Jun 2016

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.


PO BOX 106 954, AUCKLAND CITY 1143<br />

Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz<br />

JUNE <strong>2016</strong><br />





Start with ME.<br />

TECNIS Symfony and TECNIS are trademarks owned by or licensed to Abbott Laboratories, its subsidiaries or affiliates.<br />

Australia: Abbott Medical Optics, 299 Lane Cove Road, Macquarie Park, NSW 2113, Australia. New Zealand: Abbott Medical Optics (AMO Australia Pty Ltd) PO Box 401, Shortland Street, Auckland, 1140.<br />

©<strong>2016</strong> Abbott Medical Optics Inc. www.AbbottMedicalOptics.com PP<strong>2016</strong>CT0415

IT’S TIME TO PLAY...<br />

OFFER<br />


TO END<br />

OF JUNE!<br />



With a market shortage of optometrists in both Australia and New Zealand, alongside a goal<br />

of further growth from Specsavers franchise partners in <strong>2016</strong>, we’re taking a new<br />

approach to boosting our optometry team – and everyone can benefit.<br />

Until the end of <strong>Jun</strong>e, every optometrist you refer to our recruitment<br />

teams – who subsequently joins us as a locum, as a partner or in an employed role<br />

- will earn a ‘Refer a Friend’ payment. Depending on the location<br />

and role taken up, payments you are eligible for range from $1000 to $50,000!<br />

And here’s a tip – if you’re really up for it and refer yourself, you’ll still be<br />

entitled to claim your referral payment…<br />

To find out more and to explore the Terms and Conditions associated with this<br />

industry-wide offer, contact Carly Parkinson on 0800 717 350 or<br />

carly.parkinson@specsavers.com – or visit spectrum-blog.com.<br />

Retail<br />

Employer<br />

of the Year<br />

2015<br />

Franchise<br />

Innovation<br />

Award<br />

2015<br />

NZ Franchise<br />

System of<br />

the Year<br />

2014<br />

Retail<br />

Innovator<br />

of the Year<br />

2014<br />

Multichannel<br />

Retailer<br />

of the Year<br />

2014<br />

Roy Morgan<br />

Research<br />

No. 1 for eye tests<br />

2014<br />

FCA International<br />

Franchisor<br />

of the Year<br />

2014<br />

FCA Social<br />

Responsibility<br />

Award<br />

2014<br />

FCA Established<br />

Franchisor<br />

of the Year<br />

2013<br />

FCA Excellence<br />

in Marketing<br />

Award Winner<br />

2013<br />

Australian<br />

Retailer<br />

of the Year<br />

2013<br />

2 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong>

From frustrated<br />

ophthalmologist to entrepreneur<br />

A month<br />

of firsts<br />

After becoming increasingly exasperated with the inefficient way the system dealt with<br />

cataract surgery referrals, Dr James McKelvie decided to do something about it.<br />


Around 30,000 people have cataract surgery<br />

in New Zealand each year, says Dr James<br />

McKelvie, a corneal fellow at the University<br />

of Auckland and Auckland District Health Board.<br />

“It’s the most frequently performed surgical<br />

procedure in New Zealand by far, and the public<br />

health system in New Zealand is likely to struggle<br />

with the increasing demand for cataract surgery in<br />

the near future.”<br />

The way the system works right now, and has<br />

done for some time, is that a GP or community<br />

optometrist will identify a possible need for surgery,<br />

write a referral – often by hand – and post it. The<br />

patient has to wait for the letter to be assessed by<br />

the administration staff and triaged before they can<br />

be booked into an appointment with a specialist to<br />

find out if they are eligible for surgery. The patient is<br />

then placed on the surgical waiting list, and then it<br />

may take up to another four months until they have<br />

their surgery.<br />

“From a patient perspective the current system,<br />

with the long waiting time and uncertainty around<br />

surgery, is not ideal,” says Dr McKelvie. “Cataracts<br />

are normally identified at the time of an event; like<br />

failing an eye sight test for a drivers licence. This<br />

means the situation is both urgent and distressing<br />

for the patient.”<br />

On top of that, DHBs are missing out on the<br />

opportunity to collect vital data that could help<br />

identify the burden of cataract in the community, he<br />

says. This data would enable the health community<br />

to plan ahead and ensure surgical intervention<br />

rates and access to surgery between DHBs, ethnic<br />

subgroups and all geographic locations remains<br />

consistent across New Zealand.<br />

To tackle the problem, Dr McKelvie began<br />

designing an electronic, real-time referral system in<br />

his spare time that could reduce wait times and give<br />

patients immediate information, as well as record<br />

data in a uniform and useful way.<br />

“It’s a web-based app that a GP or optometrist can<br />

use on a computer, phone or tablet,” he explains.<br />

“While they’re still with the patient, they can use the<br />

app to send a referral to the hospital.”<br />

This referral will not only reach the relevant team<br />

in the hospital quicker, it will include significantly<br />

more, relevant, clinical data that can be used at the<br />

pre-surgical appointment.<br />

The app also processes the application instantly<br />

and assesses whether the patient meets the<br />

criteria for surgery, says Dr McKelvie. “This means<br />

that within a few minutes the patient can leave<br />

their GP’s or optometrist’s office either with a<br />

plan for community-based care or a pre-surgery<br />

appointment with an ophthalmologist.” (Fig. 1)<br />

It also means the DHB using the system can<br />

capture useful information about both the patients<br />

referred and those in community care that are subthreshold,<br />

to allow better predictions to be made<br />

about the volume of people that are likely to require<br />

surgery in the near future.<br />

Dr McKelvie’s app doesn’t stop there, however. As<br />

well as being a system for electronic referral, the<br />

app can complete a risk assessment and a real-time<br />

audit of cataract surgery to help the surgeons.<br />

“Phase two of the project will seek to digitise the<br />

information we collect in a pre-surgery appointment<br />

and provide a risk analysis,” he explains.<br />

Currently, a clinical exam before surgery requires<br />

a variety of different tests and measurements to<br />

be taken, typically generating 20 to 30 pages of<br />

hand-written notes, forms and calculations for each<br />

operation.<br />

“Ophthalmologists are notorious for their<br />

excellent attention to detail and careful assessment<br />

and documentation of a surgical plan” says Dr<br />

McKelvie. “This close attention to detail is partly<br />

why the vast majority of patients achieve excellent<br />

outcomes following cataract surgery. However, there<br />

is no doubt this system can be improved upon using<br />

the benefits of cloud-based computing to improve<br />

efficiency and add another layer of error checking.”<br />

Dr McKelvie’s system will introduce a paperless,<br />

digitised trail of standardised information relating<br />

to each patient, including a comprehensive, concise,<br />

one-page summary of all relevant information<br />

required in the operating theatre. As part of this<br />

summary each patient will have an evidence-based<br />

Dr James McKelvie is working on<br />

a real-time referral system<br />

risk assessment that<br />

uses a number of<br />

variables to predict the<br />

probability of a major<br />

complication during<br />

surgery. High risk cases<br />

will be highlighted as<br />

less suitable for junior<br />

trainee surgeons to<br />

reduce the risk of<br />

complications and<br />

improve outcomes for<br />

patients. Other features<br />

include a customised<br />

consent form, electronic operation note and several<br />

additional features that will improve efficiency and<br />

patient safety in the operating theatre.<br />

“The third stage of the project is a real-time<br />

audit of surgical results,” says Dr McKelvie. “At the<br />

moment, audits are time consuming and very labour<br />

intensive, so they’re typically performed sparingly<br />

on selected cohorts of patients. This system will<br />

allow all patient data to become part of an audit,<br />

effortlessly conducted in real time.”<br />

With an up-to-date, confidential and secure audit<br />

of personal surgical data at their fingertips, on<br />

their phone or computer, surgeons will be able to<br />

access vital feedback about their surgical outcomes<br />

and have the ability to compare their results with<br />

those of an (anonymised) pool of their peers. This<br />

will provide information about different surgical<br />

techniques, complications and visual outcomes and<br />

can provide customised data that will be of interest<br />

to surgeons, such as personalised A-constants,<br />

surgically-induced astigmatism and more. “This<br />

information may be used to refine surgical<br />

techniques, calculations and further improve visual<br />

outcomes for patients,” says Dr McKelvie.<br />

Since presenting his ideas at the Health<br />

Informatics New Zealand Conference in Christchurch<br />

in October, where he won the Clinician’s Challenge:<br />

Fig 1. Dr James McKelvie’s real-time referral ssystem will speed up the process from weeks to minutes<br />


Community optom<br />

identifies a need for<br />

referal<br />

A hand written referal is posted<br />

5-10 DAYS<br />

Letters are sorted assessed and triaged<br />

10-14 DAYS<br />

Patient receives a response<br />

3-4 WEEKS<br />

New Ideas category, Dr McKelvie has been<br />

congratulated by Health Minister Jonathan Coleman<br />

and received a number of expressions of interest<br />

from parties across New Zealand.<br />

He is currently working on perfecting the<br />

prototype, with the Waikato DHB lined up to trial<br />

the system later this year. Auckland DHB have also<br />

expressed interest in trialling the system in the<br />

near future.<br />

“I’ve had some fantastic feedback. The<br />

possibilities for this system across health in<br />

general are endless,” says Dr McKelvie.<br />

“I didn’t set out to be a businessman or an<br />

entrepreneur, and I’m no IT expert, but I’m<br />

interested in new ideas and wanted to see the<br />

best outcome for patients and ophthalmologists.<br />

Once people heard about the project it took on a<br />

life of its own.”<br />

Dr McKelvie admits there are still challenges<br />

ahead, but says it is exciting to see the potential of<br />

a system like this. “The ophthalmologists that have<br />

seen what this can do for them are very enthusiastic<br />

to start using it as soon as possible. Naturally<br />

change is often difficult, but the aim of this system<br />

is to make cataract surgery better, faster and<br />

safer for everyone, while making better use of our<br />

resources to address the increasing demand for<br />

cataract surgery in the future.”<br />

It’s fair to say this is a critical time in the<br />

healthcare industry, with medicine becoming<br />

increasingly more digitised, says Dr McKelvie,<br />

adding if he hadn’t come up with the idea, nodoubt<br />

someone else would have.<br />

“There are not enough doctors or dollars to<br />

address the critical mass of patients we are heading<br />

toward, our only choice is to get smarter about<br />

the way we do things. Cataract surgery is the most<br />

common surgical procedure in New Zealand – if<br />

we can make the change for cataract surgery,<br />

chances are we could apply this to other areas of<br />

ophthalmology and surgery also.” ▀<br />

<br />

<br />

<br />


Date: 18-May <strong>2016</strong><br />

Dear Joe Brown<br />

Ulpa eum int vendio to dolla que praeptumquasDandi<br />

qui officiusam, con porerion prorem faceraernat option<br />

nos aut vellecto temquas pellestias aut et vendit quae.<br />

Ehenem et, sinulla boremped exerias velest, quuntint,<br />

temporeium re accum sum quam, tem apis simin rest<br />

labo. Ullaut optate ex eum arum dolorem. Itassi andi quo<br />

totae sed ma none qui odi blab.<br />

Regards<br />

Dr Lesley Springall<br />


Welcome to your <strong>Jun</strong>e issue of<br />

NZ Optics – my first full issue at the<br />

helm. Thus far, Lesley has very kindly<br />

steered me through the early stages of taking<br />

on the editor’s role, and I’m excited to have<br />

now been set free (relatively speaking!) on this<br />

wonderful title.<br />

This issue contains several other firsts, such<br />

as the CentraSight surgery performed on an<br />

MD patient in Tauranga, the first of its kind in<br />

the Southern Hemisphere (p4) and news about<br />

New Zealand’s upcoming hosting of the APAO<br />

conference – the first time an event of this size<br />

has made it to Aotearoa (p4).<br />

Another first in the events calendar was the<br />

Ocular Therapeutics one-day conference, which<br />

we cover in detail inside (p8-9). We talk to Dr<br />

James McKelvie about the ground breaking,<br />

real-time referral and audit software he will<br />

be trialling later this year (this page), and we<br />

celebrate Associate Professor Dr Dr Bruce<br />

Hadden and the Optometry School class of<br />

2015, who graduated on 11 May (p17 and p19).<br />

I hope you enjoy the magazine, and whether<br />

you want to congratulate us or berate us, rest<br />

assured our virtual doors are always open. We’d<br />

love to hear your feedback and suggestions<br />

via email, editor@nzoptics.co.nz – and who<br />

knows, you might even find your kind words or<br />

constructive criticism in print! ▀<br />

Jai Breitnauer, editor, NZ Optics<br />


Community optom<br />

identifies a need for<br />

referal<br />

They complete an online referal while<br />

patient is present<br />

2 MINUTES<br />

They receive an instant response<br />

and pre-surgery appointment if<br />

necessary<br />

30 SECONDS<br />

<br />

<br />


<strong>Jun</strong>e <strong>2016</strong><br />



News<br />

in brief<br />


The Ministry of Transport is considering allowing drivers to renew<br />

their driver licences online without the need for an eye test. People<br />

will still have to get their eyes tested when they first get a licence<br />

and after age 75, but only make a declaration about the state<br />

of their eyesight when renewing their licence online. The Driver<br />

Licensing system is under review as part of the Government’s<br />

commitment to achieve a more efficient transport regulatory<br />

system. A discussion paper was released on 19 April <strong>2016</strong> and<br />

submissions are due to close on 2 <strong>Jun</strong>e.<br />


NovaBay published clinical data at the ARVO meeting in Seattle<br />

demonstrating its lid and lash hygiene product, Avenova, reduced<br />

the bacterial load on the ocular surface by more than 90% in 20<br />

minutes without affecting the diversity of bacteria remaining. This<br />

made Avenova the only commercial clinical product validated in<br />

a multicentre study to substantially reduce the bacteria that can<br />

cause blepharitis, said Glenn Moro, NovaBay’s vice president, sales<br />

and marketing.<br />


In other news from ARVO <strong>2016</strong>, results from a series of pre-clinical<br />

