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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! ▀ PROBABLY THE MOST EXCITING SAFETY FEATURE IN YOUR CAR. 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
Page 1 and 2: THE MAGAZINE FOR NEW ZEALAND’S OP
Page 3 and 4: OTs tackle low vision Collaboration
Page 5 and 6: IT’S TIME TO PLAY... $..‘000’
Page 7 and 8: Making the revolutionary, routine.
Page 9 and 10: A NEW LOOK FOR AUCKLAND EYE After n
Page 11 and 12: oDocs goes commercial, seeks invest
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