. The fluctuation in average RNFL thickness between exams is within the 95%
confidence limits for scan repeatability. Signal strength is adequate in all scans.
Macular OCT Scans in Glaucoma
Although the use of OCT in glaucoma has been primarily focused on
the assessment of peripapillary RNFL thickness, in recent years the
macular region has emerged as an area of interest; glaucomatous
macular damage can occur early in the disease process. Although the
macular region represents less than 2% of the retinal area, it contains
30% of the retinal ganglion cells 4 . One of the main advantages of
12 NEW ZEALAND OPTICS April 2016
macular assessment in glaucoma is that a significant portion of
retinal thickness at the macula is composed of the RNFL, ganglion
cell layer and the inner plexiform layer. Spectral-domain retinal
layer segmentation algorithms have allowed for the quantification
of individual layers in the macular region, and the measurement
of ganglion cell complex thickness (the combined thickness of the
RNFL, ganglion cell layer and the inner plexiform layer, although
macular analysis in some OCT models includes only the ganglion
cell and inner plexiform layers) 3 . The GCC thins as the glaucomatous
damage progresses, with lower thickness values associated with
poorer mean deviation scores on visual field testing 2,5 . Ganglion cell
complex thickness in glaucoma can correlate well with RNFL thinning
and visual field loss (figure 3). Repeatability of ganglion cell complex
measurements may be reduced in more advanced glaucoma 6 .
Fig 3. Structure-function correlation. The top left image shows a glaucomatous right optic nerve
with vertical elongation of the optic cup and thinning of the superior and inferior neuroretinal
rim. The rim thinning is most pronounced inferiorly. This correlates with functional changes on
visual field testing, with almost complete loss of the superior visual field, and greatly reduced
sensitivity in the inferior visual field. The lower images show diffuse thinning of the ganglion
cell complex (measured with the Zeiss Cirrus OCT), with more extensive thinning in the inferior
region. This correlates with the optic nerve and visual field appearance.
Consider Other Ocular and Systemic Pathology
Glaucoma is not the only condition that can cause thinning of the
retinal layers. A vast number of ocular and systemic disorders can
lead to peripapillary RNFL and macular thickness changes on OCT
and it is always important to consider these conditions as part of
the examination process. A comprehensive history and complete
eye examination is essential. The patterns of RNFL loss can vary
greatly between conditions. For example, patients with optic neuritis
are more likely to have temporal RNFL thinning (figure 4) and the
degree of RNFL loss may be out of proportion to visual field results.
Multiple sclerosis is associated with thinning of the RNFL and macula
(including the ganglion cell complex), even in patients with no history
of optic neuritis 7 . Patients with compressive optic neuropathies
can present with thinning of the RNFL. These patients are likely to
have reduced RNFL thickness in the nasal and temporal quadrants
compared with glaucoma patients 8 . A tilted disc, particularly in
myopic patients, can cause a localised RNFL defect in the superior or
inferior quadrants, similar to glaucomatous RNFL loss 9 . Longitudinal
follow-up is necessary to determine whether the RNFL thinning is
glaucomatous or due to the tilting of the optic nerve head 10 .
Fig 4. RNFL thinning in a patient with a history of optic neuritis. This patient had a single episode
of right optic neuritis (confirmed by MRI examination). Note the dramatic reduction in RNFL
thickness, particularly in the temporal quadrant (less likely to be affected in glaucoma). The
average RNFL thickness was 55 µm. The visual field was normal.
Factors Affecting OCT Measurements
A number of factors influence the quality and accuracy of retinal
measurements acquired with OCT:
••
Image resolution is affected by eye movement. The degradation
of the image is a function of the frequency and size of saccadic
eye movements, compared with the image acquisition time and
the transverse resolution of the OCT 11 . Newer OCT technology
attempts to counter this with the use of eye-tracking systems
incorporated into the software 12 .
••
Scans should be well-centred: macular scans should be centred
at the fovea and accurate measurement of the peripapillary
RNFL requires the reference to be centred precisely at the optic
nerve head 13 .
••
The signal strength of the scan needs to be adequate.
Recommended minimum signal strength varies by manufacturer.
Even scans with adequate signal strength may show software
segmentation failure, where the automatic segmentation of
the retinal layers is incorrect. If possible, these scans should be
re-taken.
••
Scans can be acquired effectively over a range of pupil sizes,
however if the pupil size is less than 3 mm this can affect
thickness measurements and scan quality 14 .
••
Opacities of the lens generally give rise to lower thickness
values (affecting results by up to 12%), with more advanced lens
opacities leading to a greater decrease in thickness 14 . Image
repeatability significantly improves following cataract extraction
••
OCT measurements are affected by axial length and,
subsequently, refractive error 15 , and measurements are most
accurate within the range of +5 to -5 dioptres 14,16 . Longer, more
myopic eyes tend to have thinner RNFL thickness values 15 .
••
RNFL values for people of different ethnicities vary modestly,
although it has been found that all ethnicities examined had
95% confidence limits that overlapped 15 .
••
RNFL thickness decreases with age - by approximately 2 µm per
decade, with loss of about 5000 axons per year 15 .