studies provided proof-of-principle that gene targeting using<br />

CRISPR-Cas9 genome-editing technology can prevent or treat<br />

glaucoma associated with mutations in the myocilin (MYOC) gene.<br />

The research was led by Professor Val Sheffield from University of<br />

Iowa’s Carver College of Medicine.<br />

Professor Douglas Jabs, chair of the Department of Ophthalmology<br />

and Professor of Medicine at the Mount Sinai School of Medicine<br />

in New York City, said modern combination antiretroviral therapy<br />

(cART) has transformed the AIDS epidemic and the management<br />

of cytomegalovirus (CMV) retinitis. Information presented by<br />

Professor Jabs at ARVO demonstrated interactions between CMV<br />

and HIV and the importance of the immune response in controlling<br />

CMV disease. For more on ARVO, see page 19.<br />


In May, the Royal Australasian College of Surgeons (RACS) launched<br />

Let’s Operate with Respect, a call to action for the 7,000 surgeons<br />

and 1,300 trainees in Australia and New Zealand to put an end to<br />

discrimination, bullying and sexual harassment in surgery. “We<br />

know these problems are common throughout the health sector,<br />

but it’s up to us to improve things in surgery,” said RACS President,<br />

Professor David Watters OBE.<br />

The Let’s Operate With Respect campaign results from the<br />

recommendations of an Expert Advisory Group established last<br />

March in response to complaints. It aims to get surgeons talking<br />

about these problems and affect a culture change in the profession.<br />


Launched in 2013, Alcon’s Dry Eye Academy is led by<br />

ophthalmologists and optometrists with expertise in identifying<br />

and treating dry eye. The next New Zealand workshop will be held<br />

in Auckland on Sunday 31 July.<br />


New ‘artificial eye’ liquid contact lenses have been developed by<br />

Professor Hongrui Jiang from Wisconsin University in the US. The<br />

liquid contact lenses give perfect vision at any distance, even as<br />

conditions change and it gets darker, and automatically focus in<br />

less than a blink of an eye, using tiny, solar-powered computers,<br />

said Professor Jiang in a report on his discovery published in<br />

Proceedings of the National Academy of Sciences.<br />


Sony has filed a patent application for a smart contact lens that<br />

can take photos and record videos at the blink of an eye and play<br />

back the captured images for the user. The move comes hot on the<br />

heels of Samsung’s patent, which was filed in April, for a contact<br />

lens with a tiny camera that can be controlled by blinking. Sony’s<br />

lens, however, also includes a storage medium negating the need<br />

for an external storage device, while Samsung’s requires captured<br />

images to be sent to another device, such as a smartphone.<br />


There is a science behind lighting that nightclubs and retailers<br />

understand and have invested in for many years, but now, thanks<br />

to new research, the “right” lighting for academic achievement may<br />

make its way into schools. Researchers in a South Korean study,<br />

published in Optics Express at the end of April, found that lighting<br />

can be optimised for various activities from test-taking to reading.<br />

They characterised lighting by measuring different, correlatedcolour<br />

temperatures from “warm” to “cool” using the Kelvin scale<br />

and found different types had a profound effect on our physical and<br />

mental condition. ▀<br />

Telescopic treatment for AMD<br />

A<br />

new<br />

treatment programme for<br />

advanced macular degeneration<br />

(MD), called CentraSight, has finally<br />

made its way to New Zealand. The surgery,<br />

which involves inserting a tiny telescope<br />

into the eye of the patient in order to<br />

offer more visual acuity, had only been<br />

performed on a few hundred patients in<br />

the USA and UK until now. Consultant<br />

ophthalmologist Dr Mike O’Rourke of<br />

Tauranga Eye Specialists successfully<br />

performed the first operation of its kind in<br />

the Southern Hemisphere in February this<br />

year. The patient, 77-year-old Alisa Shaw<br />

from Whakatane, is recovering well.<br />

“The first study on this method was<br />

initiated in 2002 in the USA and the<br />

treatment earned FDA approval in 2008,”<br />

says Dr O’Rourke. “It was introduced in the<br />

UK three years ago. The surgery involves<br />

making a large incision around the limbus<br />

for 180 degrees to insert a 4.4mm glass<br />

telescope into the eye.”<br />

There is nothing special about the<br />

telescope itself, as optically it is a Galilean<br />

telescope, just miniaturised. It offers an<br />

almost 300% increase in the size of the<br />

image in one eye, making it easier for<br />

patients to see around the black spot that<br />

forms in their central vision.<br />

“Careful patient selection is key to<br />

the success of this surgery,” explains<br />

Dr O’Rourke. “The eyes will never work<br />

together again as the eye with the implant<br />

will be used for central vision, while the<br />

other eye will be relied upon for peripheral<br />

vision.”<br />

The pre-surgical assessment actually<br />

includes a simulation of the telescope to<br />

make sure patients can cope and the surgery<br />

will be beneficial. There are a number of<br />

other factors affecting patient selection<br />

also, says Dr O’Rourke.<br />

“Their bilateral MD needs to be stable,<br />

with no other health issues like diabetes or<br />

problems with the cornea. They need to be<br />

off any further macula treatment and be<br />

6/24 or worse in their best eye.”<br />

Then there’s the cost. The lens itself, handmade<br />

in Israel, costs $19,500 and then you<br />

need to account for the surgery and rehab<br />

An artist’s impression of the implant in the eye<br />

The telescopic implant is just 4.4mm<br />

costs. “It all adds up,” admits Dr O’Rourke,<br />

who expects to perform around four<br />

surgeries of this nature a year. “You won’t<br />

get much change from $30,000”.<br />

Another factor is there are only two New<br />

Zealand optometrists, Lynley Smith in<br />

Tauranga and Rodney Stedall in Hamilton,<br />

qualified to assess and recommend patients<br />

for surgery and to guide them through<br />

recovery, so ability to travel is important. A<br />

third optometrist may be travelling to the<br />

UK for training in the near future, adds Dr<br />

O’Rourke, but for patients like Alisa Shaw,<br />

whose sight had deteriorated to the point<br />

where she was unable to function on a daily<br />

basis, the CentraSight programme offers<br />

a new quality of life where patients had<br />

previously been told nothing could be done. ▀<br />

APAO coming to Auckland<br />

Auckland’s new, but as yet unbuilt,<br />

international conference centre<br />

is booked as the venue for one<br />

of the largest, if not the largest, medical<br />

conferences New Zealand has ever held when<br />

New Zealand plays host to the Asia-Pacific<br />

Academy of Ophthalmology (APAO) annual<br />

Congress in March 2020.<br />

Professor Charles McGhee, head of the<br />

Department of Ophthalmology at the<br />

University of Auckland and newly-made<br />

President Elect for APAO, will take on the twoyear<br />

APAO president term in 2019 and thus<br />

will be the convenor of the 2020 Congress.<br />

“This is a really big deal for New Zealand.<br />

We expect about 3,500 to 4,000 people and,<br />

allowing for a large industry subscription,<br />

we expect we may get as many as 4,200. It<br />

will bring people and exhibitors together<br />

from all over Asia and the Pacific. It’s the<br />

biggest grouping of (ophthalmological)<br />

societies there is.”<br />

Professor McGhee says just because he<br />

was made president elect at this year’s<br />

APAO Congress in Taipei, didn’t mean New<br />

Zealand would automatically host the 2020<br />

conference as Congress’s can be held in<br />

neighbouring countries. But given Australia<br />

was host in 2011 (ably helped by Professor<br />

McGhee who was then APAO scientific chair)<br />

it fell to New Zealand for 2020.<br />

APAO’s four-day congress attracts several<br />

hundred highly-experienced speakers from<br />

all over world, he says. “We will also run<br />

a number of instructor courses so junior<br />

surgeons can upskill and more experienced<br />

surgeons can re-skill.<br />

“A major international conference allows<br />

you to network across many different<br />

platforms, exchange ideas from many<br />

different societies and economic groups.<br />

Different ethnicities have different diseases so<br />

what is state-of-the-art in Australia and New<br />

Zealand might be quite different to what is in<br />

China or India.”<br />

Though the event is about building<br />

relationships with peers overseas and<br />

education, Professor McGhee says he expects<br />

the exhibition side to be the biggest ever held<br />

in New Zealand as well, as it’s one of the few<br />

times the industry side of the profession can<br />

expose their products and ideas to more than<br />

4,000 ophthalmologists in one place.<br />

The 31 st APAO in Taipei in March this year<br />

was very well attended and very exciting,<br />

he says, with a good showing from the New<br />

Zealand ophthalmological side. Highlights<br />

included a memorandum of understanding<br />

between APAO and Sight for All, a non-profit<br />

Australian organisation, that enables the<br />

organisations to work together on the first<br />

APAO Gateway Project in Laos.<br />

The APAO Gateway Projects were conceived<br />

as a way for wealthier nations to help<br />

those in need. They encompass all the main<br />

charitable and non-profit groups throughout<br />

the Asia-Pacific region, and the relevant<br />

government health departments, to reduce<br />

avoidable blindness and visual impairment in<br />

Professor Charles McGhee<br />

Dr Mike O’Rouke has brought the<br />

CentraSight programme to NZ<br />

a region of need.<br />

APAO was founded in 1960 by Budapestborn,<br />

but Hawaiian-based ophthalmologist<br />

Dr William John Holmes, with the<br />

principal objective of fostering closer<br />

relationships among ophthalmologists and<br />

ophthalmological societies in the Asia-<br />

Pacific region in order to combat blindness.<br />

Other objectives are to encourage the free<br />

exchange of ophthalmic knowledge and the<br />

advancement of the standard of eye care. ▀<br />

www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand<br />

For general enquiries, please email info@nzoptics.co.nz<br />

For editorial and classifieds, please contact Jai Breitnauer, editor, on 022 424 9322 or editor@nzoptics.co.nz.<br />

For advertising, marketing, the OIG and everything else, please contact Lesley Springall, publisher, on 027 445 3543 or lesley@<br />

nzoptics.co.nz.<br />

To submit artwork, or to query a graphic, please email lesley@nzoptics.co.nz.<br />

NZ Optics magazine is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times<br />

a year, by New Zealand Optics 2015 Ltd. Copyright is held by NZ Optics 2015 Ltd. As well as the magazine and the website,<br />

NZ Optics publishes the annual New Zealand Optical Information Guide (OIG), a comprehensive listing guide that profiles the<br />

products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The<br />

views expressed in this publication are not necessarily those of NZ Optics (2015) Ltd.<br />

4 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong>

New optometry collective<br />

launches in Australia<br />

Call to action<br />

for children<br />

George & Matilda Eyecare (G&M), a new<br />

optometry group headed by Luxottica’s<br />

former Asia-Pacific CEO Chris Beer, launched<br />

in Australia last month and is on the hunt for<br />

Australian optometry businesses to join the brand.<br />

According to the company’s website, G&M is<br />

an Australian-owned and operated optometry<br />

collective. “We offer leading optometrists a unique<br />

partnership model that’s unlike any other franchise<br />

or buying group in the optical industry.”<br />

The branding and advertising for G&M is being<br />

handled by Saatchi & Saatchi, which worked with<br />

Beer when he worked with OPSM on the successful<br />

Penny the Pirate children’s screening book and app<br />

campaign.<br />

In an announcement to the Australian marketing<br />

press, Beer commented: “George & Matilda is<br />

all about providing customers with stylish, fresh<br />

products in an approachable and familiar way. We<br />

want people to get more out of their optometry<br />

experience and Saatchi & Saatchi’s strategic and<br />

creative approach to this ambition will help us<br />

differentiate immediately.”<br />

Michael Rebelo, chairman and CEO of Saatchi<br />

& Saatchi Australia said it wasn’t often the<br />

company was given the chance to build a brand<br />

from a blank sheet of paper. “This has been a<br />

unique opportunity for our team to leverage<br />

our experience in this industry and apply it to a<br />

disruptive start-up business.”<br />

The name George & Matilda was chosen to reflect<br />

Australia and the vision of the brand with George<br />

representing the first high street in Australia and<br />

Matilda echoing one of the nation’s favourite songs.<br />

The new collective has already signed up the<br />

11 practices of Port Macquarie-based Hanks<br />

Optometrists and Peter Hewett Optometry in<br />

Mosman, Sydney.<br />

Beer did not return NZ Optics’ calls by press time.<br />

• Another new chain also launched in Australia<br />

last month, Better Eyecare. The new group is 60%<br />

owned by optometrist Paul Sheehan, now CEO of<br />

Better Eyecare, with the remaining 40% held by<br />

CFO Anthony Anderson and COO Michael Tanzer.<br />

Speaking to Insight magazine, Sheehan said<br />

Better Eyecare is an Australian-owned and<br />

operated company that has identified a prime<br />

opportunity in the Australian market to aggregate<br />

profitable practices into a new group that will<br />

compete with existing corporate groups. ▀<br />

The Brien Holden Institute, a global nonprofit<br />

scientific research and education<br />

organisation, has teamed up with Vision<br />

for Life, an Essilor social impact initiative, to<br />

tackle the growing problem of childhood myopia.<br />

Announced in New York on 12 April, their new,<br />

joint campaign, Our Children’s Vision, aims to<br />

screen 50 million children worldwide by 2020.<br />

Recent research from the Brien Holden Institute<br />

indicates that by 2050, 4.76 billion people (half<br />

the current global population) will suffer from<br />

myopia, with the majority of them needing<br />

glasses.<br />

Our Children’s Vision aims to encourage<br />

countries to act now to tackle the increasing<br />

impact poor eyesight has on educational<br />

outcomes and social development.<br />

“[Children with uncorrected vision] can’t play<br />

outside safely, so they struggle to make friends.<br />

They can’t see the blackboard, so they struggle<br />

to learn. They are hindered in every aspect of<br />

their life and it doesn’t stop at childhood,” said<br />

Jayanth Bhuvaraghan, chairman of Vision For<br />

Our childern’s vision graphic<br />

Life and chief corporate mission officer at Essilor<br />

International.<br />

Yet many children, particularly those in some of<br />

the poorest communities, don’t have access to eye<br />

care. This issue has already been highlighted in<br />

New Zealand by Essilor, who has implemented its<br />

own Essilor Vision Foundation initiative, screening<br />

children in decile 1 and 2 schools (NZ Optics, May<br />

<strong>2016</strong>, p4). But the Our Children’s Vision campaign<br />

takes this concern to the next, global level of action.<br />

“We are potentially facing the biggest public<br />

health challenge of our generation,” said<br />

Professor Kovin Naidoo, CEO, Brien Holden Vision<br />

Institute and campaign director for Our Children’s<br />

Vision. “This trend can be slowed down through<br />

preventative or corrective care, but only if a child<br />

is reached while their eyes are still developing. An<br />

effective eye health programme in schools would<br />

have an unprecedented impact. Our Children’s<br />

Vision is a global campaign designed to make this<br />

impact a reality. We need to act now.”<br />

For more information, visit<br />

www.ourchildrensvision.org. ▀<br />

Education Series <strong>2016</strong><br />

Seminars<br />

are FREE!<br />


Tuesday 16th August<br />

6.30pm - 8.45pm<br />

Theme:<br />

Diagnostics and<br />

Therapeutics in<br />

Everyday Practice<br />

Venue:<br />

Ellerslie Event Centre<br />

Racecourse, 80 Ascot Ave<br />

Ellerslie, Auckland<br />

Eye Institute’s Education Series continues to offer an opportunity for the Optometry Profession to gain exposure<br />

to the latest advances in therapeutics, shared-care management and surgical advances in New Zealand.<br />

You are invited to join us at our August Seminar and November Conference for the <strong>2016</strong> year.<br />

