Oct 2015

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
October 2015
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2 NEW ZEALAND OPTICS October 2015
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9/18/2015 6:43:18 AM
4/09/2015 12:27 pm

EVF launches
eye screening
initiative at
Kiwi schools
The Essilor Vision Foundation (EVF) has kicked off a new
eye screening programme for low decile Kiwi schools.
More than 120 year-four to year-seven kids were screened
at Flaxmere Primary School in Hastings and nearly 40
per cent were found to be suffering at least some vision problem,
including cases of high myopia and hyperopia.
Kumuda Setty, Essilor New Zealand’s marketing manager, says
she was surprised how high it was despite the figures reflecting
similar statistics overseas.
Setty says part of the reason Flaxmere was chosen as the first
school was because Robyn Isaacson, Flaxmere’s principal, was
a visionary who quickly grasped the power of the screening
programme. “She’s so proud of her school and the children and
as she said ‘it’s all about eliminating the barriers for them not
reaching their full potential’.”
Also supporting the programme were local optometrists Jenny
Stewart, from Grant and Douglas Optometry & Eyewear Hastings
and Havelock North, and Frederick Swain of Frederick Swain
Optometrists in Napier, who both provided their time for free; and
Tim Way from Ophthalmic Instrument Company (OIC), who kindly
donated all the equipment for free. They were helped by locum
optometrists Anita Pistorius and Tracey Jones along with Essilor
staff Vineet Chauhan, Guy Parbury and Gordon Stevenson.
Setty says the programme’s launch in New Zealand has been
on the cards for a while, but it was only at ODMA this year, when
she had a chance to sit down with the head of the foundation and
find out about what worked best overseas, that the ball really got
rolling.
Stewart says the level of eye conditions picked up was
concerning. “In particular we found a large number of cases where
the child’s eyes were not tracking together properly; which means
these students would have difficulty concentrating on written
material after just a few minutes.”
All the Flaxmere children who required further examinations
have opted to go to Stewart as their local optometrist, says Setty.
Essilor has also put together a frame and lens package, including
very tough, kid-friendly frames and Crizal UV-protection lenses,
for those kids who need them. The further eye tests and two
sets of glasses – so they can leave one at school – will be covered
under the community card “Enable” subsidy. If parents don’t have
a community card, Grant and Douglas Optometry have agreed to
cover the cost of any additional eye tests, while EVF will cover the
cost of the glasses.
The programme is already picking up wider interest, with TVNZ’s
Seven Sharp covering the Flaxmere trial, and a few principals of
low decile schools writing to the Foundation to ask if their schools
could be included. Optometrists from different regions are also
excited to be part of this programme and are approaching their
local schools, says Setty.
“There simply isn’t enough awareness within the schools and the
parent community, especially in low decile areas, even if they have
community cards, so we need to drive it through the schools and
the teachers, because they know when their kids are struggling.”
Essilor created the Essilor Vision Foundation in 2008 to “eliminate
poor vision and its lifelong consequences”. A public, non-profit
foundation, based in Dallas, Texas, the programme has now been
rolled out in Canada, China, Singapore, India and parts of Europe,
Latin America and Asia Pacific.
Essilor: a most innovative company
For the fifth year in a row, Essilor has been ranked as one of Forbes
magazine’s top 100 most innovative companies.
A pioneer in ophthalmic optics for more than 165 years, Essilor
is credited with breakthroughs such as progressive, organic and
photochromic organic lenses.
“Innovation is part of our DNA and a key driver in our business
of providing solutions to a fundamental human need: good
vision,” said Jean Carrier, Essilor International’s chief operating
officer.
Essilor has five research and development centres, including
three centres of innovation and technology in France, the US,
Singapore. The Group also operates a photochromic technology
centre (Transitions) in Pinnelas Park, US, and a joint research
centre with Nikon (NEIJRC) in Japan. The company has more than
100 research agreements with universities, public and private
sector laboratories and industrial companies. Last year it invested
180 million Euros in research and innovation. It holds 7200
patents, and 40 per cent of its revenue is generated by products
less than four years old. ▀
(L to R) Vineet Chauhan, Gordon Stevenson, Kumuda Setty, Jenny Stewart, Anita
Pistorius, Tracey Jones and vGuy Parbury at Flaxmere Primary
Optometrist Jenny Stewart tests a young patient’s eyes
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PROUDLY NEW ZEALAND OWNED
What a month
and RANZCO to come
EDITORIAL BY LESLEY SPRINGALL
What a month. From the Eye Institute’s Night of
Mystery and Intrigue to Specsavers fourth clinical
conference in Brisbane, and two new product
launches, the month was packed with new
developments and a host of educational opportunities.
