Nov 2015

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Progress for retinal prosthesis system New views From time to time I feature guest columnists. My dear wife Karen has written a few well received pieces for me. They’ve featured contact lens and makeup tips, experiences with multifocal contact lenses, lens care and solutions. I thus recently suggested she do another. Here follows her latest contribution. A tribute to my mother Alan recently sent me an email. It read: “u must write more columns for me!” His September column paid tribute to Brien Holden and Trevor Duncan, who both passed away in July. I knew them both. Their sad passing added to a winter of losses; a few other people we knew recently passed on, as did a favourite dog called Max. We miss them all. I always proof read Alan’s writing, (which is why it’s so good ). The final version of the September In Contact column was submitted on the 17th of August, which happens to be my mother’s birthday. The thought came to me that sometimes we should pay tribute before it’s too late, to let people know how much we value them. We should say thank you for the richness they bring to our and other’s lives, while they are still able to hear or read our words. Like Alan, my mom Rita is also a writer. Early on she wrote a few novels, particularly in the early stages of my father’s publishing career. One or two books might have been written because they had to have something for the monthly Mills & Boon-like, subscription books my dad published. My dad also wrote a book, for the same reason, over a weekend at the kitchen table: talk about doing what you have to. My mom’s writing was good, always inspirational. The books she really enjoyed working on though were the interior decorating books that followed later. Creating a visual delight on each page brought her immense joy. By that stage I’d joined the family publishing company that was founded by my grandfather. We had a huge amount of fun together, working on these publications. The interior decorating books were really a summary of my mother’s philosophy. She often said things like “beauty before practicality”, or actually, “practicality be damned, this is a jewel”, which is an odd thing for an interior decorator to say, but totally in character. My mother sees the world through rose-tinted glasses, her glass is always half full, the horoscope always has a positive message, good things lie ahead, life is amazing! My mother hears the birds, she sees the first hint of spring in the garden. She has champagne in her veins, despite being a lifelong teetotaller. She is high on life, when times are good, and even when they’re not so good. Dark days mean that a turning point is near, that the next dawn will be the brightest ever! As Jim Morrison once said, “the future is uncertain and the end is always near”. All we really have with some degree of certainty is NOW. Live life while you have it, do the things that you want to do, stick your neck out, take risks. Optometrists, or optimists as our daughter used to say when she was young, give the gift of improved vision. A new pair of stylish frames can work miracles, or no frames and improved vision with contact lenses can be life changing. A new image, a new phase in life… Let there be sight, and see the beauty around you! A rosy outlook I’m finishing this column off after a whirlwind trip to Silmo in Paris; a fantastic exposition of frames, sunglasses, lenses, instruments and low vision aids. Read all about it in this edition in Maryanne’s report. It’s taken me over thirty years to finally visit Silmo. I’ve always had a more senior partner ahead of me in the queue to attend overseas trade fairs. Thanks to Maryanne for showing me the ropes. I was amazed to see how many people knew Maryanne and were so happy to see her. We hung out with a few Danes, French, Kiwis, Aussies, POHMS and the odd South African, German and Austrian. We had entertaining meals, including a memorable dinner with the legendary Oliver Goldsmith, a real character and stalwart of the optical world. He’s always good for a story. Any independent optometrist looking for a competitive edge, or simply seeking maximum exposure to the widest range of frames possible, would be well-served by attending Silmo. France in the Autumn is also rather pleasant. I enjoyed some great walks wandering the suburbs of Paris and exploring the canals, cemetries, museums, parks and shops, before the ever hectic trade fair kicked off. Having being relatively uninvolved in frame buying since selling our practices around seven One of the many colourful, attractive stands. A giant years ago, it was a great opprtunity to get up to model of a printed frame. speed on the latest trends, fashion and technology. I was impressed with some new innovations and with the quality and technological development. Maryanne will elaborate in her report. Proper people What Silmo also reinforced for me was the importance of working with a great team of people and the importance of the suitability, quality and functionaility of the dispensed eyewear. Every person in the supply chain plays a role. Spectacles are commonly the physical manifestation and summation of all that we do. They largely determine the success of the outcome and overall satisfaction of the patient. Dispensing can be rather challenging at times. I’ve been very