Jun 2016

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY 

PO BOX 106 954, AUCKLAND CITY 1143 

Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz 

JUNE 2016 

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©2016 Abbott Medical Optics Inc. www.AbbottMedicalOptics.com PP2016CT0415

IT’S TIME TO PLAY... 

OFFER 

EXTENDED 

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OF JUNE! 

$..‘000’S ON OFFER FOR EVERY REFERRAL 

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With a market shortage of optometrists in both Australia and New Zealand, alongside a goal 

of further growth from Specsavers franchise partners in 2016, we’re taking a new 

approach to boosting our optometry team – and everyone can benefit. 

Until the end of June, every optometrist you refer to our recruitment 

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

- will earn a ‘Refer a Friend’ payment. Depending on the location 

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

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

entitled to claim your referral payment… 

To find out more and to explore the Terms and Conditions associated with this 

industry-wide offer, contact Carly Parkinson on 0800 717 350 or 

carly.parkinson@specsavers.com – or visit spectrum-blog.com. 

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2 NEW ZEALAND OPTICS June 2016

From frustrated 

ophthalmologist to entrepreneur 

A month 

of firsts 

After becoming increasingly exasperated with the inefficient way the system dealt with 

cataract surgery referrals, Dr James McKelvie decided to do something about it. 

BY JAI BREITNAUER 

Around 30,000 people have cataract surgery 

in New Zealand each year, says Dr James 

McKelvie, a corneal fellow at the University 

of Auckland and Auckland District Health Board. 

“It’s the most frequently performed surgical 

procedure in New Zealand by far, and the public 

health system in New Zealand is likely to struggle 

with the increasing demand for cataract surgery in 

the near future.” 

The way the system works right now, and has 

done for some time, is that a GP or community 

optometrist will identify a possible need for surgery, 

write a referral – often by hand – and post it. The 

patient has to wait for the letter to be assessed by 

the administration staff and triaged before they can 

be booked into an appointment with a specialist to 

find out if they are eligible for surgery. The patient is 

then placed on the surgical waiting list, and then it 

may take up to another four months until they have 

their surgery. 

“From a patient perspective the current system, 

with the long waiting time and uncertainty around 

surgery, is not ideal,” says Dr McKelvie. “Cataracts 

are normally identified at the time of an event; like 

failing an eye sight test for a drivers licence. This 

means the situation is both urgent and distressing 

for the patient.” 

On top of that, DHBs are missing out on the 

opportunity to collect vital data that could help 

identify the burden of cataract in the community, he 

says. This data would enable the health community 

to plan ahead and ensure surgical intervention 

rates and access to surgery between DHBs, ethnic 

subgroups and all geographic locations remains 

consistent across New Zealand. 

To tackle the problem, Dr McKelvie began 

designing an electronic, real-time referral system in 

his spare time that could reduce wait times and give 

patients immediate information, as well as record 

data in a uniform and useful way. 

“It’s a web-based app that a GP or optometrist can 

use on a computer, phone or tablet,” he explains. 

“While they’re still with the patient, they can use the 

app to send a referral to the hospital.” 

This referral will not only reach the relevant team 

in the hospital quicker, it will include significantly 

more, relevant, clinical data that can be used at the 

pre-surgical appointment. 

The app also processes the application instantly 

and assesses whether the patient meets the 

criteria for surgery, says Dr McKelvie. “This means 

that within a few minutes the patient can leave 

their GP’s or optometrist’s office either with a 

plan for community-based care or a pre-surgery 

appointment with an ophthalmologist.” (Fig. 1) 

It also means the DHB using the system can 

capture useful information about both the patients 

referred and those in community care that are subthreshold, 

to allow better predictions to be made 

about the volume of people that are likely to require 

surgery in the near future. 

Dr McKelvie’s app doesn’t stop there, however. As 

well as being a system for electronic referral, the 

app can complete a risk assessment and a real-time 

audit of cataract surgery to help the surgeons. 

“Phase two of the project will seek to digitise the 

information we collect in a pre-surgery appointment 

and provide a risk analysis,” he explains. 

Currently, a clinical exam before surgery requires 

a variety of different tests and measurements to 

be taken, typically generating 20 to 30 pages of 

hand-written notes, forms and calculations for each 

operation. 

“Ophthalmologists are notorious for their 

excellent attention to detail and careful assessment 

and documentation of a surgical plan” says Dr 

McKelvie. “This close attention to detail is partly 

why the vast majority of patients achieve excellent 

outcomes following cataract surgery. However, there 

is no doubt this system can be improved upon using 

the benefits of cloud-based computing to improve 

efficiency and add another layer of error checking.” 

Dr McKelvie’s system will introduce a paperless, 

digitised trail of standardised information relating 

to each patient, including a comprehensive, concise, 

one-page summary of all relevant information 

required in the operating theatre. As part of this 

summary each patient will have an evidence-based 

Dr James McKelvie is working on 

a real-time referral system 

risk assessment that 

uses a number of 

variables to predict the 

probability of a major 

complication during 

surgery. High risk cases 

will be highlighted as 

less suitable for junior 

trainee surgeons to 

reduce the risk of 

complications and 

improve outcomes for 

patients. Other features 

include a customised 

consent form, electronic operation note and several 

additional features that will improve efficiency and 

patient safety in the operating theatre. 

“The third stage of the project is a real-time 

audit of surgical results,” says Dr McKelvie. “At the 

moment, audits are time consuming and very labour 

intensive, so they’re typically performed sparingly 

on selected cohorts of patients. This system will 

allow all patient data to become part of an audit, 

effortlessly conducted in real time.” 

With an up-to-date, confidential and secure audit 

of personal surgical data at their fingertips, on 

their phone or computer, surgeons will be able to 

access vital feedback about their surgical outcomes 

and have the ability to compare their results with 

those of an (anonymised) pool of their peers. This 

will provide information about different surgical 

techniques, complications and visual outcomes and 

can provide customised data that will be of interest 

to surgeons, such as personalised A-constants, 

surgically-induced astigmatism and more. “This 

information may be used to refine surgical 

techniques, calculations and further improve visual 

outcomes for patients,” says Dr McKelvie. 

Since presenting his ideas at the Health 

Informatics New Zealand Conference in Christchurch 

in October, where he won the Clinician’s Challenge: 

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

CURRENT SYSTEM 

Community optom 

identifies a need for 

referal 

A hand written referal is posted 

5-10 DAYS 

Letters are sorted assessed and triaged 

10-14 DAYS 

Patient receives a response 

3-4 WEEKS 

New Ideas category, Dr McKelvie has been 

congratulated by Health Minister Jonathan Coleman 

and received a number of expressions of interest 

from parties across New Zealand. 

He is currently working on perfecting the 

prototype, with the Waikato DHB lined up to trial 

the system later this year. Auckland DHB have also 

expressed interest in trialling the system in the 

near future. 

“I’ve had some fantastic feedback. The 

possibilities for this system across health in 

general are endless,” says Dr McKelvie. 

“I didn’t set out to be a businessman or an 

entrepreneur, and I’m no IT expert, but I’m 

interested in new ideas and wanted to see the 

best outcome for patients and ophthalmologists. 

Once people heard about the project it took on a 

life of its own.” 

Dr McKelvie admits there are still challenges 

ahead, but says it is exciting to see the potential of 

a system like this. “The ophthalmologists that have 

seen what this can do for them are very enthusiastic 

to start using it as soon as possible. Naturally 

change is often difficult, but the aim of this system 

is to make cataract surgery better, faster and 

safer for everyone, while making better use of our 

resources to address the increasing demand for 

cataract surgery in the future.” 

It’s fair to say this is a critical time in the 

healthcare industry, with medicine becoming 

increasingly more digitised, says Dr McKelvie, 

adding if he hadn’t come up with the idea, nodoubt 

someone else would have. 

“There are not enough doctors or dollars to 

address the critical mass of patients we are heading 

toward, our only choice is to get smarter about 

the way we do things. Cataract surgery is the most 

common surgical procedure in New Zealand – if 

we can make the change for cataract surgery, 

chances are we could apply this to other areas of 

ophthalmology and surgery also.” ▀ 

 

 

 

APPOINTMENT REQUEST 

Date: 18-May 2016 

Dear Joe Brown 

Ulpa eum int vendio to dolla que praeptumquasDandi 

qui officiusam, con porerion prorem faceraernat option 

nos aut vellecto temquas pellestias aut et vendit quae. 

Ehenem et, sinulla boremped exerias velest, quuntint, 

temporeium re accum sum quam, tem apis simin rest 

labo. Ullaut optate ex eum arum dolorem. Itassi andi quo 

totae sed ma none qui odi blab. 

Regards 

Dr Lesley Springall 

EDITORIAL 

Welcome to your June issue of 

NZ Optics – my first full issue at the 

helm. Thus far, Lesley has very kindly 

steered me through the early stages of taking 

on the editor’s role, and I’m excited to have 

now been set free (relatively speaking!) on this 

wonderful title. 

This issue contains several other firsts, such 

as the CentraSight surgery performed on an 

MD patient in Tauranga, the first of its kind in 

the Southern Hemisphere (p4) and news about 

New Zealand’s upcoming hosting of the APAO 

conference – the first time an event of this size 

has made it to Aotearoa (p4). 

Another first in the events calendar was the 

Ocular Therapeutics one-day conference, which 

we cover in detail inside (p8-9). We talk to Dr 

James McKelvie about the ground breaking, 

real-time referral and audit software he will 

be trialling later this year (this page), and we 

celebrate Associate Professor Dr Dr Bruce 

Hadden and the Optometry School class of 

2015, who graduated on 11 May (p17 and p19). 

I hope you enjoy the magazine, and whether 

you want to congratulate us or berate us, rest 

assured our virtual doors are always open. We’d 

love to hear your feedback and suggestions 

via email, editor@nzoptics.co.nz – and who 

knows, you might even find your kind words or 

constructive criticism in print! ▀ 

Jai Breitnauer, editor, NZ Optics 

NEW CLOUD- BASED SYSTEM 

Community optom 

identifies a need for 

referal 

They complete an online referal while 

patient is present 

2 MINUTES 

They receive an instant response 

and pre-surgery appointment if 

necessary 

30 SECONDS 

 

 

APPOINTMENT REQUEST 

June 2016 

NEW ZEALAND OPTICS 

3

News 

in brief 

EYE TESTS FOR DRIVER LICENCES UNDER REVIEW 

The Ministry of Transport is considering allowing drivers to renew 

their driver licences online without the need for an eye test. People 

will still have to get their eyes tested when they first get a licence 

and after age 75, but only make a declaration about the state 

of their eyesight when renewing their licence online. The Driver 

Licensing system is under review as part of the Government’s 

commitment to achieve a more efficient transport regulatory 

system. A discussion paper was released on 19 April 2016 and 

submissions are due to close on 2 June. 

AVENOVA PUBLISHES CLINICAL DATA 

NovaBay published clinical data at the ARVO meeting in Seattle 

demonstrating its lid and lash hygiene product, Avenova, reduced 

the bacterial load on the ocular surface by more than 90% in 20 

minutes without affecting the diversity of bacteria remaining. This 

made Avenova the only commercial clinical product validated in 

a multicentre study to substantially reduce the bacteria that can 

cause blepharitis, said Glenn Moro, NovaBay’s vice president, sales 

and marketing. 

ARVO NEWS 

In other news from ARVO 2016, results from a series of pre-clinical 

studies provided proof-of-principle that gene targeting using 

CRISPR-Cas9 genome-editing technology can prevent or treat 

glaucoma associated with mutations in the myocilin (MYOC) gene. 

The research was led by Professor Val Sheffield from University of 

Iowa’s Carver College of Medicine. 

Professor Douglas Jabs, chair of the Department of Ophthalmology 

and Professor of Medicine at the Mount Sinai School of Medicine 

in New York City, said modern combination antiretroviral therapy 

(cART) has transformed the AIDS epidemic and the management 

of cytomegalovirus (CMV) retinitis. Information presented by 

Professor Jabs at ARVO demonstrated interactions between CMV 

and HIV and the importance of the immune response in controlling 

CMV disease. For more on ARVO, see page 19. 

RACS SEEKS TO ELIMINATE DISCRIMINATION 

In May, the Royal Australasian College of Surgeons (RACS) launched 

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

and 1,300 trainees in Australia and New Zealand to put an end to 

discrimination, bullying and sexual harassment in surgery. “We 

know these problems are common throughout the health sector, 

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

Professor David Watters OBE. 

The Let’s Operate With Respect campaign results from the 

recommendations of an Expert Advisory Group established last 

March in response to complaints. It aims to get surgeons talking 

about these problems and affect a culture change in the profession. 

ALCON’S DRY EYE ACADEMY 

Launched in 2013, Alcon’s Dry Eye Academy is led by 

ophthalmologists and optometrists with expertise in identifying 

and treating dry eye. The next New Zealand workshop will be held 

in Auckland on Sunday 31 July. 

LIQUID CLS SHARPEN IMAGES EVEN AT NIGHT 

New ‘artificial eye’ liquid contact lenses have been developed by 

Professor Hongrui Jiang from Wisconsin University in the US. The 

liquid contact lenses give perfect vision at any distance, even as 

conditions change and it gets darker, and automatically focus in 

less than a blink of an eye, using tiny, solar-powered computers, 

said Professor Jiang in a report on his discovery published in 

Proceedings of the National Academy of Sciences. 

SONY TOPS SAMSUNG’S PATENT 

Sony has filed a patent application for a smart contact lens that 

can take photos and record videos at the blink of an eye and play 

back the captured images for the user. The move comes hot on the 

heels of Samsung’s patent, which was filed in April, for a contact 

lens with a tiny camera that can be controlled by blinking. Sony’s 

lens, however, also includes a storage medium negating the need 

for an external storage device, while Samsung’s requires captured 

images to be sent to another device, such as a smartphone. 

ACADEMIC MOOD LIGHTING 

There is a science behind lighting that nightclubs and retailers 

understand and have invested in for many years, but now, thanks 

to new research, the “right” lighting for academic achievement may 

make its way into schools. Researchers in a South Korean study, 

published in Optics Express at the end of April, found that lighting 

can be optimised for various activities from test-taking to reading. 

They characterised lighting by measuring different, correlatedcolour 

temperatures from “warm” to “cool” using the Kelvin scale 

and found different types had a profound effect on our physical and 

mental condition. ▀ 

Telescopic treatment for AMD 

A 

new 

treatment programme for 

advanced macular degeneration 

(MD), called CentraSight, has finally 

made its way to New Zealand. The surgery, 

which involves inserting a tiny telescope 

into the eye of the patient in order to 

offer more visual acuity, had only been 

performed on a few hundred patients in 

the USA and UK until now. Consultant 

ophthalmologist Dr Mike O’Rourke of 

Tauranga Eye Specialists successfully 

performed the first operation of its kind in 

the Southern Hemisphere in February this 

year. The patient, 77-year-old Alisa Shaw 

from Whakatane, is recovering well. 

“The first study on this method was 

initiated in 2002 in the USA and the 

treatment earned FDA approval in 2008,” 

says Dr O’Rourke. “It was introduced in the 

UK three years ago. The surgery involves 

making a large incision around the limbus 

for 180 degrees to insert a 4.4mm glass 

telescope into the eye.” 

There is nothing special about the 

telescope itself, as optically it is a Galilean 

telescope, just miniaturised. It offers an 

almost 300% increase in the size of the 

image in one eye, making it easier for 

patients to see around the black spot that 

forms in their central vision. 

“Careful patient selection is key to 

the success of this surgery,” explains 

Dr O’Rourke. “The eyes will never work 

together again as the eye with the implant 

will be used for central vision, while the 

other eye will be relied upon for peripheral 

vision.” 

The pre-surgical assessment actually 

includes a simulation of the telescope to 

make sure patients can cope and the surgery 

will be beneficial. There are a number of 

other factors affecting patient selection 

also, says Dr O’Rourke. 

“Their bilateral MD needs to be stable, 

with no other health issues like diabetes or 

problems with the cornea. They need to be 

off any further macula treatment and be 

6/24 or worse in their best eye.” 

Then there’s the cost. The lens itself, handmade 

in Israel, costs $19,500 and then you 

need to account for the surgery and rehab 

An artist’s impression of the implant in the eye 

The telescopic implant is just 4.4mm 

costs. “It all adds up,” admits Dr O’Rourke, 

who expects to perform around four 

surgeries of this nature a year. “You won’t 

get much change from $30,000”. 

Another factor is there are only two New 

Zealand optometrists, Lynley Smith in 

Tauranga and Rodney Stedall in Hamilton, 

qualified to assess and recommend patients 

for surgery and to guide them through 

recovery, so ability to travel is important. A 

third optometrist may be travelling to the 

UK for training in the near future, adds Dr 

O’Rourke, but for patients like Alisa Shaw, 

whose sight had deteriorated to the point 

where she was unable to function on a daily 

basis, the CentraSight programme offers 

a new quality of life where patients had 

previously been told nothing could be done. ▀ 

APAO coming to Auckland 

Auckland’s new, but as yet unbuilt, 

international conference centre 

is booked as the venue for one 

of the largest, if not the largest, medical 

conferences New Zealand has ever held when 

New Zealand plays host to the Asia-Pacific 

Academy of Ophthalmology (APAO) annual 

Congress in March 2020. 