The Eye Institute introduced a far more interactive and fun
approach to its evening and delivered a packed series of tutorials,
while Specsavers added an interesting afternoon to its conference,
both covered in detail in this month’s NZ Optics, while Hoya’s
launch of its newly improved Workstyle V+ and Johnson &
Johnson Vision Care’s new 1-Day Acuvue Moist multifocal provided
some exciting new choices for optometrists.
Then there was OphthalmicDocs (oDocs), a Kiwi-based social
enterprise determined to bring better eye care to developing
nations, which hosted an Auckland dinner to spread the word,
attracted Google and was nominated for an innovation award. And
Maryanne and Simon were at them all, armed with their cameras.
If that wasn’t enough, we’ve also got a special feature
on RANZCO covering what’s on at the conference for
ophthalmologists, orthoptists and practice managers, who’s
exhibiting, what’s new and what to do in Wellington.
Enjoy and don’t forget to let us know what you think.
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3
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12:27 pm

Scientists identify gene
mutation in Acrginatopsia
A
rare
eye disorder marked by colour
blindness, light sensitivity, and other
vision problems can result from a
newly discovered gene mutation
identified by an international research team. The
team published their findings in Nature Genetics,
which may lead to treatments for this form of
colour blindness.
According to the research, mutations to the
ATF6 gene, a key regulator of the unfolded
protein response, can lead to achromatopsia, a
hereditary visual disorder characterised by colour
blindness, decreased vision, light sensitivity and
uncontrolled eye movement in children.
The unfolded protein response is a mechanism
cells use to prevent the dangerous accumulation
of unfolded or mis-folded proteins. Based on
mouse studies, the researchers suspect that the
cone cells of people with achromatopsia are not
permanently damaged and could be revived
by enhancing the pathway that regulates the
unfolded protein response.
“Several drugs that activate this pathway have
already been approved by the FDA for other
conditions and could potentially benefit patients
with achromatopsia,” said one of the study
leaders, Associate Professor Stephen Tsang.
“Five genes had previously been linked to
achromatopsia, however they accounted for only
about half of all cases. Using next-generation
gene sequencing on a small group of patients,
we found that mutations in a sixth gene - ATF6 -
can independently lead to the disease.”
Mutations in ATF6 (activating transcription
factor 6A) have been implicated in other
conditions including diabetes and Alzheimer
disease models, but this is the first time that
they have been directly linked to human disease.
The researchers estimate that ATF6 mutations
account for only about one per cent of cases of
the disease.
“As we sequence more and more achromatopsia
patients, we’re likely to identify other genes,”
said Dr Tsang. “The important lesson of this
study is that it demonstrates how advanced
technologies are bringing precision medicine to
the field of ophthalmology. Certain diseases may
look the same based on the clinical diagnosis,
but we’re finding that each patient is a little bit
different and may benefit from a personalised
approach to treatment.” ▀
Special practice
managers seminar
to be held after RANZCO
A
specialty
seminar is being held after the
RANZCO practice managers conference
in Wellington in November.
The one-day event on Wednesday,
November 4, is open to all optometry and
ophthalmology practice managers. Seminar
topics include how to become a practice leader,
how to manage staff, the behaviours that build
practice leadership, dealing with conflicts, and
developing a leadership style .
Organiser Simon Thiessen, CEO and learning
facilitator of the Real Learning Experience, says
he welcomes optometry practice managers to the
event as similar problems arise across all kinds of
practices.
“Our experience working with hundreds of
practice managers has made it clear: no matter
how long you have been a practice manager,
managing poor performance, dealing with poor
behaviour and resolving conflict are among the
greatest challenges.
“These staff issues can consume more of your
time than they should – and much more than
you would like. However, success as a practice
manager depends on your ability to address
performance and behaviour that is below your
expectations. Left unresolved, these issues
have the potential to undermine performance,
create conflict, frustrate team members and
compromise patient outcomes.”
A discounted registration rate is available
for optometry practice managers, the same
as RANZCO member managers. For more
information and to register visit
http://pm-wellington.eventbrite.com. Book before
October 24 to receive the early bird rate. ▀
Hong Kong expo
focus on designer labels
Organisers of the annual Hong Kong
Optical Fair say the three-day event
will feature more than 200 “wellknown
brands” from around the world
in its Brand Name Gallery, among the total 700
exhibitors expected this year.
