Jul 2016

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SPECIAL FEATURE: RANZCO NZ BRANCH SCIENTIFIC MEETING Convenor Dr Logan Mitchell (right) thanks keynote Dr Mark Chehade CONTINUED FROM P8 Dr Shuan Dai, a consultant ophthalmologist with Eye Doctors and Greenlane Hospital in Auckland, presented the new New Zealand guidelines for the screening and treatment of ROP, while Dr Justin Mora, a consultant ophthalmologist with Eye Doctors and Greenlane Hospital in Auckland, shared the results of the International Paediatric Ophthalmology and Strabismus Council survey of worldwide trends in ROP. Dr Mora’s presentation showed the alarming trend of ROP growing in middle income countries and the concern that this same trend could occur in lower income countries as their neonatal care improves. As ROP is almost always a preventable cause of blindness, it was encouraging to see the work going on both nationally and internationally. Amblyopia was also well covered, firstly by Professor Gole and then Dr Ben Thompson, adjunct professor at the Department of Ophthalmology at McGill University, who Skyped in from Canada for his session. Dr Thompson presented on novel binocular treatments for amblyopia including a modified tetris game and non-invasive brain stimulation. Encouragingly randomised control trials with the tetris game have begun as a possible treatment for amblyopia. The neuro-scientific basis of his presentation challenged us to think of why and how we treat as we do. An extremely interesting body of work presented beautifully from the other side of the world. Professor Gole wrapped up his keynote presentations on the developing eye with conversation on the appropriate correction of childhood refractive errors. He emphasised the need to cycloplege all children for accurate refraction, the importance of dynamic retinoscopy for near prescribing and the worrying increase in myopia worldwide. Professor Gole shared his solution to this workforce issue, the Paediatric Optometry Alignment Pilot Project. Optometrists interested in paediatrics could be up-skilled and become allied providers. The alignment project brings unity between optometry and ophthalmology, aids patients to transition smoothly from diagnosis to glasses and maximises the workforce skills available. The presentation was honest, to the point, and driven with a passion for seeing patients looked after. Developing techniques Developing techniques is often what draws us all together at conference, the desire to do more for our patients, to achieve better, to fix more and thus, many great talks fell into this category. Ophthalmic imaging is core to ophthalmic Janette McLeod showing Allergan’s new app practice. Dr David Squirrell, from Greenlane Hospital in Auckland and Milford Eye Clinic, presented a fascinating review of the importance of choroid imaging, questioning the role of the choroid in chronic macular disease pathophysiology. It was an enlightened talk that made many people stop and think about their practice and understanding of “everyday diseases” such as age-related macular degeneration. Dr Chehade, our keynote speaker from Adelaide, and Dr Brian Kent-Smith, from Eye Specialists Whangarei and Northland DHB, discussed developing techniques for workforce management. Dr Chehade shared his insights and queries of what the future of ophthalmology will look like. This included electronic health records, medical scribes, increasing patient load and decreasing funds, which all combined to give an emotive and topical presentation that kept many people talking afterwards, both privately and in open discussion in the large auditorium. Dr Kent- Smith talked about his personal experience of upskilling nursing staff. His technique was to offer varying, interesting roles to nurses allowing them to rotate through theatre, clinic and pre/ post-op in any given week. Team morale and job satisfaction results in better outcomes for patients, consistency for surgeons—due to less staff turnover—and a nicer work environment. Two great talks on a topic that affects us all. Many more interesting techniques were discussed throughout the conference. Dr Jo Sims, of Auckland Eye and Greenlane Hospital in Auckland, gave an interesting talk titled Something old, something new, something borrowed, something blue. The take-home information was the astounding new data of gut microbe effects on our overall health and thus eye conditions. The developing technique of nanosecond laser for age-related macular degeneration treatment was presented Dr David Worsley of Hamilton Eye Clinic, who shared his experience and specific technique. Developing treatments: from lab to clinic Talk of new treatments always causes the ears to prick and the heart to patter; the idea of making the blind see is an inspiration for many of us, and