Professor Charles McGhee, head of the 

Department of Ophthalmology at the 

University of Auckland and newly-made 

President Elect for APAO, will take on the twoyear 

APAO president term in 2019 and thus 

will be the convenor of the 2020 Congress. 

“This is a really big deal for New Zealand. 

We expect about 3,500 to 4,000 people and, 

allowing for a large industry subscription, 

we expect we may get as many as 4,200. It 

will bring people and exhibitors together 

from all over Asia and the Pacific. It’s the 

biggest grouping of (ophthalmological) 

societies there is.” 

Professor McGhee says just because he 

was made president elect at this year’s 

APAO Congress in Taipei, didn’t mean New 

Zealand would automatically host the 2020 

conference as Congress’s can be held in 

neighbouring countries. But given Australia 

was host in 2011 (ably helped by Professor 

McGhee who was then APAO scientific chair) 

it fell to New Zealand for 2020. 

APAO’s four-day congress attracts several 

hundred highly-experienced speakers from 

all over world, he says. “We will also run 

a number of instructor courses so junior 

surgeons can upskill and more experienced 

surgeons can re-skill. 

“A major international conference allows 

you to network across many different 

platforms, exchange ideas from many 

different societies and economic groups. 

Different ethnicities have different diseases so 

what is state-of-the-art in Australia and New 

Zealand might be quite different to what is in 

China or India.” 

Though the event is about building 

relationships with peers overseas and 

education, Professor McGhee says he expects 

the exhibition side to be the biggest ever held 

in New Zealand as well, as it’s one of the few 

times the industry side of the profession can 

expose their products and ideas to more than 

4,000 ophthalmologists in one place. 

The 31 st APAO in Taipei in March this year 

was very well attended and very exciting, 

he says, with a good showing from the New 

Zealand ophthalmological side. Highlights 

included a memorandum of understanding 

between APAO and Sight for All, a non-profit 

Australian organisation, that enables the 

organisations to work together on the first 

APAO Gateway Project in Laos. 

The APAO Gateway Projects were conceived 

as a way for wealthier nations to help 

those in need. They encompass all the main 

charitable and non-profit groups throughout 

the Asia-Pacific region, and the relevant 

government health departments, to reduce 

avoidable blindness and visual impairment in 

Professor Charles McGhee 

Dr Mike O’Rouke has brought the 

CentraSight programme to NZ 

a region of need. 

APAO was founded in 1960 by Budapestborn, 

but Hawaiian-based ophthalmologist 

Dr William John Holmes, with the 

principal objective of fostering closer 

relationships among ophthalmologists and 

ophthalmological societies in the Asia- 

Pacific region in order to combat blindness. 

Other objectives are to encourage the free 

exchange of ophthalmic knowledge and the 

advancement of the standard of eye care. ▀ 

www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand 

For general enquiries, please email info@nzoptics.co.nz 

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

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

nzoptics.co.nz. 

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

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

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

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

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

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


New optometry collective 

launches in Australia 

Call to action 

for children 

George & Matilda Eyecare (G&M), a new 

optometry group headed by Luxottica’s 

former Asia-Pacific CEO Chris Beer, launched 

in Australia last month and is on the hunt for 

Australian optometry businesses to join the brand. 

According to the company’s website, G&M is 

an Australian-owned and operated optometry 

collective. “We offer leading optometrists a unique 

partnership model that’s unlike any other franchise 

or buying group in the optical industry.” 

The branding and advertising for G&M is being 

handled by Saatchi & Saatchi, which worked with 

Beer when he worked with OPSM on the successful 

Penny the Pirate children’s screening book and app 

campaign. 

In an announcement to the Australian marketing 

press, Beer commented: “George & Matilda is 

all about providing customers with stylish, fresh 

products in an approachable and familiar way. We 

want people to get more out of their optometry 

experience and Saatchi & Saatchi’s strategic and 

creative approach to this ambition will help us 

differentiate immediately.” 

Michael Rebelo, chairman and CEO of Saatchi 

& Saatchi Australia said it wasn’t often the 

company was given the chance to build a brand 

from a blank sheet of paper. “This has been a 

unique opportunity for our team to leverage 

our experience in this industry and apply it to a 

disruptive start-up business.” 

The name George & Matilda was chosen to reflect 

Australia and the vision of the brand with George 

representing the first high street in Australia and 

Matilda echoing one of the nation’s favourite songs. 

The new collective has already signed up the 

11 practices of Port Macquarie-based Hanks 

Optometrists and Peter Hewett Optometry in 

Mosman, Sydney. 

Beer did not return NZ Optics’ calls by press time. 

• Another new chain also launched in Australia 

last month, Better Eyecare. The new group is 60% 

owned by optometrist Paul Sheehan, now CEO of 

Better Eyecare, with the remaining 40% held by 

CFO Anthony Anderson and COO Michael Tanzer. 

Speaking to Insight magazine, Sheehan said 

Better Eyecare is an Australian-owned and 

operated company that has identified a prime 

opportunity in the Australian market to aggregate 

profitable practices into a new group that will 

compete with existing corporate groups. ▀ 

The Brien Holden Institute, a global nonprofit 

scientific research and education 

organisation, has teamed up with Vision 

for Life, an Essilor social impact initiative, to 

tackle the growing problem of childhood myopia. 

Announced in New York on 12 April, their new, 

joint campaign, Our Children’s Vision, aims to 

screen 50 million children worldwide by 2020. 

Recent research from the Brien Holden Institute 

indicates that by 2050, 4.76 billion people (half 

the current global population) will suffer from 

myopia, with the majority of them needing 

glasses. 

Our Children’s Vision aims to encourage 

countries to act now to tackle the increasing 

impact poor eyesight has on educational 

outcomes and social development. 

“[Children with uncorrected vision] can’t play 

outside safely, so they struggle to make friends. 

They can’t see the blackboard, so they struggle 

to learn. They are hindered in every aspect of 

their life and it doesn’t stop at childhood,” said 

Jayanth Bhuvaraghan, chairman of Vision For 

Our childern’s vision graphic 

Life and chief corporate mission officer at Essilor 

International. 

Yet many children, particularly those in some of 

the poorest communities, don’t have access to eye 

care. This issue has already been highlighted in 

New Zealand by Essilor, who has implemented its 

own Essilor Vision Foundation initiative, screening 

children in decile 1 and 2 schools (NZ Optics, May 

2016, p4). But the Our Children’s Vision campaign 

takes this concern to the next, global level of action. 

“We are potentially facing the biggest public 

health challenge of our generation,” said 

Professor Kovin Naidoo, CEO, Brien Holden Vision 

Institute and campaign director for Our Children’s 

Vision. “This trend can be slowed down through 

preventative or corrective care, but only if a child 

is reached while their eyes are still developing. An 

effective eye health programme in schools would 

have an unprecedented impact. Our Children’s 

Vision is a global campaign designed to make this 

impact a reality. We need to act now.” 

For more information, visit 

www.ourchildrensvision.org. ▀ 

Education Series 2016 

Seminars 

are FREE! 

NEXT SEMINAR 

Tuesday 16th August 

6.30pm - 8.45pm 

Theme: 

Diagnostics and 

Therapeutics in 

Everyday Practice 

Venue: 

Ellerslie Event Centre 

Racecourse, 80 Ascot Ave 

Ellerslie, Auckland 

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

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

You are invited to join us at our August Seminar and November Conference for the 2016 year. 

Optometry Conference 

Sunday 6th November 

8am - 5pm 

Waipuna Hotel & Conference Centre, 

58 Waipuna Road, Mt Wellington, Auckland 

PLUS 1/2 day workshops 

Saturday PM 5th November 

REGISTER ONLINE: 

www.eyeinstitute.co.nz/optometry 

Dispensing Optician Conference 

Sunday 6th November 

8am - 5pm 

Waipuna Hotel & Conference Centre, 

58 Waipuna Road, Mt Wellington, Auckland 

August Seminar generously 

sponsored by 

Registration: 

5.45pm - 6.30pm 

Light Meal & Beverages 

provided 

BOOK NOW! 

for your 2016 CPD Credits 

(including Therapeutics) 

Or register by contacting... 

Tracy Richmond 

Ph 09 522 2125 | Fax 09 522 5770 

conference@eyeinstitute.co.nz 



5

Eyeing the power of algae 

New Zealand’s ophthalmic 

community is being targeted for 

direct sales of a home-grown 

“super-antioxidant” product 

harvested from algae. 

Celebrating 

excellence 

BY LESLEY SPRINGALL 

Kiwi supplement company Supreme 

Biotechnologies’ move into the world of eye 

health was completely serendipitous. 

Founder and chief executive Tony Dowd was 

seeking further investment for the company’s 

AstaSupreme products, when one London-based 

potential investor, who’d been using the product 

for a couple of months, asked if astaxanthin was 

any good for eyes. 

Astaxanthin (pronounced asta-zan-thin), 

a carotenoid found in algae and responsible 

for the red colour in salmon and shellfish, is a 

powerful antioxidant and the key ingredient in 

AstaSupreme products. The investor was a City 

trader who spent long hours in front of a screen 

and normally went home with very sore eyes. 

But, since taking AstaSupreme, said he’d noticed 

a remarkable improvement in how his eyes felt at 

the end of a long day. 

The observation led to some serious research by 

Dowd, key to which was a 1994 study by Dr Mark 

Tso of the University of Illinois, who discovered 

(or confirmed, as many claim to have spotted the 

benefits of astaxanthin for eyes over the years) that 

astaxanthin can help halt the progression of and 

prevent macular degeneration as well as protect 

our eyes against photic injury, ischemic diseases 

and inflammatory diseases. 

Further research led to Supreme Biotechnologies 

developing AstaSupreme Advanced Eye Care, with 

astaxanthin and the AREDS2 (see box) verified 

carotenoids, lutein and zeaxanthin, plus other 

products known to be important to eye health, 

including zinc and saffron. 

The product has been available through 

pharmacists and online for nearly 18 months 

now and qualitative studies by the company, 

sales growth and repeat purchase data is proof of 

how good it is, claims Dowd, who says he’s had 

to reduce his lens prescription twice in the last 

three years since taking AstaSupreme products. 

Sales have been so good in New Zealand— 

where Supreme Biotechnologies rolls out all its 

products first before taking them to the world— 

AstaSupreme Advanced Eye Care is now the 

company’s second highest selling product. 

Given the positive feedback, Dowd is now keen to 

introduce the product to New Zealand’s ophthalmic 

community, so they can sell it direct to consumers, 

with a hefty margin for themselves, of course, he 

laughs. He admits some education is required, 

however, as most of the profession is familiar with 

AREDS2 formulations, but not so familiar with the 

benefits of astaxanthin or saffron (despite saffron 

being used for eye remedies for many years). 

Dowd has considered, and is still considering, 

developing a specific product just for eye health 

Oculo launches 

Dr Kate Taylor 

and her team 

at Oculo, based 

in Melbourne, 

have successfully 

gained approval 

from the National 

Health Information 

Technology Board 

for their cloudbased 

clinical 

communication 

software and will 

Dr Kate Taylor, head of Oculo 

be rolling it out in 

New Zealand from 

the start of June. 

“It’s a really exciting time for us,” said Dr Taylor, 

who began testing the platform in July 2015. “It’s 

wonderful to see a good idea flourishing.” 

In October, NZ Optics first reported on Oculo, 

whose software was born from work at the Centre 

for Eye Research Australia (CERA) and allows 

optometrists to identify an ophthalmologist that 

may meet their patient’s need, refer them using a 

digital system and securely exchange important 

clinical data. 

Tony Dowd in Supreme Biotechnologies’ algae growing facility 

professionals that contains more of the AREDS’ 

ingredients to help introduce the profession more 

slowly to the benefits of astaxanthin, despite his 

company’s own research showing not all AREDS’ 

ingredients are as important as perhaps they 

were once thought. For the moment, however, the 

company is sticking with the product it has and will 

take the educational path with the country’s eye 

health professionals, says Dowd. 

Astaxanthin is considered a “superantioxidant”—6,000 

times more powerful than 

vitamin C and 500 times more powerful than 

green tea, according to Supreme Biotechnologies’ 

website. Unlike vitamin C, which can be harmful 

at high doses by becoming pro-oxidant, damaging 

cells just like free radicals do, it also doesn’t appear 

to have any harmful side effects. 

But the key difference between astaxanthin and 

other antioxidants is that most are either water 

soluble or fat soluble, which restricts which parts 

of the body they reach. Astaxanthin is both, so it 

can reach outside and inside cells…it can penetrate 

the blood-brain and thus the blood-eye barrier, says 

Dowd. “It can sit across the membrane as it has 

polar and non-polar parts to it; and because it can 

AREDS2 

The Age-Related Eye Disease Study 2 (AREDS2) 

was a multi-centre, randomised trial designed 

to assess the effects of oral supplementation 

of macular xanthophylls (lutein and 

zeaxanthin) and/or long-chain omega-3 

fatty acids (docosahexaenoic acid) [DHA] and 

eicosapentaenoic acid [EPA] on the progression 

to advanced age-related macular degeneration 

(AMD). An additional goal of the study was to 

assess whether forms of the AREDS nutritional 

supplement with reduced zinc and/or no 

beta-carotene works as well as the original 

supplement in reducing the risk of progression 

to advanced AMD. Enrolment concluded in June 

2008 and participants were followed between 

five and six years. Source, and for more: 

www.areds2.org/ 

The Australian roll-out began in April and 

now numbers some 250 optometry practices 

and 150 ophthalmologists, and numbers are 

growing daily, said Dr Taylor. “We developed 

the system alongside the big corporates: Bupa 

Optical, Luxottica’s OPSM and Laubman and 

Pank, and Specsavers have all been involved 

in testing.” But the Oculo team are now keen 

to get as many independents on board as 

possible, and have set a “really achievable” 

monthly subscription price for the product of 

just US$99, she said. “This system needs to be 

accessible because the patient benefit comes 

from the connectedness of the network.” 

Dr Taylor noted that while there have been 

a number of digital advances in treatment 

programmes, an update in communication 

practises is well overdue. “Eye care 

professionals usually communicate by fax, 

handwritten letter and – even more worryingly 

– email and Facebook. The need for a safe, secure 

and confidential platform for collaboration was 

great.” 

The amount of time involved in handwritten 

communications can cause both optometrists 

and patients ongoing stress, she added. “It can 

get in, it can get to the free radicals that are sitting 

there—caused by ultraviolet light and pollution, 

and everything else—and cause the damage.” 

Further studies have shown the benefits of 

astaxanthin in slowing and even reducing cataract 

formation, plus there’s a multitude of studies 

showing astaxanthin’s benefits combating or 

mitigating diabetes, epilepsy, dementia, heart 

disease and even stroke. 

“That’s the best thing about the product,” says 

Dowd. “It not only gives you all the eye health 

benefits, it also gives you all the other benefits as 

well. There’s a huge market potential.” 

Dowd is in the process of collating a number 

of peer-reviewed studies into a dossier for eye 

health professionals, which he will be distributing 

shortly. He’s also talking to a couple of people 

about running a proper clinical study, involving 

a statistically significant number of patients, to 

clinically back up the company’s qualitative data. 

“This is a world with an aging population, where 

more and more people are spending more and 

more time on their screens. It’s a huge issue. And, 

yes, we’re in business to make money, but the stuff 

works; it really works.” 

SUPREME BIOTECHNOLOGIES 

Supreme Biotechnologies is a Nelsonbased, 

private company that specialises 

in the production of bioactive compounds 

derived from micro-algae, specifically natural 

astaxanthin. Developed in partnership with 

researchers at the Cawthorn Institute, the 

company’s algae-growing facility is a unique, 

fully-enclosed, indoor environment, providing 

the perfect nutrient and light conditions for 

the algae, and ensuring the algae is free from 

environmental contaminants. The process has 

the added benefit of consuming CO 2 

while 

releasing oxygen. 

The company was a finalist in the 2015 and 

2014 New Zealand Innovator Awards and has 

attracted significant investment from New 

Zealand’s angel investment community. 

Oculo Screen Shot 

take months to even receive an acknowledgement 

a referral has been received. Getting feedback 

regarding a referral within hours or days takes a 

great weight off optometrists’ minds, to know their 

duty of care is appropriately discharged and the 

patient is likely to come back to them.” ▀ 

Dr Ilva Rupenthal receives her Excellence Award from HRC’s 

Professor Kath McPherson 

In a glittering event at Auckland University 

on 4 May, Dr Ilva Rupenthal became one 

of the first researchers to receive a Health 

Research Council (HRC) Celebrating Research 

Excellence Award. 

Dr Rupenthal, a senior lecturer with the 

University’s Department of Ophthalmology 

and director of the Department’s Buchanan 

Ocular Therapeutics Unit (BOTU), was 

honoured as an emerging researcher who has 

made an outstanding contribution to health 

research. 

HRC chief executive, Professor Kath 

McPherson, presenting the award, said that 

since completing her PhD eight years ago, Dr 

Rupenthal has shown excellent progression in 

her research career. 