The Optical Fair, organised by the Hong Kong
Trade Development Commission (HKTDC)
in conjunction with the Hong Kong Optical
Manufacturers Association, runs from November
4 to November 6. The event, in its 23rd year,
will showcase frames, lenses, optometric
instruments and equipment, and other products
and services at the Hong Kong Convention and
Exhibition Centre.
The gallery will focus on designer and fashion
labels, with Converse, Deep, Groover, ic! berlin,
Italia Independent, Jaeger, L.G.R, Lee Cooper,
Masaki Matsushima, Minima, Morgenrot, Moscot,
Rochester Optical and others set to exhibit.
The organisers will be holding the 17th Hong
Kong Eyewear Design Competition with the
general theme of “Cosmopolitan Glamour.”
Design winners will be announced in October,
with finalists on display at the fair.
The fair also runs concurrently with the 13th
Annual Hong Kong Optometric Conference on
November 5 and November 6. The conference will
focus on anterior ocular disorders and dry eye
syndrome, featuring guest speakers from the US,
UK, Australia and Sweden,
For more information on the fair, and to register,
visit www.hktdc.com/fair/hkopticalfair-en/.
Optical Coherence Tomography (OCT) imaging revealed the loss of outer segments in foveal cone cells in the
‘optical gap’ of a patient with ATF6A defects. Photo credit: Dr. Stephen Tsang, Columbia University Medical Centre
Elective surgeries climb,
with aging population
The number of elective surgeries
performed in District Health Boards grew
42 per cent between 2007/2008 and
2014/2015, according to New Zealand’s
Health Ministry, while the number of all elective
surgeries climbed from 117,954 to 167,188.
Health Minister Jonathan Coleman says the
government’s focus on elective surgery has been
to address the fact that more New Zealanders
are living longer and retirees are beginning to
represent a larger part of the population. The
Ministry of Social Development says 13 per cent
of the population in 2009 was 65 and over, but
in two short years that has increased to 14 per
cent, as the first baby boomers reached 65. By
June 2015, the figure is estimated to be close to
15 per cent.
Elective cataract surgeries have grown over the
years but not as steeply as all electives. The DHBs
performed 12,093 cataract removals in 2007/2008
and 15,203 removals in 2014/2015, a 25 per cent
increase. Cataract removals represented about 10
per cent of all electives in 2007/2008, falling slightly
to nine per cent in 2014/2015.
Health officials say the service had determined
a desired intervention rate for cataract removals
from 2005 to 2008 and has been meeting or
exceeding targets since then.
“The Cataract Initiative was established by
the Ministry of Health in 2005 to increase
cataract service levels and to reduce variation
in intervention rates between DHBs,” says
Clare Perry, manager of Electives and National
Services for the National Health Board. “The
recommended rate for cataract procedures was
set as a standardised intervention rate (SIR) of 27
per 10,000 population.
“In 2008, when the Initiative was complete,
a review was undertaken. It was agreed that
cataract surgery should remain a priority and the
target SIR has remained at 27 per 10,000.”
The national interventation rate for cataracts
has been over 30 per 10,000 since March 2011,
and this year reached 33.41 per 10,000, according
to the Ministry of Health.
Meanwhile, Coleman said the government had
targeted 4,000 more operations per year, and in
2014/2015 had exceeded that goal with 5,000
electives performed. Other government releases
suggest that funding for elective surgery is
being used more for prevention and treatment of
orthopaedic conditions, especially hip, shoulder,
knee and spinal conditions.
The Health Ministry announced in May that it
had set aside money to continue elective surgery
growth, with extra resources for hernia, vein and
gall stone operations, and greater support for
multi-disciplinary early intervention teams to
manage and diagnose orthopaedic conditions. ▀
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 Simon Eskow, editor, at 027 288 5401 or editor@nzoptics.co.nz.
For advertising, marketing, the OIG and everything else, please contact Lesley Springall, publisher, at
027 445 3543 or lesley@nzoptics.co.nz.
To submit artwork, or to query a graphic, please email kirsten.newton@outlook.co.nz and copy in Lesley.
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 Limited. 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 optical 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.
4 NEW ZEALAND OPTICS October 2015
October 2015.indd 4
9/18/2015 6:43:21 AM

Blur puts creative
sensibility in second practice
The owners of Blur Eyecare in Tauranga always knew they
would expand their practice in the area. They just didn’t
know what the timing would be.