RANZCO Dunedin was littered with lectures that made this inspiration seem a lot closer. Professor Lotery described how ophthalmology is at the forefront in genetics because ophthalmologists are great phenotypers and “good phenotyping allows for good genotyping”. However, just finding the genes is not enough. The development of gene therapy for genetic conditions is needed. Professor Lotery then went on to inspire the audience with the story of Lancelot, a Briard sheep dog with Leber’s congenital amaurosis (LCA), who following a single treatment of gene therapy in one eye was able to see and continues to see. This same treatment for LCA is continuing to Phase III clinical trials in humans. Professor Lotery also left us with the question, “but what about the ‘common’ folk?”; those diseases that affect a large number of people coming through our clinics, such as age-related macular degeneration (AMD), could gene therapy be the answer? AMD had a further spotlight with Dr Andrew Thompson from Tauranga Eye Specialists presenting his research into the availability of Avastin throughout New Zealand. Disparity in availability was noted even when population demographics were taken into account. The presentation was met with lively discussion and debate, summed up by Dr Thompson thus: “to reach a desirable future where all who need treatment have access, three things are required: a national planning strategy, adequate funding and patient advocacy for change.” Professor Lotery returned on Saturday morning to again excite the delegates with interesting new treatments. This time he was talking about non-neovascular macular diseases and pharmacological treatments. Fascinating results were presented for eplerenone for central serous retinopathy and lampalizumab for geographic atrophy. Ongoing clinical trials are underway, so watch this space. Personal highlights There are always sessions at conference that stay in your memory. For me, there were two this year. Firstly, the eloquent and entertaining Gordon Sanderson, associate professor, ophthalmology at the University of Otago, who presented his journey through 40-plus years of ophthalmic teaching. This was a light-hearted, memory-filled journey of Gordon’s experience from first arriving in New Zealand to the present day. Photos accompanied his wonderful anecdotes with many familiar faces popping up along the way, many capturing members of the audiences’ much younger selves! Through the hilarity some pearls of wisdom were included: undergraduates need to be entertained to keep their focus; students and registrars appreciate your interest in them as people; and registrars need to know how to refract. My second highlight was the rapid fire/free paper session. Presenters included registrars, an optometrist, ophthalmologists and a public health physician. Topics ranged from bench to bedside and everywhere in between. Health economics, surgical and clinical techniques, atropine and SLT treatment, imaging and thought-provoking case reports. The standard of presentations was high with well-considered and inquisitive questions from the floor to both aid and guide research endeavours in the future. The collegial support of the junior presenters was felt by all. Developing friendships Although there was a plethora of interesting content and discussion at RANZCO there was also a great social atmosphere where friendships, old and new, were developed and rekindled. The Friday evening welcome function was held in the main hall of The Dunedin Centre amongst the exhibitors. Drinks, nibbles, the largest pipe organ in New Zealand and a beautiful acapella group added to the warm and friendly atmosphere. While on the Saturday evening conference attendees were given a real treat at the conference dinner. The Toitu Otago Settlers Museum was lit up as we arrived for drinks and then, when it was time for dinner, we were able to meander through the stunning displays of vehicles, outfits and images depicting the life and times of the Otago region. We were then entertained by a Lion Dance from the Otago Southland Chinese Association, featuring Dr Casey Ung’s own children, and were treated to a wonderful, thought-provoking presentation from “that blind woman” Julie Woods, a Dunedin local who is challenging the perception of blind people worldwide. Mix that with delicious food, great company and dancing and it was a wonderful evening. In summary Dunedin RANZCO 2016 was a collegial, interesting, and thought-provoking event. A conference that fed our brains, bellies and friendships. I can’t wait for the next one. ▀ * Samantha Simkin is a therapeutically qualified optometrist from the University of Auckland. She is currently pursuing her PhD in the Department of Ophthalmology with a focus on visual impairment in children. Samantha is supervised