Apr 2016

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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
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