“There is never a right time,” says Blur’s co-owner, Stuart
Laing. “We had been keeping an ear out for suitable options. An
opportunity arose while speaking to a patient (a real estate agent)
and the deal was done within a matter of weeks.”
In August, Blur Eyecare officially opened its second practice in
Mt Maunganui.
Laing founded Blur in 2010 with his wife, Haidee Mannix, both
optometrists who graduated together from Auckland University in
2007, both with a therapeutics endorsement.
Laing says after uni, he and Mannix locumed through Australia
for a few years, before growing tired of living out of a suitcase.
Laing grew up in Auckland, but his parents had owned a place
in Mt Maunganui for decades. With close relatives in the area,
the Bay of Plenty seemed the ideal place to put down their
professional roots, and Laing says it didn’t take much to win
Mannix over to the idea. So, with Devon Palairet on board as the
dispensing optician, they launched the Blur brand two-and-a-half
years ago.
“The second practice allows for higher brand recognition in the
region and a platform to try out different ideas and push some
boundaries. We are not trying to be everything to everybody as we
do not want to lose our direction,” says Laing.
Blur has established itself as a practice that looks for distinctive
brands and the interior of their Mt Maunganui practice reflects a
similarly deep concern with materials and design sensibility.
“Haidee, Devon and I had ideas of what we wanted and needed
in the new space. Breaking the brief down to its core, we wanted
trees, Corten (weathering steel) and butterfly cabinets,” Laing says.
Corten’s earthy, controlled rusting look meshed perfectly with
the concept of an earthy, arboreal interior. Blur enlisted sculptor
Nic Clegg, who works with Paul Mossong, to bring the interior of
the new practice to life in a highly collaborative process.
“(Clegg) is a patient and friend of the practice who also happens
to be a metal work artist, so the fit was very natural. The process
was a very interactive collaboration of ideas from start to finish.”
Laing says the new site brings with it some challenges and the
need for more manpower. Blur has hired two new people who will
be enrolled in the OTEN course, bringing the Blur staff to five. Staff
split their time between the two practices.
Laing says Blur looks for brands that capture the principals’
imaginations, but the roster continues to change.
“We are learning as we go: brands and wholesalers have
NZ LAUNCH AT ADONZ
contact MSO on (09) 849 3415
www.europeaneyewear.com.au
come and gone, as we are trying to achieve the right balance
for the store. We sell product that we enjoy selling. We try and
experiment with styles and aren’t afraid of taking some risks.”
With some experience under his belt, Laing sees more plusses in
working as an independent than negatives.
“As a bricks and mortar, independent optometrist, our advantage
lies in the ability to shape our surroundings to reflect our offer.
Product selection is important to those of us who choose to
differentiate ourselves in this way. Specialist services could be
another, as long as there is a clear, focused direction. The ‘race
to the bottom’ for consultation cost and product cost was an
inevitable outcome of the industry events over the last decade.
Independents should be adding value to products and services as
opposed to stripping away quality to discount price.” ▀
US approves
device that
“sees” with
tongue
The BrainPort V100
The US FDA has given marketing
clearance to a new device that
when used along with a cane or
guide dog can orientate the blind
by enabling them to process visual
images with their tongues. The
BrainPort V100, manufactured
by Wicab, is a battery-powered
video camera mounted on a pair
of glasses, and a small, flat intraoral
device containing a series of
electrodes the user holds against
their tongue. The device processes
optical signals to vibrations and
sensations felt on the user’s
tongue. Users must be trained to
interpret the signals to determine
the location, position, size and
shape of objects, and to determine
if objects are moving or stationary.
Clinical data supporting the
safety and effectiveness of the
BrainPort V100 included several
assessments, such as object
recognition and word identification,
as well as oral health exams to
determine risks associated with
holding the intra-oral device in the
mouth. Studies showed that 69%
of the 74 subjects who completed
one year of training with the
device were successful at object
recognition. There were no serious
device-related adverse events. ▀
News
in brief
UK OPTOMETRIST CHARGED WITH MANSLAUGHTER
Honey Rose, 34, a locum optometrist in the UK, has been charged with
negligent manslaughter after allegedly failing to see a swelling on the
optic nerve of an 8 year old boy during a routine eye examination. The
youngster collapsed and died four months later. According to media
reports, the UK’s Crown Prosecution Service is expected to claim Rose
should have spotted the boy had papilledema as it is a feature of
every sight test. The trial, the first of its kind involving an optometrist,
is set to take place between January and March next year.