Dr Rupenthal received a HRC Emerging 

Researcher First Grant followed by the HRC’s 

prestigious $500,000 Sir Charles Hercus 

Fellowship, before being appointed inaugural 

director of the BOTU. 

“Jumping the hurdle from being a 

postdoctoral research fellow under another 

principle investigator to an independent 

researcher can be quite difficult especially 

with the limited funding opportunities 

available to emerging researchers,” said Dr 

Rupenthal. “These two HRC grants supported 

me immensely in overcoming this hurdle and 

becoming an independent research leader and 

internationally recognised expert in the area 

of ocular drug delivery.” 

The HRC also honoured New Zealand’s preeminent 

brain researcher, Professor Richard 

Faull, director of the Centre for Brain Research 

at the University of Auckland and co-director 

of the Brain Research New Zealand Centre for 

Research Excellence. 

Since being awarded his first HRC project 

grant 25 years ago, Professor Faull has gone 

on to lead a further three more HRC-funded 

projects and four HRC-funded programmes in 

the area of neurodegeneration in the human 

brain. He was also awarded the prestigious 

Liley Medal in 2005. 

The awards ceremony was the first of a series 

of events in partnership with New Zealand’s 

leading institutions, celebrating HRC’s 25th 

anniversary. 

HRC grants awarded 

In related news, Dr Jie Zhang and Dr 

Stuti Misra at the University of Auckland 

were awarded HRC grants recognising the 

importance of their projects to eye health. 

Dr Zhang received an HRC emerging 

researcher first grant, to carry out a study to 

determine the potential of adult stem cells 

in the transition zone for corneal endothelial 

transplants. Theoretically, using transition 

zone cells each future human donor cornea 

could provide grafts for several transplants, 

explained Dr Zhang. 

Dr Misra also received an HRC emerging 

researcher first grant for a project entitled 

Corneal nerve microstructural changes in 

diabetes. This study looks to monitor changes 

in the eye that occur in morbidly obese 

patients using weight-loss or bypass surgery to 

control their diabetes. ▀ 


NEW ZEALAND’s 

ONLY NATURAL ASTAXANTHIN 

AstaSupreme ® Advanced Eye Care, the first eye care formulation to combine the 

power of Astaxanthin with Lutein, Zeaxanthin and Saffron to create a powerful 

carotenoid complex to boost all aspects of eye health and protect the eye, 

whatever age you are. 

For eye health professionals who want to know more about AstaSupreme ® 

Advanced Eye Care please contact Supreme Biotechnologies on 0800 289-278 or 

email info@astasupreme.co.nz or refer to www.astasupreme.co.nz. 

For eye health professionals who would like to become a supplier, please contact 

Pharmabroker on 09 415 5050 or email ruth@pharrmabroker.co.nz 

June 2016 NEW ZEALAND OPTICS 

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

7

Ocular Therapetics Conference 

New Ocular Therapeutics Conference a success 

The inaugural Ocular Therapeutics Conference attracted nearly 350 delegates 


Department of Ophthalmology at the 

University of Auckland, opened the inaugural 

Ocular Therapeutics Conference on the 10 April in 

Auckland with gusto, announcing that with nearly 

350 attendees, it was already one of, if not the 

biggest, ocular event in New Zealand. 

Invited specialist speakers delivered rapid-fire 

lectures on a wide variety of topics designed 

to empower, educate and enhance the work 

of attending optometrists, ophthalmologists, 

therapeutic nurses, pharmacists and others. 

Organisers, Professor McGhee and Drs Trevor Gray 

and Ilva Rupenthal, director of the Buchanan Ocular 

Therapeutics Unit (BOTU), said with the success of 

this inaugural Ocular Therapeutics Conference it 

will now become a regular annual feature on the 

industry’s continuing education calendars. 

NZ Optics was there to record the highlights 

of the day. 

8 NEW ZEALAND OPTICS June 2016 

History and breaking down differences 

The first presentation was appropriately given by 

Dr Rupenthal. She provided an historical overview 

of medications and the eye, noting the first record 

of treating eyes with eye-drops dated back to 

Babylon, around 2250 BC. Acacia was used in 

Ancient Egypt to reduce eyelid inflammation, 

while Cleopatra used Atropa Belladonna (Deadly 

Nightshade) to make her pupils larger to enhance 

her beauty. 

Later Dr Rupenthal also discussed the difference 

between various drops given as gels, ointments, 

solutions and suspensions, as well as the 

importance of using them correctly. Suspensions 

must be shaken, she said, as the active particles 

sink to the bottom, while obstructing the nasal 

passage for five minutes after applying drops can 

result in a far better retention time. 

Professor McGhee discussed how topical 

eye-drops get into the eye, noting that when 

CLINICAL DESKTOP 

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Simply email your full name and occupation to info@nzoptics.co.nz, 

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

prescribing it’s essential clinicians focus on the ease 

of application and how quickly the drops start to 

work. An understanding of pharmacokinetics – the 

time and dosage relationship – is also essential as 

with some drops there is a point where too much 

leads to toxicity. With all, a lot is lost through tears 

and spillage, he said. 

Dr Gray talked about the role for oral Rx for 

Meibomian gland dysfunction and dry dye disease, 

noting a 2005 study highlighting the positive 

benefits of omega 3 fatty acids – a natural antiinflammatory 

– and the negative effects of omega 

6s in our diet. When it comes to treating dry eye 

beyond dietary considerations, however, Dr Gray 

highlighted a study on oral azithromycin, which 

showed it was far more effective than those treated 

with the more commonly used doxycycline, with 

side effects in just 4%. 

Dr Andrew Thompson closed the morning session 

with his talk, The Ingredients You Don’t Know About. 

A pharmacist turned ophthalmologist, Dr Thompson 

offered a unique perspective on what goes into an 

eye drop and why. He talked the audience through 

surfactants, buffers and preservatives and noted 

preservatives can cause ocular surface disease, 

especially when used over long periods of time such 

as in the case of glaucoma patients. 

Funding drugs, artificial tears and 

antibiotics 

Professor Colin Green kicked off the second session 

after morning tea, with his look at what it takes to 

get a drug approved by the US FDA. It costs about 

US$350 million to get a new medicine to market, so 

it is along and expensive, but well understood path, 

he said. Safety and toxicology take time and require 

at least one non-rodent species before human trials 

can be considered. For devices, the pathway is faster, 

while repurposing a drug often allows you to bypass 

certain stages, making development faster and 

cheaper. 

The funding of new medicines in New Zealand 

is a contentious issue so it was fascinating to hear 

from Sarah Fitt, PHARMAC’s operations director. 

PHARMAC’s aim is to get the best health outcomes 

for the maximum number of people within the 

amount of funding provided. Its focus is on creating 

competition to generate cost-savings as it needs 

to find $50m a year in savings just to manage the 

ever-increasing prescription volume. Fitt admitted 

there will never be enough money to fund all 

the medicines people want, but each application 

is considered on its merits. An ophthalmology 

sub-committee, PTAC, advises PHARMAC on eye 

medicines. 

Associate Professor Jennifer Craig discussed how 

to pick the best artificial tear supplements for 

individual patients. Dry eye is a complex condition 

and simply adding moisture is not the quick fix 

we once thought it might be, she said. Highly 

viscous supplements can be helpful with moisture 

retention, but blur vision, whereas improving diet 

to increase natural lipids can be more helpful in the 

treatment for those with evaporative dry eye. 

Dr Mark Saunders and Dr Penny McAllum then 

moved the talk to antibiotics, with Dr Saunders 

providing an overview of their action and use, and 

Dr McAllum focusing on how they should be used 

in two common eye conditions, conjunctivitis and 

blepharitis. 

Dr Saunders injected some humour into the day 

with the unusual case of a 17-year-old boy who was 

kicked in the face by a hedgehog. The case posed 

several complications, beyond the damage to the 

boy’s left eye, as hedgehogs are full of diseases. The 

boy’s mother was able to provide Dr Saunders with 

the (now deceased) hedgehog for testing and this 

allowed Dr Saunders to target the boy’s treatment 

so he could make a full recovery. 

Dr McCallum shared how the management 

of bacterial conjunctivitis is centred around 

hygiene, but a short course of antibiotics for more 

irritating infections is effective. The most common 

treatments are drops, such as Chlorafast or fusidic 

acid, with Brolene used sparingly due to potential 

toxicity issues and ciprofloxacin reserved for more 

serious infections. With posterior blepharitis, 

Dr McAllum noted that 40% of patients have 

Meibomian gland dysfunction. The appearance 

of ‘cylindrical dandruff’ could indicate a Demodex 

Kerensa McCamish and Germaine Joblin 

Essi Kokkinen, Priyanka Agarwal and Di Huang 

Catherine Wong, Bev and Jonathan Payne and Louise Wood 

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

OCULAR THERAPEUTICS CONFERENCE SPONSORS 

OptiMed NZ 

Ophthalmic Instrument Company 

Alcon 

Corneal Lens Corporation 

Designs for Vision 

Device Technologies 

Abby Long, Lari Dkhar and Ghada Zidan 

Kent Napier, Nawras Nabhani and Bharat Raniga 

Jonathan Albert, Deanne Jordan, Amy Young and Melanie Lipinski 

David Joe checks out OptiMed’s wares with Robert Nyenkamp and Craig 

Norman 

Alcon’s Deanna Graham and Caroline Perkinson talking to delegates 

Shelley Brannigan, Scott Dumbleton, Craig Holmes and Tony Cradwick 

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

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

mite infestation in the follicles, which can be 

treated with a tea tree oil product. 

Glaucoma drugs and the dangers of 

corticosteroids 

Dr Stephen Best kicked off the post-lunch slot with 

a personal overview of glaucoma drugs, saying he 

tended to recommend a prostaglandin analogue 

(the most commonly prescribed medication for 

glaucoma currently) at least initially, as they have 

few systemic side effects. Other drugs such as beta 

blockers, adrenergic agonists, carbonic anhydrase 

inhibitors have varying side effects and don’t tend to 

be as effective. 

Dr Best ended his presentation with a plea to the 

audience for more patients for a trial he’s involved 

in where a slow-release pellet of the prostaglandin 

analogue Bimatoprost is injected into the anterior 

chamber. If successful this will replace frequent eye 

drop application. Every patient is different and we 

need to have a number of options available in order 

to treat them all well, he said. 

Dr Hussain Patel continued the glaucoma theme 

with an overview of how best to systematically treat 

glaucoma. He preferred to set a target IOP, based 

on the glaucoma’s severity and the patient’s life 

expectancy. Important management considerations 

include patient education about diet and lifestyle, 

the different medications and their side effects, 

selective laser trabeculoplasty (SLT) and surgery. 

A flow chart approach works best for identifying 

the best treatment, though initially Dr Patel also 

said he favours a prostaglandin analogue, with 

beta blockers added or swapped in if the results 

aren’t as good as hoped. Early glaucoma patients 

need to be clinically assessed at least once every 12 

months; moderate glaucoma every six months; and 

advanced glaucoma every four months. 

Professor McGhee then presented an amusing 

overview of topical ophthalmic corticosteroids, 

beginning with a warning that, on the whole, 

corticosteroids are “the devil’s work” as they 

tended to be the go-to option for most. Yes, 

they are important and often sight-saving antiinflammatory 

drugs, he said, but they are also “a 

blunderbuss therapy” with significant side effects, 

including cataract, glaucoma and severe microbial 

infections. In summary, steroids should only be used 

when there’s a firm diagnosis and, never if any sort 

of infection is suspected. 

Dr Sue Ormonde, a former Corneal Fellow of 

Professor McGhee’s, continued the corticosteroid 

theme by looking at their use in practice. This is 

not easy in a 12-minute presentation, she said, as 

it takes years of experience to use steroids well 

– a concern backed up by several slides of eyes 

irrevocably damaged by poor steroid use. You have 

to be sure of your diagnosis and the specifics of 

that diagnosis, said Dr Ormonde. Correct use also 

depends on the specifics of the disease, how you 

are going to treat it and how it progresses. Once a 

diagnosis is made, you need to “hit hard” and, if the 

steroids don’t do what you want them to, stop, keep 

calm and reassess, she said. 

Steroid alternatives, myopia, more on 

glaucoma and the future 

Opening the final session, Dr Simon Dean’s 

presentation was a much needed look at the 

alternatives to corticosteroids and how to avoid 

their unwanted effects. 

In general steroids should not be used for a long 

time and should be avoided for things like allergy 

as patients can get too easily hooked on them as 

they work so well, he said. Alternatives include mast 

cell stabilisers, non-steroidal anti-inflammatory 

medications (NSAIDS), such as Voltaren, and 

cyclosporin, which reduces the activity of the 

immune system by interfering with the activity of 

T-cells (lymphocytes). 

Dr Rasha Altaie provided a fascinating review 

of studies on the effectiveness of dilute topical 

atropine in reducing the progression of childhood 

myopia. Atropine use is not new, she reminded the 

audience, with Atropa Belladonna used for myopia 

treatment since the 19th century. In summary, Dr 

Altaie said despite the fact we don’t fully know 

how it works, studies show atropine 0.01% does 

slow the progression of myopia, in children with 

mild to moderate myopia, by up to 50%, with no 

obvious side effects, but it doesn’t stop it. Prevention 

is far better than cure, however, she said, with 

many studies now showing how important it is for 

children to stay away from screens and play outside 

for at least three hours a day. 

Professor Helen Danesh-Meyer returned to the 

topic of glaucoma with her presentation on common 

glaucoma drop side-effects. All of these are a 

problem for compliance as patients often don’t have 

any problems when glaucoma is first identified, she 

said. “Patients are well until the come to see us and 

then we make them unwell with our drugs, so the 

bar is very different for a silent disease.” 

Practitioners need to have a “high index of 

Get to the main 

cause of dry, 

irritated eyes* 

How does Optrex ActiMist work? 

Optrex ActiMist contains 

liposomes (tiny bubbles fi lled with 

moisture) that migrate across the 

surface of the eyelid and collect 

at the edges of the eye. 

Hygienic. Can be used 

by multiple people 

Lasts 6 months 

after opening 

These liposomes mix with natural 

lipids on the eyelid. 

Won’t smudge 

make-up 

ActiMist liposomes 

ActiMist liposomes 

When the eyes are open the new 

lipid mixture spreads over the 

whole tear fi lm, and helps fi ll the 

gaps to restore the damaged 

lipid layer. 

Convenient and 

portable 

Suitable for use 

with contact lenses 

suspicion” as side effects can be extremely varied. 

For example, prostaglandin analogues can change 

iris colour and cause hair growth—great for 

eyelashes, less for other facial hair—and cause some 

pre-existing conditions, such as HSV, to flare up 

again. Beta blockers have a number of well-known 

systemic side effects, but can also cause impotence, 

depression and even nightmares, while Brimonidine 

can cause fatigue and follicular conjunctivitis. If the 

patient develops unsatisfactory side effects, stop 

the medication, reassess and identify an alternative, 

such as SLT, she said. 

Dr Ilva Rupenthal closed the conference with 

a look into the future, focusing on the work of 

the BOTU and some of the most prominent and 

interesting ocular therapeutics potentials out 

there. This included a cationic nanoemulsion 

of ciclosporin from Santen; a semi-fluorinated 

alkane eye drop by Novaliq that is currently being 

investigated by BOTU; mucus penetrating particles 

from Kala Pharmaceuticals; and Ocular Therapeutix’ 

drug-delivering punctum plugs. Other interesting 

developments include Helios, a silicone ring loaded 

with the anti-glaucoma drug bimatoprost, which 

is inserted in the eye. BOTU is currently involved in 

several therapeutic clinical trials to identify novel 

new agents and drug delivery vehicles, including a 

number of stimuli-responsive drug delivery systems 

involving ultrasound- and laser-activated particles as 

well as an implant activated by a small current. 

Dr Rupenthal closed the conference by thanking 

everyone who had been involved in making it 

happen, especially Dr Trevor Gray and Professor 

Charles McGhee, all the attendees and the 

exhibitors (see box) for their support. ▀ 

4UP TO 

HOURS 

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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: 

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 



9

Focus 

on Business 

IRD INVESTIGATIONS 

Who are they targeting and what to do 

if you get a query 

BY DAVID PEARSON AND TIM ZONNEVELD* 

Over the past few years the 

Government has been steadily 

increasing budget funding for Inland 

Revenue investigations, with a current budget 

allocation of $74 million over five years 

(expected to yield an 800% return). While 

the focus has been more on aggressive tax 

planning and hidden economy initiatives, this 

is also having a flow on effect with initiatives 

such as the basic compliance package (BCP) 

information requests, which you may have 

heard of or even received. 

There are a number of different reasons 

Inland Revenue may select you for an audit. 

Some of the more common reasons our BDO 

tax team see include: 

i. Your past compliance history (ie. have you 

been filing returns and making payments 

on time?). 

ii. Checking your records as a result of an 

audit of another related taxpayer, or 

an unrelated taxpayer you have had 

transactions with. 

iii. Examining a particular issue facing groups 

of taxpayers. 

Past compliance history 

This is often one of the more common reasons 

for an audit and is the easiest to remedy. 