Optometry Conference<br />

Sunday 6th November<br />

8am - 5pm<br />

Waipuna Hotel & Conference Centre,<br />

58 Waipuna Road, Mt Wellington, Auckland<br />

PLUS 1/2 day workshops<br />

Saturday PM 5th November<br />


www.eyeinstitute.co.nz/optometry<br />

Dispensing Optician Conference<br />

Sunday 6th November<br />

8am - 5pm<br />

Waipuna Hotel & Conference Centre,<br />

58 Waipuna Road, Mt Wellington, Auckland<br />

August Seminar generously<br />

sponsored by<br />

Registration:<br />

5.45pm - 6.30pm<br />

Light Meal & Beverages<br />

provided<br />

BOOK NOW!<br />

for your <strong>2016</strong> CPD Credits<br />

(including Therapeutics)<br />

Or register by contacting...<br />

Tracy Richmond<br />

Ph 09 522 2125 | Fax 09 522 5770<br />

conference@eyeinstitute.co.nz<br />

<strong>Jun</strong>e <strong>2016</strong><br />



Eyeing the power of algae<br />

New Zealand’s ophthalmic<br />

community is being targeted for<br />

direct sales of a home-grown<br />

“super-antioxidant” product<br />

harvested from algae.<br />

Celebrating<br />

excellence<br />


Kiwi supplement company Supreme<br />

Biotechnologies’ move into the world of eye<br />

health was completely serendipitous.<br />

Founder and chief executive Tony Dowd was<br />

seeking further investment for the company’s<br />

AstaSupreme products, when one London-based<br />

potential investor, who’d been using the product<br />

for a couple of months, asked if astaxanthin was<br />

any good for eyes.<br />

Astaxanthin (pronounced asta-zan-thin),<br />

a carotenoid found in algae and responsible<br />

for the red colour in salmon and shellfish, is a<br />

powerful antioxidant and the key ingredient in<br />

AstaSupreme products. The investor was a City<br />

trader who spent long hours in front of a screen<br />

and normally went home with very sore eyes.<br />

But, since taking AstaSupreme, said he’d noticed<br />

a remarkable improvement in how his eyes felt at<br />

the end of a long day.<br />

The observation led to some serious research by<br />

Dowd, key to which was a 1994 study by Dr Mark<br />

Tso of the University of Illinois, who discovered<br />

(or confirmed, as many claim to have spotted the<br />

benefits of astaxanthin for eyes over the years) that<br />

astaxanthin can help halt the progression of and<br />

prevent macular degeneration as well as protect<br />

our eyes against photic injury, ischemic diseases<br />

and inflammatory diseases.<br />

Further research led to Supreme Biotechnologies<br />

developing AstaSupreme Advanced Eye Care, with<br />

astaxanthin and the AREDS2 (see box) verified<br />

carotenoids, lutein and zeaxanthin, plus other<br />

products known to be important to eye health,<br />

including zinc and saffron.<br />

The product has been available through<br />

pharmacists and online for nearly 18 months<br />

now and qualitative studies by the company,<br />

sales growth and repeat purchase data is proof of<br />

how good it is, claims Dowd, who says he’s had<br />

to reduce his lens prescription twice in the last<br />

three years since taking AstaSupreme products.<br />

Sales have been so good in New Zealand—<br />

where Supreme Biotechnologies rolls out all its<br />

products first before taking them to the world—<br />

AstaSupreme Advanced Eye Care is now the<br />

company’s second highest selling product.<br />

Given the positive feedback, Dowd is now keen to<br />

introduce the product to New Zealand’s ophthalmic<br />

community, so they can sell it direct to consumers,<br />

with a hefty margin for themselves, of course, he<br />

laughs. He admits some education is required,<br />

however, as most of the profession is familiar with<br />

AREDS2 formulations, but not so familiar with the<br />

benefits of astaxanthin or saffron (despite saffron<br />

being used for eye remedies for many years).<br />

Dowd has considered, and is still considering,<br />

developing a specific product just for eye health<br />

Oculo launches<br />

Dr Kate Taylor<br />

and her team<br />

at Oculo, based<br />

in Melbourne,<br />

have successfully<br />

gained approval<br />

from the National<br />

Health Information<br />

Technology Board<br />

for their cloudbased<br />

clinical<br />

communication<br />

software and will<br />

Dr Kate Taylor, head of Oculo<br />

be rolling it out in<br />

New Zealand from<br />

the start of <strong>Jun</strong>e.<br />

“It’s a really exciting time for us,” said Dr Taylor,<br />

who began testing the platform in July 2015. “It’s<br />

wonderful to see a good idea flourishing.”<br />

In October, NZ Optics first reported on Oculo,<br />

whose software was born from work at the Centre<br />

for Eye Research Australia (CERA) and allows<br />

optometrists to identify an ophthalmologist that<br />

may meet their patient’s need, refer them using a<br />

digital system and securely exchange important<br />

clinical data.<br />

Tony Dowd in Supreme Biotechnologies’ algae growing facility<br />

professionals that contains more of the AREDS’<br />

ingredients to help introduce the profession more<br />

slowly to the benefits of astaxanthin, despite his<br />

company’s own research showing not all AREDS’<br />

ingredients are as important as perhaps they<br />

were once thought. For the moment, however, the<br />

company is sticking with the product it has and will<br />

take the educational path with the country’s eye<br />

health professionals, says Dowd.<br />

Astaxanthin is considered a “superantioxidant”—6,000<br />

times more powerful than<br />

vitamin C and 500 times more powerful than<br />

green tea, according to Supreme Biotechnologies’<br />

website. Unlike vitamin C, which can be harmful<br />

at high doses by becoming pro-oxidant, damaging<br />

cells just like free radicals do, it also doesn’t appear<br />

to have any harmful side effects.<br />

But the key difference between astaxanthin and<br />

other antioxidants is that most are either water<br />

soluble or fat soluble, which restricts which parts<br />

of the body they reach. Astaxanthin is both, so it<br />

can reach outside and inside cells…it can penetrate<br />

the blood-brain and thus the blood-eye barrier, says<br />

Dowd. “It can sit across the membrane as it has<br />

polar and non-polar parts to it; and because it can<br />

AREDS2<br />

The Age-Related Eye Disease Study 2 (AREDS2)<br />

was a multi-centre, randomised trial designed<br />

to assess the effects of oral supplementation<br />

of macular xanthophylls (lutein and<br />

zeaxanthin) and/or long-chain omega-3<br />

fatty acids (docosahexaenoic acid) [DHA] and<br />

eicosapentaenoic acid [EPA] on the progression<br />

to advanced age-related macular degeneration<br />

(AMD). An additional goal of the study was to<br />

assess whether forms of the AREDS nutritional<br />

supplement with reduced zinc and/or no<br />

beta-carotene works as well as the original<br />

supplement in reducing the risk of progression<br />

to advanced AMD. Enrolment concluded in <strong>Jun</strong>e<br />

2008 and participants were followed between<br />

five and six years. Source, and for more:<br />

www.areds2.org/<br />

The Australian roll-out began in April and<br />

now numbers some 250 optometry practices<br />

and 150 ophthalmologists, and numbers are<br />

growing daily, said Dr Taylor. “We developed<br />

the system alongside the big corporates: Bupa<br />

Optical, Luxottica’s OPSM and Laubman and<br />

Pank, and Specsavers have all been involved<br />

in testing.” But the Oculo team are now keen<br />

to get as many independents on board as<br />

possible, and have set a “really achievable”<br />

monthly subscription price for the product of<br />

just US$99, she said. “This system needs to be<br />

accessible because the patient benefit comes<br />

from the connectedness of the network.”<br />

Dr Taylor noted that while there have been<br />

a number of digital advances in treatment<br />

programmes, an update in communication<br />

practises is well overdue. “Eye care<br />

professionals usually communicate by fax,<br />

handwritten letter and – even more worryingly<br />

– email and Facebook. The need for a safe, secure<br />

and confidential platform for collaboration was<br />

great.”<br />

The amount of time involved in handwritten<br />

communications can cause both optometrists<br />

and patients ongoing stress, she added. “It can<br />

get in, it can get to the free radicals that are sitting<br />

there—caused by ultraviolet light and pollution,<br />

and everything else—and cause the damage.”<br />

Further studies have shown the benefits of<br />

astaxanthin in slowing and even reducing cataract<br />

formation, plus there’s a multitude of studies<br />

showing astaxanthin’s benefits combating or<br />

mitigating diabetes, epilepsy, dementia, heart<br />

disease and even stroke.<br />

“That’s the best thing about the product,” says<br />

Dowd. “It not only gives you all the eye health<br />

benefits, it also gives you all the other benefits as<br />

well. There’s a huge market potential.”<br />

Dowd is in the process of collating a number<br />

of peer-reviewed studies into a dossier for eye<br />

health professionals, which he will be distributing<br />

shortly. He’s also talking to a couple of people<br />

about running a proper clinical study, involving<br />

a statistically significant number of patients, to<br />

clinically back up the company’s qualitative data.<br />

“This is a world with an aging population, where<br />

more and more people are spending more and<br />

more time on their screens. It’s a huge issue. And,<br />

yes, we’re in business to make money, but the stuff<br />

works; it really works.”<br />


Supreme Biotechnologies is a Nelsonbased,<br />

private company that specialises<br />

in the production of bioactive compounds<br />

derived from micro-algae, specifically natural<br />

astaxanthin. Developed in partnership with<br />

researchers at the Cawthorn Institute, the<br />

company’s algae-growing facility is a unique,<br />

fully-enclosed, indoor environment, providing<br />

the perfect nutrient and light conditions for<br />

the algae, and ensuring the algae is free from<br />

environmental contaminants. The process has<br />

the added benefit of consuming CO 2<br />

while<br />

releasing oxygen.<br />

The company was a finalist in the 2015 and<br />

2014 New Zealand Innovator Awards and has<br />

attracted significant investment from New<br />

Zealand’s angel investment community.<br />

Oculo Screen Shot<br />

take months to even receive an acknowledgement<br />

a referral has been received. Getting feedback<br />

regarding a referral within hours or days takes a<br />

great weight off optometrists’ minds, to know their<br />

duty of care is appropriately discharged and the<br />

patient is likely to come back to them.” ▀<br />

Dr Ilva Rupenthal receives her Excellence Award from HRC’s<br />

Professor Kath McPherson<br />

In a glittering event at Auckland University<br />

on 4 May, Dr Ilva Rupenthal became one<br />

of the first researchers to receive a Health<br />

Research Council (HRC) Celebrating Research<br />

Excellence Award.<br />

Dr Rupenthal, a senior lecturer with the<br />

University’s Department of Ophthalmology<br />

and director of the Department’s Buchanan<br />

Ocular Therapeutics Unit (BOTU), was<br />

honoured as an emerging researcher who has<br />

made an outstanding contribution to health<br />

research.<br />

HRC chief executive, Professor Kath<br />

McPherson, presenting the award, said that<br />

since completing her PhD eight years ago, Dr<br />

Rupenthal has shown excellent progression in<br />

her research career.<br />

Dr Rupenthal received a HRC Emerging<br />

Researcher First Grant followed by the HRC’s<br />

prestigious $500,000 Sir Charles Hercus<br />

Fellowship, before being appointed inaugural<br />

director of the BOTU.<br />

“Jumping the hurdle from being a<br />

postdoctoral research fellow under another<br />

principle investigator to an independent<br />

researcher can be quite difficult especially<br />

with the limited funding opportunities<br />

available to emerging researchers,” said Dr<br />

Rupenthal. “These two HRC grants supported<br />

me immensely in overcoming this hurdle and<br />

becoming an independent research leader and<br />

internationally recognised expert in the area<br />

of ocular drug delivery.”<br />

The HRC also honoured New Zealand’s preeminent<br />

brain researcher, Professor Richard<br />

Faull, director of the Centre for Brain Research<br />

at the University of Auckland and co-director<br />

of the Brain Research New Zealand Centre for<br />

Research Excellence.<br />

Since being awarded his first HRC project<br />

grant 25 years ago, Professor Faull has gone<br />

on to lead a further three more HRC-funded<br />

projects and four HRC-funded programmes in<br />

the area of neurodegeneration in the human<br />

brain. He was also awarded the prestigious<br />

Liley Medal in 2005.<br />

The awards ceremony was the first of a series<br />

of events in partnership with New Zealand’s<br />

leading institutions, celebrating HRC’s 25th<br />

anniversary.<br />

HRC grants awarded<br />

In related news, Dr Jie Zhang and Dr<br />

Stuti Misra at the University of Auckland<br />

were awarded HRC grants recognising the<br />

importance of their projects to eye health.<br />

Dr Zhang received an HRC emerging<br />

researcher first grant, to carry out a study to<br />

determine the potential of adult stem cells<br />

in the transition zone for corneal endothelial<br />

transplants. Theoretically, using transition<br />

zone cells each future human donor cornea<br />

could provide grafts for several transplants,<br />

explained Dr Zhang.<br />

Dr Misra also received an HRC emerging<br />

researcher first grant for a project entitled<br />

Corneal nerve microstructural changes in<br />

diabetes. This study looks to monitor changes<br />

in the eye that occur in morbidly obese<br />

patients using weight-loss or bypass surgery to<br />

control their diabetes. ▀<br />

6 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong>



AstaSupreme ® Advanced Eye Care, the first eye care formulation to combine the<br />

power of Astaxanthin with Lutein, Zeaxanthin and Saffron to create a powerful<br />

carotenoid complex to boost all aspects of eye health and protect the eye,<br />

whatever age you are.<br />

For eye health professionals who want to know more about AstaSupreme ®<br />

Advanced Eye Care please contact Supreme Biotechnologies on 0800 289-278 or<br />

email info@astasupreme.co.nz or refer to www.astasupreme.co.nz.<br />

For eye health professionals who would like to become a supplier, please contact<br />

Pharmabroker on 09 415 5050 or email ruth@pharrmabroker.co.nz<br />

<strong>Jun</strong>e <strong>2016</strong> NEW ZEALAND OPTICS<br />

Always read the label. Use only as directed. If symptoms persist, see your healthcare professional.<br />


Ocular Therapetics Conference<br />

New Ocular Therapeutics Conference a success<br />

The inaugural Ocular Therapeutics Conference attracted nearly 350 delegates<br />

Professor Charles McGhee, head of the<br />

Department of Ophthalmology at the<br />

University of Auckland, opened the inaugural<br />

Ocular Therapeutics Conference on the 10 April in<br />

Auckland with gusto, announcing that with nearly<br />

350 attendees, it was already one of, if not the<br />

biggest, ocular event in New Zealand.<br />

Invited specialist speakers delivered rapid-fire<br />

lectures on a wide variety of topics designed<br />

to empower, educate and enhance the work<br />

of attending optometrists, ophthalmologists,<br />

therapeutic nurses, pharmacists and others.<br />

Organisers, Professor McGhee and Drs Trevor Gray<br />

and Ilva Rupenthal, director of the Buchanan Ocular<br />

Therapeutics Unit (BOTU), said with the success of<br />

this inaugural Ocular Therapeutics Conference it<br />

will now become a regular annual feature on the<br />

industry’s continuing education calendars.<br />

NZ Optics was there to record the highlights<br />

of the day.<br />

8 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong><br />

History and breaking down differences<br />

The first presentation was appropriately given by<br />

Dr Rupenthal. She provided an historical overview<br />

of medications and the eye, noting the first record<br />

of treating eyes with eye-drops dated back to<br />

Babylon, around 2250 BC. Acacia was used in<br />

Ancient Egypt to reduce eyelid inflammation,<br />

while Cleopatra used Atropa Belladonna (Deadly<br />

Nightshade) to make her pupils larger to enhance<br />

her beauty.<br />

Later Dr Rupenthal also discussed the difference<br />

between various drops given as gels, ointments,<br />

solutions and suspensions, as well as the<br />

importance of using them correctly. Suspensions<br />

must be shaken, she said, as the active particles<br />

sink to the bottom, while obstructing the nasal<br />

passage for five minutes after applying drops can<br />

result in a far better retention time.<br />

Professor McGhee discussed how topical<br />

eye-drops get into the eye, noting that when<br />


Free to you from NZ Optics – Clinical Desktop<br />

No more tussling over NZ Optics each month, just sign up to our<br />

monthly e-newsletter, Clinical Desktop. Stay up-to-date with the latest<br />

research from our own Eye on Ophthalmology, plus the often amusing<br />

look at the world of CLs from our well-known columnist Alan Saks. It’s<br />

free to sign up and you don’t have to be an existing subscriber.<br />

Simply email your full name and occupation to info@nzoptics.co.nz,<br />

put ‘Clinical Desktop’ in the subject box, and you’re on the list.<br />

prescribing it’s essential clinicians focus on the ease<br />

of application and how quickly the drops start to<br />

work. An understanding of pharmacokinetics – the<br />

time and dosage relationship – is also essential as<br />

with some drops there is a point where too much<br />

leads to toxicity. With all, a lot is lost through tears<br />

and spillage, he said.<br />

Dr Gray talked about the role for oral Rx for<br />

Meibomian gland dysfunction and dry dye disease,<br />

noting a 2005 study highlighting the positive<br />

benefits of omega 3 fatty acids – a natural antiinflammatory<br />

– and the negative effects of omega<br />

6s in our diet. When it comes to treating dry eye<br />

beyond dietary considerations, however, Dr Gray<br />

highlighted a study on oral azithromycin, which<br />

showed it was far more effective than those treated<br />

with the more commonly used doxycycline, with<br />

side effects in just 4%.<br />

Dr Andrew Thompson closed the morning session<br />

with his talk, The Ingredients You Don’t Know About.<br />

A pharmacist turned ophthalmologist, Dr Thompson<br />

offered a unique perspective on what goes into an<br />

eye drop and why. He talked the audience through<br />

surfactants, buffers and preservatives and noted<br />

preservatives can cause ocular surface disease,<br />

especially when used over long periods of time such<br />

as in the case of glaucoma patients.<br />

Funding drugs, artificial tears and<br />

antibiotics<br />

Professor Colin Green kicked off the second session<br />

after morning tea, with his look at what it takes to<br />

get a drug approved by the US FDA. It costs about<br />

US$350 million to get a new medicine to market, so<br />

it is along and expensive, but well understood path,<br />

he said. Safety and toxicology take time and require<br />

at least one non-rodent species before human trials<br />

can be considered. For devices, the pathway is faster,<br />

while repurposing a drug often allows you to bypass<br />

certain stages, making development faster and<br />

cheaper.<br />

The funding of new medicines in New Zealand<br />

is a contentious issue so it was fascinating to hear<br />

from Sarah Fitt, PHARMAC’s operations director.<br />

PHARMAC’s aim is to get the best health outcomes<br />

for the maximum number of people within the<br />

amount of funding provided. Its focus is on creating<br />

competition to generate cost-savings as it needs<br />

to find $50m a year in savings just to manage the<br />

ever-increasing prescription volume. Fitt admitted<br />

there will never be enough money to fund all<br />

the medicines people want, but each application<br />

is considered on its merits. An ophthalmology<br />

sub-committee, PTAC, advises PHARMAC on eye<br />

medicines.<br />

Associate Professor Jennifer Craig discussed how<br />

to pick the best artificial tear supplements for<br />

individual patients. Dry eye is a complex condition<br />

and simply adding moisture is not the quick fix<br />

we once thought it might be, she said. Highly<br />

viscous supplements can be helpful with moisture<br />

retention, but blur vision, whereas improving diet<br />

to increase natural lipids can be more helpful in the<br />

treatment for those with evaporative dry eye.<br />

Dr Mark Saunders and Dr Penny McAllum then<br />

moved the talk to antibiotics, with Dr Saunders<br />

providing an overview of their action and use, and<br />

Dr McAllum focusing on how they should be used<br />

in two common eye conditions, conjunctivitis and<br />

blepharitis.<br />

Dr Saunders injected some humour into the day<br />

with the unusual case of a 17-year-old boy who was<br />

kicked in the face by a hedgehog. The case posed<br />

several complications, beyond the damage to the<br />

boy’s left eye, as hedgehogs are full of diseases. The<br />

boy’s mother was able to provide Dr Saunders with<br />

the (now deceased) hedgehog for testing and this<br />

allowed Dr Saunders to target the boy’s treatment<br />

so he could make a full recovery.<br />

Dr McCallum shared how the management<br />

of bacterial conjunctivitis is centred around<br />

hygiene, but a short course of antibiotics for more<br />

irritating infections is effective. The most common<br />

treatments are drops, such as Chlorafast or fusidic<br />

acid, with Brolene used sparingly due to potential<br />

toxicity issues and ciprofloxacin reserved for more<br />

serious infections. With posterior blepharitis,<br />

Dr McAllum noted that 40% of patients have<br />

Meibomian gland dysfunction. The appearance<br />

of ‘cylindrical dandruff’ could indicate a Demodex<br />

Kerensa McCamish and Germaine Joblin<br />

Essi Kokkinen, Priyanka Agarwal and Di Huang<br />

Catherine Wong, Bev and Jonathan Payne and Louise Wood<br />

John Adam, Diane Pearson, Dr Trevor Gray and Grant Dabb


OptiMed NZ<br />

Ophthalmic Instrument Company<br />

Alcon<br />

Corneal Lens Corporation<br />

Designs for Vision<br />

Device Technologies<br />

Abby Long, Lari Dkhar and Ghada Zidan<br />

Kent Napier, Nawras Nabhani and Bharat Raniga<br />

Jonathan Albert, Deanne Jordan, Amy Young and Melanie Lipinski<br />

David Joe checks out OptiMed’s wares with Robert Nyenkamp and Craig<br />

Norman<br />

Alcon’s Deanna Graham and Caroline Perkinson talking to delegates<br />

Shelley Brannigan, Scott Dumbleton, Craig Holmes and Tony Cradwick<br />

Speakers: (back) Drs Sarah Fitt, Hussain Patel, Simon Dean and Trevor Gray, Professor Colin Green, Drs Mark Saunders, Andrew Thompson and Stephen<br />

Best and Professor Charles McGhee (front) A/Prof Jennifer Craig, Drs Ilva Rupenthal, Rasha Altaie, Penny McAllum and Sue Ormonde<br />