CALIFORNIA OPTOMS TO PERFORM SOME MINOR SURGERY
In a move designed to ease the physician shortage in California,
the state senate has approved a bill to allow optometrists to
perform minor eye surgeries and administer vaccinations to adults.
Optometrists will be required to undertake 50 hours of post-doctoral
education and training on human patients to qualify. They will be
able to administer vaccinations to people aged 18 years and older for
influenza, herpes zoster and pneumonia. They will also be eligible
to perform laser procedures to treat glaucoma and to remove small
lesions from the surface of the eyelid.
AUSTRALIA APPOINTS NEW OPTOMETRY BOARD CHAIR
South Australian optometrist Ian Bluntish has been
appointed chairman of the Optometry Board of
Australia effective September 1. He succeeds Colin
Waldron who stepped down having held the inaugural
Chair since 2009. A former president of Optometry
Australia, Bluntish was an inaugural government
Ian Bluntish
appointee to the Optometry Board of Australia in
2009. He is currently the chairman of ProVision. His
appointment to the leadership role reflects the depth and breadth of
his skills and experience.
TOTAL EYECARE’S VESPA RAISES $5,600 FOR CHARITY
Total Eyecare in Lower Hutt raised $5,600 for the Te Omanga Hospice
from the sale of its donated Vespa at the Te Omanga Hospice Vintners’
Lunch fundraiser. Total Eyecare won the slick, red Vespa Sprint 50
(valued at $5,990) in a Transitions promotion and decided to donate
the bike to a charity auction for the nearby hospice.
TRUSSARDI LICENSE MOVES
Well-known and long-established Italian brand Trussardi has signed on
De Rigo Vision for the design, production and worldwide distribution of
the Trussardi-branded optical and sun collection. The Trussardi Eyewear
license had belonged to the Charmant Group from 2011.
FEMTO LASER STUDY
A study in progress in France aims to provide evidence to support the
use of femtosecond laser in cataract surgery in lieu of phaco in the
country’s national health service. News sources report 1,800 people
have been enrolled in the study, which should be completed by mid-
2016. The NZ$5.7 million research project compares femtosecond
laser-assisted cataract surgery with phacoemulsification among 2,000
patients across five participating universities in France, using Abbott
Medical Optic’s CATALYS laser system. Preliminary analysis shows
very good visual acuity results and a complication rate of 16 per cent
among the first ten cases. The ultimate goal is to prove the procedure
provides a better cost-utility ratio over phaco, despite higher costs of
the procedure.
NOT JUST DRY EYE?
Two related studies published in Optometry and Vision Science suggest
patients experiencing contact lens-induced dry eye symptoms may
have a binocular vision disorder instead of, or in addition to, dryness.
Researchers evaluated 104 normal and dry eye patients, and separately
evaluated 29 myopic participants who wore soft contact lenses. In the
first group, researchers found a significant correlation between dry
eye and convergence insufficiency symptom survey (CISS) diagnostic
results, as well as ocular surface disease index measures. In the
second group, researchers found that 48.3 per cent had a BV disorder.
Researchers say clinicians can use the results to address contact lens
induced dry eye, and add binocular vision testing to their exclusion
criteria and subject evaluations in order to eliminate subjects who do
not have dry eye or have both dry eye and a BV disorder.
FORMER FIRST LADY AWARDED PERSON OF VISION ACCOLADE
Prevent Blindness, the US volunteer eye health and safety
organisation dedicated to fighting blindness and saving sight, named
former US First Lady Laura Bush as the recipient of the 2015 Prevent
Blindness Person of Vision Award. The award recognises an individual
for outstanding leadership and dedication in the field of vision and
eye health. Bush has been a long time champion of children’s literacy
and is a strong advocate for the importance of healthy eyesight to
help a child succeed in school and beyond.
“We want to honour her for her tireless efforts to improve the lives
of our children through enriching literacy and educational programs
and advocating for vision care to be part of the strategy,” said Mary
Blankenship Pointer, chair of the 2015 Prevent Blindness Person of
Vision Committee.
October 2015
NEW ZEALAND OPTICS
5
October 2015.indd 5
9/18/2015 6:43:25 AM

Specsavers
fourth clinical conference
turns Brisbane green
Specsavers fourth clinical conference (SCC4) literally turned
Brisbane green. The company’s clever marketers arranged
for the town hall to be flooded in emerald light for the
evening drinks event, while the conference venue’s
communal areas sported huge floating green light logos.