Maintaining a good compliance history with 

Inland Revenue goes a long way to both 

reducing the risk of an audit and also putting 

you on an equal footing in the event an audit 

does occur. 

The good compliance history should 

extend beyond simply filing the returns 

and making the payments on time. The 

importance of keeping good, well-referenced 

documentation to support the tax positions 

adopted also demonstrates you have 

taken reasonable care and can be crucial 

in ensuring a smooth process should an 

audit arise. It goes without saying that your 

accountant and/or tax adviser should play an 

important role in assisting here. 

Checking records with another taxpayer 

The most common occurrence in this regard 

is where other companies or shareholders in a 

group are incorporated into an audit of one of 

the other members. Selection for an audit as a 

result of an audit of an unrelated party arises 

less often. 

While taxpayers can control their own 

tax position and compliance history, they 

unfortunately cannot control those of the 

people they do business with. In these 

situations, you will need to trust and rely on 

your own documentation and compliance 

history to minimise your risk. 

Examining particular issues facing groups of 

taxpayers 

If you have followed recent media reports 

on tax audits you will have noticed Inland 

Revenue’s particular focus on the hospitality 

and, more recently, the trade and construction 

industries. In this regard Inland Revenue is 

targeting the “hidden economy” or “cash 

transactions” which are not reported or 

included in tax returns to Inland Revenue. 

The landmark case Penny and Hooper 

v Commissioner of Inland Revenue is an 

excellent example of Inland Revenue’s 

approach to groups of tax payers, in this case 

orthopaedic surgeons. The Court unanimously 

found that the two Christchurch surgeons, 

who were paid artificially low salaries, via their 

business structures, were avoiding tax. As an 

outcome, the Inland Revenue broadened their 

focus to a wide range of professional taxpayer 

groups with significant ramifications. 

What to do if you get a query 

It goes without saying that the first thing you 

should do is contact your accountant and/or 

tax adviser, however some other helpful tips 

are as follows: 

1. Don’t panic! Information requests and 

audits are becoming more common as 

a result of increased investment by the 

government, so don’t take it personally. 

2. Comply with all requests in a timely 

manner 

3. Maintain good communication. Audits 

and information requests typically occur 

at the busiest times so, if you think it 

will be difficult to supply the requested 

information in time, it is important to 

discuss this with the investigator as soon as 

possible and arrange for more appropriate 

deadlines. In our experience most Inland 

Revenue investigators are quite reasonable 

and accommodating in this regard. Make 

sure your key personal, such as payroll 

or IT managers, aren’t on holiday when 

considering the best time for the audit 

to take place. In some cases, Inland 

Revenue will be more relaxed in relation to 

extending deadlines if it can receive at least 

some information before the deadline. This 

may give the investigator confidence and 

ensures that internally, things will not be 

left to the last minute. 

4. Consider making a voluntary disclosure. A 

voluntary disclosure can deliver a reduction 

of penalties. It will often be as a result of 

an internal review of the tax matters that 

are the subject of the audit; and perhaps 

a review of other tax matters that may 

be included if the scope of the audit is 

expanded. Assistance with such reviews 

may be provided by your accountant and/ 

or tax adviser and the findings from such 

reviews may be provided to or requested 

by the Inland Revenue. If done well it will 

demonstrate you are serious about tax 

compliance, and may result in less Inland 

Revenue time on-premises. 

So should you be worried? 

The fact that you are being audited or asked 

for information does not mean that you 

are necessarily ‘in trouble’. Even if you are 

in what Inland Revenue might consider to 

be a ‘high-risk category’, it is important to 

remember that it is an individual situation 

that matters. Provided you have a good 

compliance history, have good records and 

work with your accountant/tax adviser to 

maintain good communication with Inland 

Revenue, the risk review or audit should be a 

relatively smooth process. ▀ 

ABOUT THE AUTHORS: 

* David Pearson is 

anaging partner in the 

Napier firm of BDO, 

a global network of 

chartered accountants 

and advisers. He has a 

specialisation in advice to 

the medical sector. 

* Tim is a partner in the 

Taxation Services division 

of BDO in Auckland. 

conference 2016 

Registrations are now open for the annual 

Save Sight Society one-day conference on 26 

August in Tauranga. 

The event is shaping up to be a “must-do” date on 

the calendar for New Zealand based practitioners, 

says Dr Sam Kain, this year’s conference convenor. 

“It’s our main fundraiser and it’s open to the entire 

optometry and ophthalmology community. It’s 

quite different to other events as it has a very ‘local 

flavour’ peculiar to NZ.” 

A smaller, more personal meeting than many 

other conferences and symposiums, the Save 

Sight Society conference focuses specifically on 

issues facing those practicing in Aotearoa, with a 

series of short presentations and the floor always 

open to questions. This year the presentations 

will centre around updates across three main subspecialities—cornea, 

retina and uveitis. 

People aren’t afraid to ask questions at the 

Save Sight Society conference, so much of the 

education comes from the floor, says Dr Kain. “The 

speaker really just opens the discussion. You don’t 

need to be an expert to join in; the atmosphere 

is friendly and open to new ideas. It’s a great 

networking event.” 

Dr Kain says it’s also a great event to talk 

about the idiosyncrasies of local DHBs, funding 

streams and issues relating to the very specific 

demographics of New Zealand, such as the large 

Maori and Pasifika communities. The constraints 

of practicing in a small and isolated island with 

limited funds and unusual challenges also create 

some very innovative responses, and discussion of 

this nature will run freely, he says. 

“Practice is unique in New Zealand, even 

compared to Australia. At some of the bigger 

international meetings it can be hard to have 

open discussions about things specific to us, 

because it’s not relevant to the wider audience.” 

The Save Sight Society continues to be one of 

the biggest, non-government funding agencies in 

New Zealand, having given more than $700,000 in 

research grants in recent years. For more visit 

www.savesightsociety.org.nz. ▀ 

ODOB’s new guidelines on oral 

medications 

The Optometrists and Dispensing Opticians’ 

Board (ODOB) new guidelines for prescribing 

medications are now available online. The 

board has been working on this for some time and 

would like to encourage all certified therapeutic 

pharmaceutical agent (TPA) optometrists to 

familiarise themselves with the documents, says 

Lindsey Pine, ODOB registrar. 

“Regulations were changed in 2014 giving TPA 

optometrists more freedom to prescribe, rather than 

having to stick to an approved list of medications. 

“It was recognised clear guidelines were 

needed for more high-risk medications and 

medicines with contraindications. They have 

now been published, and we will be making TPA 

optometrists and dispensing opticians aware they 

are available.” 

The new guidelines focus specifically on allergic 

eye disease, herpes simplex virus, keratitis and 

herpes zoster ophthalmicus. More guidelines are 

expected to be added soon. 

The new guidelines can be accessed by visiting: 

www.odob.health.nz/cms_display. 

php?sn=74&st=1&pg=1529 . ▀ 

Visionz tackles low vision 

Visionz 2016 will include a one-day low vision 

conference on Friday 14 October as part of a 

comprehensive educational programme for 

optometrists, practice managers and other optical 

staff alongside its industry showcase. 

The biennial conference, organised by the 

New Zealand Optical Wholesalers Association 

(NZOWA) and run in tandem with the Association 

of Dispensing Opticians (ADONZ), is being held on 

Friday 14th to Sunday 16th October at the Ellerslie 

Events Centre in Auckland. 

Planning is well under way with 60 exhibition 

booths displaying all that’s new in the industry 

including frames, sunglasses, lenses, equipment, 

accessories, software and services, while the 

education programme, Eduvisionz, already includes 

an impressive slate of speakers. 

On the low vision side this includes Dr Mike 

O’Rourke, ophthalmologist at Tauranga Eye 

Specialists, who recently carried out a lifechanging 

procedure, using an intraocular 

mini-telescope implant, (see story P4); Professor 

Stephen Lord, senior principal research fellow 

from the Falls and Balance Research Group from 

Sydney, who will address Falls in Older People: 

Visual Risk Factors and Intervention Strategies; 

and Dr Alan Johnston, a low vision specialist from 

Melbourne, who will discuss his recently updated, 

sliding scale logMAR visual acuity calculator, 

which includes ETDRS scoring principles, now 

widely used for monitoring any vision gain or 

loss with intra-vitreal injection of anti-VEGF, and 

Telescopes for low vision: principles, practice and 

rationales for clinical choice. 

Other sessions include: 

•• 

The latest developments in technology and 

innovation in low vision products 

•• 

Incorporating low vision clinics into a busy 

optometry practice 

•• 

Identifying a person’s low vision needs and 

rehabilitation goals 

•• 

Sharing important strategies for daily life 

•• 

The latest research into the use of mobility 

scooters, digital devices and neurological vision 

impairment 

•• 

The current development of an occupationbased 

low vision model incorporating the level 8 

Visionz 

2014 2016 

postgraduate curriculum in low vision for allied 

health professionals 

•• 

The Blind Foundation’s Prevalence Study Work 

and the Level 7 Vision Rehab diploma to be 

launched in 2017 

On Saturday, the focus will move to the business of 

optometry with speakers addressing the commercial 

aspects of running a business in today’s competitive 

environment, says Gary Edgar, NZOWA president. 

“We are planning to deliver an event to suit the 

changing needs of our clients and the broader 

industry in general.” 

Speakers include Juanita Neville-Te Rito from The 

Retail Collective who will share insights drawn from 

her 25-year career in retail, and her personal passion 

for shopping, including five key trends in retail 

that any retail business owner should be aware of; 

business mentor, Tanya Unkovich, who will present 

on how to use your life experiences to know and 

get what you want in life; and John Saywell, CEO of 

Christchurch software and consulting company RPM 

Retail, who will discuss how to analyse your optical 

practice’s strengths, weaknesses, opportunities and 

threats. Other topics include: 

•• 

Coming to terms with the new Health & Safety 

laws 

•• 

The pros and cons of social media and whether a 

practice can benefit from incorporating a social 

media platform into its marketing strategy 

•• 

Picking the best team and getting it right from 

the start 

Another attraction at Visionz 2016 will be the 

opportunity to register for a St John’s Basic Life 

Support course, that teaches essential life-saving 

skills, on the Saturday afternoon. Participants will 

receive a NZQA 6401/6402 acknowledgment at the 

end of the 4-5 hour course. 

Visionz and Eduvisionz, as well as being held in 

conjunction with ADONZ’s annual conference, 

will also incorporate the International Opticians 

Association Annual Meeting, which is being hosted 

for the first time in New Zealand. A Visionz ‘Happy 

Hour’ has also been organised for late on the Friday 

afternoon for all delegates. 

Registration for Visionz and Eduvisionz will open 

in July. Keep reading NZ Optics magazine for more 

information or email: contact@nzowa.org.nz. ▀ 


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11

Focus on 

Eye Research 

SMILE and pseudophakia 

CLINICAL OUTCOMES AFTER SMILE 

AND FEMTOSECOND LASER-ASSISTED 

LASIK FOR MYOPIA AND MYOPIC 

ASTIGMATISM: A PROSPECTIVE 

RANDOMISED COMPARATIVE STUDY. 

Liu M; Chen Y; Wang D; Zhou Y; Zhang 

X; He J; Zhang T; Sun Y; Liu Q. 

Cornea. 35(2):210-6, 2016 Feb 

Review: This prospective, randomised, 

comparative study compared the 

clinical outcomes of small-incision 

lenticule extraction (SMILE) and 

femtosecond laser-assisted LASIK (FS- 

LASIK) for the correction of myopia and 

myopic astigmatism. SMILE surgery 

was performed in 113 eyes with a 

mean spherical equivalent (MSE) of 

-5.22 +/- 1.70D, and FS-LASIK was 

performed in 84 eyes with an MSE of 

-5.18 +/- 1.93D. At six months 97% 

of SMILE eyes, and 100% of FS-LASIK 

eyes were within +/- 0.5D of the 

target refraction, with no statistically 

significant difference. There were also 

no statistically significant differences 

between the two groups in terms of 

astigmatic correction. At six months 

96% of SMILE eyes, and 99% of 

FS-LASIK eyes achieved uncorrected 

visual acuity of 20/20 or better, with 

no statistically significant difference 

between the two groups. There 

were also no statistically significant 

differences between the groups 

regarding loss of best corrected visual 

acuity, with loss of one line or more in 

6% of the SMILE group, and 5% of the 

FS-LASIK group. Looking at wavefront 

aberration at six months, the SMILE 

group had statistically significantly 

lower induced rates of spherical 

aberration than the FS-LASIK group. 

Comment: SMILE is the latest advance 

in corneal refractive surgery. In 

comparison to LASIK, no corneal flap 

is created, and this has already been 

shown to result in a lower rate of 

dry-eye post-operatively, as well as 

potentially reducing the risk of postoperative 

keratectasia. This prospective 

randomised study indicates visual 

outcomes between the two treatments 

are statistically similar, and that 

induced rates of spherical aberration 

are statistically lower with SMILE. 

COMBINED SMALL-INCISION 

LENTICULE EXTRACTION AND 

INTRASTROMAL CORNEAL COLLAGEN 

CROSSLINKING TO TREAT MILD 

KERATOCONUS: LONG-TERM 

FOLLOW-UP. 

Graue-Hernandez EO; Pagano GL; 

Garcia-De la Rosa G; Ramirez-Miranda 

A; Cabral-Macias J; Lichtinger A; Abdala- 

Figuerola A; Navas A. 

Journal of Cataract & Refractive Surgery. 

41(11):2524-32, 2015 Nov. 

Review: This prospective interventional 

case series looked at the visual, 

refractive, and topographic outcomes 

of sequential, same-day smallincision 

lenticule extraction (SMILE) 

and intrastromal corneal collagen 

crosslinking (CXL) in eyes with mild 

keratoconus. Fifteen eyes with forme 

fruste keratoconus and/or irregular 

corneas, were treated with SMILE 

followed by intrastromal injection 

of riboflavin inside the pocket, and 

then 30 minutes of Ultraviolet A light 

with a wavelength of 370 nm to 3 

mW/cm(2). The mean age was 29.5 

years +/- 5.5 (SD), and patients were 

followed for 24 months. Pre-operative 

uncorrected distance visual acuity 

improved from Snellen 20/796 to 

Snellen 20/26 post-operatively, which 

was statistically significant. Bestcorrected 

distance visual acuity did 

not change significantly. The spherical 

equivalent improved from -4.3 +/- 

REVIEWED BY DR SUE ORMONDE* 

1.02D preoperatively to 0.2 +/- 0.66D 

postoperatively, and 100% of eyes were 

within +/- 1.0D of refractive target. 

With regards to complications, all 

eyes exhibited corneal haze initially 

(as expected with CXL), but this had 

cleared in all eyes by three months. 

One eye lost two lines of best corrected 

visual acuity due to a partial lenticule. 

No cases of progressive ectasia were 

noted. 

Comment: By preserving the 

biomechanically more stable anterior 

layers of the cornea, SMILE potentially 

offers a reduced risk of creating 

ectasia or promoting progression of 

keratoconus in abnormal corneas. 

Combining this with CXL may offer a 

safe predictable refractive treatment 

for patients with mild keratoconus 

who cannot be corrected with glasses, 

and who are intolerant of contact 

lenses. More prolonged follow-up and 

larger samples are needed to confirm 

the findings. 

COMPARISON OF CONVENTIONAL 

VERSUS CROSSED MONOVISION IN 

PSEUDOPHAKIA. 

Kim J; Shin HJ; Kim HC; Shin KC. 

British Journal of Ophthalmology. 

99(3):391-5, 2015 Mar 

Review: This prospective randomised 

study compared the visual 

performances and patient satisfaction 

of conventional monovision (correcting 

the dominant eye for distance), and 

crossed monovision (correcting the 

non-dominant eye for distance) in 

patients with pseudophakia. Twentyeight 

patients underwent bilateral 

cataract surgery with conventional 

monovision, and 31 patients with 

crossed monovision. The mean 

post-operative spherical errors in the 

conventional group were -0.085D 

(distance eye) and -1.433D (near eye), 

and in the crossed group -0.109D 

(distance eye) and -1.560D (near 

eye). At two months post-operatively, 

binocular uncorrected distance 

visual acuity of 20/25 or better was 

achieved in 89.3% of the conventional 

monovision group, and 83.9% of 

the crossed monovision group. 

Binocular uncorrected near visual 

acuity was at least 20/32 in 71.4% of 

the conventional group, and 67.7% 

of the crossed monovision group. 

There was no statistical difference 

between the two groups with regards 

to binocular visual acuity. A patient 

satisfaction survey indicated there was 

no significant difference in patient 

satisfaction for unaided binocular 

distance and near vision between 

the conventional and crossed groups. 

Distance glasses independence was 

reported by 67.9% of the conventional 

group, and 80.6% of the crossed 

group. Near glasses independence was 

reported by 50.0% of the conventional 

group, and 77.4% of the crossed group. 

There was no statistical difference 

between the two groups. Near 

stereopsis improved post-operatively 

and there was no statistical difference 

between the two groups. 