mite infestation in the follicles, which can be<br />

treated with a tea tree oil product.<br />

Glaucoma drugs and the dangers of<br />

corticosteroids<br />

Dr Stephen Best kicked off the post-lunch slot with<br />

a personal overview of glaucoma drugs, saying he<br />

tended to recommend a prostaglandin analogue<br />

(the most commonly prescribed medication for<br />

glaucoma currently) at least initially, as they have<br />

few systemic side effects. Other drugs such as beta<br />

blockers, adrenergic agonists, carbonic anhydrase<br />

inhibitors have varying side effects and don’t tend to<br />

be as effective.<br />

Dr Best ended his presentation with a plea to the<br />

audience for more patients for a trial he’s involved<br />

in where a slow-release pellet of the prostaglandin<br />

analogue Bimatoprost is injected into the anterior<br />

chamber. If successful this will replace frequent eye<br />

drop application. Every patient is different and we<br />

need to have a number of options available in order<br />

to treat them all well, he said.<br />

Dr Hussain Patel continued the glaucoma theme<br />

with an overview of how best to systematically treat<br />

glaucoma. He preferred to set a target IOP, based<br />

on the glaucoma’s severity and the patient’s life<br />

expectancy. Important management considerations<br />

include patient education about diet and lifestyle,<br />

the different medications and their side effects,<br />

selective laser trabeculoplasty (SLT) and surgery.<br />

A flow chart approach works best for identifying<br />

the best treatment, though initially Dr Patel also<br />

said he favours a prostaglandin analogue, with<br />

beta blockers added or swapped in if the results<br />

aren’t as good as hoped. Early glaucoma patients<br />

need to be clinically assessed at least once every 12<br />

months; moderate glaucoma every six months; and<br />

advanced glaucoma every four months.<br />

Professor McGhee then presented an amusing<br />

overview of topical ophthalmic corticosteroids,<br />

beginning with a warning that, on the whole,<br />

corticosteroids are “the devil’s work” as they<br />

tended to be the go-to option for most. Yes,<br />

they are important and often sight-saving antiinflammatory<br />

drugs, he said, but they are also “a<br />

blunderbuss therapy” with significant side effects,<br />

including cataract, glaucoma and severe microbial<br />

infections. In summary, steroids should only be used<br />

when there’s a firm diagnosis and, never if any sort<br />

of infection is suspected.<br />

Dr Sue Ormonde, a former Corneal Fellow of<br />

Professor McGhee’s, continued the corticosteroid<br />

theme by looking at their use in practice. This is<br />

not easy in a 12-minute presentation, she said, as<br />

it takes years of experience to use steroids well<br />

– a concern backed up by several slides of eyes<br />

irrevocably damaged by poor steroid use. You have<br />

to be sure of your diagnosis and the specifics of<br />

that diagnosis, said Dr Ormonde. Correct use also<br />

depends on the specifics of the disease, how you<br />

are going to treat it and how it progresses. Once a<br />

diagnosis is made, you need to “hit hard” and, if the<br />

steroids don’t do what you want them to, stop, keep<br />

calm and reassess, she said.<br />

Steroid alternatives, myopia, more on<br />

glaucoma and the future<br />

Opening the final session, Dr Simon Dean’s<br />

presentation was a much needed look at the<br />

alternatives to corticosteroids and how to avoid<br />

their unwanted effects.<br />

In general steroids should not be used for a long<br />

time and should be avoided for things like allergy<br />

as patients can get too easily hooked on them as<br />

they work so well, he said. Alternatives include mast<br />

cell stabilisers, non-steroidal anti-inflammatory<br />

medications (NSAIDS), such as Voltaren, and<br />

cyclosporin, which reduces the activity of the<br />

immune system by interfering with the activity of<br />

T-cells (lymphocytes).<br />

Dr Rasha Altaie provided a fascinating review<br />

of studies on the effectiveness of dilute topical<br />

atropine in reducing the progression of childhood<br />

myopia. Atropine use is not new, she reminded the<br />

audience, with Atropa Belladonna used for myopia<br />

treatment since the 19th century. In summary, Dr<br />

Altaie said despite the fact we don’t fully know<br />

how it works, studies show atropine 0.01% does<br />

slow the progression of myopia, in children with<br />

mild to moderate myopia, by up to 50%, with no<br />

obvious side effects, but it doesn’t stop it. Prevention<br />

is far better than cure, however, she said, with<br />

many studies now showing how important it is for<br />

children to stay away from screens and play outside<br />

for at least three hours a day.<br />

Professor Helen Danesh-Meyer returned to the<br />

topic of glaucoma with her presentation on common<br />

glaucoma drop side-effects. All of these are a<br />

problem for compliance as patients often don’t have<br />

any problems when glaucoma is first identified, she<br />

said. “Patients are well until the come to see us and<br />

then we make them unwell with our drugs, so the<br />

bar is very different for a silent disease.”<br />

Practitioners need to have a “high index of<br />

Get to the main<br />

cause of dry,<br />

irritated eyes*<br />

How does Optrex ActiMist work?<br />

Optrex ActiMist contains<br />

liposomes (tiny bubbles fi lled with<br />

moisture) that migrate across the<br />

surface of the eyelid and collect<br />

at the edges of the eye.<br />

Hygienic. Can be used<br />

by multiple people<br />

Lasts 6 months<br />

after opening<br />

These liposomes mix with natural<br />

lipids on the eyelid.<br />

Won’t smudge<br />

make-up<br />

ActiMist liposomes<br />

ActiMist liposomes<br />

When the eyes are open the new<br />

lipid mixture spreads over the<br />

whole tear fi lm, and helps fi ll the<br />

gaps to restore the damaged<br />

lipid layer.<br />

Convenient and<br />

portable<br />

Suitable for use<br />

with contact lenses<br />

suspicion” as side effects can be extremely varied.<br />

For example, prostaglandin analogues can change<br />

iris colour and cause hair growth—great for<br />

eyelashes, less for other facial hair—and cause some<br />

pre-existing conditions, such as HSV, to flare up<br />

again. Beta blockers have a number of well-known<br />

systemic side effects, but can also cause impotence,<br />

depression and even nightmares, while Brimonidine<br />

can cause fatigue and follicular conjunctivitis. If the<br />

patient develops unsatisfactory side effects, stop<br />

the medication, reassess and identify an alternative,<br />

such as SLT, she said.<br />

Dr Ilva Rupenthal closed the conference with<br />

a look into the future, focusing on the work of<br />

the BOTU and some of the most prominent and<br />

interesting ocular therapeutics potentials out<br />

there. This included a cationic nanoemulsion<br />

of ciclosporin from Santen; a semi-fluorinated<br />

alkane eye drop by Novaliq that is currently being<br />

investigated by BOTU; mucus penetrating particles<br />

from Kala Pharmaceuticals; and Ocular Therapeutix’<br />

drug-delivering punctum plugs. Other interesting<br />

developments include Helios, a silicone ring loaded<br />

with the anti-glaucoma drug bimatoprost, which<br />

is inserted in the eye. BOTU is currently involved in<br />

several therapeutic clinical trials to identify novel<br />

new agents and drug delivery vehicles, including a<br />

number of stimuli-responsive drug delivery systems<br />

involving ultrasound- and laser-activated particles as<br />

well as an implant activated by a small current.<br />

Dr Rupenthal closed the conference by thanking<br />

everyone who had been involved in making it<br />

happen, especially Dr Trevor Gray and Professor<br />

Charles McGhee, all the attendees and the<br />

exhibitors (see box) for their support. ▀<br />

4UP TO<br />

HOURS<br />

RELIEF 2<br />


Optrex ActiMist – clinically proven to work<br />

Natural lipids<br />

Order stock for your practice today<br />

FREE CALL 0800 393 564 EYELOGIC<br />

www.optrex.co.nz optrex@eyelogic.com.au<br />

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:<br />

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<br />

<strong>Jun</strong>e <strong>2016</strong><br />



Focus<br />

on Business<br />


Who are they targeting and what to do<br />

if you get a query<br />


Over the past few years the<br />

Government has been steadily<br />

increasing budget funding for Inland<br />

Revenue investigations, with a current budget<br />

allocation of $74 million over five years<br />

(expected to yield an 800% return). While<br />

the focus has been more on aggressive tax<br />

planning and hidden economy initiatives, this<br />

is also having a flow on effect with initiatives<br />

such as the basic compliance package (BCP)<br />

information requests, which you may have<br />

heard of or even received.<br />

There are a number of different reasons<br />

Inland Revenue may select you for an audit.<br />

Some of the more common reasons our BDO<br />

tax team see include:<br />

i. Your past compliance history (ie. have you<br />

been filing returns and making payments<br />

on time?).<br />

ii. Checking your records as a result of an<br />

audit of another related taxpayer, or<br />

an unrelated taxpayer you have had<br />

transactions with.<br />

iii. Examining a particular issue facing groups<br />

of taxpayers.<br />

Past compliance history<br />

This is often one of the more common reasons<br />

for an audit and is the easiest to remedy.<br />

Maintaining a good compliance history with<br />

Inland Revenue goes a long way to both<br />

reducing the risk of an audit and also putting<br />

you on an equal footing in the event an audit<br />

does occur.<br />

The good compliance history should<br />

extend beyond simply filing the returns<br />

and making the payments on time. The<br />

importance of keeping good, well-referenced<br />

documentation to support the tax positions<br />

adopted also demonstrates you have<br />

taken reasonable care and can be crucial<br />

in ensuring a smooth process should an<br />

audit arise. It goes without saying that your<br />

accountant and/or tax adviser should play an<br />

important role in assisting here.<br />

Checking records with another taxpayer<br />

The most common occurrence in this regard<br />

is where other companies or shareholders in a<br />

group are incorporated into an audit of one of<br />

the other members. Selection for an audit as a<br />

result of an audit of an unrelated party arises<br />

less often.<br />

While taxpayers can control their own<br />

tax position and compliance history, they<br />

unfortunately cannot control those of the<br />

people they do business with. In these<br />

situations, you will need to trust and rely on<br />

your own documentation and compliance<br />

history to minimise your risk.<br />

Examining particular issues facing groups of<br />

taxpayers<br />

If you have followed recent media reports<br />

on tax audits you will have noticed Inland<br />

Revenue’s particular focus on the hospitality<br />

and, more recently, the trade and construction<br />

industries. In this regard Inland Revenue is<br />

targeting the “hidden economy” or “cash<br />

transactions” which are not reported or<br />

included in tax returns to Inland Revenue.<br />

The landmark case Penny and Hooper<br />

v Commissioner of Inland Revenue is an<br />

excellent example of Inland Revenue’s<br />

approach to groups of tax payers, in this case<br />

orthopaedic surgeons. The Court unanimously<br />

found that the two Christchurch surgeons,<br />

who were paid artificially low salaries, via their<br />

business structures, were avoiding tax. As an<br />

outcome, the Inland Revenue broadened their<br />

focus to a wide range of professional taxpayer<br />

groups with significant ramifications.<br />

What to do if you get a query<br />

It goes without saying that the first thing you<br />

should do is contact your accountant and/or<br />

tax adviser, however some other helpful tips<br />

are as follows:<br />

1. Don’t panic! Information requests and<br />

audits are becoming more common as<br />

a result of increased investment by the<br />

government, so don’t take it personally.<br />

2. Comply with all requests in a timely<br />

manner<br />

3. Maintain good communication. Audits<br />

and information requests typically occur<br />

at the busiest times so, if you think it<br />

will be difficult to supply the requested<br />

information in time, it is important to<br />

discuss this with the investigator as soon as<br />

possible and arrange for more appropriate<br />

deadlines. In our experience most Inland<br />

Revenue investigators are quite reasonable<br />

and accommodating in this regard. Make<br />

sure your key personal, such as payroll<br />

or IT managers, aren’t on holiday when<br />

considering the best time for the audit<br />

to take place. In some cases, Inland<br />

Revenue will be more relaxed in relation to<br />

extending deadlines if it can receive at least<br />

some information before the deadline. This<br />

may give the investigator confidence and<br />

ensures that internally, things will not be<br />

left to the last minute.<br />

4. Consider making a voluntary disclosure. A<br />

voluntary disclosure can deliver a reduction<br />

of penalties. It will often be as a result of<br />

an internal review of the tax matters that<br />

are the subject of the audit; and perhaps<br />

a review of other tax matters that may<br />

be included if the scope of the audit is<br />

expanded. Assistance with such reviews<br />

may be provided by your accountant and/<br />

or tax adviser and the findings from such<br />

reviews may be provided to or requested<br />

by the Inland Revenue. If done well it will<br />

demonstrate you are serious about tax<br />

compliance, and may result in less Inland<br />

Revenue time on-premises.<br />

So should you be worried?<br />

The fact that you are being audited or asked<br />

for information does not mean that you<br />

are necessarily ‘in trouble’. Even if you are<br />

in what Inland Revenue might consider to<br />

be a ‘high-risk category’, it is important to<br />

remember that it is an individual situation<br />

that matters. Provided you have a good<br />

compliance history, have good records and<br />

work with your accountant/tax adviser to<br />

maintain good communication with Inland<br />

Revenue, the risk review or audit should be a<br />

relatively smooth process. ▀<br />


* David Pearson is<br />

anaging partner in the<br />

Napier firm of BDO,<br />

a global network of<br />

chartered accountants<br />

and advisers. He has a<br />

specialisation in advice to<br />

the medical sector.<br />

* Tim is a partner in the<br />

Taxation Services division<br />

of BDO in Auckland.<br />

conference <strong>2016</strong><br />

Registrations are now open for the annual<br />

Save Sight Society one-day conference on 26<br />

August in Tauranga.<br />

The event is shaping up to be a “must-do” date on<br />

the calendar for New Zealand based practitioners,<br />

says Dr Sam Kain, this year’s conference convenor.<br />

“It’s our main fundraiser and it’s open to the entire<br />

optometry and ophthalmology community. It’s<br />

quite different to other events as it has a very ‘local<br />

flavour’ peculiar to NZ.”<br />

A smaller, more personal meeting than many<br />

other conferences and symposiums, the Save<br />

Sight Society conference focuses specifically on<br />

issues facing those practicing in Aotearoa, with a<br />

series of short presentations and the floor always<br />

open to questions. This year the presentations<br />

will centre around updates across three main subspecialities—cornea,<br />

retina and uveitis.<br />

People aren’t afraid to ask questions at the<br />

Save Sight Society conference, so much of the<br />

education comes from the floor, says Dr Kain. “The<br />

speaker really just opens the discussion. You don’t<br />

need to be an expert to join in; the atmosphere<br />

is friendly and open to new ideas. It’s a great<br />

networking event.”<br />

Dr Kain says it’s also a great event to talk<br />

about the idiosyncrasies of local DHBs, funding<br />

streams and issues relating to the very specific<br />

demographics of New Zealand, such as the large<br />

Maori and Pasifika communities. The constraints<br />

of practicing in a small and isolated island with<br />

limited funds and unusual challenges also create<br />

some very innovative responses, and discussion of<br />

this nature will run freely, he says.<br />

“Practice is unique in New Zealand, even<br />

compared to Australia. At some of the bigger<br />

international meetings it can be hard to have<br />

open discussions about things specific to us,<br />

because it’s not relevant to the wider audience.”<br />

The Save Sight Society continues to be one of<br />

the biggest, non-government funding agencies in<br />

New Zealand, having given more than $700,000 in<br />

research grants in recent years. For more visit<br />

www.savesightsociety.org.nz. ▀<br />

ODOB’s new guidelines on oral<br />

medications<br />

The Optometrists and Dispensing Opticians’<br />

Board (ODOB) new guidelines for prescribing<br />

medications are now available online. The<br />

board has been working on this for some time and<br />

would like to encourage all certified therapeutic<br />

pharmaceutical agent (TPA) optometrists to<br />

familiarise themselves with the documents, says<br />

Lindsey Pine, ODOB registrar.<br />

“Regulations were changed in 2014 giving TPA<br />

optometrists more freedom to prescribe, rather than<br />

having to stick to an approved list of medications.<br />

“It was recognised clear guidelines were<br />

needed for more high-risk medications and<br />

medicines with contraindications. They have<br />

now been published, and we will be making TPA<br />

optometrists and dispensing opticians aware they<br />

are available.”<br />

The new guidelines focus specifically on allergic<br />

eye disease, herpes simplex virus, keratitis and<br />

herpes zoster ophthalmicus. More guidelines are<br />

expected to be added soon.<br />

The new guidelines can be accessed by visiting:<br />

www.odob.health.nz/cms_display.<br />

php?sn=74&st=1&pg=1529 . ▀<br />

Visionz tackles low vision<br />

Visionz <strong>2016</strong> will include a one-day low vision<br />

conference on Friday 14 October as part of a<br />

comprehensive educational programme for<br />

optometrists, practice managers and other optical<br />

staff alongside its industry showcase.<br />

The biennial conference, organised by the<br />

New Zealand Optical Wholesalers Association<br />

(NZOWA) and run in tandem with the Association<br />

of Dispensing Opticians (ADONZ), is being held on<br />

Friday 14th to Sunday 16th October at the Ellerslie<br />

Events Centre in Auckland.<br />

Planning is well under way with 60 exhibition<br />

booths displaying all that’s new in the industry<br />

including frames, sunglasses, lenses, equipment,<br />

accessories, software and services, while the<br />

education programme, Eduvisionz, already includes<br />

an impressive slate of speakers.<br />

On the low vision side this includes Dr Mike<br />

O’Rourke, ophthalmologist at Tauranga Eye<br />

Specialists, who recently carried out a lifechanging<br />

procedure, using an intraocular<br />

mini-telescope implant, (see story P4); Professor<br />

Stephen Lord, senior principal research fellow<br />

from the Falls and Balance Research Group from<br />

Sydney, who will address Falls in Older People:<br />

Visual Risk Factors and Intervention Strategies;<br />

and Dr Alan Johnston, a low vision specialist from<br />

Melbourne, who will discuss his recently updated,<br />

sliding scale logMAR visual acuity calculator,<br />

which includes ETDRS scoring principles, now<br />

widely used for monitoring any vision gain or<br />

loss with intra-vitreal injection of anti-VEGF, and<br />

Telescopes for low vision: principles, practice and<br />

rationales for clinical choice.<br />

Other sessions include:<br />

••<br />

The latest developments in technology and<br />

innovation in low vision products<br />

••<br />

Incorporating low vision clinics into a busy<br />

optometry practice<br />

••<br />

Identifying a person’s low vision needs and<br />

rehabilitation goals<br />

••<br />

Sharing important strategies for daily life<br />

••<br />

The latest research into the use of mobility<br />

scooters, digital devices and neurological vision<br />

impairment<br />

••<br />

The current development of an occupationbased<br />

low vision model incorporating the level 8<br />

Visionz<br />

2014 <strong>2016</strong><br />

postgraduate curriculum in low vision for allied<br />

health professionals<br />

••<br />

The Blind Foundation’s Prevalence Study Work<br />

and the Level 7 Vision Rehab diploma to be<br />

launched in 2017<br />

On Saturday, the focus will move to the business of<br />

optometry with speakers addressing the commercial<br />

aspects of running a business in today’s competitive<br />

environment, says Gary Edgar, NZOWA president.<br />

“We are planning to deliver an event to suit the<br />

changing needs of our clients and the broader<br />

industry in general.”<br />

Speakers include Juanita Neville-Te Rito from The<br />

Retail Collective who will share insights drawn from<br />

her 25-year career in retail, and her personal passion<br />

for shopping, including five key trends in retail<br />

that any retail business owner should be aware of;<br />

business mentor, Tanya Unkovich, who will present<br />

on how to use your life experiences to know and<br />

get what you want in life; and John Saywell, CEO of<br />

Christchurch software and consulting company RPM<br />

Retail, who will discuss how to analyse your optical<br />

practice’s strengths, weaknesses, opportunities and<br />

threats. Other topics include:<br />

••<br />

Coming to terms with the new Health & Safety<br />

laws<br />

••<br />

The pros and cons of social media and whether a<br />

practice can benefit from incorporating a social<br />

media platform into its marketing strategy<br />

••<br />

Picking the best team and getting it right from<br />

the start<br />

Another attraction at Visionz <strong>2016</strong> will be the<br />

opportunity to register for a St John’s Basic Life<br />

Support course, that teaches essential life-saving<br />

skills, on the Saturday afternoon. Participants will<br />

receive a NZQA 6401/6402 acknowledgment at the<br />

end of the 4-5 hour course.<br />

Visionz and Eduvisionz, as well as being held in<br />

conjunction with ADONZ’s annual conference,<br />

will also incorporate the International Opticians<br />

Association Annual Meeting, which is being hosted<br />

for the first time in New Zealand. A Visionz ‘Happy<br />

Hour’ has also been organised for late on the Friday<br />

afternoon for all delegates.<br />

Registration for Visionz and Eduvisionz will open<br />

in July. Keep reading NZ Optics magazine for more<br />

information or email: contact@nzowa.org.nz. ▀<br />

10 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong>

All<br />

shades<br />

of life<br />

Coming<br />

soon!<br />

Adapt to all light conditions<br />

• Stabilight Technology ensures consistent performance in different climates and seasons<br />

• Excellent contrast and glare reduction with Sensity’s deep, natural colours<br />

• Exceptional optical quality and durability due to Photochromic Precision Technology<br />