Anterior Segment OCT in Glaucoma
It is worth briefly mentioning the role of OCT in the examination of
the anterior segment of glaucoma patients. Anterior segment OCT
imaging, using a 1310 nm light source, permits the visualisation
of the angle structures and provides quantitative data that can be
useful in the identification of the mechanism of IOP elevation and
the diagnosis of angle closure glaucoma (figure 5) 17,18 . OCT of the AC
angle is a tool that is a useful addition to gonioscopy, but it should
not replace gonioscopic examination. It can be used to measure
the actual size of the angle, and is also particularly helpful for
visualising structural changes to the angle following YAG peripheral
iridotomy. Anterior segment OCT can also be used to as a noninvasive
measure of central corneal thickness, a useful measure in
initial glaucoma assessment.
Fig 5. Anterior segment OCT scan showing narrow anterior chamber angles
Conclusion
There have been significant developments in glaucoma imaging
over the last decade, and these imaging modalities, particularly
OCT scans of the peripapillary RNFL and macula, are now used
routinely in glaucoma diagnosis and on-going management. There
are continuous advances in spectral-domain OCT technology, with
increased resolution, reduced scan acquisition time, progression
analysis software updates, en face imaging and eye movement
tracking allowing for more accurate and reproducible scans, and
more in-depth analysis of the ocular structures. Although OCT
examination is an important component of the modern glaucoma
assessment, it is not a diagnostic tool 3 ; it is a useful test in the
armamentarium of the ophthalmologist and optometrist, and it
should be used in conjunction with other measures of optic nerve
structure and function. ▀
References
1. Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science 1991;254:1178-1181.
2. Grewal DS, Tanna AP. Diagnosis of glaucoma and detection of glaucoma progression using spectral
domain optical coherence tomography. Curr Opin Ophthalmol 2013;24:150-161.
3. Bussel, II, Wollstein G, Schuman JS. OCT for glaucoma diagnosis, screening and detection of glaucoma
progression. British Journal of Ophthalmology 2014;98 Suppl 2:ii15-19.
4. Curcio CA, Allen KA. Topography of ganglion cells in human retina. Journal of Comparative Neurology
1990;300:5-25.
5. Hood DC, Raza AS, de Moraes CG, Liebmann JM, Ritch R. Glaucomatous damage of the macula. Prog
Retin Eye Res 2013;32:1-21.
6. Sung MS, Kang BW, Kim HG, Heo H, Park SW. Clinical validity of macular ganglion cell complex
by spectral domain-optical coherence tomography in advanced glaucoma. Journal of Glaucoma
2014;23:341-346.
7. Petzold A, de Boer JF, Schippling S, et al. Optical coherence tomography in multiple sclerosis: a
systematic review and meta-analysis. Lancet neurol 2010;9:921-932.
8. Danesh-Meyer HV, Yap J, Frampton C, Savino PJ. Differentiation of Compressive from Glaucomatous
Optic Neuropathy with Spectral-Domain Optical Coherence Tomography. Ophthalmology 2014; 121:
1516-1523
9. Hwang YH, Yoo C, Kim YY. Characteristics of peripapillary retinal nerve fiber layer thickness in eyes
with myopic optic disc tilt and rotation. Journal of Glaucoma 2012;21:394-400.
10. Chang RT, Singh K. Myopia and glaucoma: diagnostic and therapeutic challenges. Curr Opin
Ophthalmol 2013;24:96-101.
11. Hee MR, Izatt JA, Swanson EA, et al. Optical coherence tomography of the human retina. Arch
Ophthalmol 1995;113:325-332.
12. Serbecic N, Beutelspacher SC, Aboul-Enein FC, Kircher K, Reitner A, Schmidt-Erfurth U. Reproducibility
of high-resolution optical coherence tomography measurements of the nerve fibre layer with
the new Heidelberg Spectralis optical coherence tomography. British Journal of Ophthalmology
2011;95:804-810.
13. Cheung CYL, Yiu CKF, Weinreb RN, et al. Effects of scan circle displacement in optical coherence
tomography retinal nerve fibre layer thickness measurement: a RNFL modelling study. Eye
2009;23:1436-1441.
14. Savini G, Zanini M, Barboni P. Influence of pupil size and cataract on retinal nerve fiber layer
thickness measurements by Stratus OCT. Journal of Glaucoma 2006;15:336-340.
15. Budenz DL, Anderson DR, Varma R, et al. Determinants of normal retinal nerve fiber layer thickness
measured by Stratus OCT.[Erratum appears in Ophthalmology. 2008 Mar;115(3):472]. Ophthalmology
2007;114:1046-1052.
16. Menke MN, Knecht P, Sturm V, Dabov S, Funk J. Reproducibility of nerve fiber layer thickness
measurements using 3D fourier-domain OCT. Invest Ophthalmol Vis Sci 2008;49:5386-5391.
17. Sharma R, Sharma A, Arora T, et al. Application of anterior segment optical coherence tomography in
glaucoma. Survey of Ophthalmology 2014;59:311-327.
18. Smith SD, Singh K, Lin SC, et al. Evaluation of the anterior chamber angle in glaucoma: a report by
the american academy of ophthalmology. Ophthalmology 2013;120:1985-1997.