Comment: This study gives reassurance 

that monovision can still be considered 

in patients who attend for second eye 

surgery, when the first eye has already 

been operated on and corrected for 

distance vision, irrespective of which is 

the dominant eye. ▀ 

* Dr Sue Ormonde is a 

consultant ophthalmologist 

specialising in refractive, 

corneal, cataract and anterior 

segment surgery. She works 

at Greenlane Hospital, 

Auckland and in private 

practice at Auckland Eye. 

Giving sight a sporting chance 

How one optometrist is 

helping New Zealand athletes 

up their game. 

BY JAI BREITNAUER 

When Wellington-based 

optometrist Renee Edgar 

was in her final year at 

University she completed a research 

project looking at the moving visual 

acuity of cricket players. At the time it 

seemed like a novel topic to complete 

her degree, but 13-years-later it has 

become a legacy project that is shaping 

her career. 

“I’ve always been interested in the 

relationship between vision and sport,” 

says Edgar. “I’m quite sporty myself and 

have always wondered why we don’t do 

different types of eye-testing for athletes. 

The demands on their eyes are so 

different to the majority of my patients 

in the CBD who are very static and spend 

most of the day in front of a computer.” 

Edgar notes that sports people, 

especially those involved in ball sports, 

are working daily with a moving target 

and have to make quick, split second 

decisions while that target is in motion. 

“It’s a lot to do with the brain as 

well as the eye,” says Edgar. “Eye-hand 

coordination develops at an early age and 

doesn’t always develop effectively. But 

those visual pathways can be re-trained.” 

Until recently, this interest had 

remained a sideline in Edgar’s work. Then 

she had a patient referred to her who 

wanted to improve his cricket game. 

“He was an under-16 player wanting 

to move up to the next level and his 

optometrist knew this was an area of 

interest for me,” says Edgar. “We began 

working together to improve his visual 

acuity. This sort of training can be very 

helpful for players looking to move to 

an elite level as it helps them perform 

Alcon business as usual in ANZ 

Despite 

the flurry 

of news 

this year on 

Novartis’ moves 

to turnaround its 

Alcon business, 

little is expected 

to change in 

Australasia. 

In response to questions from NZ 

Luxin Wang, general 

manager, Alcon ANZ 

Optics, Luxin Wang, general manager of 

Alcon Australia and New Zealand (ANZ), 

said Novartis’ decision to move its 

ophthalmic pharmaceuticals business 

to its wider pharmaceuticals division, 

allowing the Alcon division to focus 

solely on the surgical and vision care 

businesses, will have little impact here. 

“Our customers should see no change 

in our daily interactions. We have the 

same team in place in New Zealand 

who will continue to support our New 

Zealand customers.” 

Neither the Surgical business structure 

nor the vision care business structure will 

change in ANZ, said Wang. “There are no 

plans to change this structure although 

there has been a decision to combine 

Alcon’s ophthalmic pharmaceuticals with 

our parent company’s Novartis pharma 

Retina franchise to create a Novartis 

ophthalmic franchise. This will create a 

broad portfolio of ophthalmic medicines 

that treat both the front and back of the 

eye.” 

Recognising surgical and consumer 

require specialised expertise, Wang 

assured customers the plan is to 

continue to have two teams, one for the 

consumer business, for vision care and 

OTC pharmaceuticals, and another for 

surgical. 

Contrary to what may be happening 

further afield, ANZ customers can 

expect to see more investment from 

Renee Edgar and Firebirds’ Luke Woodcock, Michael Papps and Jeetan Patel 

at the best of their ability the majority 

of the time.” 

Mentioning this work in conversation 

with the mother of another patient 

lead to a further project for Edgar. 

“It turned out the lady in question 

was a netball umpire. She was very 

interested in what I was doing with the 

cricketer and wondered if I could help 

her and her colleagues as well.” 

However, it was when the brother of 

Firebirds’ coach Bruce Edgar (no relation) 

came in for an appointment that the 

project really gained momentum. 

“I had some information up on the 

wall about my work,” says Edgar. “He 

was very interested and got his brother 

to give me a call.” 

That was last spring, and as the 

cricket season had already started 

there wasn’t much work Edgar could 

do with the team, but now the season 

has closed for the winter the players are 

undergoing assessments with Edgar to 

see what areas need work. 

“So far we’ve undertaken some baseline 

testing to see where improvements 

can be made. We have concentrated 

very closely on spatial awareness and I 

have created some activities to improve 

the players’ perception of a moving 

target in space.” 

One such activity involves a player 

Alcon in both Australia and New 

Zealand, said Wang. “We will also 

continue to bring true innovation to the 

market and have several new product 

launches planned for 2016.” 

Alcon invests in AIOL technology 

In other news, Alcon head office 

announced it had entered into a 

strategic alliance with PowerVision a 

privately-held, US-based medical device 

company focused on developing fluidbased 

lens implants. 

PowerVision, has developed an 

accommodating IOL (AIOL) for cataract 

patients with presbyopia, which, in pilot 

studies, has been shown to be able to 

change focus via a fluid-driven shapechanging 

technology, said Michael 

Onuscheck, global surgical franchise 

head for Alcon in a statement. “The 

technology utilises the eye’s natural 

accommodating muscles to transport 

fluid in the intraocular lens which is 

implanted in the eye’s capsular bag. The 

fluid-based technology that PowerVision 

is working on represents a potential 

game-changer in the category with 

the promise to offer patients a natural, 

continuous range of near to far vision.” 

Alcon’s investment in PowerVision will 

fund further development and clinical 

trials and provides Alcon with an option 

to acquire the company at a later stage. 

Alcon NZ appointment 

Alcon announced that Tristan Tuhi has 

joined its New 

Zealand surgical 

sales team as 

surgical account 

manager. 

“Tristan comes 

to us after five 

Tristan Tuhi 

years with Covidien 

reading a heart chart on the wall 

in time to a metronome, while also 

keeping time with flashing lights in the 

periphery of their vision working on a 

different rhythm. 

“It’s actually really hard,” laughs 

Edgar. “But these are exactly the sorts 

of exercises players in teams overseas 

regularly do. In the US, for example, 

it’s usual for basketball teams to have 

an optometrist work with the players, 

attending to their visual needs. I’ve 

thought we should offer this service for 

a while.” 

Edgar had an updated version of her 

university research paper published 

last year in the American journal, 

Optometry and Visual Performance, 

and has gained a number of clients in 

this area, including a golfer keen to 

improve his putting technique. 

“There are so many situations these 

improvement techniques could apply 

to,” says Edgar, who is pleased interest 

is gaining momentum. 

“It’s always been a goal for me to 

take this sort of work to the next level 

– it’s so useful and done really well 

overseas. I enjoy my day-to-day work 

as an optometrist, but this is another 

way of doing things a bit differently. 

It certainly makes my day more 

interesting!” ▀ 

covering respiratory and advanced 

monitoring with a focus anaesthesia,” 

said Greg Engelbrecht, Alcon’s surgical 

sales manager for New Zealand. “He 

brings a wealth of knowledge to Alcon.” 

Tuhi has a BSc in physical education/ 

health and a Diploma in Business and 

will be based. ▀ 

Crosslinking 

advances 

Researchers have developed a 

new light-based procedure that 

could reduce the risk of cornea 

damage in crosslinking. Currently 

ultraviolet light is used to perform 

crosslinking across the entire cornea, 

said research leader Seok-Hyun 

Yun from Massachusetts General 

Hospital’s Wellman Center for 

Photomedicine in the US. “However, 

this comes with a risk of damaging 

the innermost layer of the cornea, 

a complication that changes the 

corneal function and can cause it to 

become very hazy.” The study focused 

on whether two-photon absorption 

could be used to precisely control 

the area of corneal crosslinking - 

an approach that has been used 

to harden liquid resins to create 

microscopic optical components and 

other 3D structures, but until now 

has not been applied to stiffen tissue. 

Researchers found that exposing the 

tissue to 200-milliwatt laser light 

for ten minutes induced collagen 

crosslinking without damaging tissue, 

but said more research is needed. ▀ 


Glaucoma: from 

Moorfields to NZ 

BY DR SHENTON CHEW* 

ANZ Strabismus Society report 

ANZSS Keynotes Drs Fiona Rowe and David Guyton 

The Australian and New Zealand Strabismus 

Society (aka “Squint Club”) entered its 25th 

year following the annual scientific meeting 

at the Royal Children’s Hospital in Melbourne 

from 4 to 6 March this year. 

The guest speakers at this year’s meeting 

were Dr David Guyton, professor of paediatric 

ophthalmology at John Hopkins Medicine in 

Balitmore, USA; and Dr Fiona Rowe, a senior 

lecturer in orthoptics at the University of 

Liverpool, a research fellow for the British and 

Irish Orthoptic Society and associate-editor-inchief 

for the journal Strabismus. 

Both speakers contributed greatly to the success 

of the meeting, which attracted 120 registrants, 

with a highlight being the patient presentations 

and discussions from Dr Guyton’s Gillies Lecture: 

Changes in strabismus over time: clinical 

implications for the future. 

Fiona Gillies presented the certificate of 

appreciate to Dr Guyton and commented on 

how pleased her father, Bill, would be with the 

enduring strength of the strabismus meeting. 

The meeting concluded with a Nystagmus 

Workshop on Sunday morning attended by 

35 people. 

Next year’s meeting will be in Auckland with guest 

speakers: University of Toronto Professor Stephen 

Kraft, staff ophthalmologist at The Hospital for Sick 

Children and Toronto Western Hospital; and Kyle 

Arnoldi, clinical instructor in ophthalmology at the 

Jacobs School of Medicine and Biomedical Sciences 

at the University of Buffalo in New York. ▀ 

Edited from an original article supplied by the ANZSS 

New app for CooperVision 

Dr Shenton Chew (right) enjoying a beer with colleagues in a London pub next to Moorfields 

Travelling to the opposite end of the earth is 

an experience many Kiwis cherish as part 

of their big “OE”, and for good reason— 

pounds, pints and plentiful European destinations 

at your doorstep. Unfortunately, for those of us 

in the ophthalmic and optometric fields, this has 

been getting more difficult with strict regulations 

for both visas and professional qualification 

equivalency. 

One such route available to me was a twoyear, 

London-based glaucoma fellowship at the 

prestigious Moorfields Eye Hospital. I had a truly 

fantastic time away, soaking up not just the sights 

and sounds of London and its surrounds, but also 

the collective wisdom from some of the giants of 

the glaucoma world, such as Mr Keith “Mr Tube” 

Barton, Professor Paul “I am angle closure” Foster 

and the knight of the realm himself, Professor Sir 

Peng Khaw. 

Moorfields was a great blend of tradition and 

innovation and my hopes of being comprehensively 

trained in the management of complex surgical 

glaucoma mingled nicely with cutting-edge 

experience in the wide gamut of minimally 

invasive devices such as the iStent, Hydrus, Aquesys 

and Cypass, the latter two of which are not 

currently available in Australasia. 

Glaucoma is a challenging specialty. We are often 

faced with the difficult task of convincing a patient 

who has no symptomatic concerns that firstly, they 

have irreversible vision loss and secondly, adherence 

to eyedrops, which have a significant side-effect 

profile, is essential in preventing progression. It can 

be a hard sell, especially when you know that you 

may have 100 more patients in the waiting room, as 

was often the case in a busy Moorfields glaucoma 

clinic. Add to that, increasing demand from an aging 

population with increased life-expectancy and you 

can see why glaucoma services throughout the 

world are struggling to keep afloat. 

Fancy surgical techniques aside, efficient service 

provision was another aspect I hoped to glean 

some insight into from the largest glaucoma 

service in the UK. Unfortunately, Moorfields also 

appeared to be struggling with the burden, with 

obvious difficulties in seeing patients at their 

requested follow-up times leading to over-booked 

and over-running clinics, which had a significant 

effect on staff and patient morale. As a fellow, it 

was easy to suck up the workload and experience 

that came with it for a couple of years, but 

imagine a lifetime in this system and it becomes 

obvious as to why the poor working conditions 

within the British NHS (National Health Service) 

feature as a common news headline. 

Increasing staffing within the current clinic 

structure was the obvious initial choice to stem 

the overflow, given the physical space that 

Moorfields has. Picture a throng of patients in a 

large waiting area, with a large clinic area broken 

into eight or more cubicles, with dividers, but no 

walls or doors, and you have a typical Moorfields 

clinic. The incredible lack of privacy was an issue 

that patients were surprisingly accustomed to, 

and it did allow for rapid consultation between 

a variety of clinicians that manned the clinic 

including a consultant, a couple of fellows, 

a registrar, a staff specialist and a couple of 

optometrists. 

Technician-led virtual clinics were used for both 

stable monitoring and for new patient assessment. 

These certainly have scope as the use of visual field 

analysers and optical coherence tomography can 

occur on no-consultant-led glaucoma clinics days. A 

higher number of patients can then be “seen” by the 

consultant in a reporting session. As a safeguard, 

every patient is assessed back in the consultant 

clinic every three years. 

One would think that patient satisfaction 

would be lower with this style, but the analysed 

Moorfields’ data suggests satisfaction levels were 

high, perhaps due to factors such as decreased 

journey time and being assessed in a timely fashion. 

Collaborative care models have also been 

established with motivated community-based 

optometrists. Because of the wide range of 

optometric practices in London, those optometrists 

who were involved tended to have worked, or still 

worked, within the Moorfields glaucoma service 

and thus already had close relationships with their 

ophthalmic colleagues. This allowed them to feel 

confident in their own abilities and limitations, 

knowing that support was easy to access if required. 

In terms of translation to glaucoma service 

provision here in New Zealand, I feel a key concept 

is first to stratify patients by risk of visual loss. 

For example, a patient with early glaucoma in 

their 90s is unlikely to progress to functionally 

significant levels in their lifetime. Whereas a patient 

with advanced glaucoma in their 40s is going to 

be a challenge to keep sighted throughout their 

remaining years. 

This stratification will allow for the appropriate 

delivery of care. In the hospital setting, lower 

risk patients could funnel into a larger volume 

“Moorfields-style” multi-clinician clinic, while higher 

risk patients could feed into a smaller, ophthalmicstaffed 

clinic as these patients have a higher 

chance of needing more time for counselling and 

management decisions. In areas where staffing 

and physical space is more limited, the lower risk 

cohort could be reviewed through a technician-led 

stable monitoring service, which is what I am in the 

process of setting up at Waitakere Hospital, where I 

spend part of my clinical time. 

Finally, we are fortunate in New Zealand 

to have high quality optometrists who value 

eye health as a priority and a have both the 

knowledge-base and skill set to be invaluable 

in sharing this burden of glaucoma care. In fact, 

we ophthalmologists already rely on this with 

the large number of low-risk glaucoma suspects 

we discharge back to optometric care. Thus 

establishing clear lines of communication and 

management pathways in collaborative-care 

models seems like a highly successful strategy 

and something Moorfields, perhaps, could one 

day learn from us. ▀ 

* Dr Shenton Chew is currently working with the Eye Clinic at 

Greenlane Clinical Centre in Auckland 

CooperVision has launched an app to assist 

optometrists in fitting toric and multifocal 

lenses. The free OptiExpert app with 

multifocal and toric calculators is available to 

download for iOS and Android devices and provides 

diagnostic lens suggestions from CooperVision’s 

product families: Avaira, Biofinity, Biomedics, clariti 

and Proclear 

For toric lens choices, as well as the patient’s 

prescription, OptiExpert considers back vertex 

distance adjustment and on-eye orientation, says 

the marketing material, plus the app converts the 

Efron Grading Scales into an easy-to-use digital 

tool, allowing practitioners to grade patients 

against 16 sets of images and covers the key 

anterior ocular complications of contact lens 

wear. The app also includes the ability to securely 

store images of the patient’s eye condition and for 

practitioners to add their own comments. 

Commenting on the expansion, Joe Tanner, 

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deliver a truly multi-functional 

digital pocket tool and this 

demonstrates our continued 

commitment to support the 

eye care professional who 

wants to make the initial 

diagnostic lens selection 

process as comprehensive as 

possible.” 

• In other news CooperVision announced it had 

launched Biofinity XR toric, to its Biofinity range of 

monthly silicone hydrogel contact lenses. Biofinity 

XR toric extends the high oxygen and advanced 

comfort of the range to patients who have both high 

prescriptions and astigmatism, said the company in 

a statement. ▀ 

Shamir quarter page ad NZ OPTICS JUNE 2016.indd 1 


11/05/2016 3:58:08 PM 


13

Fresh eyes on fashion 

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. 

TAVAT EYEWEAR COMES TO NZ 

interested in design, purpose and functionality. 

TAVAT’s latest launch is its “Soupcan” collection, 

inspired by the crude googles worn by a group of 

crop sprayers in Arizona, back in the ‘30s, who got 

together on weekends to give air-shows and called 

themselves, “The Flying Burritos”. 

A particular feature of the optical and sunglass 

ranges is the ex-cam hinge, a highly-engineered 

concept producing a fluid motion from opening 

to closing. 

SILHOUETTE WINS RED DOT 

Silhouette’s new Titan Minimal Art (TMA) Pulse 

collection has won a Red Dot Design award—the 

eighth award TMA has received since its launch 

in 1999. 

They’re handmade in Italy and, although titanium 

is a difficult product to work with, the frames are 

of the absolute highest quality.” 