The venue, the Brisbane Hilton, was at capacity with record
attendance of more than 500 attendees. The majority were Specsavers
partners (franchise holders), but 50 non-Specsavers optometrists from
Australia and New Zealand, 50 students, and representatives of most of
the associations also attended. A good complement of attendees from
sponsors Alcon, Zeiss, Johnson & Johnson Vision Care, BOC Instruments
and Cooper Vision were also present.
Specsavers this year introduced an extra afternoon of clinical
education sessions from some of Australasia’s key tertiary
education providers. Participants had the option of attending three
sessions on therapeutic optometry or three on clinical optometry,
to bring their total CPD points to 10 (New Zealand).
Charles Hornor, Specsavers director of communications, says the
extra afternoon sessions were added as a direct result of participant
feedback. “People said ‘wouldn’t it be nice if we had something on
the first day’ and they wanted more opportunity to increase their
CPD points. Sunday is about ophthalmologists imparting their
knowledge, so we thought let’s make Saturday different.”
Ben Ashby, Specsavers’ optometry development manager, says
the event was unique in that all the content was being presented
by optometrists to optometrists.
About 100 to 150 participants were expected for the new
afternoon, but more than 300 attended so Specsavers will definitely
be keeping the new format, says Hornor, but given the popularity of
this fourth conference, will be looking for a bigger venue next year.
CLINICAL OPTOMETRY
Dr Isabelle Jalbert, a senior lecturer at the University of New
South Wales, whose research focuses on evidence-based eye care,
eye care quality and health education, discussed the evidence
for the Matrix FDT perimeter with an emphasis on glaucoma.
With the majority of Specsavers optometrists using the Matrix
perimeter, this talk was highly relevant to day-to-day practice.
The talk confirmed the Matrix perimeter was comparable on most
metrics to the HFA, considered by many to be the gold standard
in perimetry, and, according to an analysis of the research, is even
slightly more effective in detecting glaucoma earlier than the HFA.
Dr Nicola Anstice, a senior lecturer in the School of Optometry
and Vision Science at Auckland University, extolled the virtues of
good record keeping and conducting regular clinical audits—a
dry topic that Anstice made highly relevant with case examples
of inadequate record keeping and the impact that had on patient
care and professional standards. Clinical audits should be done
reflectively not punitively to identify areas where change or
improvement is needed, she said.
The third and final speaker in the clinical optometry sessions,
Dr Shelley Hopkins, optometry clinic co-ordinator at Queensland
University of Technology Health Clinics, fought off a child-caused
sore throat to discuss how to run effective vision screenings
for kids. With increasing numbers of children attending stores,
particularly in NZ, the talk was designed to equip optometrists
with the tools to formulate their own vision screening tests and
referral criteria, and confidently assess children who present as a
result of failing a vision screening.
THERAPEUTIC OPTOMETRY
In the therapeutics stream, Professor Fiona Stapleton, head
of optometry at the University of New South Wales, spoke on
the contact lens red eye patient. Stapleton’s talk covered two of
the most common contact lens-related complications in corneal
infiltrates and eyelid-related issues. Particular areas of relevance
included the role of storage cases in microbial disease, diagnosis
of sterile or infective corneal infiltrates and the impact and
management of meibomian gland dysfunction.
In terms of CL-related disease, practitioners should first rule
out microbial keratitis, while everything else is self-limiting, she
said. Consider differential diagnoses, such as infiltrates and other
ocular surface problems and if there is intercurrent disease related
to lens wear.
Professor Alex Gentle, course director of the optometry program
in the School of Medicine at Deakin University, reviewed and
interpreted clinical myopia control trials published since 2011. This
included an in-depth look at the implications for myopia control
using medications, lenses and light exposure.
“Low dose atropine, multifocal contact lenses and
orthokeratology are all promising interventions for mypoia control
and offer sustainable reduction of progression between 25 per cent
and 65 per cent,” he said.
The verdict on low dose atropine was that myopia progression
reduced by 40 per cent, with 0.01 per cent over two years with
few side-effects and little evidence of progression on withdrawal.
Younger children with higher myopia are at the greatest risk of
continuing to show signs of significant myopia progression during
atropine therapy.
Recent clinical trials involving various designs of multifocal soft
contact lenses are generating promising results in controlling
progression. Studies have found that people of Asian ethnicity with
higher myopia are most likely to benefit from orthokeratology in
limiting the rate of axial length change.