• Available across a wide product range in PAL, single vision and bifocal<br />

• Available in grey, brown and green.<br />

P: 09 630 3182 | E: hapl_cs_nz@hoya.com | www.hoyalens.com.au/sensity<br />

<strong>Jun</strong>e <strong>2016</strong><br />



Focus on<br />

Eye Research<br />

SMILE and pseudophakia<br />






Liu M; Chen Y; Wang D; Zhou Y; Zhang<br />

X; He J; Zhang T; Sun Y; Liu Q.<br />

Cornea. 35(2):210-6, <strong>2016</strong> Feb<br />

Review: This prospective, randomised,<br />

comparative study compared the<br />

clinical outcomes of small-incision<br />

lenticule extraction (SMILE) and<br />

femtosecond laser-assisted LASIK (FS-<br />

LASIK) for the correction of myopia and<br />

myopic astigmatism. SMILE surgery<br />

was performed in 113 eyes with a<br />

mean spherical equivalent (MSE) of<br />

-5.22 +/- 1.70D, and FS-LASIK was<br />

performed in 84 eyes with an MSE of<br />

-5.18 +/- 1.93D. At six months 97%<br />

of SMILE eyes, and 100% of FS-LASIK<br />

eyes were within +/- 0.5D of the<br />

target refraction, with no statistically<br />

significant difference. There were also<br />

no statistically significant differences<br />

between the two groups in terms of<br />

astigmatic correction. At six months<br />

96% of SMILE eyes, and 99% of<br />

FS-LASIK eyes achieved uncorrected<br />

visual acuity of 20/20 or better, with<br />

no statistically significant difference<br />

between the two groups. There<br />

were also no statistically significant<br />

differences between the groups<br />

regarding loss of best corrected visual<br />

acuity, with loss of one line or more in<br />

6% of the SMILE group, and 5% of the<br />

FS-LASIK group. Looking at wavefront<br />

aberration at six months, the SMILE<br />

group had statistically significantly<br />

lower induced rates of spherical<br />

aberration than the FS-LASIK group.<br />

Comment: SMILE is the latest advance<br />

in corneal refractive surgery. In<br />

comparison to LASIK, no corneal flap<br />

is created, and this has already been<br />

shown to result in a lower rate of<br />

dry-eye post-operatively, as well as<br />

potentially reducing the risk of postoperative<br />

keratectasia. This prospective<br />

randomised study indicates visual<br />

outcomes between the two treatments<br />

are statistically similar, and that<br />

induced rates of spherical aberration<br />

are statistically lower with SMILE.<br />






FOLLOW-UP.<br />

Graue-Hernandez EO; Pagano GL;<br />

Garcia-De la Rosa G; Ramirez-Miranda<br />

A; Cabral-Macias J; Lichtinger A; Abdala-<br />

Figuerola A; Navas A.<br />

Journal of Cataract & Refractive Surgery.<br />

41(11):2524-32, 2015 Nov.<br />

Review: This prospective interventional<br />

case series looked at the visual,<br />

refractive, and topographic outcomes<br />

of sequential, same-day smallincision<br />

lenticule extraction (SMILE)<br />

and intrastromal corneal collagen<br />

crosslinking (CXL) in eyes with mild<br />

keratoconus. Fifteen eyes with forme<br />

fruste keratoconus and/or irregular<br />

corneas, were treated with SMILE<br />

followed by intrastromal injection<br />

of riboflavin inside the pocket, and<br />

then 30 minutes of Ultraviolet A light<br />

with a wavelength of 370 nm to 3<br />

mW/cm(2). The mean age was 29.5<br />

years +/- 5.5 (SD), and patients were<br />

followed for 24 months. Pre-operative<br />

uncorrected distance visual acuity<br />

improved from Snellen 20/796 to<br />

Snellen 20/26 post-operatively, which<br />

was statistically significant. Bestcorrected<br />

distance visual acuity did<br />

not change significantly. The spherical<br />

equivalent improved from -4.3 +/-<br />


1.02D preoperatively to 0.2 +/- 0.66D<br />

postoperatively, and 100% of eyes were<br />

within +/- 1.0D of refractive target.<br />

With regards to complications, all<br />

eyes exhibited corneal haze initially<br />

(as expected with CXL), but this had<br />

cleared in all eyes by three months.<br />

One eye lost two lines of best corrected<br />

visual acuity due to a partial lenticule.<br />

No cases of progressive ectasia were<br />

noted.<br />

Comment: By preserving the<br />

biomechanically more stable anterior<br />

layers of the cornea, SMILE potentially<br />

offers a reduced risk of creating<br />

ectasia or promoting progression of<br />

keratoconus in abnormal corneas.<br />

Combining this with CXL may offer a<br />

safe predictable refractive treatment<br />

for patients with mild keratoconus<br />

who cannot be corrected with glasses,<br />

and who are intolerant of contact<br />

lenses. More prolonged follow-up and<br />

larger samples are needed to confirm<br />

the findings.<br />




Kim J; Shin HJ; Kim HC; Shin KC.<br />

British Journal of Ophthalmology.<br />

99(3):391-5, 2015 Mar<br />

Review: This prospective randomised<br />

study compared the visual<br />

performances and patient satisfaction<br />

of conventional monovision (correcting<br />

the dominant eye for distance), and<br />

crossed monovision (correcting the<br />

non-dominant eye for distance) in<br />

patients with pseudophakia. Twentyeight<br />

patients underwent bilateral<br />

cataract surgery with conventional<br />

monovision, and 31 patients with<br />

crossed monovision. The mean<br />

post-operative spherical errors in the<br />

conventional group were -0.085D<br />

(distance eye) and -1.433D (near eye),<br />

and in the crossed group -0.109D<br />

(distance eye) and -1.560D (near<br />

eye). At two months post-operatively,<br />

binocular uncorrected distance<br />

visual acuity of 20/25 or better was<br />

achieved in 89.3% of the conventional<br />

monovision group, and 83.9% of<br />

the crossed monovision group.<br />

Binocular uncorrected near visual<br />

acuity was at least 20/32 in 71.4% of<br />

the conventional group, and 67.7%<br />

of the crossed monovision group.<br />

There was no statistical difference<br />

between the two groups with regards<br />

to binocular visual acuity. A patient<br />

satisfaction survey indicated there was<br />

no significant difference in patient<br />

satisfaction for unaided binocular<br />

distance and near vision between<br />

the conventional and crossed groups.<br />

Distance glasses independence was<br />

reported by 67.9% of the conventional<br />

group, and 80.6% of the crossed<br />

group. Near glasses independence was<br />

reported by 50.0% of the conventional<br />

group, and 77.4% of the crossed group.<br />

There was no statistical difference<br />

between the two groups. Near<br />

stereopsis improved post-operatively<br />

and there was no statistical difference<br />

between the two groups.<br />

Comment: This study gives reassurance<br />

that monovision can still be considered<br />

in patients who attend for second eye<br />

surgery, when the first eye has already<br />

been operated on and corrected for<br />

distance vision, irrespective of which is<br />

the dominant eye. ▀<br />

* Dr Sue Ormonde is a<br />

consultant ophthalmologist<br />

specialising in refractive,<br />

corneal, cataract and anterior<br />

segment surgery. She works<br />

at Greenlane Hospital,<br />

Auckland and in private<br />

practice at Auckland Eye.<br />

Giving sight a sporting chance<br />

How one optometrist is<br />

helping New Zealand athletes<br />

up their game.<br />


When Wellington-based<br />

optometrist Renee Edgar<br />

was in her final year at<br />

University she completed a research<br />

project looking at the moving visual<br />

acuity of cricket players. At the time it<br />

seemed like a novel topic to complete<br />

her degree, but 13-years-later it has<br />

become a legacy project that is shaping<br />

her career.<br />

“I’ve always been interested in the<br />

relationship between vision and sport,”<br />

says Edgar. “I’m quite sporty myself and<br />

have always wondered why we don’t do<br />

different types of eye-testing for athletes.<br />

The demands on their eyes are so<br />

different to the majority of my patients<br />

in the CBD who are very static and spend<br />

most of the day in front of a computer.”<br />

Edgar notes that sports people,<br />

especially those involved in ball sports,<br />

are working daily with a moving target<br />

and have to make quick, split second<br />

decisions while that target is in motion.<br />

“It’s a lot to do with the brain as<br />

well as the eye,” says Edgar. “Eye-hand<br />

coordination develops at an early age and<br />

doesn’t always develop effectively. But<br />

those visual pathways can be re-trained.”<br />

Until recently, this interest had<br />

remained a sideline in Edgar’s work. Then<br />

she had a patient referred to her who<br />

wanted to improve his cricket game.<br />

“He was an under-16 player wanting<br />

to move up to the next level and his<br />

optometrist knew this was an area of<br />

interest for me,” says Edgar. “We began<br />

working together to improve his visual<br />

acuity. This sort of training can be very<br />

helpful for players looking to move to<br />

an elite level as it helps them perform<br />

Alcon business as usual in ANZ<br />

Despite<br />

the flurry<br />

of news<br />

this year on<br />

Novartis’ moves<br />

to turnaround its<br />

Alcon business,<br />

little is expected<br />

to change in<br />

Australasia.<br />

In response to questions from NZ<br />

Luxin Wang, general<br />

manager, Alcon ANZ<br />

Optics, Luxin Wang, general manager of<br />

Alcon Australia and New Zealand (ANZ),<br />

said Novartis’ decision to move its<br />

ophthalmic pharmaceuticals business<br />

to its wider pharmaceuticals division,<br />

allowing the Alcon division to focus<br />

solely on the surgical and vision care<br />

businesses, will have little impact here.<br />

“Our customers should see no change<br />

in our daily interactions. We have the<br />

same team in place in New Zealand<br />

who will continue to support our New<br />

Zealand customers.”<br />

Neither the Surgical business structure<br />

nor the vision care business structure will<br />

change in ANZ, said Wang. “There are no<br />

plans to change this structure although<br />

there has been a decision to combine<br />

Alcon’s ophthalmic pharmaceuticals with<br />

our parent company’s Novartis pharma<br />

Retina franchise to create a Novartis<br />

ophthalmic franchise. This will create a<br />

broad portfolio of ophthalmic medicines<br />

that treat both the front and back of the<br />

eye.”<br />

Recognising surgical and consumer<br />

require specialised expertise, Wang<br />

assured customers the plan is to<br />

continue to have two teams, one for the<br />

consumer business, for vision care and<br />

OTC pharmaceuticals, and another for<br />

surgical.<br />

Contrary to what may be happening<br />

further afield, ANZ customers can<br />

expect to see more investment from<br />

Renee Edgar and Firebirds’ Luke Woodcock, Michael Papps and Jeetan Patel<br />

at the best of their ability the majority<br />

of the time.”<br />

Mentioning this work in conversation<br />

with the mother of another patient<br />

lead to a further project for Edgar.<br />

“It turned out the lady in question<br />

was a netball umpire. She was very<br />

interested in what I was doing with the<br />

cricketer and wondered if I could help<br />

her and her colleagues as well.”<br />

However, it was when the brother of<br />

Firebirds’ coach Bruce Edgar (no relation)<br />

came in for an appointment that the<br />

project really gained momentum.<br />

“I had some information up on the<br />

wall about my work,” says Edgar. “He<br />

was very interested and got his brother<br />

to give me a call.”<br />

That was last spring, and as the<br />

cricket season had already started<br />

there wasn’t much work Edgar could<br />

do with the team, but now the season<br />

has closed for the winter the players are<br />

undergoing assessments with Edgar to<br />

see what areas need work.<br />

“So far we’ve undertaken some baseline<br />

testing to see where improvements<br />

can be made. We have concentrated<br />

very closely on spatial awareness and I<br />

have created some activities to improve<br />

the players’ perception of a moving<br />

target in space.”<br />

One such activity involves a player<br />

Alcon in both Australia and New<br />

Zealand, said Wang. “We will also<br />

continue to bring true innovation to the<br />

market and have several new product<br />

launches planned for <strong>2016</strong>.”<br />

Alcon invests in AIOL technology<br />

In other news, Alcon head office<br />

announced it had entered into a<br />

strategic alliance with PowerVision a<br />

privately-held, US-based medical device<br />

company focused on developing fluidbased<br />

lens implants.<br />

PowerVision, has developed an<br />

accommodating IOL (AIOL) for cataract<br />

patients with presbyopia, which, in pilot<br />

studies, has been shown to be able to<br />

change focus via a fluid-driven shapechanging<br />

technology, said Michael<br />

Onuscheck, global surgical franchise<br />

head for Alcon in a statement. “The<br />

technology utilises the eye’s natural<br />

accommodating muscles to transport<br />

fluid in the intraocular lens which is<br />

implanted in the eye’s capsular bag. The<br />

fluid-based technology that PowerVision<br />

is working on represents a potential<br />

game-changer in the category with<br />

the promise to offer patients a natural,<br />

continuous range of near to far vision.”<br />

Alcon’s investment in PowerVision will<br />

fund further development and clinical<br />

trials and provides Alcon with an option<br />

to acquire the company at a later stage.<br />

Alcon NZ appointment<br />

Alcon announced that Tristan Tuhi has<br />

joined its New<br />

Zealand surgical<br />

sales team as<br />

surgical account<br />

manager.<br />

“Tristan comes<br />

to us after five<br />

Tristan Tuhi<br />

years with Covidien<br />

reading a heart chart on the wall<br />

in time to a metronome, while also<br />

keeping time with flashing lights in the<br />

periphery of their vision working on a<br />

different rhythm.<br />

“It’s actually really hard,” laughs<br />

Edgar. “But these are exactly the sorts<br />

of exercises players in teams overseas<br />

regularly do. In the US, for example,<br />

it’s usual for basketball teams to have<br />

an optometrist work with the players,<br />

attending to their visual needs. I’ve<br />

thought we should offer this service for<br />

a while.”<br />

Edgar had an updated version of her<br />

university research paper published<br />

last year in the American journal,<br />

Optometry and Visual Performance,<br />

and has gained a number of clients in<br />

this area, including a golfer keen to<br />

improve his putting technique.<br />

“There are so many situations these<br />

improvement techniques could apply<br />

to,” says Edgar, who is pleased interest<br />

is gaining momentum.<br />

“It’s always been a goal for me to<br />

take this sort of work to the next level<br />

– it’s so useful and done really well<br />

overseas. I enjoy my day-to-day work<br />

as an optometrist, but this is another<br />

way of doing things a bit differently.<br />

It certainly makes my day more<br />

interesting!” ▀<br />

covering respiratory and advanced<br />

monitoring with a focus anaesthesia,”<br />

said Greg Engelbrecht, Alcon’s surgical<br />

sales manager for New Zealand. “He<br />

brings a wealth of knowledge to Alcon.”<br />

Tuhi has a BSc in physical education/<br />

health and a Diploma in Business and<br />

will be based. ▀<br />

Crosslinking<br />

advances<br />

Researchers have developed a<br />

new light-based procedure that<br />

could reduce the risk of cornea<br />

damage in crosslinking. Currently<br />

ultraviolet light is used to perform<br />

crosslinking across the entire cornea,<br />

said research leader Seok-Hyun<br />

Yun from Massachusetts General<br />

Hospital’s Wellman Center for<br />

Photomedicine in the US. “However,<br />

this comes with a risk of damaging<br />

the innermost layer of the cornea,<br />

a complication that changes the<br />

corneal function and can cause it to<br />

become very hazy.” The study focused<br />

on whether two-photon absorption<br />

could be used to precisely control<br />

the area of corneal crosslinking -<br />

an approach that has been used<br />

to harden liquid resins to create<br />

microscopic optical components and<br />

other 3D structures, but until now<br />

has not been applied to stiffen tissue.<br />

Researchers found that exposing the<br />

tissue to 200-milliwatt laser light<br />

for ten minutes induced collagen<br />

crosslinking without damaging tissue,<br />

but said more research is needed. ▀<br />

12 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong>

Glaucoma: from<br />

Moorfields to NZ<br />


ANZ Strabismus Society report<br />

ANZSS Keynotes Drs Fiona Rowe and David Guyton<br />

The Australian and New Zealand Strabismus<br />

Society (aka “Squint Club”) entered its 25th<br />

year following the annual scientific meeting<br />

at the Royal Children’s Hospital in Melbourne<br />

from 4 to 6 March this year.<br />

The guest speakers at this year’s meeting<br />

were Dr David Guyton, professor of paediatric<br />

ophthalmology at John Hopkins Medicine in<br />

Balitmore, USA; and Dr Fiona Rowe, a senior<br />

lecturer in orthoptics at the University of<br />

Liverpool, a research fellow for the British and<br />

Irish Orthoptic Society and associate-editor-inchief<br />

for the journal Strabismus.<br />

Both speakers contributed greatly to the success<br />

of the meeting, which attracted 120 registrants,<br />

with a highlight being the patient presentations<br />

and discussions from Dr Guyton’s Gillies Lecture:<br />

Changes in strabismus over time: clinical<br />

implications for the future.<br />

Fiona Gillies presented the certificate of<br />

appreciate to Dr Guyton and commented on<br />

how pleased her father, Bill, would be with the<br />

enduring strength of the strabismus meeting.<br />

The meeting concluded with a Nystagmus<br />

Workshop on Sunday morning attended by<br />

35 people.<br />

Next year’s meeting will be in Auckland with guest<br />

speakers: University of Toronto Professor Stephen<br />

Kraft, staff ophthalmologist at The Hospital for Sick<br />

Children and Toronto Western Hospital; and Kyle<br />

Arnoldi, clinical instructor in ophthalmology at the<br />

Jacobs School of Medicine and Biomedical Sciences<br />

at the University of Buffalo in New York. ▀<br />

Edited from an original article supplied by the ANZSS<br />

New app for CooperVision<br />

Dr Shenton Chew (right) enjoying a beer with colleagues in a London pub next to Moorfields<br />

Travelling to the opposite end of the earth is<br />

an experience many Kiwis cherish as part<br />

of their big “OE”, and for good reason—<br />

pounds, pints and plentiful European destinations<br />

at your doorstep. Unfortunately, for those of us<br />

in the ophthalmic and optometric fields, this has<br />

been getting more difficult with strict regulations<br />

for both visas and professional qualification<br />

equivalency.<br />

One such route available to me was a twoyear,<br />

London-based glaucoma fellowship at the<br />

prestigious Moorfields Eye Hospital. I had a truly<br />

fantastic time away, soaking up not just the sights<br />

and sounds of London and its surrounds, but also<br />

the collective wisdom from some of the giants of<br />

the glaucoma world, such as Mr Keith “Mr Tube”<br />

Barton, Professor Paul “I am angle closure” Foster<br />

and the knight of the realm himself, Professor Sir<br />

Peng Khaw.<br />

Moorfields was a great blend of tradition and<br />

innovation and my hopes of being comprehensively<br />

trained in the management of complex surgical<br />

glaucoma mingled nicely with cutting-edge<br />

experience in the wide gamut of minimally<br />

invasive devices such as the iStent, Hydrus, Aquesys<br />

and Cypass, the latter two of which are not<br />

currently available in Australasia.<br />

Glaucoma is a challenging specialty. We are often<br />

faced with the difficult task of convincing a patient<br />

who has no symptomatic concerns that firstly, they<br />

have irreversible vision loss and secondly, adherence<br />

to eyedrops, which have a significant side-effect<br />

profile, is essential in preventing progression. It can<br />

be a hard sell, especially when you know that you<br />

may have 100 more patients in the waiting room, as<br />

was often the case in a busy Moorfields glaucoma<br />

clinic. Add to that, increasing demand from an aging<br />

population with increased life-expectancy and you<br />

can see why glaucoma services throughout the<br />

world are struggling to keep afloat.<br />

Fancy surgical techniques aside, efficient service<br />

provision was another aspect I hoped to glean<br />

some insight into from the largest glaucoma<br />

service in the UK. Unfortunately, Moorfields also<br />

appeared to be struggling with the burden, with<br />

obvious difficulties in seeing patients at their<br />

requested follow-up times leading to over-booked<br />

and over-running clinics, which had a significant<br />

effect on staff and patient morale. As a fellow, it<br />

was easy to suck up the workload and experience<br />

that came with it for a couple of years, but<br />

imagine a lifetime in this system and it becomes<br />

obvious as to why the poor working conditions<br />

within the British NHS (National Health Service)<br />

feature as a common news headline.<br />

Increasing staffing within the current clinic<br />

structure was the obvious initial choice to stem<br />

the overflow, given the physical space that<br />

Moorfields has. Picture a throng of patients in a<br />

large waiting area, with a large clinic area broken<br />

into eight or more cubicles, with dividers, but no<br />

walls or doors, and you have a typical Moorfields<br />

clinic. The incredible lack of privacy was an issue<br />

that patients were surprisingly accustomed to,<br />

and it did allow for rapid consultation between<br />

a variety of clinicians that manned the clinic<br />

including a consultant, a couple of fellows,<br />

a registrar, a staff specialist and a couple of<br />

optometrists.<br />

Technician-led virtual clinics were used for both<br />

stable monitoring and for new patient assessment.<br />

These certainly have scope as the use of visual field<br />

analysers and optical coherence tomography can<br />

occur on no-consultant-led glaucoma clinics days. A<br />

higher number of patients can then be “seen” by the<br />

consultant in a reporting session. As a safeguard,<br />

every patient is assessed back in the consultant<br />

clinic every three years.<br />

One would think that patient satisfaction<br />

would be lower with this style, but the analysed<br />

Moorfields’ data suggests satisfaction levels were<br />

high, perhaps due to factors such as decreased<br />

journey time and being assessed in a timely fashion.<br />

Collaborative care models have also been<br />

established with motivated community-based<br />

optometrists. Because of the wide range of<br />

optometric practices in London, those optometrists<br />

who were involved tended to have worked, or still<br />

worked, within the Moorfields glaucoma service<br />

and thus already had close relationships with their<br />

ophthalmic colleagues. This allowed them to feel<br />

confident in their own abilities and limitations,<br />

knowing that support was easy to access if required.<br />

In terms of translation to glaucoma service<br />

provision here in New Zealand, I feel a key concept<br />

is first to stratify patients by risk of visual loss.<br />

For example, a patient with early glaucoma in<br />

their 90s is unlikely to progress to functionally<br />

significant levels in their lifetime. Whereas a patient<br />

with advanced glaucoma in their 40s is going to<br />

be a challenge to keep sighted throughout their<br />

remaining years.<br />

This stratification will allow for the appropriate<br />

delivery of care. In the hospital setting, lower<br />

risk patients could funnel into a larger volume<br />

“Moorfields-style” multi-clinician clinic, while higher<br />

risk patients could feed into a smaller, ophthalmicstaffed<br />

clinic as these patients have a higher<br />

chance of needing more time for counselling and<br />

management decisions. In areas where staffing<br />

and physical space is more limited, the lower risk<br />

cohort could be reviewed through a technician-led<br />

stable monitoring service, which is what I am in the<br />

process of setting up at Waitakere Hospital, where I<br />

spend part of my clinical time.<br />

Finally, we are fortunate in New Zealand<br />

to have high quality optometrists who value<br />

eye health as a priority and a have both the<br />

knowledge-base and skill set to be invaluable<br />

in sharing this burden of glaucoma care. In fact,<br />

we ophthalmologists already rely on this with<br />

the large number of low-risk glaucoma suspects<br />

we discharge back to optometric care. Thus<br />

establishing clear lines of communication and<br />

management pathways in collaborative-care<br />

models seems like a highly successful strategy<br />

and something Moorfields, perhaps, could one<br />

day learn from us. ▀<br />

* Dr Shenton Chew is currently working with the Eye Clinic at<br />

Greenlane Clinical Centre in Auckland<br />

CooperVision has launched an app to assist<br />

optometrists in fitting toric and multifocal<br />

lenses. The free OptiExpert app with<br />

multifocal and toric calculators is available to<br />

download for iOS and Android devices and provides<br />

diagnostic lens suggestions from CooperVision’s<br />

product families: Avaira, Biofinity, Biomedics, clariti<br />

and Proclear<br />

For toric lens choices, as well as the patient’s<br />

prescription, OptiExpert considers back vertex<br />

distance adjustment and on-eye orientation, says<br />

the marketing material, plus the app converts the<br />

Efron Grading Scales into an easy-to-use digital<br />

tool, allowing practitioners to grade patients<br />

against 16 sets of images and covers the key<br />

anterior ocular complications of contact lens<br />

wear. The app also includes the ability to securely<br />

store images of the patient’s eye condition and for<br />

practitioners to add their own comments.<br />

Commenting on the expansion, Joe Tanner,<br />




Visit us at<br />

shamir.co.nz<br />

For more information contact<br />


New Zealand Sales Rep<br />

021 449 819<br />

Coopervision ANZ’s<br />

professional services manager,<br />

said: “When we launched the<br />

app we made a promise to<br />

deliver a truly multi-functional<br />

digital pocket tool and this<br />

demonstrates our continued<br />

commitment to support the<br />

eye care professional who<br />

wants to make the initial<br />

diagnostic lens selection<br />

process as comprehensive as<br />

possible.”<br />

• In other news CooperVision announced it had<br />

launched Biofinity XR toric, to its Biofinity range of<br />

monthly silicone hydrogel contact lenses. Biofinity<br />

XR toric extends the high oxygen and advanced<br />

comfort of the range to patients who have both high<br />

prescriptions and astigmatism, said the company in<br />

a statement. ▀<br />

Shamir quarter page ad NZ OPTICS JUNE <strong>2016</strong>.indd 1<br />

<strong>Jun</strong>e <strong>2016</strong><br />

11/05/<strong>2016</strong> 3:58:08 PM<br />



Fresh eyes on fashion<br />

It’s the middle of the year and a perfect time to review what’s new in the style stakes with a number of high-profile new frame launches.<br />