* Hannah Kersten is a therapeutically qualified optometrist with
glaucoma prescriber accreditation. She has recently completed
her doctoral studies in the Department of Ophthalmology
at the University of Auckland, under the supervision of
Professor Helen Danesh-Meyer, and Dr Richard Roxburgh of the
Department of Neurology. The topic of her thesis was optical
coherence tomography in neurodegenerative disease. Hannah
is currently working as a post-doctoral research fellow in the
Department of Ophthalmology and she is also involved in
glaucoma co-management with Professor Danesh-Meyer at Eye
Institute in Auckland.

Colour vision test ends
Routine, school-based check-ups of 11 and
12-year-old students will no longer include
testing for colour vision deficiency as of July 1.
The Ministry of Health announced it would
eliminate the test in February to allow more time
for technicians to identify hearing and vision
problems among children at an earlier age when
intervention makes a bigger difference.
Colour blindness is relatively unusual, especially
among girls. The condition is found in 0.5% of
the female population, whereas colour vision
deficiency affects about 10% of the 26,000 boys
screened annually as part of the standard Year 7
checks.
The Ministry’s decision was influenced by a
summer research project, which reviewed the
medical literature on the efficacy of colour vision
testing, and was overseen by ophthalmologist Dr
Graham Wilson, in his role as clinical senior lecturer
at the University of Otago, and his brother Nick
Wilson, a professor at Otago’s Department of Public
Health.
“We found there was no evidence to support
screening for colour blindness,” says Dr Wilson.
“We screen for things like breast cancer and
cervical cancer, things that can kill you, and colour
blindness doesn’t rise to that level.”
Ministry Chief Advisor, Child and Youth Health, Dr
Pat Tuohy explained the policy change to medical
technicians who conduct the school checks at a
conference in late February.
“They feel it will free up their time to do other
things,” says Dr Wilson, who attended the conference.
“I think people see the common sense in it.”
Dr Wilson, his brother and Nishanthan
Ramachandran, a health policy student, published
their paper Is screening for congenital colour vision
deficiency in school students worthwhile? A review
in the November 2014 edition of Clinical and
Experimental Optometry.
The review analysed the literature on screening
for congenital colour vision deficiency in school
students, which predominantly uses the Ishihara
test, and found no association between congenital
colour vision deficiency and the level of educational
achievement; only a rare association between the
condition and other health and lifestyle impacts;
and limited interventions.
“Given this picture, the weight of evidence
appears to be in favour of not adopting (or
discontinuing) routine colour vision screening
programmes for school students; however, it may
be worthwhile for a career advisor to refer school
students to an optometrist or ophthalmologist for
colour vision screening, upon expression of interest
in an occupation where normal colour vision is
either particularly desirable or is a regulatory
requirement,” concluded their paper. ▀
Donations for ship-clinic
The Tauranga Rotary club is raising
funds and looking for equipment
donations for a humanitarian group
to bring an ophthalmic clinic to remote
Pacific islands.
The club has launched a campaign
to raise $95,000 for Marine Reach, a
humanitarian organisation that delivers
health services to isolated populations
from its vessel, the MV Pacific Hope. The
total money raised—likely to include a
matching grant from a Rotary international
fund—will be used to purchase items on
an ophthalmic clinic “wish list”, including
a Sonamed Portable AB Scanner, Nidek
hand held keratometer, a slit lamp, an instrument
sterilising container, portable microscope and an
operating bed.
The plan is for the ship-board clinic to be
dedicated and named The Rotary Foundation
Ophthalmology Clinic, with contributors of
over $500 recognised by inscription on a special
plaque displayed in the Clinic. Other donors
will be invited to sponsor a specific piece of
equipment and have their name inscribed on an
appropriate plaque fixed to the item. The club
is also open to surplus equipment donations or
discounted price offerings.
Marine Reach purchased the Pacific Hope and
refit the vessel in 2013. It undertook its first
clinical voyage, with a dental and general medical
outreach programme in Fiji and Vanuatu, from
late June to early October 2015. The next voyage
is likely to begin in June 2016.
Anyone interested in making a financial or
equipment contribution should contact project
coordinator David Garland on 07 543 2012. You
can also make a direct financial contribution
through Give a Little at https://givealittle.co.nz/
org/tgarotary. For more information on Marine
Reach, visit www.marinereach.com. ▀
ZEISS launches
DriveSafe
Zeiss has launched new DriveSafe lenses to provide better vision
in challenging driving conditions.
Calling them “probably the most exciting safety feature in
your car,” Zeiss says the new lenses are designed to maximise safety
and comfort for spectacle wearers through a new premium coating
and state-of-the art lens design.
According to Zeiss’ research, 83% of drivers wear glasses and the
majority (72%) of these prefer a single pair for everyday use that can
also assist with the visual challenges of driving. Spectacle wearers
report feeling discomfort when driving in rain (94%), at dusk (88%), at
night (76%) and in fog (74%). While the majority of traffic accidents
occur at dusk or after nightfall. “DriveSafe lenses address the major
challenges facing spectacle wearers while driving in difficult light and
weather conditions,” the company said.
To better understand the requirements for dynamic vision while
driving, ZEISS commissioned a study by the Research Institute of
Automotive Engineering and Vehicle Engines in Stuttgart (FKFS) using
a modified car on a real-world course. The setup included head and
eye tracking systems to observe drivers’ visual behaviour.