by Professor Charles McGhee and Drs Shuan Dai and Stuti Misra Dr Alastair Papali’i-Curtin, Samantha Simkin and Dr Ammar Binsadiq Drs Muhammed Kahlid, Casey Ung and John Ah-Chan Drs Kevin Taylor and Peter Haddard Dr Paul Cohen, Tricia MacDonald and Chris Williamson Niamh Kelly, Sally-Anne Herring and Libby Kelly Drs Shenton Chew and David Worsley Drs Chee-Foong Chong and Mike O’Rourke with Chantal O’Rourke and Drs Mark Donaldson and Sid Ogra THEME: NGA TANIWHA TIGERS AND TRAPS: Avoiding problems and acquiring sub-speciality pearls in ophthalmology New Zealand Branch Annual Scientific Meeting Friday 12 and Saturday 13 May 2017 Copthorne Hotel Bay of Islands, Paihia Incorporating the New Zealand Ophthalmic Nurses’ Group Meeting, New Zealand Orthoptists’ Society Meeting and Practice Managers‘ Meeting www.ranzco2017.co.nz T H E L E A D E R S I N E Y E C A R E Blackmore’s Nicole Jellard, Drs Dianne Sharp and Ian Eilliott and Phillippa Pitcher from MDNZ 10 NEW ZEALAND OPTICS July 2016
A nurse’s perspective What’s new: from the exhibitors’ hall BY RACHEL COOK* An acapella group entertains in the Dunedin Town Hall Dr Sheng Chiong Hong and Rachel Cook Dunedin was a chilly destination for this year’s RANZCO conference, but I felt warmed by the wonderful atmosphere and the opportunity to meet with fellow colleagues. The topics and presenters were varied, my only regret was that by skipping between the specialist and nurse sessions you were bound to miss out on something! Great information was presented on patient pathways, ranging from intraocular tumours to eye prosthetics. This included some very personal insights from presenters into the journey patients travel. Also interesting were the talks emphasising the benefits of teamwork and open communication in the workplace—something we all know, but perhaps need to make more time for. In particular, I enjoyed hearing from our clinical nurse specialists on interesting cases they have encountered in their practices. Kathryn Lee, from the Auckland District Health Board (ADHB), shed light on the more uncommon side of floppy eyelid syndrome, while Waikato District Health Board’s Lynn Scott discussed the rare serpiginous chorioretinitis. It was not just the syndromes that held my interest, but the way nursing practice can have such a positive impact on a patient’s perception of their healthcare. It was great also to hear from Jennifer Mor, a tutor with the Fred Hollows Foundation in Papua New Guinea, and Artika Avikashni from Fiji about the challenges they face in their daily nursing practice. Clinical nurse specialist Carol Slight from ADHB provided valuable information on standing order requirements—I wonder how many of us would love to access ADHB’s online “moodle” site to sit the competency modules? The real highlight for me this year, however, was “that blind woman,” motivational speaker Julie Woods, who was the guest speaker at the conference dinner on the Saturday night. She provided insight into her life since her 30s when, as a mother of two small children she was registered as blind. Her speech was inspiring as she related how she maintained her independence and learnt to step out of her comfort zones by saying “yes” to any opportunity and experience, despite the worry of wondering whether there would be a railing at the top of the Eiffel tower! An honest and real ambassador for what we are all here for. It was humbling to hear her story. In line with saying “yes”, I also put myself forward this year to present with Dr Sheng Hong on how the ODocs EyeCare smartphone system has been used to enhance nursing practice in the small town of Gisborne. Perhaps some of you will also put yourself and your experiences out there at the next conference. It’s a rewarding challenge, as we learn so much from the diversity of each other’s experiences, of our challenges and our triumphs. Roll on RANZCO 2017! ▀ * Rachel Cook is an ophthalmology speciality nurse at the Eye Clinic at Gisborne Hospital The grand baroque style of The Dunedin Town Hall with its imposing, floor to ceiling 1919 symphonic organ, provided a stunning backdrop to the exhibition portion of the 2016 New Zealand Branch of RANZCO’s Annual Scientific Meeting. The event was well supported with 19 exhibitors, including three major sponsors: Abbott Medical Optics, Alcon and Toomac Ophthalmic. The atmosphere was both warm and busy, with some cleverly-staged timing by the exhibition organisers—staggering the break times of the main scientific programme and the concurrent ophthalmic nurses and technicians programmes— ensuring exhibitors weren’t too overrun during the breaks. The following are some of the highlights from the exhibitors’ hall. Abbott Medial Optics Abbott was showcasing two key products, the Signature Pro Phaco machine, which was launched in April, and