Blackfin frames weigh about 10g each, yet they 

are exceptionally strong, with both classic and 

modern designs appealing to a variety of age 

groups and styles. 

“Key West is the most popular, but we stock 30 

styles and they’re all in demand,” says van der Maas. 

New additions to the range this month are 

Amelie and Norman. Amelie offers a modern take 

on the vintage cat-eye style, with clean, angular 

lines and a metallic colour palette. Norman has 

a similar, heavy-set brow, but with squared-off 

corners and a broader temple-line. 

INNOTEC INTRODUCES THE FUTURE 

Innotec by Ogi has announced two original 

styles—Emery and Ward—joining its collection of 

eyewear. These futuristic frames are handcrafted 

from TR-90 surgical-grade plastic and ultem— 

ground-breaking materials in the optical industry 

that set records for strength and weight. 

TAVAT now available in NZ 

Beni Vision in Palmerston North has added another 

Italian brand, TAVAT Eyewear, to its range of quality 

frames, which include the award-winning brand 

FEB31st wooden, and Blackfin titanium frames (see 

other story for Blackfin’s news). 

Dennis van der Maas, sales director for Beni Vision, 

says TAVAT Eyewear compliments the company’s 

existing product range and meets its goal of 

providing high quality, innovative, handmade 

eyewear with unique points of difference. “Having 

four complimenting materials, wood, titanium and 

now surgical stainless steel and acetate means we 

can now offer our customers the very best in Italian 

design, materials and construction.” 

Launched in 2010, TAVAT’s creative heart is the 

hills of Pasadena, California, though the frames 

are crafted in Northern Italy. According to the 

company, TAVAT offers functional iconic eyewear 

with real performance benefits for those in search of 

modernity, excellence and refined elegance and are 

The 4 days of Optics 

23 - 26 September 2016 

Sihouette’s TMA Pulse range awarded a Red Dot 

Weighing a mere 1.8g, with no rims, screws or 

hinges, TMA Pulse celebrates the sale of more than 

10 million items of TMA eyewear worldwide, said 

Silhouette the Austrian, family-owned business, 

which prides itself on producing super-lightweight 

quality eyewear. “With colour highlights on their 

Silhouette caps and glass fixtures in 12 fresh colours, 

not to mention the 12 lens shapes, this collection 

brings radiance to every face.” 

Over 5,200 products, from 57 countries, were 

considered by the jury for this year’s Red Dot 

awards. Criteria included, but were not limited to: 

degree of innovation, formal quality, functionality 

and longevity of the product. The German-based, 

international Product Design competition has 

existed since 1954. Its award, the Red Dot, is an 

internationally recognised quality seal. 

Silhouette is distributed by Elegance in Eyewear in 

New Zealand. 

BLACKFIN’S POPULARITY GROWS 

Since Beni Vision began stocking Blackfin frames 10 

months ago the company has seen a huge increase 

in demand based on word-of-mouth. 

Ward, the new style from Innotec by Ogi 

The Emery is a classic rectangular shape, 

handmade from TR-90 surgical plastic and 

ultem, an ultra-lightweight and flexible plastic 

with applications in aerospace. Equipped with 

metal hinge pieces and adjustable nose pads, 

it is comfortable and reliable, according to a 

statement by Ogi. 

Innotec’s Ward design offers an innovative keyhole 

bridge and is also handcrafted from TR-90 surgical 

plastic and ultem, with adjustable nose pads. 

Both styles have four different burnished colour 

options, and are distributed in New Zealand by BTP 

International Designz. 

WOOW! DRESSING UP URBAN STYLE 

WOOW partners with clothing line Le Bijou Parisien 

Blackfin sunglasses are stocked by Beni Vision 

“I have about 15 practices ordering weekly,” 

says Beni Vision’s Dennis van der Maas. “The 

construction of these frames is impeccable. 

WOOW eyewear have teamed up with clothing 

line Le Bijou Parisien for a series of photoshoots 

marrying together urban chic and classic style. 

WOOW sunglasses are handmade to a high 

standard while offering a modern street style that 

is proving to be popular with all ages. WOOW is 

distributed for Eyes Right Optical (NZ) by CMI Optical 

in New Zealand. ▀ 

Building awareness for MD 

LIVE THE EXPERIENCE 

silmoparis.com 

Macular Degeneration New Zealand 

(MDNZ) once again invited our 

ophthalmic community to support 

the MD Awareness week at the end of May with 

local visibility activities. 

Many responded with positive actions, 

including displays in practices, Facebook activity 

and encouraging local media coverage. The 

2016 week featured a significant social media 

campaign as there are 631,000 New Zealanders 

over 60 years of age who use Facebook. Four 

large billboards were displayed in Auckland, a 

double-page feature published in the NZ Listener, 

and local stories published in local media around 

the country. There was even full page published 

on MD in the 

Mad Butcher 

Newsletter. 

Ooh Media 

continue to 

sponsor MDNZ 

with the digital 

display signage 

in shopping 

malls across New 

Zealand and optometrists based in the malls 

were invited to capitalise on this. 

The consistent call to action is to save sight with 

the Amsler grid and for people to have their eyes 

tested at least once every two years. ▀ 


ACO accredited 

Jolanda de Jong, ACO’s head of professional development 

The Australian College of Optometry 

(ACO) has gained accreditation 

for CPD points in New Zealand 

for its online webinars and seminars, 

Therapeutics Refresher Weekend, 

Glaucoma (Diagnostic Skills) Course and 

its clinical workshops on BIO, Gonioscopy 

and OCT. 

Given this success, it will also be applying 

for accreditation for New Zealand attendees 

to its ACO National Conference, which will be 

held in Melbourne from the 22-23 October, 

once the programme has been finalised, said 

Jolanda de Jong, ACO’s general manager, 

professional development. 

“This year is the first year that we have 

asked for accreditation for our events in New 

Zealand. The ACO has provided professional 

development for Australian optometrists 

since 1975. We are very proud of our track 

record in this field and are delighted that we 

have an increasing number of New Zealand 

optometrists interested in joining the ACO 

as members take up the benefits offered by 

our growing number of events, either online 

or in person.” 

The time was right to apply, given the 

increasing ease and familiarity with online 

certificate courses, says de Jong. “The 

ACO now offers a very comprehensive 

CPD programme and the fact that these 

activities are now accredited in New Zealand 

offers an expanded suite of options to New 

Zealand optometrists. Overall we see this 

as a great opportunity to share knowledge, 

present diverse speakers, broaden networks 

and strengthen the relationship between 

colleagues in both countries. Learning 

together is a positive step forward for the 

profession as a whole.” ▀ 

Reflections on long careers 

Mike Firmston and Bryan 

Matthews take time out to 

reflect on a combined 100 

plus years in business with 

NZ Optics’ editor-at-large 

Maryanne Dransfield 

After 46 and 55 years in the 

optical business, respectively, 

Mike Firmston and Bryan 

Matthews have sold their “retirement” 

practice, Specs Direct. 

“It was the right time to go. 

Optometrist Donald Klaassen who has worked for us for many years 

was interested in buying the practice so it made the decision a little 

easier to make,” said Mike. 

Bryan and Mike were responsible for changing the face of retail 

optics in New Zealand when they opened the Optique Boutique chain 

of stores in the mid-80s. 

“I guess we were at the cutting edge of the change that started in the 

mid-80s. The retail appearance we presented in Optique Boutique was 

revolutionary for the time and changed the way DO’s and optometrists 

thought about how they marketed themselves and their services to 

the public,” said Bryan. 

The opening of the stores was like a rollercoaster ride, they both 

added. The first to open was in Sandringham, followed closely by 

Symonds Street and then High Street in central Auckland. 

“The public was ready for a new approach in buying their glasses. 

Licenses on spectacles had been removed and as a result there was a 

tsunami of agencies and brands available to us. It was very exciting 

times,” said Mike. 

The wholesale and manufacturing arm of the company, Bryan 

Matthews Optical, established in 1970, was supplying its own stores 

as well as other practices. Originally owned by Bryan and his brother 

Craig, brother-in-law Mike joined them in 1973 on his return to New 

Zealand from working overseas. Mike brought with him experience in 

management and accounting, enabling the Matthews to develop their 

business further. Dennis Irvine also joined them at this time to assist 

with the opening of the stores. 

Optique Boutique underwent a name change once the stores opened 

in malls in Auckland and Chartwell in Hamilton, becoming known as 

Optique Eyewear. In 1995 the chain of eight stores was sold to OPSM 

giving the Australian company a foothold in the New Zealand market. 

For Mike, the next five years were spent as New Zealand 

administration manager for OPSM, while Bryan continued with 

Tranzoptics, the wholesale successor to Bryan Matthews Optical. 

Then, in June 2000, Mike and Bryan joined forces again in a new 

business venture, Specs Direct. The first, factory-type outlet was 

in Sandringham and another in Albany soon followed. A semiretirement 

venture, the philosophy behind the business was 

that product was to be priced to the overheads, which were low 

compared to retail practices. 

“At the time there was a definite public perception that 

prescription glasses were too expensive and until then there 

had been nowhere people could go except The Warehouse and 

pharmacies to purchase ready-readers. We decided to fill that market 

gap,” Mike said. 

Bryan has an extensive background in the industry and is probably 

the only person in New Zealand who has been involved in the 

production of lenses, frame making, dispensing and retail. His 

career began in 1960 at Standard Optical in Auckland before moving 

to Arthur Cocks in 1963, where he also worked with lenses. Two 

years later he joined Owen Optical to work for a year with Robert 

Leitl training in the frame-making process, before moving on to 

overseeing frame production. In 1974 he left to establish his own 

frame making company, but market forces came into play prohibiting 

him from gaining a license to obtain the materials necessary to 

manufacture frames. Whilst continuing to lobby for a license, Bryan 

began dispensing from these premises gaining a lot of referrals from 

ophthalmologists. It was around this time he formed a business 

relationship with Harold Searle who established Reads Optical and 

Press clipping of Mike and Bryan at their Balmoral shop in the mid 70’s 

Brian Matthews Optical in the ‘80s 

Mike Firmston and Bryan Matthews today 

with whom he would place his lens business for the next 40 years. 

“When no-one else would handle our lens business, Harold was the 

only one. I was very grateful to him. Of course it was a different story 

when we setup our chain of stores, I had everyone knocking on my 

door.” 

By 1975, Bryan Matthews Optical gained its frame license. It 

manufactured frames for their own outlets as well as selling to 

optometrists once they gained some big-brand agencies. The company 

was the first in the country to obtain a license for CR39 lenses, much to 

the dismay of other labs. 

“Once Optique Boutique opened, a lot of practices did not like the 

fact that we were retailing as well so they wouldn’t buy from us…we 

were so busy with our retail operation it suited us to wind down the 

wholesaling side,” said Bryan. 

Bryan was able to dispense as he got in under the “grandfather 

clause,” but Mike decided to do the dispensing opticians course, 

qualifying in 1980. He joined what was then known as Dispensing 

Opticians of New Zealand (now ADONZ) and worked tirelessly 

serving in a variety of roles for the organisation over the next 

three and half decades. He was elected to the Opticians’ Board 

(now ODOB) in 2001 serving for nine years. He helped establish, 

and is still a director of, OptiBlocks, the educational course for 

trainee dispensers. 

Mike was awarded the Robert Maher Award in 2010, recognising 

his significant contribution to the industry, and life membership 

of ADONZ in 2012. He was also awarded the prestigious Essilor 

scholarship to the Varilux Academy, which he took in 2009. 

One of the highlights of Mike’s career in optics has been the 

camaraderie and professionalism among the people in the industry, he 

said. “I have enjoyed the interaction with everyone I have encountered 

over the years…and I have made many lifelong friends. It’s been an 

incredible industry to work in and I feel privileged to have made links 

with people worldwide and to have had the opportunity to understand 

the different perspectives people have. I’ve seen many changes, but 

most of all it’s been great to see how our Association (ADONZ) has 

developed to what it is today.” 

Bryan said the last 56 years has been one big journey with many 

ups and downs. “We were successful because we trusted each other. 

We were a great combination - Mike is a people’s person, Craig was 

highly efficient in the area of technology. We would have been the first 

wholesaler in New Zealand to have run a computerised system, while 

my travelling gave me insights into trends and what was the next big 

thing in eyewear, which always kept us ahead of the competition.” 

Asked about his plans for retirement, Bryan said optics is still very 

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much in his blood and is planning to dabble in small-time production 

again with Craig. “Out of everything I’ve done over the past 56 years, 

the manufacturing aspect was the thing I enjoyed the most.” 

Mike and his wife Rae are planning a four-month overseas trip to 

Europe. When they return, Mike said he is looking forward to becoming 

a volunteer in several organisations and undertaking a massive 

gardening challenge with his neighbour. ▀ 



15

with 

Prof Charles McGhee 

& A/Prof Dipika Patel 

Series Editors 

Choosing topical antibiotics wisely 

BY JAY MEYER* 

There are many factors that influence the selection of an 

antibiotic for a given clinical scenario. Some questions that 

assist in the decision-making process include the following: 

•• 

Is the antibiotic for prophylaxis or for treatment of infection? 

•• 

If treating infection, is the causative organism known? 

•• 

If the causative organism is unknown, is there a 

predisposition for gram positive or gram negative organisms 

to cause this type of infection? 

•• 

Does the patient have any contraindications to antibiotics? 

Common situations where topical antibiotics are used 

for infection prophylaxis include: corneal abrasions, pre or 

postoperative following extraocular surgery (refractive surgery, 

pterygium excision, etc.) or intraocular surgery (cataract, glaucoma, 

or retinal surgery, etc.). Superficial ocular infections that are often 

bacterial include conjunctivitis and keratitis. Some “non-infectious” 

conditions that are often adjunctively treated with antibiotics 

include blepharitis and marginal keratitis. Considerations regarding 

some of these specific clinical conditions are presented below: 

Conjunctivitis. Major causes of conjunctivitis include: viral, 

bacterial, chlamydial, and allergic. Acute bacterial conjunctivitis 

is often self-limiting; however, treatment with an antibiotic may 

accelerate the resolution of infection. Most bacteria causing 

this condition in children (excluding infants) and adults are 

gram positive, such as Staphylococcus aureus or Streptococcus 

pneumoniae. A broad spectrum antibiotic with gram positive 

coverage such as chloramphenicol or fusidic acid would be 

expected to treat the infection. Ciprofloxacin has poor coverage 

of streptococcus and is generally reserved for use in more severe 

ocular infections. Clinical response is generally seen within a few 

days and the course continued for 5-7 days total. A conjunctival 

swab for bacteria, viruses (HSV, adenovirus), or chlamydia may be 

performed for chronic conjunctivitis or for cases where the history 

and exam suggest an alternative etiology or do not respond to 

initial antibacterial treatment. 

Keratitis. In New Zealand, the majority (70-80%) of bacterial 

keratitis isolates are gram positive organisms, most commonly 

coagulase negative staphylococci or Staphylococcus aureus. Of 

gram negative organisms, Moraxella spp. and Pseudomonas 

aeruginosa are the most common. Fungal and acanthamoeba 

keratitis rarely occur in New Zealand, and combined they represent 

less than 5% of isolates from severe keratitis. 1,2 

Standard treatment regimens for microbial keratitis are 

monotherapy with a fluoroquinolone, such as ciprofloxacin, or 

dual therapy with fortified antibiotics (usually aminoglycoside 

and cephalosporin). Studies have not shown a difference in the 

effectiveness between these two regimens. 3 Ciprofloxacin has the 

advantage of being a single, commercially available agent, and is 

generally well tolerated. In contrast, the fortified aminoglycoside/ 

cephalosporin antibiotics have a short shelf life, require 

refrigeration, must be obtained from a specialised pharmacy, 

and may cause more surface toxicity. As a result, ciprofloxacin is 

frequently used to empirically treat keratitis, and a study from 

Waikato Hospital from 2003-2007 showed that 99% of bacterial 

keratitis isolates were sensitive to ciprofloxacin. 1 However, there 

are some reported gaps in ciprofloxacin’s coverage of gram positive 

organisms 4 and many clinicians treat severe, central, visionthreatening 

keratitis (Fig. 1) using dual therapy for additional 

coverage of potential organisms. Because chloramphenicol is 

bacteriostatic, rather than bactericidal, it is generally not used as 

primary treatment of severe corneal infections. The addition of 

an antibiotic ointment at bedtime (such as chloramphenicol or 

tobramycin) may augment the use of daytime eye drops. 

When treating a bacterial infection (conjunctivitis or keratitis), 

there is usually improvement (or in the case of severe keratitis, at 

least no worsening) within 2-3 days of treatment. If the infection 

is not responding, consider: incorrect diagnosis, non-compliance, 

subtherapeutic dosing frequency, or inappropriate choice of drug. 

Blepharitis. While blepharitis is not due to an infection per 

se, treatment with an antibiotic may be a beneficial adjunct 

to other treatments, particularly when due to staphylococcal 

hypersensitivity. Similarly, “staphylococcal” marginal keratitis 

(Fig. 2) is due to a hypersensitivity reaction to bacterial antigens. 