The study found that drivers focus on the road ahead and distant
moving objects about 97% of the time, look at the dashboard 2% of
the time and alternate viewing between the mirrors 1% of the time.
Progressive lens wearers move their heads more than single vision
wearers in order to avoid lens zones of incorrect power or that have
high levels of aberration. FKFS also found that the closest object
viewed on the dashboard is approximately 50-75 cm away from the
driver’s eye, implying the near zone of a progressive lens, designed for
a much closer distance, is virtually unused.
“Drivers must contend with a rapidly alternating set of
circumstances that require constant attention and dynamic vision.
The DriveSafe lens is optimised to provide uncompromised distance
vision, with a large intermediate zone that supports quick and
comfortable focus when switching between the dashboard and
mirrors.”
The new lenses incorporate ZEISS DuraVision DriveSafe antireflective
coating to mitigate the uncomfortable blue-light glare
from Xenon/HID and LED headlights and Zeiss’ Luminance Design
Technology that takes into account pupil size in different light
conditions to assist drivers in detecting objects in conditions where
they are more likely to feel stressed or insecure, such as twilight, rain
or at night.
European wearer trials revealed very high satisfaction levels for
ZEISS DriveSafe lenses, the company reported, with 97% of test
subjects satisfied with the new lenses when driving, including in
challenging situations such as in the dark and twilight. Respondents
reported good dynamic vision in near, intermediate and distant
zones, good perception of colours and reduced dazzle/glare from
headlights. In addition, 94% of respondents found the new lenses
suitable for doing everyday tasks.
“Drivers require the best technology for their vision needs today,”
says Hilke Fitzsimons, managing director for ZEISS Australia and New
Zealand. “Surveys show over two-thirds of adults have difficulty in
driving in low light or adverse weather conditions. Our new DriveSafe
lenses address problems of glare, depth perception, and vision acuity
at all distances.”
ZEISS DriveSafe will be available in New Zealand from April 4
in both progressive and single vision designs. The launch will be
supported by an extensive digital promotion where consumers will
be invited to become “test drivers” and win a pair of ZEISS DriveSafe
Lenses at www.zeiss.com.au/DriveSafe. ▀
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Always read the label. Use only as directed. If symptoms persist, see your healthcare professional. †When wearing make-up, it is recommended to apply from 20cm. *Due to disturbed lipid layer of the tear fi lm. References:
1. Lee S et al. Klin Monatsbl Augenheilkd 2004; 221:1–12. 2. Khaireddin R, Schmidt KG. Klin Monatsbl Augenheilkd. 2010; 227: 128-134. 3. Pult H et al. Contact Lens Anterior Eye 2012, 35:203-207. Reckitt Benckiser, Auckland. TAPS DA1541
April 2016
NEW ZEALAND OPTICS
13

Great
Memories
In recent times, I’ve been writing a five
thousand-word article on the history and
evolution of soft lenses. In doing so, I asked
my long term friend, mentor and fellow South
African Des Fonn if he would like to share
some of his thoughts on this subject.
Des was my final year lecturer in contact
lenses, after his return from spending eighteen
months doing his MOptom with Brien Holden
and the gang at the CCLRU in Sydney in 1980.
We did some research together and served on
the South African Contact Lens Society council
and arranged many conferences together. He
was one of the people who motivated me to
excel in contact lenses and inspired me in many
ways. I have mentioned Professor Desmond
Fonn in numerous missives in this column over
the years so won’t repeat it here but this link
will give you some of that. Des is the founder
of the prestigious CCLR at Waterloo, one of the
top CL research facilities in the world and has
published widely.
Des had the following to share.
The 1980s: game
changing events in
which Australia led
the way
1976 was a momentous year for the University
of New South Wales School of Optometry as
the Cornea and Contact Lens Research Unit was
established under the leadership of Brien Holden.
It was this organisation that would lead the
world in cornea and contact lens research and
was the forerunner of all the organisations to
follow culminating in 2010 as the Brien Holden
Vision Institute in recognition for his lifetime of
work in research and humanitarian initiatives
related to vision.
During the mid 70s the popularity of soft lenses
gained momentum to equal that of rigid lenses
but it was soon demonstrated that daily wear of
soft lenses produced clinically significant corneal
edema. During this period, John De Carle had
developed the high-water-content Permalens
and claimed successful extended wear without
ocular complications. These two topics became
the cornerstones of research at the CCLRU. Drs
Steve Zantos and Lewis Williams were Brien’s
first two PhD students working on extended
wear of soft lenses and the effects of soft lenses
and hypoxia on the corneal endothelium. Brien’s
paper in the Australian Journal of Optometry in
1975 on the principles and practice of correcting
astigmatism with soft lenses peaked my interest
at that time, and thousands of others because
he showed that 35% of patients require toric
lenses. This figure was corroborated by others
years later. It was not a coincidence that Brien
and colleagues at the Institute for Eye Research,
which superseded the CCLRU in the late eighties,
developed a unique toric lens design that yielded
millions of royalty dollars.
By 1980 the CCLRU comprised about 30 people
dedicated to research on contact lenses and
their effects on the eye. Brien’s vision in those
early years was that Australian and international
collaboration were essential to understand the
effects of contact lenses and this became the
cornerstone of their research endeavors.