Richard Johnson, from Greenlane Hospital and the School of
Optometry and Vision Science at Auckland University, discussed
viral infections of the anterior segment. He covered the big three:
herpes simplex, VZV/HZV and adenovirus, looking first at their
aetiology, infection locations, their clinical presentation, diagnostic
procedures and management.
Useful tips include employing steroids for virus-associated
inflammation less frequently than for non-viral (If the IOP is high
or if there is conjunctival chemosis, it is likely to be viral) and taper
off over several months.
Red flags for optometry include stromal HSV/VZV, posterior
involvement of viral infection, steroid drops on active epithelial
disease, steroids without antiviral cover (because of their ability to
reactivate) and not under-treating with topical antivirals.
CLINICAL CONFERENCE OVERVIEW
Specsavers Australia and New Zealand CEO Paul Fussey opened
the conference proper, saying he was “blown away” by the high
attendance and positive atmosphere.
Peter Larsen, Specsavers professional services director,
announced the launch of the new Oculo data-sharing platform
(see separate story page 15), extolling the virtues of good
communication between optometrists and ophthalmologists to
boost productivity and provide better patient outcomes.
Ophthalmologist Dr Angus Turner shared his experiences
of and hopes for teleophthalmology for delivering better eye
health to remote indigenous communities, while Dr Justin Mora,
a paediatric ophthalmologist and strabismus surgeon dealing
with binocular vision at Auckland Eye, covered three areas of
paediatric ophthalmology: paediatric glaucoma, paediatric allergic
Brisbane Town Hall turns green for Specsavers
conjunctivitis and assessing vertical strabismus.
Key points included:
• Optic nerve cupping in paediatric glaucoma is reversible
• Normal tension glaucoma does not exist in children – large cups
can be normal
• Surgery is key to managing paediatric glaucoma in children
under three
• Children under six are at higher risk of increased IOP with
steroid use
• Vertical strabismus is almost always a nerve or muscle problem
• Don’t assume the fixating eye is the normal eye
Dr Anthony Pane from the Queensland Eye Institute discussed
investigation of diplopia, pupil dilation and motility in serious
neuro-ophthalmology cases. Unexplained visual loss will lead to
many questions: is visual acuity worse than expected, is colour
vision normal, is there a visual field defect and are the optic discs
normal (a late sign). Transient visual loss should raise particular
alarms: if it presents without migraine, refer; if there’s loss in one
eye only, refer urgently.
Professor Stuart Graham, a glaucoma specialist with Macquarie
University, looked at the practical aspects of perimetry for
assessing progression, covering the use of the Humphries and
Matrix instruments.
Dr David Hilford, from the Toowomba Eye Clinic, outlined a new
international (and more intuitive) classification system to describe
diseases of the macula, the latest approach to the management
of these conditions, and a new drug – ocriplasmin (traded Jetrea).
The new classification system and associated management plan,
including the new drug, could be summarised as follows:
• VMA—Vitreomacular Adhesion—Observe
• VMT—Vitreomacular Traction—Observe or Ocriplasmin
• FTMH—Full Thickness Macular Hole—less than 400 um in size
—Ocriplasmin or surgery
• FTMH—Full Thickness Macular Hole—greater than 400 um in
size—surgery
Dr Michael Coote, a CERA lead investigator and the clinical
director of ophthalmology at the Royal Victorian Eye and Ear
Hospital, reminded delegates that 50 per cent of glaucoma patients
have normal IOPs and that a significant proportion of glaucoma
goes undiagnosed. He spoke about the Glaucomatous Optic
Neuropathy Evaluation (GONE ) project, which more than 6,000 eye
care professionals and trainees have registered with over the past
six years, and showed how important good disc examination was
to diagnosing and evaluating the severity of the disease.
The conference was closed by the popular and well known
Australian ophthalmologist Dr Charles Su who discussed the
function of the tear film and eyelids and how they can be better
managed to treat dry eye. ▀
Dr Michael Coote extols the benefits of GONE
Speakers Professor Stuart Graham, Dr Justin Mora, Dr Michael Coote, Dr Charles Su,
flanked by Specsavers’ Peter Larsen and Paul Fussey
6 NEW ZEALAND OPTICS October 2015
October 2015.indd 6
9/18/2015 6:43:27 AM

Debra and Richard Johnson, William Perriam, Rob Jacobs and Nicola Anstice
David Anderson, Melinda Chen, Defini Tai, Megan Glover, David Hooker, Helen, Haslett with Niall McCormack at
the front
Get to the main
cause of dry,
irritated eyes*
Jennifer Robinson, Ian Russell, Danny Gainford and Chris
Specsavers Gisborne takes
Top Shop award
Trade organisation Retail New Zealand named Gisborne’s
Specsavers supreme winner in the annual Top Shop awards.