interested in design, purpose and functionality.<br />

TAVAT’s latest launch is its “Soupcan” collection,<br />

inspired by the crude googles worn by a group of<br />

crop sprayers in Arizona, back in the ‘30s, who got<br />

together on weekends to give air-shows and called<br />

themselves, “The Flying Burritos”.<br />

A particular feature of the optical and sunglass<br />

ranges is the ex-cam hinge, a highly-engineered<br />

concept producing a fluid motion from opening<br />

to closing.<br />


Silhouette’s new Titan Minimal Art (TMA) Pulse<br />

collection has won a Red Dot Design award—the<br />

eighth award TMA has received since its launch<br />

in 1999.<br />

They’re handmade in Italy and, although titanium<br />

is a difficult product to work with, the frames are<br />

of the absolute highest quality.”<br />

Blackfin frames weigh about 10g each, yet they<br />

are exceptionally strong, with both classic and<br />

modern designs appealing to a variety of age<br />

groups and styles.<br />

“Key West is the most popular, but we stock 30<br />

styles and they’re all in demand,” says van der Maas.<br />

New additions to the range this month are<br />

Amelie and Norman. Amelie offers a modern take<br />

on the vintage cat-eye style, with clean, angular<br />

lines and a metallic colour palette. Norman has<br />

a similar, heavy-set brow, but with squared-off<br />

corners and a broader temple-line.<br />


Innotec by Ogi has announced two original<br />

styles—Emery and Ward—joining its collection of<br />

eyewear. These futuristic frames are handcrafted<br />

from TR-90 surgical-grade plastic and ultem—<br />

ground-breaking materials in the optical industry<br />

that set records for strength and weight.<br />

TAVAT now available in NZ<br />

Beni Vision in Palmerston North has added another<br />

Italian brand, TAVAT Eyewear, to its range of quality<br />

frames, which include the award-winning brand<br />

FEB31st wooden, and Blackfin titanium frames (see<br />

other story for Blackfin’s news).<br />

Dennis van der Maas, sales director for Beni Vision,<br />

says TAVAT Eyewear compliments the company’s<br />

existing product range and meets its goal of<br />

providing high quality, innovative, handmade<br />

eyewear with unique points of difference. “Having<br />

four complimenting materials, wood, titanium and<br />

now surgical stainless steel and acetate means we<br />

can now offer our customers the very best in Italian<br />

design, materials and construction.”<br />

Launched in 2010, TAVAT’s creative heart is the<br />

hills of Pasadena, California, though the frames<br />

are crafted in Northern Italy. According to the<br />

company, TAVAT offers functional iconic eyewear<br />

with real performance benefits for those in search of<br />

modernity, excellence and refined elegance and are<br />

The 4 days of Optics<br />

23 - 26 September <strong>2016</strong><br />

Sihouette’s TMA Pulse range awarded a Red Dot<br />

Weighing a mere 1.8g, with no rims, screws or<br />

hinges, TMA Pulse celebrates the sale of more than<br />

10 million items of TMA eyewear worldwide, said<br />

Silhouette the Austrian, family-owned business,<br />

which prides itself on producing super-lightweight<br />

quality eyewear. “With colour highlights on their<br />

Silhouette caps and glass fixtures in 12 fresh colours,<br />

not to mention the 12 lens shapes, this collection<br />

brings radiance to every face.”<br />

Over 5,200 products, from 57 countries, were<br />

considered by the jury for this year’s Red Dot<br />

awards. Criteria included, but were not limited to:<br />

degree of innovation, formal quality, functionality<br />

and longevity of the product. The German-based,<br />

international Product Design competition has<br />

existed since 1954. Its award, the Red Dot, is an<br />

internationally recognised quality seal.<br />

Silhouette is distributed by Elegance in Eyewear in<br />

New Zealand.<br />


Since Beni Vision began stocking Blackfin frames 10<br />

months ago the company has seen a huge increase<br />

in demand based on word-of-mouth.<br />

Ward, the new style from Innotec by Ogi<br />

The Emery is a classic rectangular shape,<br />

handmade from TR-90 surgical plastic and<br />

ultem, an ultra-lightweight and flexible plastic<br />

with applications in aerospace. Equipped with<br />

metal hinge pieces and adjustable nose pads,<br />

it is comfortable and reliable, according to a<br />

statement by Ogi.<br />

Innotec’s Ward design offers an innovative keyhole<br />

bridge and is also handcrafted from TR-90 surgical<br />

plastic and ultem, with adjustable nose pads.<br />

Both styles have four different burnished colour<br />

options, and are distributed in New Zealand by BTP<br />

International Designz.<br />


WOOW partners with clothing line Le Bijou Parisien<br />

Blackfin sunglasses are stocked by Beni Vision<br />

“I have about 15 practices ordering weekly,”<br />

says Beni Vision’s Dennis van der Maas. “The<br />

construction of these frames is impeccable.<br />

WOOW eyewear have teamed up with clothing<br />

line Le Bijou Parisien for a series of photoshoots<br />

marrying together urban chic and classic style.<br />

WOOW sunglasses are handmade to a high<br />

standard while offering a modern street style that<br />

is proving to be popular with all ages. WOOW is<br />

distributed for Eyes Right Optical (NZ) by CMI Optical<br />

in New Zealand. ▀<br />

Building awareness for MD<br />


silmoparis.com<br />

Macular Degeneration New Zealand<br />

(MDNZ) once again invited our<br />

ophthalmic community to support<br />

the MD Awareness week at the end of May with<br />

local visibility activities.<br />

Many responded with positive actions,<br />

including displays in practices, Facebook activity<br />

and encouraging local media coverage. The<br />

<strong>2016</strong> week featured a significant social media<br />

campaign as there are 631,000 New Zealanders<br />

over 60 years of age who use Facebook. Four<br />

large billboards were displayed in Auckland, a<br />

double-page feature published in the NZ Listener,<br />

and local stories published in local media around<br />

the country. There was even full page published<br />

on MD in the<br />

Mad Butcher<br />

Newsletter.<br />

Ooh Media<br />

continue to<br />

sponsor MDNZ<br />

with the digital<br />

display signage<br />

in shopping<br />

malls across New<br />

Zealand and optometrists based in the malls<br />

were invited to capitalise on this.<br />

The consistent call to action is to save sight with<br />

the Amsler grid and for people to have their eyes<br />

tested at least once every two years. ▀<br />

14 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong>

ACO accredited<br />

Jolanda de Jong, ACO’s head of professional development<br />

The Australian College of Optometry<br />

(ACO) has gained accreditation<br />

for CPD points in New Zealand<br />

for its online webinars and seminars,<br />

Therapeutics Refresher Weekend,<br />

Glaucoma (Diagnostic Skills) Course and<br />

its clinical workshops on BIO, Gonioscopy<br />

and OCT.<br />

Given this success, it will also be applying<br />

for accreditation for New Zealand attendees<br />

to its ACO National Conference, which will be<br />

held in Melbourne from the 22-23 October,<br />

once the programme has been finalised, said<br />

Jolanda de Jong, ACO’s general manager,<br />

professional development.<br />

“This year is the first year that we have<br />

asked for accreditation for our events in New<br />

Zealand. The ACO has provided professional<br />

development for Australian optometrists<br />

since 1975. We are very proud of our track<br />

record in this field and are delighted that we<br />

have an increasing number of New Zealand<br />

optometrists interested in joining the ACO<br />

as members take up the benefits offered by<br />

our growing number of events, either online<br />

or in person.”<br />

The time was right to apply, given the<br />

increasing ease and familiarity with online<br />

certificate courses, says de Jong. “The<br />

ACO now offers a very comprehensive<br />

CPD programme and the fact that these<br />

activities are now accredited in New Zealand<br />

offers an expanded suite of options to New<br />

Zealand optometrists. Overall we see this<br />

as a great opportunity to share knowledge,<br />

present diverse speakers, broaden networks<br />

and strengthen the relationship between<br />

colleagues in both countries. Learning<br />

together is a positive step forward for the<br />

profession as a whole.” ▀<br />

Reflections on long careers<br />

Mike Firmston and Bryan<br />

Matthews take time out to<br />

reflect on a combined 100<br />

plus years in business with<br />

NZ Optics’ editor-at-large<br />

Maryanne Dransfield<br />

After 46 and 55 years in the<br />

optical business, respectively,<br />

Mike Firmston and Bryan<br />

Matthews have sold their “retirement”<br />

practice, Specs Direct.<br />

“It was the right time to go.<br />

Optometrist Donald Klaassen who has worked for us for many years<br />

was interested in buying the practice so it made the decision a little<br />

easier to make,” said Mike.<br />

Bryan and Mike were responsible for changing the face of retail<br />

optics in New Zealand when they opened the Optique Boutique chain<br />

of stores in the mid-80s.<br />

“I guess we were at the cutting edge of the change that started in the<br />

mid-80s. The retail appearance we presented in Optique Boutique was<br />

revolutionary for the time and changed the way DO’s and optometrists<br />

thought about how they marketed themselves and their services to<br />

the public,” said Bryan.<br />

The opening of the stores was like a rollercoaster ride, they both<br />

added. The first to open was in Sandringham, followed closely by<br />

Symonds Street and then High Street in central Auckland.<br />

“The public was ready for a new approach in buying their glasses.<br />

Licenses on spectacles had been removed and as a result there was a<br />

tsunami of agencies and brands available to us. It was very exciting<br />

times,” said Mike.<br />

The wholesale and manufacturing arm of the company, Bryan<br />

Matthews Optical, established in 1970, was supplying its own stores<br />

as well as other practices. Originally owned by Bryan and his brother<br />

Craig, brother-in-law Mike joined them in 1973 on his return to New<br />

Zealand from working overseas. Mike brought with him experience in<br />

management and accounting, enabling the Matthews to develop their<br />

business further. Dennis Irvine also joined them at this time to assist<br />

with the opening of the stores.<br />

Optique Boutique underwent a name change once the stores opened<br />

in malls in Auckland and Chartwell in Hamilton, becoming known as<br />

Optique Eyewear. In 1995 the chain of eight stores was sold to OPSM<br />

giving the Australian company a foothold in the New Zealand market.<br />

For Mike, the next five years were spent as New Zealand<br />

administration manager for OPSM, while Bryan continued with<br />

Tranzoptics, the wholesale successor to Bryan Matthews Optical.<br />

Then, in <strong>Jun</strong>e 2000, Mike and Bryan joined forces again in a new<br />