The image below is a collage of colleagues
working at the CCLRU in 1980. Brien used
the image in his presentations to describe a
renaissance that began in 1980. Of course there
were many others at the time and hundreds that
followed in a similar vein to work at the world’s
most exciting institution in the contact lens field.
During the late seventies Dr George Mertz
published two important papers on corneal
swelling. In his 1978 paper he showed that
an ultra-thin low water HEMA lens decreased
corneal swelling compared to a standard
thickness lens suggesting that decreasing
hypoxia led to decreased corneal swelling. His
1980 paper was also on the subject of hypoxia
in which he found that the overnight closed eye
(without a lens) produced significant corneal
swelling. These papers were part of the stimulus
for further study in an attempt to determine
what the critical oxygen transmission of a
DO takes on the Sky Tower
hydrogel lens should be to avoid corneal swelling.
Holden, Mertz and McNally published a series
of papers on hypoxia that started in the early
eighties, the most renowned of which is the
“Critical oxygen levels to avoid corneal edema
for daily and extended wear contact lenses”.
Their conclusion from this study was that 87 x
10-9 oxygen transmissibility (Dk/t) was required
for overnight wear and 24 x 10-9 for daily wear.
The limitation of this work was that only one
high Dk lens (silicone elastomer) and an ultra
thin low water content hydrogel lens (20μm)
was included in the study. This is the second
most cited paper in the contact lens field aside
from those on corneal infection. Since then
the EW value has been revised to 150 – 190
Dk/t to avoid corneal edema as a result of the
availability of silicone hydrogel lenses that we
used in overnight corneal swelling studies.
Brien’s highest cited paper was known as the
Gothenburg study. This study examined the longterm
effects of extended contact lens wear and
the conclusion was that adverse reactions could
be avoided by fitting lenses that have higher
oxygen transmissibility, looser fitting, lenses
should be removed from the eye more frequently
and lenses should be more regularly replaced.
These studies on hypoxia and others on
extended wear were unquestionably the
stimulus to develop a highly oxygen permeable
soft lens. The collaboration between the
Cooperative Research Centre for Eye Research and
Technology at UNSW with an industry partner
developed the first silicone hydrogel contact lens,
which was the game changer for the contact lens
industry by eliminating virtually all the problems
of hypoxia. These materials now constitute
approximately 60% of all contact lenses worn.
The hope was the same for microbial keratitis
(MK) but research with silicone hydrogels has
shown that elimination of hypoxia has not
decreased the incidence of MK nor inflammatory
complications.
How amazingly fortunate I was to meet and
befriend Brien and then work with those people
featured in the photograph. Thirty-five glorious
years of contact lens research that started in
1980 at the CCLRU and was the springboard for
industry/institution collaboration unmatched by
any others.
For more go to www.brienholdenvision.org
Thanks Des for sharing your insights. Next time
we see each other dinner and a few beers are
on me. It’s great to see that our recollections of
such things are more or less on the same page
so it seems our grey matter is still having good
recall of events! ▀
ODMA
appoints
IEC
The Board of the Optical Distributors &
Manufacturers Association (ODMA) has
appointed International Exhibition and
Conference Group (IEC) to organise ODMA2017,
to be held July 7 to 9 at Sydney’s International
Convention Centre.
“The company was selected from a very capable
list due to their key personnel’s history of working
with associations, their commitment to excellence
and their enthusiastic and creative approach,” said
Finola Carey, ODMA’s chief executive, in a statement.
‘’I am confident that IEC is best-placed to closely
work with ODMA to deliver the event to suit the
changing needs of our members and the broader
industry in general.”
IEC has managed a number of major industry
events, including Fashion Exposed and Furnitex,
under the leadership of its CEO Marie Kinsella.
“I have always admired the ODMA fair over
many years for its high quality presentation and
its professional approach,” said Kinsella. “We look
forward to working closely with ODMA and its
members to deliver outstanding results.”
ODMA has frozen floor space rates at 2015
levels and will include new interactive features,
networking events and educational content. ▀
Glaucoma NZ
book fundraiser
Glaucoma NZ is selling Entertainment Books,
with a portion of the proceeds going
towards vital funds for the charity. A digital
membership is also on offer, which allows you to
redeem offers from your smartphone.
Entertainment Books contain hundreds of
25-50% off and two-for-one offers from popular
restaurants, cinemas, hotel accommodation, the
arts, lifestyle and sporting events. All offers are
valid until June 2016 to give buyers plenty of time
to get their money’s worth!
Books are priced at $65 for Auckland (including
Whangarei and Bay of Islands), Christchurch,
Canterbury and Nelson; and $60 for Waikato & Bay
of Plenty, Wellington (includes Palmerston North),
Dunedin, Invercargill and Queenstown.
Visit https://www.entertainmentbook.co.nz/
orderbooks/102253y to buy.
March 6 to 12 was World Glaucoma Week, an
international campaign to help raise awareness
of the disease that can go undetected for years
and eventually lead to blindness. A number
of countries took part with events aimed at
educating the public and getting people tested. ▀
Optical history made at Tattoo
Maria Paterson training for the Sky Tower
Maria Paterson, dispensing technician
with Frederick Swain Optometrists in
Hawke’s Bay is going to race up the Sky
Tower in her full firefighting kit to raise funds and
awareness for Leukaemia & Blood Cancer NZ as
part of the annual Firefighter Sky Tower Challenge.