lucky in my career to work with great teams of people and skilled professionals, who are focussed on excellent outomes for our patients. That is after all what it’s all about. Let there be light. Let there be sight, and see the beauty around you. After two interesting days back at the office, writing three columns, washing clothes, some gardening and repacking my bags, it’s off to New Orleans, a city high on my bucket list. The American Academy of Optometry conference, arguably the number one optometric conference in the world, beckons. Not that our local CPD managers recognise that. I have to do a heap of paperwork and pay to have the CPD recognised in NZ, so I usually don’t bother. If I ever lacked points for an annual registration, I’d probably bother more. The upside is I can skip a few lectures and enjoy more of New Orleans. Yeeehah. I’ll report back on my return. Cheers from the departure lounge! Larry Hester, the seventh person in the U.S. to have an Argus II Retinal Prosthesis Device implanted allowing him to see for the first time in 33 years Popular press trumpeted the first implant of a “bionic eye” for patients with dry agerelated macular degeneration when doctors performed the first implant and activation of the Argus II Retinal Prosthesis system earlier this year. The bionic eye part is debatable, but the operation—performed at the Manchester Royal Eye Hospital in June by Dr Paulo Stanga—was a step forward for the Argus II system, which was originally tested, and approved for restoring some vision in patients with retinitis pigmentosa (RP) in the US in 2013 and Europe in 2011. The Argus II System has now been implanted in 150 patients in the US, Canada, France, Italy, Germany, the Netherlands, Saudi Arabia, Spain, Switzerland and the UK. The Manchester implant was part of a feasibility trial for evaluating Argus II for treating late-stage Dry AMD. While Second Sight Inc.—the California, based company behind the Argus II system—has not been the only company in the last 15 years to pursue retinal implant systems, it appears to have gone the furthest, at least as far as feasibility and clinical trials, and regulatory approval. Argus II is comprised of a small electronic device implanted in and around the eye, a small video camera attached to a pair of glasses, and a video processing unit worn or carried by the patient. The video processing unit receives images captured by the camera, and turns them into signals transmitted to the implant wirelessly. The implant transmits the signals to the retina in electrical pulses, which are intended to bypass damaged photoreceptors by stimulating the retina’s remaining cells. The system creates the perception of patterns of light which patients can learn to interpret as visual patterns. According to an announcement released by Change of guard at Younger Optics Younger Optics Australasian sales and marketing manager Trevor Inglis is retiring after 10 years. To work on his golf handicap, he says jokingly. Speaking to NZ Optics at ADONZ 2015, Inglis says he’s been planning the move for some time, but wanted to make sure he had the right successor in place and he was on hand to ensure a smooth handover before moving on. That successor is Samantha “Sam” Crooke, an Australian optometrist by training, who has held a variety of positions in the optical field including practice manager, professional education manager and even Queensland territory manager for Younger Optics. The two have known each other since 2008 and Inglis was visibly delighted to be Samantha Crooke Second Sight, the Argus II Manchester implant was the first of a larger study to expand the application of the system. Eligibility for this study includes patients 25 to 85 years of age with advanced dry AMD, some residual light perception and a previous history of useful form vision. Study subjects will be followed for three years to evaluate safety and utility of the system on visual function. The first recipient of the Argus II in the study was Ray Flynn, 80, of Manchester who had lost his central vision to AMD, but had some peripheral vision. According to reports, Flynn was able to detect the pattern of horizontal, vertical and diagonal lines on a computer screen using the implant in a test just two weeks after surgery. In its approval of the device for use in up to 4,000 procedures per year, the FDA in 2013 stated it had reviewed data that included a clinical study of 30 participants with RP who received the Argus II Retinal Prosthesis System. Investigators monitored participants for adverse events related to the device or to the implant surgery and regularly assessed their vision for at least two years after receiving the implant. Results from the clinical study show that most participants were able to perform basic activities better with the Argus II than without it including locating and touching a square on a white field, detecting motion direction and recognising large letters, words, or sentences, among other tests. Following the implant surgery, 19 of the 30 study patients experienced no adverse events related to the device or the surgery. However, 11 study subjects experienced a total of 23 serious adverse events, including erosion of the conjunctiva, dehiscence, retinal detachment, inflammation, and low intraocular pressure. ▀ able to introduce Sam at ADONZ to many existing and would-be New Zealand customers. With several new products in the pipeline, including the as yet to be launched Camber it’s an exciting time to be taking over, says Crooke. “In an ever-consolidating and competitive market, Trevor has contributed to Younger Optics’ growth, and more importantly our customers’ growth by understanding their needs, providing exceptional customer service and support,” said Mark Rupert, Younger Optics general manager, Asia Pacific, in a statement. “Both Younger Optics and our customers will miss him, and we wish him the best.” Inglis will leave Younger at the end of the year, ending a 35-year career in the optical industry. ▀ Trevor Inglis 22 NEW ZEALAND OPTICS November 2015