The acute management of marginal keratitis requires treatment 

with a topical corticosteroid. However, strategies to minimise the 

recurrence include the institution of an eyelid cleaning regimen 

along with a course of nightly topical antibiotic with activity 

against gram positive organisms. Fusidic acid has good coverage 

against staphylococcus and also has immunosuppressive properties 

which make it a useful treatment option for many patients to 

reduce bacterial loads and inflammation. 

ANTIBIOTICS 

An overview of the commercially available topical antibiotics is 

presented below. Other antibiotics may be available through special 

order through a compounding pharmacy and are not covered in 

this review. Additionally, anti-viral and anti-fungal agents have not 

been included. 

CHLORAMPHENICOL. Available as 0.5% eye drops (Chlorafast) or 1% 

ointment (Chlorsig). 

Mechanism of Action: Bacteriostatic. Inhibits protein synthesis. 

Spectrum of coverage: Broad, most gram positive and gram 

negative organisms. Not effective against Pseudomonas 

aeruginosa. 

Considerations: Aplastic anemia is a serious, life-threatening, 

side effect but the risk is extremely low with topical use (less 

than 1 in 224,716 prescriptions). 5 Other risks include gray baby 

syndrome, so treatment during pregnancy should be avoided 

during the last week before parturition and while breast-feeding. 

As with all medications, topical irritation/allergy can occur (Fig. 

3). Most commonly used to treat conjunctivitis or for prophylaxis 

of infection. The solution contains phenyl mercuric nitrate as a 

preservative, and the ointment is preservative-free, so may be used 

in patients with allergy to benzalkonium chloride (BAK). 

CIPROFLOXACIN. Available as 0.3% eye drops (Ciloxan) 

Mechanism of Action: Bactericidal. Interferes with DNA synthesis. 

Spectrum of coverage: Broad range of gram positive and gram 

negative organisms and very effective against pseudomonas. 

Considerations: May form crystalline precipitates on the ocular 

surface which may obscure the visualization of an ulcer base when 

treating keratitis. 

AMINOGLYCOSIDES. Gentamicin (Genoptic), Tobramycin (Tobrex) 

0.3% eye drops or ointment. Neomycin and Framycetin available in 

combination with dexamethasone. 

Mechanism of Action: Bactericidal (concentration dependent). 

Inhibits protein synthesis through binding of ribosomal subunits. 

Spectrum of coverage: Broad, gram negative and moderate gram 

positive with some resistance among Streptococcus pneumonia. 

Considerations: Poor ocular penetration. Among aminoglycosides, 

tobramycin has best activity against pseudomonas aeruginosa. 

Aminoglycosides may cause surface toxicity including superficial 

punctate keratitis and erythema/oedema of the conjunctiva, mostly 

after the drug is used in excess of 1-2 weeks. 

NEOMYCIN/POLYMIXIN B. Component of Maxitrol along with 

dexamethasone 0.1% as a solution or ointment. 

Mechanism of Action: Neomycin is an aminoglycoside and 

inhibits protein synthesis. Polymixin B sulfate alters bacterial cell 

membranes. 

Spectrum of coverage: Neomycin has excellent gram negative 

coverage with partial gram positive coverage. Polymixin B is 

bactericidal for gram negative with little effect on gram positive 

organisms. 

Considerations: As a combination antibiotic/steroid this is not 

frequently used in the treatment of infections. However, this 

combination is often used as postoperative prophylaxis of infection 

due to the convenience of a single medication. Roughly 5% of 

patients may experience a delayed hypersensitivity reaction to 

neomycin consisting of itching, erythema/oedema of the eyelids 

and conjunctiva, and possibly a superficial punctate keratitis. 

This usually occurs after several days of treatment, if previously 

unexposed, or within 12-72 hours if previously exposed. 

FRAMYCETIN/GRAMICIDIN. Component of Sofradex along with 

dexamethasone 0.05%. 

Mechanism of action: Framycetin sulfate is an aminoglycoside 

and inhibits protein synthesis. Gramicidin increases permeability of 

the bacterial cell. 

Spectrum of coverage: Framycetin has broad coverage with 

clinical use targeting gram organisims. Gramicidin is active against 

gram positive bacteria and reinforces the action of framycetin 

against streptococci. 

Considerations: In comparison to Maxitrol, contains a lower 

concentration of dexamethasone and may have greater activity 

against some gram positive organisms. 

SULFONAMIDES. Sulfacetamide sodium 10% solution (Bleph-10) 

Mechanism of Action: Bacteriostatic. Acts as an antimetabolite to 

inhibit folate metabolism. 

Spectrum of coverage: Inhibits gram positive and gram negative 

bacteria. Poor coverage of pseudomonas and significant percentage 

of staphylococci are resistant. 

Considerations: Should not be used if hypersensitivity to sulfa 

drugs. Rare potential side effect is Stevens-Johnson syndrome. 

FUSIDIC ACID. Available as 1% viscous eye drops (Fucithalmic) 

Mechanism of Action: Inhibits protein synthesis. 

Spectrum of coverage: Bacteriostatic activity against a wide range 

of gram positive, particularly staphylococcus. 

Considerations: Also has immunosuppressive properties, 

making it a good choice for blepharitis due to staphylococcal 

hypersensitivity. 

PROPAMIDINE. Available as (Brolene) solution or ointment without 

a prescription 

Mechanism of Action: Bacteriostatic. Causes damage to the cell 

surface. 

Spectrum of coverage: Broad spectrum antimicrobial, may have 

activity against antibiotic-resistant staphylococci. 

Considerations: This is often only prescribed by ophthalmologists 

for the treatment of acanthamoeba keratitis. ▀ 

References 

Fig 1. Severe microbial keratitis with a large, central, elevated infiltrate due 

to Moraxella. 

Fig 2. Blepharitis and staphylococcal marginal keratitis with paralimbal 

corneal infiltrates from 2 to 5 o’clock. 

Fig 3. Severe contact dermatitis and allergic conjunctivitis due to 

frequent application of chloramphenicol solution. 

1. Pandita A, Murphy C. Microbial keratitis in Waikato, New Zealand. Clin 

Experiment Ophthalmol 2011;39:393–7. 

2. Wong T, Ormonde S, Gamble G, McGhee CNJ. Severe infective keratitis leading 

to hospital admission in New Zealand. Br J Ophthalmol 2003;87:1103-1108. 

3. McDonald EM, Ram FSF, Patel DV, McGhee CNJ. Topical antibiotics for the 

management of bacterial keratitis: an evidence-based review of high quality 

randomised controlled trials. Br J Ophthalmol 2014;98:1470-7. 

4. Goldstein MH, Kowalski RP, Gordon YJ. Emerging fluoroquinolone resistance in 

bacterial keratitis. Ophthalmology 1999;106:1313-8. 

5. Lancaster T, Stewart AM, Jick H. Risk of serious haematological toxicity with 

use of chloramphenicol eye drops in a British general practice database. Br 

Med J 1998;316:667. 

About the author 

* Jay Meyer is an anterior segment fellow at the 

University of Auckland and has an interest 

in ocular infections. Prior to his training in 

ophthalmology, he completed a B.S. degree 

in microbiology and as a medical student 

described a novel species of mycobacteria 

(Mycobacterium arupense). 


Celebrating Bruce Hadden MD 

Associate Professor Bruce Hadden’s long 

standing support for (and association 

with) the Department of Ophthalmology 

at the University of Auckland was honoured in a 

celebration in April. The evening also marked 

A/Prof Hadden’s recent success for achieving an 

MD (Doctor of Medicine) by research. 


Ophthalmology Department, chaired the event, 

Professor Stuart McCutcheon (left) andProfessor Alan Merry (right) raise a glass to A/Prof Bruce Hadden 

welcoming the 50 plus guests, before sharing 

some amusing anecdotes about how he met 

Bruce (in the men’s room in Melbourne) and 

how he was one of five key people who were 

responsible for him coming to New Zealand and 

happily remaining here. 

To the continued amusement of the audience, 

Professor McGhee also related the tale of how he 

conspired with Bruce’s wife, Dr Wendy Hadden, 

to keep Bruce busy when he retired from a long 

and distinguished ophthalmological career, 

appointing him honorary Associate Professor in 

Ophthalmology. Since then Bruce has become a 

favourite with students as a teacher, is still the 

go-to person for any clinical or diplomatic advice, 

has published a major textbook on eye surgery 

and eye surgeons in New Zealand plus 30+ papers 

in scientific journals and completed his MD. 

Professor McGhee summed up Bruce as too 

modest. “He’s an outstanding clinician and 

surgeon. He and Wendy have been fantastic 

supporters of the department…he’s retained an 

intellectual curiosity through his entire career, he 

keeps his students sharp and on their toes…he’s 

an unstinting friend of the faculty, he’s always 

diplomatic and he’s an outstanding friend.” 

Professor Stuart McCutcheon, vice chancellor of 

the University, admitted when he was first invited 

to talk, he thought the function was to mark 

Bruce’s retirement so was pleased to find out this 

wasn’t so. He thanked Bruce and Wendy for their 

long and committed support of the Faculty and 

the Department, concluding his speech by saying 

that: “Associate Professor, Doctor, Doctor, Mr 

Hadden” was without doubt a great example of 

the best in Town and Gown. 

Professor Alan Merry, head of the School 

of Medicine, also reflected on some of the 

achievements of Bruce’s outstanding career, 

including his stint as the first New Zealand 

president of RANZCO, and how he has 

been instrumental in the development of 

ophthalmology in New Zealand. ▀ 

Maree McInerney, Professor Colin Green, Dr Sue Ormonde and A/Prof 

Trevor Sherwin 

A/Prof Bruce and Dr Wendy Hadden with Suzanne Renner and A/Prof 

Gordon Sanderson 

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 

Education out 

of this world 

Jon Baines Tours, a specialist provider of fully escorted medical 

tours, is now taking bookings now for its next ophthalmology tour 

in Japan and optometry tour in Peru in 2017. The tours explore 

destinations through the eyes of a particular profession, visiting 

clinics, meeting specialists from those regions, while also providing 

a full cultural programme, covering the key sites of a country. 

Ophthalmology in Japan: 28 February - 11 March 2017 

This study tour will be led by Professor Christopher Liu, a consultant 

ophthalmic surgeon based in Britain. It encompasses Tokyo, the 

former Samurai town of Kanazawa, Osaka, Hiroshima and Kyoto and 

includes visits to eye hospitals and ophthalmic centres, lectures 

and meetings with Japanese colleagues. The wide ranging cultural 

programme will include museums, castles, gardens and temples as 

well as contemporary Japan. 

Optometry in Peru: 2–14 April 2017 

The annual optometry tour is going to Peru and will be led by regular, 

UK-based tour leader, optometrist David Shannon. Peru is a country as 

varied in culture as it is in natural landscapes. This tour will travel from 

the capital, Lima, to the ancient Inca capital, Cuzco, before heading 

to the lost city of Machu Picchu, the Andes and Lake Titicaca to visit 

traditional communities. It includes a range of professional visits 

examining emerging optometry and eyecare throughout Peru. 

For more about either tour visit: 

www.jonbainestours.co.uk/optometry. ▀ 

Lumenis presents OPT results 

Lumenis, the world’s largest energy-based medical device 

company for aesthetic, surgical and ophthalmic applications, 

presented interim results of a multicentre prospective clinical 

trial designed to study the safety and efficacy of Optimal Pulse 

Technology (OPT), the next generation of Intense Pulse Light (IPL) 

technology, for treating dry eye disease (DED). Data from the trial, led 

by Steven J. Dell, MD, of Dell Laser Consultants in Austin, Texas, was 

presented at the ASCRS conference held May 6-10 in New Orleans. 

In the trial, 40 patients from two centres received three IPL with 

OPT treatments for DED caused by Meibomian gland dysfunction 

(MGD). Tear break-up time, SPEED questionnaire scores, tear 

osmolarity and additional endpoints were measured at baseline and 

again after treatment. 

“Many of my patients with dry eye due to MGD report significant 

ocular discomfort that limits their ability to work, participate in 

hobbies or use computers, smartphones and tablets. For these 

reasons, it is important that we have effective and safe treatments 

that help patients resume normal activities without visual 

symptoms,” Dr Dell said. 

Sheila Barbarino, MD, of Dell Laser Consultants, presented interim 

results of 14 patients who finished all treatments and follow-ups. 

“I am excited to present the data from our study,” Dr Barbarino said. 

“More than 40 million Americans suffer from dry eye and several 

studies show that MGD plays a primary role in a majority of cases. 

The data from our study suggests that IPL with OPT could be an 

important addition to our armamentarium of treatments for this 

prevalent, life-altering disease.” 

Lumenis M22 IPL with OPT is a clinically-proven and TGA and 

Medsafe -cleared therapy for a wide range of skin conditions, 

including inflammatory disorders such as rosacea. More than 

a decade ago, Rolando Toyos, MD, of Toyos Clinic in Nashville, 

Tennessee, observed that patients treated with IPL for skin conditions 

reported significant improvement in ocular symptoms and signs, in 

some cases including resolution of concomitant MGD. Studies show 

that over 85% of individuals with skin and eyelid inflammation also 

suffer from inflammatory ocular conditions, such as MGD, blepharitis 

and eyelid telangiectasia. IPL with OPT may selectively target 

abnormal blood vessels and remove a major source of inflammation 

from the skin and eyelids of these patients, providing symptomatic 

relief and addressing the underlying causative pathway of their 

Lumenis’ Optimal Pulse Technology in action 

SPONSORED FEATURE 

ocular disease. 

Lumenis OPT proprietary technology ensures the delivery of 

consistent and homogenous levels of energy during brief IPL pulses, 

thus eliminating unsafe energy spikes, increasing reproducibility and 

improving results with fewer treatment sessions while reducing the 

risk of skin damage. The results of the study have indicated a 220% 

improvement in tear break up time, a greater than 50% improvement 

in SPEED Questionnaire scores and a greater than 40% improvement 

in relative osmolality readings of the tear film. This demonstrates 

both a significant improvement in the objective markers used as 

well as the patients reporting significant subjective improvements. 

The M22 with OPT is available now from Lumenis Australia/ New 

Zealand. Further information or to request a demo is on the website 

www.lumenis.com/Solutions/Ophthalmology/Products/M22. ▀ 



17

An international query 

Registrations 

open for 

WAVE 

An international reader recently sent me the following email query: 

“I have a question that you have probably answered in one of your 

columns already - hope you don’t mind! In the toss up between dailies 

that are not siHy and well cared for monthlies that are siHy, would you choose 

the dailies still?” 

That’s a tough question! 

It certainly got me thinking as this seemingly simple question involves a 

great many fundamentals of contact lenses. I have dealt with many aspects of 

such issues in past columns but felt a review was in order as our lens options 

become ever wider and better, as does our understanding of such things. 

One such aspect obviously regards oxygen permeability and lens 

thickness. We’ve talked a lot in the past about Dk/L, Holden-Mertz criteria, 

neovascularisation, striae and the like, so I won’t repeat it here. I will, however, 

try and put it into a relevant and relative context. 

Of course it’s not as simple as merely considering SiHy versus hydrogels or 

oxygen transmission. 

Today a hydrogel daily like the biomimetic 78% water content Biotrue 

ONEday hydrogel provides a Dk of around 42 units. The Dk is thus not too far 

off the Dk of some silicone-hydrogels - on the lower end of SiHy Dk range of 

around the 50 unit mark. So for many patients a hydrogel like Biotrue ONEday 

will be pretty much the same physiologically. It may, however, have some 

benefits in terms of avoiding solution-lens interactions, allergies and sensitivity 

as well as potential benefits for the so-called and rare silicone-responders. 

There are also other lenses like the biocompatible and zwitterionic Proclear 

dailies that also have reasonably decent Dk of around 25 units. 1-Day Acuvue 

Moist boasts a similar Dk yet adds the benefit of high levels of UV protection 

that are important in climes like South Africa, Australia and New Zealand. The 

Focus range of dailies also have similar Dk and perform very well. 

I have used and continue to use and prescribe all the above lenses with 

excellent results over two decades on many simple and complex patients. I 

rarely see any complications and in fact have solved many problems in patients 

with Thygeson’s-like, solution-lens related keratopathy and a variety of other 

problems, sensitivity and complications they had with reusable lenses. 

Today of course we have some next generation SiHy dailies that are providing 

fantastic levels of comfort and masses of oxygen and today these are my first 

choice. 

Qualification 

Thus I qualified the email query as I suspected that the question was not 

purely related to which was ‘better’ and suspected that cost was the issue. 

They responded that was in fact the underlying reason for their question. They 

practise in South Africa where it seems there is a wider gap in cost between an 

annual supply of dailies versus monthly lenses and also a wider gap between 

SiHy dailies versus hydrogel dailies. 

To me cost is never my first consideration. In fact I rarely even discuss the 

cost with patients. Of course it does on occasion arise. I have also discussed 

this at length in my columns over the years. The way I handle the cost issue is 

simply to state that if we provide a bulk supply of dailies and compare that to 

the annual cost of two-weekly or monthly reusable lenses, PLUS the annual 

solution cost, then we are not talking about budget busting differences. 