Paterson has been a volunteer firefighter for
seven years with the Napier Fire Station and says
she loves helping people and a challenge. She also
lost her mother and brother to cancer so is
proud to be able to support Leukaemia & Blood
Cancer NZ.
Now in its eleventh year, the Firefighter Sky
Tower Challenge has grown to include more than
750 firefighters, climbing 51 flights – or 1,103
Sky Tower steps – wearing full kit weighing 25kg.
In 2015 the event raised nearly $1.04 million, its
highest fundraising total to date.
Paterson says she’s had “awesome support” from
her colleagues at Frederick Swain, some of whom
have even been out and about with her climbing
every set of steps they can find in Napier. She’s
even joined a gym, she laughs.
The Firefighter Sky Tower Stair Challenge takes
place on Saturday May 28.
To support Paterson go to http://
firefightersclimb.org.nz/Donate.html and type in
“Maria”. ▀
Dr Simon Dean and sons Lachlan and Cameron perform at the Tattoo
A
little bit of optical history was made at
the end of February, when Eye Institute
ophthalmologist Dr Simon Dean and his sons
Cameron (12) and Lachlan (10) performed with the
Royal Edinburgh Military Tattoo in Wellington.
Cameron on pipes and Lachlan on snare drum were
the youngest performers in the 1200-strong cast,
playing in the City of Auckland Pipe Band along
with their father (also on snare drum).
Known as the
“greatest show on
earth,” the Tattoo
is always a sell-out
in Edinburgh and it
was no different in
Wellington, with more
than 82,000 tickets
sold across four soldout
performances,
making it Wellington’s
most popular show
ever.
Dr Dean said it was a
lot of hard work, with
their days starting at
6 am and finishing at
11 pm most nights for
a week. But he and his
wife, Associate Professor Jennifer Craig, a Scot by
birth, says they couldn’t have been prouder of their
sons or have enjoyed an event more.
“For one of the performances, Jennifer’s parents,
my parents, so all the boys’ grandparents, and Jen
watched. A proud moment for all generations of
our family…and a great experience and honour to
be involved; only made better by having my boys
playing in the band as well,” said Dr Dean. ▀
14 NEW ZEALAND OPTICS April 2016

Summer Student Symposium 2016
A
diversity of research, from the development
of aids for colour deficient optometrists
to optimising a test to assess vision in
Zebrafish, was presented by 11 students from the
Department of Ophthalmology and the School of
Optometry and Vision Science (SOVS) at the annual
Summer Student Symposium hosted by the New
Zealand National Eye Centre (NEC).
Professor Louise Nicholson and Associate Professor
Mark Barrow, associate dean (academic) for the
Faculty of Medical and Health Sciences, were invited
to judge the presentations made by the students
who had been working on their research projects for
five to 10 weeks over the summer.
The symposium presentations, given in a four
minute “rapid fire” format, were well attended by
senior academic staff, students and funders of the
summer studentship programme.
Symposium moderator Associate Professor Trevor
Sherwin explained that for several students their
summer projects had been their first real exposure
to complex research and the symposium was an
opportunity for them to present their findings to
the wider ophthalmic community.
First prize–Jonathan Young
First prize was awarded to fifth-year BOptom
student Jonathan Young who was supervised by
Dr Misha Vorobyev from SOVS. He was the second
presenter on the project Development of aids
for colour deficient optometrists, the first being
John Kwak who explained the development of the
software for the project, while Young presented the
results and conclusions.
The prevalence of inherited red-green colour
deficiency is quite high among the male
population (8%) so colour deficiency among
medical practitioners can pose a substantial
hazard to society. One of the diagnostic problems
that colour deficient optometrists confront
is a difficulty in differentiating pigment from
haemorrhage on a fundus image, said Young. “We
transformed colours in fundus images to improve
the discrimination and reduce ambiguity for the
colour deficient optometrists when making a
diagnosis. Each colour deficient participant’s range
of colour vision was modelled and a personalised
image transformation algorithm was developed.
We tested our participants by showing them
images of either sub-retinal pigments or subretinal
haemorrhages, and prompted them to
make a diagnosis.”
Using colour deficient optometry students
for the research, it was demonstrated that
image transformation improved their ability to
differentiate between pigment and haemorrhage
in fundus images. This was the first study of its
kind to look at colour deficiency in an optometric
clinical setting and was funded by the SOVS.
Second prize–Nikita Govender
Nikita Govender, a fourth-year BOptom student,
was awarded second prize for her presentation
on the Role of the retina in atropine control of eye
MORE CLASSIFIEDS ON PAGE 16
elongation.
Supervised by Dr Monica Acosta from SOVS
and sponsored by SOVS, this project looked at
myopia control from a different perspective. The
aim was to investigate the role of the retina in
atropine control of myopia by examining the effect
of atropine on retinal neurotransmitter levels.
The experiment involved in vitro incubation of
normal and myopic chick eyes with or without
atropine. Tissues were sectioned and stained with
a silver intensified immuno-gold technique to
label key neurotransmitters. Results showed no
significant change in neurotransmitter levels with
atropine, however, from the images it was evident
that atropine triggered redistribution of the
neurotransmitters particularly in the inner retina.