Kiwi cameos feature in Australian optometry history The Australian College of Optometry (ACO) has published a history book to commemorate its Diamond Jubilee. A History of Australian Optometry by Professor Emeritus Barry Cole was debuted at the ACO National Conference on October 24. “The college has been an important player in the history of optometry over the last 75 years and whilst it has its own chapter, the book tells the story of more than 200 years and features optometric institutions and optometrists Australia wide,” Cole said in a statement released prior to the debut. A History of Australian Optometry begins with the spectacle sellers and sight-testing opticians who became the early adapters of refraction techniques in the second half of the 19th century, and proceeds to the associations, regulations and new technologies of the 20th century. But given our close association, the book soon demonstrates that a history of optometry in Australia cannot be written without New Zealand making more than a few appearances. According to ACO’s Arwen Bardsley, the history book reports the first person to graduate with an optometry degree from the University of Melbourne was New Zealander Gavin Bridgman. “He studied optometry in the ACO expecting to qualify with a diploma of Licentiate of Optometric Science (LOSc). He was in his final year in 1961 when the course became a degree course of the university and he was admitted to the new degree course in that year with full credit for his prior studies in the college,” says Bardsley. “He obtained both the LOSc diploma from the college and a Bachelor of Applied Science (Optometry) from the university. He was in fact the only final year student in that year, so he has the single honour of being the first to obtain a degree in optometry in the University of Melbourne.” While that wasn’t the first degree in optometry awarded in Australia, it reinforces the intertwined history of the profession in Australian and New Zealand. A number of New Zealanders studied optometry in Australia through the 1950s, including Roger Sargent, John Fairmaid and Lex Grocott. A chapter focused on Registration Acts shows New Zealand also played a more active role in the Trans-Tasman Mutual Recognition Act than some Australian states. Australia, in turn, contributed Professor Emeritus Barry Cole, author of ACO’s new history book New approaches to presbyopia Pharmaceutical company Novartis has teamed up with Google to integrate the search engine giant’s technology within contact lenses. According to Reuters, Novartis is already planning initial human tests on the first product to emerge from the collaboration—contact lenses that can accommodate vision correction in presbyopes. New approaches to presbyopia are accelerating. Several companies are testing or already marketing presbyopia solutions from different angles. Presbyopes, it appears, will have a wider selection of options beyond multi-focal CLs, progressives and LASIK, with Google-Novartis’ auto focusing CLs, inlays and eye drops. In October, Texas-based Encore Vision announced the US Food and Drug Administration (FDA) had granted it permission to begin clinical trials on a topical treatment for presbyopia. Encore’s EV06 is an investigational proprietary lipoic acid choline ester compound aimed at reversing changes in the crystalline lens that result in diminished lens elasticity. The company says it will be the first clinical evaluation of a new chemical entity to address the underlying physiological processes causing presbyopia. “To have a pharmaceutical therapy that could effectively reduce dependence on bifocals or reading glasses is truly a groundbreaking approach in the treatment of presbyopia,” to the development of optometry education in New Zealand, with Australian Leon Garner becoming the foundation professor of optometry at the University of Auckland. Author Professor Cole has seen a good deal of the history of Australian optometry up close. He qualified in optometry at the ACO in 1954 and was appointed its first full-time lecturer in 1958. He was made the head of the Department of Optometry and Vision Sciences at the University of Melbourne when it was established in 1973 and he was appointed the foundation professor of optometry in the University in 1978. He is now Professor Emeritus in the University of Melbourne. A History of Australian Optometry (320 pages, illustrated) is available in softback (A$75) or deluxe hardback format ($160) from www.optometry.org.au/shoponline.aspx or www.aco.org.au/history-book. ▀ says Dr Richard Lindstrom, adjunct professor emeritus of ophthalmology at the University of Minnesota. “If EV06 proves