business venture, Specs Direct. The first, factory-type outlet was<br />

in Sandringham and another in Albany soon followed. A semiretirement<br />

venture, the philosophy behind the business was<br />

that product was to be priced to the overheads, which were low<br />

compared to retail practices.<br />

“At the time there was a definite public perception that<br />

prescription glasses were too expensive and until then there<br />

had been nowhere people could go except The Warehouse and<br />

pharmacies to purchase ready-readers. We decided to fill that market<br />

gap,” Mike said.<br />

Bryan has an extensive background in the industry and is probably<br />

the only person in New Zealand who has been involved in the<br />

production of lenses, frame making, dispensing and retail. His<br />

career began in 1960 at Standard Optical in Auckland before moving<br />

to Arthur Cocks in 1963, where he also worked with lenses. Two<br />

years later he joined Owen Optical to work for a year with Robert<br />

Leitl training in the frame-making process, before moving on to<br />

overseeing frame production. In 1974 he left to establish his own<br />

frame making company, but market forces came into play prohibiting<br />

him from gaining a license to obtain the materials necessary to<br />

manufacture frames. Whilst continuing to lobby for a license, Bryan<br />

began dispensing from these premises gaining a lot of referrals from<br />

ophthalmologists. It was around this time he formed a business<br />

relationship with Harold Searle who established Reads Optical and<br />

Press clipping of Mike and Bryan at their Balmoral shop in the mid 70’s<br />

Brian Matthews Optical in the ‘80s<br />

Mike Firmston and Bryan Matthews today<br />

with whom he would place his lens business for the next 40 years.<br />

“When no-one else would handle our lens business, Harold was the<br />

only one. I was very grateful to him. Of course it was a different story<br />

when we setup our chain of stores, I had everyone knocking on my<br />

door.”<br />

By 1975, Bryan Matthews Optical gained its frame license. It<br />

manufactured frames for their own outlets as well as selling to<br />

optometrists once they gained some big-brand agencies. The company<br />

was the first in the country to obtain a license for CR39 lenses, much to<br />

the dismay of other labs.<br />

“Once Optique Boutique opened, a lot of practices did not like the<br />

fact that we were retailing as well so they wouldn’t buy from us…we<br />

were so busy with our retail operation it suited us to wind down the<br />

wholesaling side,” said Bryan.<br />

Bryan was able to dispense as he got in under the “grandfather<br />

clause,” but Mike decided to do the dispensing opticians course,<br />

qualifying in 1980. He joined what was then known as Dispensing<br />

Opticians of New Zealand (now ADONZ) and worked tirelessly<br />

serving in a variety of roles for the organisation over the next<br />

three and half decades. He was elected to the Opticians’ Board<br />

(now ODOB) in 2001 serving for nine years. He helped establish,<br />

and is still a director of, OptiBlocks, the educational course for<br />

trainee dispensers.<br />

Mike was awarded the Robert Maher Award in 2010, recognising<br />

his significant contribution to the industry, and life membership<br />

of ADONZ in 2012. He was also awarded the prestigious Essilor<br />

scholarship to the Varilux Academy, which he took in 2009.<br />

One of the highlights of Mike’s career in optics has been the<br />

camaraderie and professionalism among the people in the industry, he<br />

said. “I have enjoyed the interaction with everyone I have encountered<br />

over the years…and I have made many lifelong friends. It’s been an<br />

incredible industry to work in and I feel privileged to have made links<br />

with people worldwide and to have had the opportunity to understand<br />

the different perspectives people have. I’ve seen many changes, but<br />

most of all it’s been great to see how our Association (ADONZ) has<br />

developed to what it is today.”<br />

Bryan said the last 56 years has been one big journey with many<br />

ups and downs. “We were successful because we trusted each other.<br />

We were a great combination - Mike is a people’s person, Craig was<br />

highly efficient in the area of technology. We would have been the first<br />

wholesaler in New Zealand to have run a computerised system, while<br />

my travelling gave me insights into trends and what was the next big<br />

thing in eyewear, which always kept us ahead of the competition.”<br />

Asked about his plans for retirement, Bryan said optics is still very<br />

WAVE <strong>2016</strong><br />

western australian<br />

vision education<br />

workshop in the west<br />

Saturday & Sunday 13-14 August <strong>2016</strong><br />

UP TO<br />

46<br />

Magazine advert 9x35.5cm.indd 1<br />

EArly bird HUGE SAViNGS<br />

rEGiSTEr<br />

NOW!<br />

Rendezvous Hotel, Perth,<br />

Western Australia<br />

www.optometry.org.au/wa<br />

UP TO<br />

31.5T<br />

29/04/<strong>2016</strong> 1:41 pm<br />

much in his blood and is planning to dabble in small-time production<br />

again with Craig. “Out of everything I’ve done over the past 56 years,<br />

the manufacturing aspect was the thing I enjoyed the most.”<br />

Mike and his wife Rae are planning a four-month overseas trip to<br />

Europe. When they return, Mike said he is looking forward to becoming<br />

a volunteer in several organisations and undertaking a massive<br />

gardening challenge with his neighbour. ▀<br />

<strong>Jun</strong>e <strong>2016</strong><br />



with<br />

Prof Charles McGhee<br />

& A/Prof Dipika Patel<br />

Series Editors<br />

Choosing topical antibiotics wisely<br />


There are many factors that influence the selection of an<br />

antibiotic for a given clinical scenario. Some questions that<br />

assist in the decision-making process include the following:<br />

••<br />

Is the antibiotic for prophylaxis or for treatment of infection?<br />

••<br />

If treating infection, is the causative organism known?<br />

••<br />

If the causative organism is unknown, is there a<br />

predisposition for gram positive or gram negative organisms<br />

to cause this type of infection?<br />

••<br />

Does the patient have any contraindications to antibiotics?<br />

Common situations where topical antibiotics are used<br />

for infection prophylaxis include: corneal abrasions, pre or<br />

postoperative following extraocular surgery (refractive surgery,<br />

pterygium excision, etc.) or intraocular surgery (cataract, glaucoma,<br />

or retinal surgery, etc.). Superficial ocular infections that are often<br />

bacterial include conjunctivitis and keratitis. Some “non-infectious”<br />

conditions that are often adjunctively treated with antibiotics<br />

include blepharitis and marginal keratitis. Considerations regarding<br />

some of these specific clinical conditions are presented below:<br />

Conjunctivitis. Major causes of conjunctivitis include: viral,<br />

bacterial, chlamydial, and allergic. Acute bacterial conjunctivitis<br />

is often self-limiting; however, treatment with an antibiotic may<br />

accelerate the resolution of infection. Most bacteria causing<br />

this condition in children (excluding infants) and adults are<br />

gram positive, such as Staphylococcus aureus or Streptococcus<br />

pneumoniae. A broad spectrum antibiotic with gram positive<br />

coverage such as chloramphenicol or fusidic acid would be<br />

expected to treat the infection. Ciprofloxacin has poor coverage<br />

of streptococcus and is generally reserved for use in more severe<br />

ocular infections. Clinical response is generally seen within a few<br />

days and the course continued for 5-7 days total. A conjunctival<br />

swab for bacteria, viruses (HSV, adenovirus), or chlamydia may be<br />

performed for chronic conjunctivitis or for cases where the history<br />

and exam suggest an alternative etiology or do not respond to<br />

initial antibacterial treatment.<br />

Keratitis. In New Zealand, the majority (70-80%) of bacterial<br />

keratitis isolates are gram positive organisms, most commonly<br />

coagulase negative staphylococci or Staphylococcus aureus. Of<br />

gram negative organisms, Moraxella spp. and Pseudomonas<br />

aeruginosa are the most common. Fungal and acanthamoeba<br />

keratitis rarely occur in New Zealand, and combined they represent<br />

less than 5% of isolates from severe keratitis. 1,2<br />

Standard treatment regimens for microbial keratitis are<br />

monotherapy with a fluoroquinolone, such as ciprofloxacin, or<br />

dual therapy with fortified antibiotics (usually aminoglycoside<br />

and cephalosporin). Studies have not shown a difference in the<br />

effectiveness between these two regimens. 3 Ciprofloxacin has the<br />

advantage of being a single, commercially available agent, and is<br />

generally well tolerated. In contrast, the fortified aminoglycoside/<br />

cephalosporin antibiotics have a short shelf life, require<br />

refrigeration, must be obtained from a specialised pharmacy,<br />

and may cause more surface toxicity. As a result, ciprofloxacin is<br />

frequently used to empirically treat keratitis, and a study from<br />

Waikato Hospital from 2003-2007 showed that 99% of bacterial<br />

keratitis isolates were sensitive to ciprofloxacin. 1 However, there<br />

are some reported gaps in ciprofloxacin’s coverage of gram positive<br />

organisms 4 and many clinicians treat severe, central, visionthreatening<br />

keratitis (Fig. 1) using dual therapy for additional<br />

coverage of potential organisms. Because chloramphenicol is<br />

bacteriostatic, rather than bactericidal, it is generally not used as<br />

primary treatment of severe corneal infections. The addition of<br />

an antibiotic ointment at bedtime (such as chloramphenicol or<br />

tobramycin) may augment the use of daytime eye drops.<br />

When treating a bacterial infection (conjunctivitis or keratitis),<br />

there is usually improvement (or in the case of severe keratitis, at<br />

least no worsening) within 2-3 days of treatment. If the infection<br />

is not responding, consider: incorrect diagnosis, non-compliance,<br />

subtherapeutic dosing frequency, or inappropriate choice of drug.<br />

Blepharitis. While blepharitis is not due to an infection per<br />

se, treatment with an antibiotic may be a beneficial adjunct<br />

to other treatments, particularly when due to staphylococcal<br />

hypersensitivity. Similarly, “staphylococcal” marginal keratitis<br />

(Fig. 2) is due to a hypersensitivity reaction to bacterial antigens.<br />

The acute management of marginal keratitis requires treatment<br />

with a topical corticosteroid. However, strategies to minimise the<br />

recurrence include the institution of an eyelid cleaning regimen<br />

along with a course of nightly topical antibiotic with activity<br />

against gram positive organisms. Fusidic acid has good coverage<br />

against staphylococcus and also has immunosuppressive properties<br />

which make it a useful treatment option for many patients to<br />

reduce bacterial loads and inflammation.<br />


An overview of the commercially available topical antibiotics is<br />

presented below. Other antibiotics may be available through special<br />

order through a compounding pharmacy and are not covered in<br />

this review. Additionally, anti-viral and anti-fungal agents have not<br />

been included.<br />

CHLORAMPHENICOL. Available as 0.5% eye drops (Chlorafast) or 1%<br />

ointment (Chlorsig).<br />

Mechanism of Action: Bacteriostatic. Inhibits protein synthesis.<br />

Spectrum of coverage: Broad, most gram positive and gram<br />

negative organisms. Not effective against Pseudomonas<br />

aeruginosa.<br />

Considerations: Aplastic anemia is a serious, life-threatening,<br />

side effect but the risk is extremely low with topical use (less<br />

than 1 in 224,716 prescriptions). 5 Other risks include gray baby<br />

syndrome, so treatment during pregnancy should be avoided<br />

during the last week before parturition and while breast-feeding.<br />

As with all medications, topical irritation/allergy can occur (Fig.<br />

3). Most commonly used to treat conjunctivitis or for prophylaxis<br />

of infection. The solution contains phenyl mercuric nitrate as a<br />

preservative, and the ointment is preservative-free, so may be used<br />

in patients with allergy to benzalkonium chloride (BAK).<br />

CIPROFLOXACIN. Available as 0.3% eye drops (Ciloxan)<br />

Mechanism of Action: Bactericidal. Interferes with DNA synthesis.<br />

Spectrum of coverage: Broad range of gram positive and gram<br />

negative organisms and very effective against pseudomonas.<br />

Considerations: May form crystalline precipitates on the ocular<br />

surface which may obscure the visualization of an ulcer base when<br />

treating keratitis.<br />

AMINOGLYCOSIDES. Gentamicin (Genoptic), Tobramycin (Tobrex)<br />

0.3% eye drops or ointment. Neomycin and Framycetin available in<br />

combination with dexamethasone.<br />

Mechanism of Action: Bactericidal (concentration dependent).<br />

Inhibits protein synthesis through binding of ribosomal subunits.<br />

Spectrum of coverage: Broad, gram negative and moderate gram<br />

positive with some resistance among Streptococcus pneumonia.<br />

Considerations: Poor ocular penetration. Among aminoglycosides,<br />

tobramycin has best activity against pseudomonas aeruginosa.<br />

Aminoglycosides may cause surface toxicity including superficial<br />

punctate keratitis and erythema/oedema of the conjunctiva, mostly<br />

after the drug is used in excess of 1-2 weeks.<br />

NEOMYCIN/POLYMIXIN B. Component of Maxitrol along with<br />

dexamethasone 0.1% as a solution or ointment.<br />

Mechanism of Action: Neomycin is an aminoglycoside and<br />

inhibits protein synthesis. Polymixin B sulfate alters bacterial cell<br />

membranes.<br />

Spectrum of coverage: Neomycin has excellent gram negative<br />

coverage with partial gram positive coverage. Polymixin B is<br />

bactericidal for gram negative with little effect on gram positive<br />

organisms.<br />

Considerations: As a combination antibiotic/steroid this is not<br />

frequently used in the treatment of infections. However, this<br />

combination is often used as postoperative prophylaxis of infection<br />

due to the convenience of a single medication. Roughly 5% of<br />

patients may experience a delayed hypersensitivity reaction to<br />

neomycin consisting of itching, erythema/oedema of the eyelids<br />

and conjunctiva, and possibly a superficial punctate keratitis.<br />

This usually occurs after several days of treatment, if previously<br />

unexposed, or within 12-72 hours if previously exposed.<br />

FRAMYCETIN/GRAMICIDIN. Component of Sofradex along with<br />

dexamethasone 0.05%.<br />

Mechanism of action: Framycetin sulfate is an aminoglycoside<br />

and inhibits protein synthesis. Gramicidin increases permeability of<br />

the bacterial cell.<br />

Spectrum of coverage: Framycetin has broad coverage with<br />

clinical use targeting gram organisims. Gramicidin is active against<br />

gram positive bacteria and reinforces the action of framycetin<br />

against streptococci.<br />

Considerations: In comparison to Maxitrol, contains a lower<br />

concentration of dexamethasone and may have greater activity<br />

against some gram positive organisms.<br />

SULFONAMIDES. Sulfacetamide sodium 10% solution (Bleph-10)<br />

Mechanism of Action: Bacteriostatic. Acts as an antimetabolite to<br />

inhibit folate metabolism.<br />

Spectrum of coverage: Inhibits gram positive and gram negative<br />

bacteria. Poor coverage of pseudomonas and significant percentage<br />

of staphylococci are resistant.<br />

Considerations: Should not be used if hypersensitivity to sulfa<br />

drugs. Rare potential side effect is Stevens-Johnson syndrome.<br />

FUSIDIC ACID. Available as 1% viscous eye drops (Fucithalmic)<br />

Mechanism of Action: Inhibits protein synthesis.<br />

Spectrum of coverage: Bacteriostatic activity against a wide range<br />

of gram positive, particularly staphylococcus.<br />

Considerations: Also has immunosuppressive properties,<br />

making it a good choice for blepharitis due to staphylococcal<br />

hypersensitivity.<br />

PROPAMIDINE. Available as (Brolene) solution or ointment without<br />

a prescription<br />

Mechanism of Action: Bacteriostatic. Causes damage to the cell<br />

surface.<br />

Spectrum of coverage: Broad spectrum antimicrobial, may have<br />

activity against antibiotic-resistant staphylococci.<br />

Considerations: This is often only prescribed by ophthalmologists<br />

for the treatment of acanthamoeba keratitis. ▀<br />

References<br />

Fig 1. Severe microbial keratitis with a large, central, elevated infiltrate due<br />

to Moraxella.<br />

Fig 2. Blepharitis and staphylococcal marginal keratitis with paralimbal<br />

corneal infiltrates from 2 to 5 o’clock.<br />

Fig 3. Severe contact dermatitis and allergic conjunctivitis due to<br />

frequent application of chloramphenicol solution.<br />

1. Pandita A, Murphy C. Microbial keratitis in Waikato, New Zealand. Clin<br />

Experiment Ophthalmol 2011;39:393–7.<br />

2. Wong T, Ormonde S, Gamble G, McGhee CNJ. Severe infective keratitis leading<br />

to hospital admission in New Zealand. Br J Ophthalmol 2003;87:1103-1108.<br />

3. McDonald EM, Ram FSF, Patel DV, McGhee CNJ. Topical antibiotics for the<br />

management of bacterial keratitis: an evidence-based review of high quality<br />

randomised controlled trials. Br J Ophthalmol 2014;98:1470-7.<br />

4. Goldstein MH, Kowalski RP, Gordon YJ. Emerging fluoroquinolone resistance in<br />

bacterial keratitis. Ophthalmology 1999;106:1313-8.<br />

5. Lancaster T, Stewart AM, Jick H. Risk of serious haematological toxicity with<br />

use of chloramphenicol eye drops in a British general practice database. Br<br />

Med J 1998;316:667.<br />

About the author<br />

* Jay Meyer is an anterior segment fellow at the<br />

University of Auckland and has an interest<br />

in ocular infections. Prior to his training in<br />

ophthalmology, he completed a B.S. degree<br />

in microbiology and as a medical student<br />

described a novel species of mycobacteria<br />

(Mycobacterium arupense).<br />

16 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong>

Celebrating Bruce Hadden MD<br />

Associate Professor Bruce Hadden’s long<br />

standing support for (and association<br />

with) the Department of Ophthalmology<br />

at the University of Auckland was honoured in a<br />

celebration in April. The evening also marked<br />

A/Prof Hadden’s recent success for achieving an<br />

MD (Doctor of Medicine) by research.<br />

Professor Charles McGhee, head of the<br />

Ophthalmology Department, chaired the event,<br />

Professor Stuart McCutcheon (left) andProfessor Alan Merry (right) raise a glass to A/Prof Bruce Hadden<br />

welcoming the 50 plus guests, before sharing<br />

some amusing anecdotes about how he met<br />

Bruce (in the men’s room in Melbourne) and<br />

how he was one of five key people who were<br />

responsible for him coming to New Zealand and<br />

happily remaining here.<br />

To the continued amusement of the audience,<br />

Professor McGhee also related the tale of how he<br />

conspired with Bruce’s wife, Dr Wendy Hadden,<br />

to keep Bruce busy when he retired from a long<br />

and distinguished ophthalmological career,<br />

appointing him honorary Associate Professor in<br />

Ophthalmology. Since then Bruce has become a<br />

favourite with students as a teacher, is still the<br />

go-to person for any clinical or diplomatic advice,<br />

has published a major textbook on eye surgery<br />

and eye surgeons in New Zealand plus 30+ papers<br />

in scientific journals and completed his MD.<br />

Professor McGhee summed up Bruce as too<br />

modest. “He’s an outstanding clinician and<br />

surgeon. He and Wendy have been fantastic<br />

supporters of the department…he’s retained an<br />

intellectual curiosity through his entire career, he<br />

keeps his students sharp and on their toes…he’s<br />

an unstinting friend of the faculty, he’s always<br />

diplomatic and he’s an outstanding friend.”<br />

Professor Stuart McCutcheon, vice chancellor of<br />

the University, admitted when he was first invited<br />

to talk, he thought the function was to mark<br />

Bruce’s retirement so was pleased to find out this<br />

wasn’t so. He thanked Bruce and Wendy for their<br />

long and committed support of the Faculty and<br />

the Department, concluding his speech by saying<br />

that: “Associate Professor, Doctor, Doctor, Mr<br />

Hadden” was without doubt a great example of<br />

the best in Town and Gown.<br />

Professor Alan Merry, head of the School<br />

of Medicine, also reflected on some of the<br />

achievements of Bruce’s outstanding career,<br />

including his stint as the first New Zealand<br />

president of RANZCO, and how he has<br />

been instrumental in the development of<br />

ophthalmology in New Zealand. ▀<br />

Maree McInerney, Professor Colin Green, Dr Sue Ormonde and A/Prof<br />

Trevor Sherwin<br />

A/Prof Bruce and Dr Wendy Hadden with Suzanne Renner and A/Prof<br />

Gordon Sanderson<br />

Heather Reynolds, Cecilia Chin, A/Prof Bruce Hadden and Jasha Morarji Heather Reynolds, A/Prof Gillian Clover and Professor Charles McGhee A/Prof Bruce Hadden mingling with guests A/Prof Dipika Patel and Drs Verity Oliver, Stuti Misra and Carol Greene<br />

Education out<br />

of this world<br />

Jon Baines Tours, a specialist provider of fully escorted medical<br />

tours, is now taking bookings now for its next ophthalmology tour<br />

in Japan and optometry tour in Peru in 2017. The tours explore<br />

destinations through the eyes of a particular profession, visiting<br />

clinics, meeting specialists from those regions, while also providing<br />

a full cultural programme, covering the key sites of a country.<br />

Ophthalmology in Japan: 28 February - 11 March 2017<br />

This study tour will be led by Professor Christopher Liu, a consultant<br />

ophthalmic surgeon based in Britain. It encompasses Tokyo, the<br />

former Samurai town of Kanazawa, Osaka, Hiroshima and Kyoto and<br />

includes visits to eye hospitals and ophthalmic centres, lectures<br />

and meetings with Japanese colleagues. The wide ranging cultural<br />

programme will include museums, castles, gardens and temples as<br />

well as contemporary Japan.<br />

Optometry in Peru: 2–14 April 2017<br />

The annual optometry tour is going to Peru and will be led by regular,<br />

UK-based tour leader, optometrist David Shannon. Peru is a country as<br />

varied in culture as it is in natural landscapes. This tour will travel from<br />

the capital, Lima, to the ancient Inca capital, Cuzco, before heading<br />

to the lost city of Machu Picchu, the Andes and Lake Titicaca to visit<br />

traditional communities. It includes a range of professional visits<br />

examining emerging optometry and eyecare throughout Peru.<br />

For more about either tour visit:<br />

www.jonbainestours.co.uk/optometry. ▀<br />

Lumenis presents OPT results<br />

Lumenis, the world’s largest energy-based medical device<br />

company for aesthetic, surgical and ophthalmic applications,<br />

presented interim results of a multicentre prospective clinical<br />

trial designed to study the safety and efficacy of Optimal Pulse<br />

Technology (OPT), the next generation of Intense Pulse Light (IPL)<br />

technology, for treating dry eye disease (DED). Data from the trial, led<br />

by Steven J. Dell, MD, of Dell Laser Consultants in Austin, Texas, was<br />

presented at the ASCRS conference held May 6-10 in New Orleans.<br />

In the trial, 40 patients from two centres received three IPL with<br />

OPT treatments for DED caused by Meibomian gland dysfunction<br />

(MGD). Tear break-up time, SPEED questionnaire scores, tear<br />

osmolarity and additional endpoints were measured at baseline and<br />

again after treatment.<br />

“Many of my patients with dry eye due to MGD report significant<br />

ocular discomfort that limits their ability to work, participate in<br />

hobbies or use computers, smartphones and tablets. For these<br />

reasons, it is important that we have effective and safe treatments<br />

that help patients resume normal activities without visual<br />

symptoms,” Dr Dell said.<br />

Sheila Barbarino, MD, of Dell Laser Consultants, presented interim<br />

results of 14 patients who finished all treatments and follow-ups.<br />

“I am excited to present the data from our study,” Dr Barbarino said.<br />

“More than 40 million Americans suffer from dry eye and several<br />

studies show that MGD plays a primary role in a majority of cases.<br />

The data from our study suggests that IPL with OPT could be an<br />

important addition to our armamentarium of treatments for this<br />

prevalent, life-altering disease.”<br />

Lumenis M22 IPL with OPT is a clinically-proven and TGA and<br />

Medsafe -cleared therapy for a wide range of skin conditions,<br />

including inflammatory disorders such as rosacea. More than<br />

a decade ago, Rolando Toyos, MD, of Toyos Clinic in Nashville,<br />

Tennessee, observed that patients treated with IPL for skin conditions<br />

reported significant improvement in ocular symptoms and signs, in<br />

some cases including resolution of concomitant MGD. Studies show<br />

that over 85% of individuals with skin and eyelid inflammation also<br />

suffer from inflammatory ocular conditions, such as MGD, blepharitis<br />

and eyelid telangiectasia. IPL with OPT may selectively target<br />

abnormal blood vessels and remove a major source of inflammation<br />

from the skin and eyelids of these patients, providing symptomatic<br />

relief and addressing the underlying causative pathway of their<br />

Lumenis’ Optimal Pulse Technology in action<br />


ocular disease.<br />

Lumenis OPT proprietary technology ensures the delivery of<br />

consistent and homogenous levels of energy during brief IPL pulses,<br />

thus eliminating unsafe energy spikes, increasing reproducibility and<br />

improving results with fewer treatment sessions while reducing the<br />

risk of skin damage. The results of the study have indicated a 220%<br />

improvement in tear break up time, a greater than 50% improvement<br />

in SPEED Questionnaire scores and a greater than 40% improvement<br />

in relative osmolality readings of the tear film. This demonstrates<br />

both a significant improvement in the objective markers used as<br />

well as the patients reporting significant subjective improvements.<br />

The M22 with OPT is available now from Lumenis Australia/ New<br />

Zealand. Further information or to request a demo is on the website<br />

www.lumenis.com/Solutions/Ophthalmology/Products/M22. ▀<br />

<strong>Jun</strong>e <strong>2016</strong><br />



An international query<br />

Registrations<br />

open for<br />

WAVE<br />

An international reader recently sent me the following email query:<br />

“I have a question that you have probably answered in one of your<br />

columns already - hope you don’t mind! In the toss up between dailies<br />

that are not siHy and well cared for monthlies that are siHy, would you choose<br />

the dailies still?”<br />

That’s a tough question!<br />

It certainly got me thinking as this seemingly simple question involves a<br />

great many fundamentals of contact lenses. I have dealt with many aspects of<br />

such issues in past columns but felt a review was in order as our lens options<br />

become ever wider and better, as does our understanding of such things.<br />

One such aspect obviously regards oxygen permeability and lens<br />

thickness. We’ve talked a lot in the past about Dk/L, Holden-Mertz criteria,<br />

neovascularisation, striae and the like, so I won’t repeat it here. I will, however,<br />

try and put it into a relevant and relative context.<br />

Of course it’s not as simple as merely considering SiHy versus hydrogels or<br />

oxygen transmission.<br />

Today a hydrogel daily like the biomimetic 78% water content Biotrue<br />

ONEday hydrogel provides a Dk of around 42 units. The Dk is thus not too far<br />

off the Dk of some silicone-hydrogels - on the lower end of SiHy Dk range of<br />

around the 50 unit mark. So for many patients a hydrogel like Biotrue ONEday<br />

will be pretty much the same physiologically. It may, however, have some<br />

benefits in terms of avoiding solution-lens interactions, allergies and sensitivity<br />

as well as potential benefits for the so-called and rare silicone-responders.<br />

There are also other lenses like the biocompatible and zwitterionic Proclear<br />

dailies that also have reasonably decent Dk of around 25 units. 1-Day Acuvue<br />

Moist boasts a similar Dk yet adds the benefit of high levels of UV protection<br />

that are important in climes like South Africa, Australia and New Zealand. The<br />

Focus range of dailies also have similar Dk and perform very well.<br />

I have used and continue to use and prescribe all the above lenses with<br />

excellent results over two decades on many simple and complex patients. I<br />

rarely see any complications and in fact have solved many problems in patients<br />

with Thygeson’s-like, solution-lens related keratopathy and a variety of other<br />

problems, sensitivity and complications they had with reusable lenses.<br />

Today of course we have some next generation SiHy dailies that are providing<br />

fantastic levels of comfort and masses of oxygen and today these are my first<br />

choice.<br />

Qualification<br />

Thus I qualified the email query as I suspected that the question was not<br />

purely related to which was ‘better’ and suspected that cost was the issue.<br />