The hypothesis is these effects are mediated by
cholinergic amacrine cells. Neurotransmitter
redistribution may correspond to a change in the
functioning of the retina and perhaps an altered
visual experience. The next step would be to
study the in vivo effects of atropine on the retina
to better understand the mechanisms of myopia
control, said Govender.
Third prize–Samuel Lie
The third prize was awarded to second-year medical
student Samuel Lie. His research, Conducting
polymers as release rate controlling membranes
for electrical stimuli-responsive drug delivery,
was funded by the Faculty of Medical and Health
Sciences and supervised by Naveed Yasin, Dr Darren
Svirskis and Dr Ilva Rupenthal.
Sustained release ocular drug delivery systems
have gained popularity when selecting treatment
methods for diseases that affect the posterior
segment of the eye. There are already a number
of implants on the market, but they release
drugs at a fixed rate, not allowing for adjustment
as required by each individual patient. In this
study, the focus was on the potential of poly(3,4-
ethylenedioxythiophene) (PEDOT) to be used as
a membrane to control drug release rates within
an ocular drug implant where tuned drug delivery
can be achieved via application of electrical
stimuli. Dexamethasone release through PEDOT
membranes was studied using Franz diffusion cells
comparing release with and without application
of electrical stimulus. By comparing PEDOT coated
membranes to plain cellulose membranes it was
found that PEDOT can be effective in limiting drug
release. Further research is required in order to fine
tune the control of release to ultimately fabricate a
PEDOT based ocular implant.
The public’s understanding of optometry
An interesting presentation was made by
Janice Chung whose study was funded by the
New Zealand Association of Optometrists. It was
conducted at the Acute Eye Clinic, Greenlane
Clinical Centre, where 311 patients completed an
anonymous questionnaire. The results show the
basic scope of optometry, such as prescription of
corrective wear and examination of eye health,
Presenters (back row) Benjamin Wright, Jaspreet Singh,
Kenny Wu, Samuel Lie, Rahul Makam and Jonathan
Young, (front row) Janet Chung, Nikita Govender, Eileen
Song, Ye Li, John Kwak and event MC Associate Professor
Trevor Sherwin
The winners with the judges: Nikita Govender, A/Prof
Mark Barrow, Jonathan Young, John Kwak, Prof. Louise
Nicholson and Samuel Lie
Fraser Alexander, Dr Monica Acosta, Shadi Jolzar and Dr
Ehsan Vaghefi
is well understood by the public. However, this
was not the case with regards to therapeutic
management and treatment of ocular disease.
The majority of patient referrals were from GPs,
with some being uncertain of an optometrist’s
capabilities – including the ability to refer,
diagnose and treat eye conditions. These findings
suggest there is room for further public education
by key stakeholders. This research was supervised
by Robert Ng, Tina Gao and Richard Johnson. ▀
NZOSS
objectives for
the year ahead
BY NIKKU SINGH, NZOSS PRESIDENT
Most of the new NZOSS excecutive, (L to R) Kendall
Johnston, Oliver Munro, Jonathan Albert, Nikku Singh,
Sophie Woodburn, Aaron Chin, Gunnika Gill and Alicia Han
Since it was established in 2013, the New
Zealand Optometry Student Society
(NZOSS) has strived to provide a platform
for all students to engage with the professional
community. Although NZOSS has only been
operating for the last few years it has rapidly
built up steam, with the student committee
working hard with the New Zealand eye care
industry to foster a great relationship among
present and future optometrists.
Each year a new bunch of students are elected
to form the NZOSS executive committee and it
is my pleasure to introduce the team for 2016:
grassroots representative Kendall Johnston;
sports representative Jonathan Albert; vicepresident
Sophie Woodburn; treasurer Aaron
Chin; public relations Gunnika Gill; secretary
Alicia Han; and general members Oliver Munro
and Xheida Mani.
This year, our main objectives are not only to
promote long-lasting relationships among all
optometry students, but to further develop our
strong connections with the eye care industry.
Through the organisation of seminars and
networking events, students will be able to
gain valuable knowledge on the vast number of
specialties and avenues involving optometry and
visual science. We will also facilitate some much
required down time through social events, such
as the Optometry Pub Quiz, pub crawls, the Eye
Ball and much, much more.
2016 is shaping up to be a great year and we
look forward to all that comes our way! ▀
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ZEISS DriveSafe Lenses
FULL-TIME OPTOMETRIST
WITH PARTNERSHIP OPPORTUNITY AT
LEADING DUNEDIN INDEPENDENT
Stewart Caithness Gray Optometrists is a well
established independent practice in the city of
Dunedin with branches in Mosgiel and Gore.
We provide a high level of professional care and
service to our patients and are looking for an
experienced optometrist to join our team. The
position is full time with potential partnership
opportunities for the successful applicant.
We have a wide range of patients of all
ages and therefore, communication and
interpersonal skills must be excellent. You need
to have a passion for independent optometry
and an interest in fitting speciality contact
lenses. You should be TPA endorsed and ideally
have at least 2-4 years experience. Salary will
be reflective on your experience.
We have a fantastic support team and
diagnostic equipment includes OCT, corneal
topographer, fundus and slit-lamp cameras and
both Matrix and Medmont VFA’s.