successful in the clinic, this will be a major shift in how we treat the massive presbyopic population.” The first EV06 study will compare the safety and efficacy of EV06 to placebo in at least 72 subjects, 45 to 55 years of age with presbyopia, and evaluate mean change in distance corrected near visual acuity (DCNVA) and best corrected distance visual acuity (BCDVA), along with additional secondary outcomes. Corneal inlays have also begun to take off with AcuFocus’ Kamra inlay receiving regulatory approval this year for marketing in the US and Europe. The Kamra device is 3.8 mm in diameter and 6 microns thick with a tiny 1.6 mm central opening that creates a pinhole camera effect. The Kamra inlay procedure takes less than 15 minutes and does not require stitches. Revision Optics of California is waiting in the wings to bring its Raindrop Inlay to market as soon as the FDA gives its final sign off, likely by mid-2016. The Raindrop is a microscopic hydrogel that is 80 per cent water, and as with existing inlay processes, is implanted in the non-dominant eye, in an in-office laser procedure. The company says the inlay changes the anterior curvature of the cornea, allowing for a “natural restoration of near vision” and because it is mostly water, the inlay does not restrict the amount of light reaching the retina. ▀ A collector’s rare frames hunt Tom Chapman has been a collector of all things vintage for years, from t-shirts to music to footwear. The young Australian school teacher, however, ventured into classic eye frames back in 2008, and has since built a small, but prized collection around original Cazal designs. “The inspiration came from a now defunct vintage store that I found in Bangkok, Thailand while I was teaching overseas,” Chapman says. “I still remember the revered Cazal 858 frames sitting in the window of the store, the price tag was about two weeks wages for me at the time and for many weeks I walked by without trying them on, and then one day I took the plunge, tried them on and immediately made the purchase.” Chapman now owns among the highest valued Cazals sought by collectors, such as the large The grey 616 (bottom) is the rarest Cazal in Chapman’s collection NEW Built on the ACUVUE ® MOIST Platform the #1 best-selling daily disposable brand around the globe 1 Her Vision Will Change. Her Experience Won’t. Now you can continue excellent care as her vision evolves into presbyopia with 1-DAY ACUVUE ® MOIST Brand MULTIFOCAL Contact Lenses of patients were successfully fit with 2 pairs of lenses or less 94 % when using the Fitting Tips.* *Up to 4 lenses total. 1 JJVC Data on File 2015 (Internal Analysis, based on independent third-party data) mottle grey 616—one of the rarest—the red 951, the large amber brown 642, and a custom 951. He says his is small compared to other vintage frame collectors who can own hundreds or thousands of items. “I have collected, sold and traded perhaps only about 50 or so frames,” Chapman says. “Any more, and I think my wife would have something to say.” His collection now also includes Cartier, Dior, and Porcshe Carrera frames, but some of his Cazals are counted by collectors as the Holy Grail of the niche. “Its distinctive style, created and designed by Cari Zalloni, was made famous long before I was around,” Chapman says. “The hip hop stars and celebrities of the 80s and 90s and now even today have favoured many of the creator’s frames. The legendary style can be still seen in many of today’s movies, music video clips and even on the catwalks.” The majority of the original frames were made in West Germany. Chapman collects from various auction and classified websites. The odd collector may come across frames in practices, Chapman says, sitting long-forgotten in a store room, covered in dust and cobwebs, but he has never had such luck. “My collection is on display and cared for in my home, but unlike some other collectors, mine are worn on a daily basis. I’m a teacher and the kids at school always get a buzz out of the frames I wear,” he says. The brand happened to enjoy a renaissance after Chapman started collecting and Cazal now sells some of its iconic lines alongside new designs. Collectors seek certain numbers (or “series”), most notably the 600 and 900 series, and some frames from the 100, 700 and 800 series. The popular frames from the extensive Cazal collection each have a unique style, making them more desirable to collectors. So if anyone out there has some old Cazal frames lying around in the practice, contact Tom Chapman at tomchapman00@gmail.com. ▀ Learn more about the predictable and positive fitting experience. ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the patient information guide for more information. Johnson & Johnson Vision Care, a division of Johnson & Johnson Pacific Pty Ltd., 45 Jones Street, Ultimo NSW 2007 Australia. Phone 1-800-125-024. www.acuvue.com.au. Johnson & Johnson Vision Care, a division of Johnson & Johnson (New Zealand) Ltd., 507 Mt. Wellington Highway, Mt. Wellington, Auckland 1060, New Zealand. Phone: 0800-449-535. www.acuvue.co.nz ®TM Registered Trademark. CCP 8785/15 ACUVUE® and 1-DAY ACUVUE® MOIST are trademarks of Johnson & Johnson Vision Care Companies. © Johnson & Johnson Vision Care Companies 2015 10314426-A April 2015 November 2015 NEW ZEALAND OPTICS 23
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