They responded that was in fact the underlying reason for their question. They<br />

practise in South Africa where it seems there is a wider gap in cost between an<br />

annual supply of dailies versus monthly lenses and also a wider gap between<br />

SiHy dailies versus hydrogel dailies.<br />

To me cost is never my first consideration. In fact I rarely even discuss the<br />

cost with patients. Of course it does on occasion arise. I have also discussed<br />

this at length in my columns over the years. The way I handle the cost issue is<br />

simply to state that if we provide a bulk supply of dailies and compare that to<br />

the annual cost of two-weekly or monthly reusable lenses, PLUS the annual<br />

solution cost, then we are not talking about budget busting differences.<br />

If you add in the increased likelihood of the need for unscheduled visits,<br />

ophthalmological referral or expensive eye drops with reusable lenses then<br />

we are looking at break-even or even dailies winning the battle. As Efron has<br />

also showed dailies break even at five days of use compared to seven day use<br />

of reusable lenses. As I’ve said many times I simply tell my patients that dailies<br />

will cost them around the cost of a cappuccino per day. Many spend more than<br />

that on coffee, booze, cigarettes and beauty products so one needs to provide<br />

a relative perspective. For many the convenience of dailies outweighs any cost<br />

differential.<br />

I won’t get into the Internet debate here as that affects both dailies and reusable<br />

lenses in a similar fashion.<br />

All Things Being Equal<br />

If someone wearing say a –3.00 Acuvue/Proclear/Focus et al daily was<br />

asymptomatic, with no sign of physiological compromise and all looked good, I<br />

would rather remain in such lenses than refit a SiHy monthly. To me going from<br />

dailies to reusable is a retrograde step!<br />

I’ve spent most of the past 20 years refitting reusable lens wearers into<br />

dailies with fantastic results. I very rarely see complications. Pretty much the<br />

only issue that occasionally arises is that of reduced end-of-day comfort or<br />

tired, heavy-feeling, dry eyes. These days we solve most of those problems<br />

refitting people into the latest generation SiHy dailies like Dailies Total 1 or the<br />

fantastic new Acuvue Oasys 1 Day (AO1D).<br />

AO1D is surpassing pretty much every other lens I’ve ever prescribed in terms<br />

of comfort, vision and all day comfort.<br />

I’ll be sharing some of these cases at the Acuvue Oasys 1 Day launches that<br />

will have just been completed by the time you read this.<br />

I hope this clarifies some of the issues and considerations that this email<br />

query spurned.<br />

I always appreciate feedback from readers and am happy to consider such<br />

questions.<br />

I asked the writer of the query if my much shorter email response satisfied<br />

her query. She responded as follows;<br />

“That does!<br />

It’s just that the siHy daily is so much more expensive than a regular daily<br />

that I am often asked that question.<br />

So basically if a patient is asymptomatic any daily is better even if it’s<br />

hydrogel! As a general rule!<br />

Thanks a million.”<br />

Like I said it is hard to oversimplify things but essentially yes, a quality<br />

hydrogel daily with sufficient Dk in an asymptomatic and physiologically<br />

uncompromised patient would be my pick over a reusable lens of any material,<br />

SiHy or hydrogel. ▀<br />

* Disclosure of interest: Alan Saks was not sponsored by J&J to review Acuvue Oasys 1-Day, but was<br />

engaged by J&J to report on his findings at a series of launch meetings in Australasia in May<br />

Rendezvous Hotel Perth Scarborough: the venue for this year’s WAVE<br />

Registrations are now open for the <strong>2016</strong><br />

Western Australian Vision Education (WAVE)<br />

Conference on the 13-14 August in Perth. The<br />

conference venue is the stunning Rendezvous Hotel<br />

overlooking the white sands of Scarborough Beach.<br />

Darrell Baker, Optometry WA president, says this<br />

year’s programme will continue to deliver the high<br />

standards of clinical and professional education<br />

WAVE has become renowned for. “It will again<br />

include a group of talented presenters leading the<br />

way in new topics and ground-breaking research<br />

discoveries. We look forward to seeing you in our<br />

wonderful state, Western Australia, and to you<br />

enjoying the WAVE experience.”<br />

Programme highlights this year include the<br />

Saturday Clinical Workshops; the short, sharp and<br />

detailed, diverse Lecture Series; the CR Surfacing<br />

Saturday Evening Sundowner soiree and the trade<br />

exhibition in the hotel’s Grand Ballroom.<br />

Speakers include Margaret Lam, founder of<br />

Sydney-based theeyecarecompany, who’s wellknown<br />

for her passionate interest in all things<br />

contact lenses; Dr Lasitha Jayasinghe, a consultant<br />

ophthalmologist and former Research and<br />

Clinical Fellow in cornea, external eye diseases<br />

and refractive surgery with the Singapore Eye<br />

Research Institute and Singapore National Eye<br />

Centre; Liz Jackson, a fellow of the Australian<br />

College of Behavioural Optometry; ophthalmic<br />

medicines prescriber Stephen Leslie on some of<br />

the more complex areas of optometry including<br />

rehabilitative optometric care of acquired brain<br />

injury; and a host of others.<br />

The venue, the Rendezvous Hotel Perth<br />

Scarborough, is just a 30-minute drive from Perth<br />

Airport and only 15 minutes from Perth’s CBD<br />

For more and for registration details see WAVE’s<br />

ad on p15. ▀<br />

School of Optometry graduation celebration<br />

The class of 2015 at the University of<br />

Auckland’s School of Optometry and Vision<br />

Science officially celebrated their graduation<br />

in May with a breakfast for the Bachelor of<br />

Optometry students, before joining the main<br />

graduation ceremony.<br />

Other notable graduates included Associate<br />

Professor Bruce Hadden, who received an MD by<br />

research (see full story p17) and Drs Carol Greene<br />

and Elissa McDonald for completing their PhDs. ▀<br />

PhD graduates Drs Carol Greene and Elissa McDonald<br />

Graduation day for the class of 2015<br />

18 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong>

Around and about at ARVO<br />

NZOSS update<br />


I<br />

was excited to be part of a group of 19<br />

researchers from the New Zealand National<br />

Eye Centre who travelled to the US for the<br />

annual meeting of the Association for Research<br />

in Vision and Ophthalmology (ARVO) at the start<br />

of May.<br />

ARVO, based in the US, is the largest<br />

association in the world for eye and vision<br />

research and their annual meeting is the<br />

place where top researchers gather to present<br />

and discuss the latest treatments, cures, and<br />

preventative measures, years before they<br />

become available. This year’s meeting, held in<br />

the Washington State Convention Centre in<br />

Seattle from 1 to 5 May, attracted approximately<br />

11,000 attendees from about 75 countries.<br />

About 45% of the attendees were from outside<br />

the States.<br />

I’d been invited to give a talk at the Aqueous<br />

humour dynamics session, one of the first of the<br />

five days. With an audience of approximately<br />

100 people it was a bit nerve wrecking at first,<br />

but I felt calm as the session coordinators<br />

introduced my topic. I was asked some<br />

reasonable questions, and the crowd at the<br />

session were generally very friendly.<br />

Other University of Auckland presenters<br />

included Professors Colin Green and Paul<br />

Donaldson, Drs Julie Lim and Hannah Kersten<br />

and Peter Qiu.<br />

Professor Green gave a very interesting talk<br />

at the Cell biology of gap junctions in the<br />

eye mini-symposium about Connexin 43 in<br />

corneal and retinal injury and disease. Professor<br />

Donaldson, Dr Lim and Mr Qiu presented their<br />

research in the Lens physiology and homeostasis<br />

session, and Dr Kersten presented in the Ocular<br />

surface neovascularization, Innervation, and<br />

Immunology session. There were on average 70<br />

paper and poster sessions and symposiums on<br />

any one day, with something exciting bound to<br />

be happening at any given time. This meant I<br />

had to make some really difficult decisions at<br />

times about which sessions to attend.<br />

The good part about speaking so early in the<br />

conference programme was feeling free to relax<br />

and enjoy the rest of the line-up. A highlight<br />

of ARVO is the multitude of guests who chose<br />

to present their work in one of the highly<br />

interactive poster sessions. There is also an “all<br />

poster” session every day to give the audience<br />

another chance to see the posters and talk to the<br />

presenters. These sessions are also well-known<br />

for their high attendance rates due to rules<br />

enforced by conference organisers. If you did not<br />

stand by your poster at the designated time, you<br />

would be banned from submitting an abstract<br />

for ARVO the next year! Poster presenters<br />

typically have between 20 and 30 visitors during<br />

a two-hour poster session, giving them plenty of<br />

chances to discuss their research and network.<br />

One highlight of the scientific programme was<br />

the release of the five-year CATT (comparison of<br />

age-related macular degeneration treatments<br />

The Space Needle observation tower<br />

trial) results, which found increasingly larger<br />

areas of geographic atrophy in patients treated<br />

for two years with ranibizumab or bevacizumab.<br />

The paper’s title is Size and Growth of<br />

Geographic Atrophy During 5 Years of Follow<br />

Up in the Comparison of Age-related Macular<br />

Degeneration Treatments Trials (CATT).<br />

Professor Shigeru Kinoshita, a pioneer in<br />

corneal wound healing and ocular surface<br />

reconstruction, received the Friedenwald Award<br />

from ARVO and gave an inspiring lecture entitled<br />

Medical Science and Future Realities in Corneal<br />

Regenerative Medicine. In this lecture, he<br />

described the safety issues they had to solve in<br />

order to translate cultured corneal endothelial<br />

cells for the treatment of corneal endothelial<br />

diseases into the clinic, which entered clinical<br />

trials in 2013 and is already showing promising<br />

results.<br />

Professor May Griffith gave an update on the<br />

development of a recombinant collagen scaffold<br />

for corneal repair. The originally non-suturable<br />

scaffold has now been reinforced with MPC<br />

for mechanical strength and suturability, and<br />

has been implanted in 10 high-risk patients in<br />

Ukraine with painful ulcerated corneal surfaces.<br />

Dr Jie Zhang, Professor Colin Green and Salim Ismail on a ferry<br />

to Bainbridge Island<br />

I look forward to hearing about the results<br />

in the coming years.<br />

And, of course, <strong>2016</strong> is the year of CRISPR<br />

– Cas9: a gene editing tool to cure diseases.<br />

Gene therapy for eye diseases was a major<br />

focus of the meeting, with one whole day<br />

education course, one symposium, one<br />

special lecture, and numerous posters<br />

dedicated to the topic.<br />

The sight-threatening consequences of<br />

recent viruses such as Ebola, Zika and West<br />

Nile also received the spotlight. A special<br />

session was dedicated to these emerging<br />

systemic infectious diseases, which<br />

reminded the ophthalmology community<br />

of the importance of contributing to an<br />

understanding of disease mechanism<br />

and treatment, and an urgent need for<br />

improved ophthalmic screening and care.<br />

With 12 to 15 concurrent sessions at any<br />

one time, we were all too busy to meet<br />

up during the event. Luckily we managed<br />

to have dinner at the Cheesecake Factory<br />

restaurant and enjoyed it very much!<br />

See you next year at ARVO in Baltimore! ▀<br />

* Jie Zhang is a research fellow in the Department of<br />

Ophthalmology at the University of Auckland. Zhang<br />

is using her biomedical science background to devise<br />

treatments for ophthalmic conditions and is currently<br />

focusing on the synthesis and testing of a novel<br />

collagen based scaffold for corneal transplantation.<br />


With the second half of semester one in full<br />

swing, it’s a struggle to comprehend where<br />

the past three months have gone! The<br />

younger years have settled in well within the school,<br />

whereas the Part 5’s are becoming more unsettled with<br />

the prospect of being let loose on the real world.<br />

Taking a look back, we kicked off this year with a<br />

week of orientation, initiation and degustation in<br />

the form of our annual New Zealand Optometry<br />

Student Society (NZOSS) BBQ. The great weather was<br />

accompanied by a massive turn out and the existing<br />

student body was able to warmly welcome the freshfaced<br />

Part 2’s. Time was spent reminiscing over our<br />

summer holidays and discussing the week that had<br />

just been. For the Part 5’s, this meant deconstructing<br />

our first taste of back-to-back patients—there’s<br />

nothing quite like a couple sausages to combat the<br />

‘first week of school’ blues.<br />

Round the Bays happened to be scheduled just<br />

two days after the BBQ, proving that a few cheeky<br />

sausages do not constitute an appropriate ‘carbo-load’.<br />

Nevertheless, we carried on in full force eager to pound<br />

the pavement. This year we also had the opportunity<br />

to work with the Fred Hollows Foundation and run for<br />

a great cause, restoring sight to the needlessly blind. It<br />

was a privilege meeting the team driving this fantastic<br />

charity. After the run we were treated to a big feed by<br />

Team Fred, bringing the tally to two BBQs in the space<br />

of a week. We were living the dream!<br />

The next few weeks carried on with our usual student<br />

shenanigans, the annual pub crawl providing a much<br />

needed release of steam following a hectic period of<br />

assessments for all. We finished off term one with our<br />

annual NZOSS Camp. The weekend away was a great<br />

way to usher in the mid-semester break (for those lucky<br />

enough to have one) and was filled with what I can only<br />

call some quality team-building exercises!<br />

<strong>2016</strong> has been a very successful year thus far,<br />

made possible through the hard work of the NZOSS<br />

committee. Of course, the events wouldn’t be what<br />

they were without the co-operation and collaboration<br />

of all the students involved. However, we’ve got plenty<br />

more work to do, with seminars and educational<br />

evenings in the pipeline. Of course, we will slip in some<br />

time for some much needed social soirees, the annual<br />

Eye Ball being the most anticipated event to come.<br />

Lastly, on behalf of the School of Optometry, I would<br />

like to thank all the sponsors for their continuing work<br />

with NZOSS. Not only does it provide us exposure<br />

to the optometry profession, but it also helps in the<br />

development of us as future clinicians.<br />

For those who are interested in collaborating with<br />

NZOSS, please do not hesitate to contact us as we<br />

are always looking for ways to further develop our<br />

connections with the eye care industry. Our email<br />

address is nzoss.uoa@gmail.com. ▀<br />

For more personalised eye care<br />

talk to Dr Hussain Patel<br />

Consultant Ophthalmologist<br />



Glaucoma Specialist / Refractive Cataract Surgery<br />

General Ophthalmology / Acute & Emergency Eye Care<br />

Available throughout Auckland<br />

and also in Hamilton<br />

Phone 09 486 4372 or Fax 09 486 3936<br />

info@eyesurgeryassociates.co.nz or<br />

Dr Patel at: patel@glaucoma.co.nz<br />

www.eyesurgeryassociates.co.nz<br />

Eye Surgery Associates are a Southern Cross Health Society Affiliated Provider<br />

Dr Jie Zhang, Peter Qiu and Professor Paul Donaldson<br />

<strong>Jun</strong>e <strong>2016</strong><br />



We need a gifted Captain<br />

To see us safe and sound<br />

Our crew is close to mutiny<br />

And stormy seas abound!<br />

Well ... not quite! But we do need to commission a store manager<br />

with optical experience to join our jolly crew at Specsavers,<br />

Pukekohe, Auckland, NZ.<br />

* Management experience Please apply in writing to:<br />

preferred<br />

Carleton Buckley<br />

* Uniform provided seebea@gmail.com<br />

* Naval experience not PO Box 127, Pukekohe,<br />

essential! Auckland, 2120<br />



AcuityKit has a comprehensive range of digital eyecharts for eyecare<br />

professionals. Ideal for low vision and domiciliary work.<br />

Visit our website www.acuitykit.com or email john@acuitykit.com<br />

With growth continuing, our store teams are<br />

currently seeking optometrists to fill permanent<br />

roles in the following NZ practice locations:<br />



North Island:<br />

• Auckland CBD<br />

• Botany<br />

• Kerikeri<br />

• Masterton<br />

• Mt Maunganui<br />

• Palmerston North<br />

• Paraparaumu<br />

• Rotorua<br />

• St Lukes<br />

• Taupo<br />

• Tauranga<br />

• Te Rapa<br />

• Wanganui<br />

• Wellington<br />

CBD South<br />

• Whangaparaoa<br />

South Island:<br />

• Dunedin • Invercargill • Shirley<br />

We are currently also seeking experienced<br />

dispensers for a variety of our New Zealand stores.<br />

Alternatively, if you’re interested in a move to<br />

Australia - either short or longer term, talk to us<br />

for the lowdown on possible locations in all states.<br />

To find out more and to explore the Terms and Conditions associated<br />

with this industry-wide offer, contact Carly Parkinson on 0800 717 350<br />

or carly.parkinson@specsavers.com – or visit spectrum-blog.com<br />


Here's a chance to work in a great optometry practice in<br />

Newmarket. We are looking for an amazing, passionate, optical<br />

assistant for a full-time role with a potential career path. You need<br />

to be efficient, totally customer focussed, well presented, able to<br />

multi-task and absolutely love beautiful eyewear. If you reckon<br />

you've got what it takes to work in our busy practice please email<br />

your CV to jeremy@gateseyewear.co.nz<br />


Call Bharat Raniga, locum optometrist, on<br />

021 424 253 or email: bharatranlga@yahoo.com<br />


<strong>2016</strong>, ANY OPTOMETRIST REFERRALS<br />





Tony Maddocks of Advanced Shopfitters is taking a well-earned<br />

break, travelling around Britain and Europe for the next 12<br />

months. NZ Optics wishes him and his wife Lynette, happy and<br />

safe travels and thanks them for their continued support of the<br />

magazine for more than 20 years.<br />

Whether you are looking for new staff, to sell your practice or buy<br />

some equipment, NZ Optics classified page connects you.<br />

For all your advertising needs email<br />

Lesley@nzoptics.co.nz or<br />

(for classifieds only) do it online at<br />

www.nzoptics.co.nz<br />



We are looking for a dispensing optician/optical assistant to<br />

join our independent, high-end optometry practice in Takapuna,<br />

by the beach. The position is for 50-60 hours per fortnight –<br />

including alternate Saturdays and Mondays.<br />

The successful applicant will:<br />

- Be a qualified Dispensing Optician or Optical Assistant with<br />

dispensing experience.<br />

- Display exceptional customer service and sales skills.<br />

- Have a passion for fashion eyewear and leading edge lens<br />

technology.<br />

- Have some social media skills – e.g. Facebook, online customer<br />

communications.<br />

- Have flexibility to provide leave cover for our full-time<br />

Dispensing Optician.<br />

- Be a good team player.<br />

If this sounds like you, please email your CV to<br />

david@haydons.co.nz<br />

C<br />

M<br />

Y<br />

CM<br />

MY<br />

CY<br />

MY<br />

K<br />

Thinking of selling your practice - we have buyers<br />

Considering buying - we’ll give you all the options<br />

OpticsNZ specialises in optometry practice sales,<br />

we've helped dozens of Optometrists buy and sell their practices<br />

For more information contact Stuart Allan on: 03 546 6996<br />

20 NEW ZEALAND OPTICS <strong>Jun</strong>e <strong>2016</strong><br />

027 436 9091 stu@opticsnz.co.nz www.opticsnz.co.nz<br />

<strong>Jun</strong>e Classifieds FINAL<br />

• Locum Service<br />

• Recruitment Services<br />

• Practice Brokering<br />

• Business Consultants<br />



Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!