We pride ourselves in providing excellence in
eye care, eyewear and service and are excited
to be able to offer this opportunity to join our
great team.
Please email Brian Stewart, brian@scgeyes.nz,
for further details.
LOOKING FOR A PRIME
OPTOMETRIST!
Great opportunity for a full-time optometrist
in an independent, family-owned business
in New Plymouth. Known for their superb
service and extremely helpful team (yes, they
have won awards for it!) they really want
someone who “gets their vision”.
They have all the latest technology, including
a Zeiss OCT/Camera and very well equipped
exam room and are led by an extremely
experienced Dispensing Optician.
What’s unique about this practice is the loyal
customer base and the amount of referrals
they get. This is not a High Street “look at me”
business. They really do like their customers
and go out of their way to help.
The good news about this role is it’s not
an immediate start and no late nights or
weekends. They are searching far and wide
for the right person to come and join them
in June of this year. So, if you are thinking
of moving to “the best place to live” in
New Zealand then now’s the time to start
planning.
Salary is in line-of-sight of market rates. For
details and to arrange an interview contact
fitzroyoptom@xtra.co.nz or phone Michael at
027 758 4974.
zeiss.com.au/DriveSafe
An everyday lens for safer and more relaxed driving – even in difficult low-light conditions.
• Better vision in difficult low-light conditions thanks to Luminance Design ® Technology
• Glare reduction at night from oncoming cars or street lights 1
• Accurate vision of the road, dashboard, rear-view mirror and side mirrors
Find out more today at zeiss.com.au/DriveSafe
1 Perceived glare compared to premium ZEISS coatings.
April 2016
NEW ZEALAND OPTICS
15

MORE CLASSIFIEDS INSIDE
ON pAgE 15
Need a locum?
Call Bharat Raniga, locum optometrist, on
021 424 253 or email: bharatraniga@yahoo.com
prActicE for sAlE
Get double-digit earnings without the sweat and toil of a CBD
location. Enjoy the superior work-life balance of the countryside,
while still within an easy drive of civilisation in downtown
Auckland. Ideally suited to an optometrist breaking out on their
own, or breaking back into the business after maternity leave or
OE, or a dispenser-optometrist team. Yes, double-digit earnings,
and potential for even more growth. If this sounds like something
you’d like to pursue, please apply in strictest confidence c/- NZ
Optics, info@nzoptics.co.nz Code PFSS1.
SPECIALIST SHOPFITTERS & dESIgnERS TO THE OPTOMETRIC PROFESSIOn
TEL:(09) 486-2070 MOB:(0274) 798-798
Email: tony.maddocks@xtra.co.nz
EquipmEnt And shop fittings
for sAlE
Six wall-mounted frame dispaly units with 10 glass shelves per
unit, 1 x light box (1.2x2m), finished in white two-pot lacquer,
Zeiss Visucam Pro Retinal Camera, Humphrey Matrix perimeter,
Reichart refractor head, Topcon IS-80 Chair and Stand, Topcon
SL3F slit lamp, Topcon OM-4 Keratometer, Nidek CR690 Projector
Chart (with screen and mirror), Kowa HA2 Tonometer with
LED Bulb, LED Confrontation wand, Trial Lens kit, Nidek OL-7
vertometer ,GFC Frame heater, Stenersen Multi-frame gauge,
Pupilometer. All offers considered. Contact
michael@eyestyle.co.nz.
EquipmEnt for sAlE
Topcon IS700 Chair and Stand, Magnon SL350 Slit Lamp, Reichart
Keratometer, Righton NP36 Projector. All in good condition.
Contact c/- info@nzoptics.co.nz, Code: EQFS12
for sAlE
Beautiful brushed aluminium frame display, holds 312 frames.
Plus lockable frame or sunglass display racks, holds 96 sunglasses/
frames. Also Gatehouse internally illuminated Eye Chart. Perfect
for practices wanting to upgrade their frames displays or a newly
opening practice. Contact Mark at 027 3806171
or focusoptom@clear.net.nz.
dispEnsing opticiAn/opticAl
AssistAnt
Paterson Burn Optometrists is one of the largest independent
optometry practice groups in New Zealand. We are totally
independent and Waikato owned and we’ve maintained our
independence in the ever changing environment of New Zealand
optometry. Our core purpose is to improve people’s lives by
providing the best visual solutions available.
Paterson Burn Optometrists value respect, integrity,
accountability, enjoyment, continuous improvement, freedom for
initiative and teamwork.
Paterson Burn Optometrists Cambridge requires an experienced,
confident and enthusiastic Dispensing Optician / Optical
Assistant to join our small, friendly team.
The successful applicant will:
• Be a qualified Dispensing Optician or Optical Assistant with a
minimum of 4 years’ dispensing experience
• Display exceptional customer service and sales skills
• Be committed to providing excellent patient care
• Be well presented with an eye for fashion
• Be a self-starter who can work with minimal supervision
• Be versatile, reliable and motivated.
The successful applicant must be available to work full time and
some Saturdays.
Please email your CV and a cover letter to
sandri@patersonburn.co.nz
16 April 2016
NEW ZEALAND OPTICS April 2016 classified NEW ZEALAND 1