Apr 2016

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
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