the Symphony extended range vision lens. Abbott offer a full range of IOLs, including an extended range option, which is different from a multifocal as it offers a continuous focus with no blurring. The compnay has developed this lens in-house and it is unique technology, said Henri Buhagiar, Abbott’s Australasian phaco specialist. Toomac Ophthalmic Toomac introduced the new SP.eye Intravitreal Injection System from Salar Surgical. The first such device of its kind, the SP.eye reportedly reduces the steps in the intravitreal workflow, by combining precise needle positioning with sharps safety. “It’s easy and safe, compared to any other system, said Toomac director Ian MacFarlane. “It was born out of necessity and developed by an ophthalmologist in the UK.” The device was lauded in the UK journal The Ophthalmologist in December 2014 as one of the top ten best innovations of the year and will become increasingly important as procedures become more nurse-led, said MacFarlane, adding there was a lot of interest in the new product at the meeting. “We only introduced it a month ago and we’re delighted with the response so far. It allows for precise measurement, proper angle and depth of injection: simplicity can’t get better.” New Zealand’s also first to get the device over Australia, though Toomac is considering taking it over there later this year. New Zealand’s also first to get the device over Drs Antony Suter and Michael Merriman Drs Mike Mair and Rod Keillor Australia, though Toomac is considering taking it over there later this year. Also attracting interest on Toomac’s stand was the Haag Streit Octopus 600 Perimeter with Pulsar Technology. Pulsar offers a very fast, one-minute screening test that is designed to be highly sensitive and specific to detect glaucoma and allows full follow-up with white on white on the same device. Molteno Ophthalmic Despite being around for more than 30 years, this was the first time Kiwi company Molteno Ophthalmic has ever taken its own stand at a conference, marking a new and exciting direction for the glaucoma implant firm, says equally new chief executive Dr Nina Molteno. Dr Molteno, a former GP and daughter of wellknown Kiwi ophthalmologist Professor Anthony Molteno, whose ground-breaking research resulted in the purpose-built implants now being marketed by the company, said for the last 30 years the product had pretty much been marketed by wordof-mouth alone. “We have a really solid reputation and a great product, but we realised we needed to tell people about ourselves so they can take advantage of it.” Produced in a purpose-built facility in Dunedin, Molteno implants are used across the world, but 424 still far too few people know about them, said Dr Molteno. “We have the longest clinical trials of any implants and that and our understanding of what makes glaucoma surgery work has informed the design of our new implants, so we have a lot to talk about.” Lumenis Attracting interest on Lumenis’ stand was its M22 with Optimal Pulse Technology, the next generation of Intense Pulse Light (IPL) technology, for treating dry eye disease and rosacea, and its Selecta Trio, a three-in-one laser product offering NOW AVAILABLE IN NEW ZEALAND THE ARTIFICIAL IRIS Regardless of partial or complete aniridia – the world’s first artificial iris prothesis provides a solution to restore vision not only optically but also aesthetically, and is now available in New Zealand from Spectrum Surgical 032 Thomas Cook, Josie Fletcher and Marcus Ebert Spectrum Surgical specialises in the sale of leading edge surgical and medical devices to health care professionals and hospitals. We offer innovative and ground-breaking solutions from companies of the highest quality, providing our clients with advancements in ophthalmic surgery, diagnostics and more. NB: Spectrum Surgical is the new distributor of FCI products, leading manufacuturer of: bicanalicular and monocanalicular intubation, punctum plugs, ptosis slings, orbital implants, purified silicone oils, perfluorocarbon liquids, disposable vitrectomy lenses, scleral buckles and intravitreal assistants. For more visit http://www.spectrumsurgical.com.au/ or contact: Peter Grech, managing director, at pgrech@spectrumsurgical.com.au or +61 3 9562 2472 CONTINUED ON P11 July 2016 NEW ZEALAND OPTICS 11
Page 1 and 2: THE MAGAZINE FOR NEW ZEALAND’S OP
Page 3 and 4: New diploma for Foundation A culmin
Page 5 and 6: ©2016 NIKE, INC. Become a stockist
Page 7 and 8: For the first time in Auckland, Alc
Page 9: It’s all in You make every move w
Page 13 and 14: The wider world of medicine and opt
Page 15 and 16: were featured on the CliC Eyewear s
Page 17 and 18: with Prof Charles McGhee & A/Prof D
Page 19 and 20: J&J launch HydraLuxe Johnson & John

Jul 2016

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