If you add in the increased likelihood of the need for unscheduled visits, 

ophthalmological referral or expensive eye drops with reusable lenses then 

we are looking at break-even or even dailies winning the battle. As Efron has 

also showed dailies break even at five days of use compared to seven day use 

of reusable lenses. As I’ve said many times I simply tell my patients that dailies 

will cost them around the cost of a cappuccino per day. Many spend more than 

that on coffee, booze, cigarettes and beauty products so one needs to provide 

a relative perspective. For many the convenience of dailies outweighs any cost 

differential. 

I won’t get into the Internet debate here as that affects both dailies and reusable 

lenses in a similar fashion. 

All Things Being Equal 

If someone wearing say a –3.00 Acuvue/Proclear/Focus et al daily was 

asymptomatic, with no sign of physiological compromise and all looked good, I 

would rather remain in such lenses than refit a SiHy monthly. To me going from 

dailies to reusable is a retrograde step! 

I’ve spent most of the past 20 years refitting reusable lens wearers into 

dailies with fantastic results. I very rarely see complications. Pretty much the 

only issue that occasionally arises is that of reduced end-of-day comfort or 

tired, heavy-feeling, dry eyes. These days we solve most of those problems 

refitting people into the latest generation SiHy dailies like Dailies Total 1 or the 

fantastic new Acuvue Oasys 1 Day (AO1D). 

AO1D is surpassing pretty much every other lens I’ve ever prescribed in terms 

of comfort, vision and all day comfort. 

I’ll be sharing some of these cases at the Acuvue Oasys 1 Day launches that 

will have just been completed by the time you read this. 

I hope this clarifies some of the issues and considerations that this email 

query spurned. 

I always appreciate feedback from readers and am happy to consider such 

questions. 

I asked the writer of the query if my much shorter email response satisfied 

her query. She responded as follows; 

“That does! 

It’s just that the siHy daily is so much more expensive than a regular daily 

that I am often asked that question. 

So basically if a patient is asymptomatic any daily is better even if it’s 

hydrogel! As a general rule! 

Thanks a million.” 

Like I said it is hard to oversimplify things but essentially yes, a quality 

hydrogel daily with sufficient Dk in an asymptomatic and physiologically 

uncompromised patient would be my pick over a reusable lens of any material, 

SiHy or hydrogel. ▀ 

* Disclosure of interest: Alan Saks was not sponsored by J&J to review Acuvue Oasys 1-Day, but was 

engaged by J&J to report on his findings at a series of launch meetings in Australasia in May 

Rendezvous Hotel Perth Scarborough: the venue for this year’s WAVE 

Registrations are now open for the 2016 

Western Australian Vision Education (WAVE) 

Conference on the 13-14 August in Perth. The 

conference venue is the stunning Rendezvous Hotel 

overlooking the white sands of Scarborough Beach. 

Darrell Baker, Optometry WA president, says this 

year’s programme will continue to deliver the high 

standards of clinical and professional education 

WAVE has become renowned for. “It will again 

include a group of talented presenters leading the 

way in new topics and ground-breaking research 

discoveries. We look forward to seeing you in our 

wonderful state, Western Australia, and to you 

enjoying the WAVE experience.” 

Programme highlights this year include the 

Saturday Clinical Workshops; the short, sharp and 

detailed, diverse Lecture Series; the CR Surfacing 

Saturday Evening Sundowner soiree and the trade 

exhibition in the hotel’s Grand Ballroom. 

Speakers include Margaret Lam, founder of 

Sydney-based theeyecarecompany, who’s wellknown 

for her passionate interest in all things 

contact lenses; Dr Lasitha Jayasinghe, a consultant 

ophthalmologist and former Research and 

Clinical Fellow in cornea, external eye diseases 

and refractive surgery with the Singapore Eye 

Research Institute and Singapore National Eye 

Centre; Liz Jackson, a fellow of the Australian 

College of Behavioural Optometry; ophthalmic 

medicines prescriber Stephen Leslie on some of 

the more complex areas of optometry including 

rehabilitative optometric care of acquired brain 

injury; and a host of others. 

The venue, the Rendezvous Hotel Perth 

Scarborough, is just a 30-minute drive from Perth 

Airport and only 15 minutes from Perth’s CBD 

For more and for registration details see WAVE’s 

ad on p15. ▀ 

School of Optometry graduation celebration 

The class of 2015 at the University of 

Auckland’s School of Optometry and Vision 

Science officially celebrated their graduation 

in May with a breakfast for the Bachelor of 

Optometry students, before joining the main 

graduation ceremony. 

Other notable graduates included Associate 

Professor Bruce Hadden, who received an MD by 

research (see full story p17) and Drs Carol Greene 

and Elissa McDonald for completing their PhDs. ▀ 

PhD graduates Drs Carol Greene and Elissa McDonald 

Graduation day for the class of 2015 


Around and about at ARVO 

NZOSS update 

BY JIE ZHANG* 

I 

was excited to be part of a group of 19 

researchers from the New Zealand National 

Eye Centre who travelled to the US for the 

annual meeting of the Association for Research 

in Vision and Ophthalmology (ARVO) at the start 

of May. 

ARVO, based in the US, is the largest 

association in the world for eye and vision 

research and their annual meeting is the 

place where top researchers gather to present 

and discuss the latest treatments, cures, and 

preventative measures, years before they 

become available. This year’s meeting, held in 

the Washington State Convention Centre in 

Seattle from 1 to 5 May, attracted approximately 

11,000 attendees from about 75 countries. 

About 45% of the attendees were from outside 

the States. 

I’d been invited to give a talk at the Aqueous 

humour dynamics session, one of the first of the 

five days. With an audience of approximately 

100 people it was a bit nerve wrecking at first, 

but I felt calm as the session coordinators 

introduced my topic. I was asked some 

reasonable questions, and the crowd at the 

session were generally very friendly. 

Other University of Auckland presenters 

included Professors Colin Green and Paul 

Donaldson, Drs Julie Lim and Hannah Kersten 

and Peter Qiu. 

Professor Green gave a very interesting talk 

at the Cell biology of gap junctions in the 

eye mini-symposium about Connexin 43 in 

corneal and retinal injury and disease. Professor 

Donaldson, Dr Lim and Mr Qiu presented their 

research in the Lens physiology and homeostasis 

session, and Dr Kersten presented in the Ocular 

surface neovascularization, Innervation, and 

Immunology session. There were on average 70 

paper and poster sessions and symposiums on 

any one day, with something exciting bound to 

be happening at any given time. This meant I 

had to make some really difficult decisions at 

times about which sessions to attend. 

The good part about speaking so early in the 

conference programme was feeling free to relax 

and enjoy the rest of the line-up. A highlight 

of ARVO is the multitude of guests who chose 

to present their work in one of the highly 

interactive poster sessions. There is also an “all 

poster” session every day to give the audience 

another chance to see the posters and talk to the 

presenters. These sessions are also well-known 

for their high attendance rates due to rules 

enforced by conference organisers. If you did not 

stand by your poster at the designated time, you 

would be banned from submitting an abstract 

for ARVO the next year! Poster presenters 

typically have between 20 and 30 visitors during 

a two-hour poster session, giving them plenty of 

chances to discuss their research and network. 

One highlight of the scientific programme was 

the release of the five-year CATT (comparison of 

age-related macular degeneration treatments 

The Space Needle observation tower 

trial) results, which found increasingly larger 

areas of geographic atrophy in patients treated 

for two years with ranibizumab or bevacizumab. 

The paper’s title is Size and Growth of 

Geographic Atrophy During 5 Years of Follow 

Up in the Comparison of Age-related Macular 

Degeneration Treatments Trials (CATT). 

Professor Shigeru Kinoshita, a pioneer in 

corneal wound healing and ocular surface 

reconstruction, received the Friedenwald Award 

from ARVO and gave an inspiring lecture entitled 

Medical Science and Future Realities in Corneal 

Regenerative Medicine. In this lecture, he 

described the safety issues they had to solve in 

order to translate cultured corneal endothelial 

cells for the treatment of corneal endothelial 

diseases into the clinic, which entered clinical 

trials in 2013 and is already showing promising 

results. 

Professor May Griffith gave an update on the 

development of a recombinant collagen scaffold 

for corneal repair. The originally non-suturable 

scaffold has now been reinforced with MPC 

for mechanical strength and suturability, and 

has been implanted in 10 high-risk patients in 

Ukraine with painful ulcerated corneal surfaces. 

Dr Jie Zhang, Professor Colin Green and Salim Ismail on a ferry 

to Bainbridge Island 

I look forward to hearing about the results 

in the coming years. 

And, of course, 2016 is the year of CRISPR 

– Cas9: a gene editing tool to cure diseases. 

Gene therapy for eye diseases was a major 

focus of the meeting, with one whole day 

education course, one symposium, one 

special lecture, and numerous posters 

dedicated to the topic. 

The sight-threatening consequences of 

recent viruses such as Ebola, Zika and West 

Nile also received the spotlight. A special 

session was dedicated to these emerging 

systemic infectious diseases, which 

reminded the ophthalmology community 

of the importance of contributing to an 

understanding of disease mechanism 

and treatment, and an urgent need for 

improved ophthalmic screening and care. 

With 12 to 15 concurrent sessions at any 

one time, we were all too busy to meet 

up during the event. Luckily we managed 

to have dinner at the Cheesecake Factory 

restaurant and enjoyed it very much! 

See you next year at ARVO in Baltimore! ▀ 

* Jie Zhang is a research fellow in the Department of 

Ophthalmology at the University of Auckland. Zhang 

is using her biomedical science background to devise 

treatments for ophthalmic conditions and is currently 

focusing on the synthesis and testing of a novel 

collagen based scaffold for corneal transplantation. 

BY NIKKU SINGH, NZOSS PRESIDENT 

With the second half of semester one in full 

swing, it’s a struggle to comprehend where 

the past three months have gone! The 

younger years have settled in well within the school, 

whereas the Part 5’s are becoming more unsettled with 

the prospect of being let loose on the real world. 

Taking a look back, we kicked off this year with a 

week of orientation, initiation and degustation in 

the form of our annual New Zealand Optometry 

Student Society (NZOSS) BBQ. The great weather was 

accompanied by a massive turn out and the existing 

student body was able to warmly welcome the freshfaced 

Part 2’s. Time was spent reminiscing over our 

summer holidays and discussing the week that had 

just been. For the Part 5’s, this meant deconstructing 

our first taste of back-to-back patients—there’s 

nothing quite like a couple sausages to combat the 

‘first week of school’ blues. 

Round the Bays happened to be scheduled just 

two days after the BBQ, proving that a few cheeky 

sausages do not constitute an appropriate ‘carbo-load’. 

Nevertheless, we carried on in full force eager to pound 

the pavement. This year we also had the opportunity 

to work with the Fred Hollows Foundation and run for 

a great cause, restoring sight to the needlessly blind. It 

was a privilege meeting the team driving this fantastic 

charity. After the run we were treated to a big feed by 

Team Fred, bringing the tally to two BBQs in the space 

of a week. We were living the dream! 

The next few weeks carried on with our usual student 

shenanigans, the annual pub crawl providing a much 

needed release of steam following a hectic period of 

assessments for all. We finished off term one with our 

annual NZOSS Camp. The weekend away was a great 

way to usher in the mid-semester break (for those lucky 

enough to have one) and was filled with what I can only 

call some quality team-building exercises! 

2016 has been a very successful year thus far, 

made possible through the hard work of the NZOSS 

committee. Of course, the events wouldn’t be what 

they were without the co-operation and collaboration 

of all the students involved. However, we’ve got plenty 

more work to do, with seminars and educational 

evenings in the pipeline. Of course, we will slip in some 

time for some much needed social soirees, the annual 

Eye Ball being the most anticipated event to come. 

Lastly, on behalf of the School of Optometry, I would 

like to thank all the sponsors for their continuing work 

with NZOSS. Not only does it provide us exposure 

to the optometry profession, but it also helps in the 

development of us as future clinicians. 

For those who are interested in collaborating with 

NZOSS, please do not hesitate to contact us as we 

are always looking for ways to further develop our 

connections with the eye care industry. Our email 

address is nzoss.uoa@gmail.com. ▀ 

For more personalised eye care 

talk to Dr Hussain Patel 

Consultant Ophthalmologist 

MBChB, MD, FRANZCO 

SERVICES INCLUDE: 

Glaucoma Specialist / Refractive Cataract Surgery 

General Ophthalmology / Acute & Emergency Eye Care 

Available throughout Auckland 

and also in Hamilton 

Phone 09 486 4372 or Fax 09 486 3936 

info@eyesurgeryassociates.co.nz or 

Dr Patel at: patel@glaucoma.co.nz 

www.eyesurgeryassociates.co.nz 

Eye Surgery Associates are a Southern Cross Health Society Affiliated Provider 

Dr Jie Zhang, Peter Qiu and Professor Paul Donaldson 



19

We need a gifted Captain 

To see us safe and sound 

Our crew is close to mutiny 

And stormy seas abound! 

Well ... not quite! But we do need to commission a store manager 

with optical experience to join our jolly crew at Specsavers, 

Pukekohe, Auckland, NZ. 

* Management experience Please apply in writing to: 

preferred 

Carleton Buckley 

* Uniform provided seebea@gmail.com 

* Naval experience not PO Box 127, Pukekohe, 

essential! Auckland, 2120 

NEED TO REPLACE 

YOUR LETTER CHART? 

AcuityKit has a comprehensive range of digital eyecharts for eyecare 

professionals. Ideal for low vision and domiciliary work. 

Visit our website www.acuitykit.com or email john@acuitykit.com 

With growth continuing, our store teams are 

currently seeking optometrists to fill permanent 

roles in the following NZ practice locations: 

NZ AND AUSTRALIAN 

OPPORTUNITIES! 

North Island: 

• Auckland CBD 

• Botany 

• Kerikeri 

• Masterton 

• Mt Maunganui 

• Palmerston North 

• Paraparaumu 

• Rotorua 

• St Lukes 

• Taupo 

• Tauranga 

• Te Rapa 

• Wanganui 

• Wellington 

CBD South 

• Whangaparaoa 

South Island: 

• Dunedin • Invercargill • Shirley 

We are currently also seeking experienced 

dispensers for a variety of our New Zealand stores. 

Alternatively, if you’re interested in a move to 

Australia - either short or longer term, talk to us 

for the lowdown on possible locations in all states. 

To find out more and to explore the Terms and Conditions associated 

with this industry-wide offer, contact Carly Parkinson on 0800 717 350 

or carly.parkinson@specsavers.com – or visit spectrum-blog.com 

OPTICAL ASSISTANT REQUIRED 

Here's a chance to work in a great optometry practice in 

Newmarket. We are looking for an amazing, passionate, optical 

assistant for a full-time role with a potential career path. You need 

to be efficient, totally customer focussed, well presented, able to 

multi-task and absolutely love beautiful eyewear. If you reckon 

you've got what it takes to work in our busy practice please email 

your CV to jeremy@gateseyewear.co.nz 

NEED A LOCUM? 

Call Bharat Raniga, locum optometrist, on 

021 424 253 or email: bharatranlga@yahoo.com 

AND REMEMBER, UNTIL THE END OF JUNE 

2016, ANY OPTOMETRIST REFERRALS 

YOU MAKE COULD EARN YOU UP TO 

$50,000 FOR EACH REFERRAL – SIMPLY 

CALL CARLY TO FIND OUT MORE! 

ADVANCED SHOPFITTERS ON O/E 

Tony Maddocks of Advanced Shopfitters is taking a well-earned 

break, travelling around Britain and Europe for the next 12 

months. NZ Optics wishes him and his wife Lynette, happy and 

safe travels and thanks them for their continued support of the 

magazine for more than 20 years. 

Whether you are looking for new staff, to sell your practice or buy 

some equipment, NZ Optics classified page connects you. 

For all your advertising needs email 

Lesley@nzoptics.co.nz or 

(for classifieds only) do it online at 

www.nzoptics.co.nz 

PART-TIME DISPENSING OPTICIAN / 

OPTICAL ASSISTANT, TAKAPUNA 

We are looking for a dispensing optician/optical assistant to 

join our independent, high-end optometry practice in Takapuna, 

by the beach. The position is for 50-60 hours per fortnight – 

including alternate Saturdays and Mondays. 

The successful applicant will: 

- Be a qualified Dispensing Optician or Optical Assistant with 

dispensing experience. 

- Display exceptional customer service and sales skills. 

- Have a passion for fashion eyewear and leading edge lens 

technology. 

- Have some social media skills – e.g. Facebook, online customer 

communications. 

- Have flexibility to provide leave cover for our full-time 

Dispensing Optician. 

- Be a good team player. 

If this sounds like you, please email your CV to 

david@haydons.co.nz 

C 

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Thinking of selling your practice - we have buyers 

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we've helped dozens of Optometrists buy and sell their practices 

For more information contact Stuart Allan on: 03 546 6996 

20 NEW ZEALAND OPTICS June 2016 

027 436 9091 stu@opticsnz.co.nz www.opticsnz.co.nz 

June Classifieds FINAL 

• Locum Service 

• Recruitment Services 

• Practice Brokering 

• Business Consultants 

NEW ZEALAND 

1

Jun 2016

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