The shop edged out runners up Carvin Streetwear in Gore
and Warehouse Stationery Royal Oak, in Auckland.
“The judges that visited the store were impressed by the very
professional layout and look. The staff were friendly and made
customers feel welcome and at ease, while providing excellent
advice,” says Retail NZ chief executive Mark Johnston.
Winning applicants were selected over three “rigorous
rounds of judging,” Johnston says, two in-store assessments by
mystery shoppers and a panel selection.
Tania Richards, a dispensing optician and Specsavers
Gisborne director since its opening six years ago, says the store
had won an in-house “champions league” in 2014, prompting
them to apply for the Top Shop award.
She says the award reflects the store’s focus on “excellent
customer service” adding that helping clients is one of her
favorite aspects of the job.
“I love the interaction with our patients and helping them to
choose the best style frames and lenses.”
Specsavers Papanui took the Top Shop award for fashion and
footwear in the upper South Island region. ▀
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These liposomes mix with natural
lipids on the eyelid.
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.
Specsavers Gisborne staff include (left to right) Nick Whittingham and
Tania Richards, Kelsey Rickard and Margaret Johnson
Hygienic. Can be used
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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
Optrex-miVisionFPC-0515.indd 1
October 2015
NEW ZEALAND OPTICS
10/08/2015 7:18 am
7
October 2015.indd 7
9/18/2015 6:43:32 AM

Eye Institute turns gaze on
mysterious and intriguing cases
Presenters at the recent Eye
Institute seminar kept an audience
of 141 optometrists riveted with
a series of brief discussions and
testing questions on a host of topics
ranging from recognising melanoma to
treatment of patients with rosacea.
The format was far more interactive
than previous seminars, with speakers
actively and often amusingly challenging
the audience on a host of subjects
applicable to their practices. The Eye
Institute’s second seminar of 2015, held
at the Ellerslie Events Centre in Auckland
on August 25, and entitled A Night of
Mystery and Intrigue, also broke the
presentations into two hour-long slots,
comprised of 15-minute presentations,
with food and drink available before and
in between.
Attendees responded positively to
the new format, telling organisers the
faster-paced delivery and varying topics
held the audience’s attention. They also
appreciated the half-time break, and the
fact that drinks were served earlier than
at previous seminars.
Attendees who applied for CPD earned
two points. The evening was sponsored
by Alcon.
FACING A COMMON PROBLEM:
ROSACEA
Dr Trevor Gray started the evening with
an overview of rosacea, a skin condition
that will affect one-in-ten people at some
time in their lives, which is marked by
a chronic inflammatory response in the
oil secreting sebaceous glands and in
one sub-type, the anatomically similar
meibomian glands.
“It’s a very common condition that
is easy to overlook, but once we clue
ourselves into it and recognise the signs
and symptoms, all of a sudden other
aspects of a patient’s eye health care
come into play,” Dr Gray said.
In the ocular sub-type of rosacea,
chronic inflammation of the meibomian
glands, like inflammation of the
sebaceous counterparts, causes the gland
to secrete irritating long-protein chain
oil, not normal soothing oils, which the
resident microflora (staphycoccae) break
down into free-fatty, pro inflammatory
acids. The cycle of inflammation can lead
to dilation of the blood vessels, which
become spider vessels (telangiectasias).
Rosacea may not be life threatening, but
ocular rosacea can lead to perforation of
the cornea.
“When you see blood vessel invasion
along the lower five o’clock and seven
o’clock quadrants, that’s typical of ocular
rosacea, and is a threat to vision.”
Dr Gray said treatment breaks down
into patient education with skin care
advice, and topical and oral medication
to treat the lesions. Dermatologists
have also used intense pulse light (IPL)
treatment, recognising it’s not an instant
or complete remedy and can take threeto-six
months to see its full benefits.
Dr Gray said ocular rosacea would be
explored in greater depth at the Eye
Institute Conference in November.
SLK: EASY TO OVERLOOK
Dr Adam Watson took the attendees
through a case study illustrating
the symptoms of superior limbic
keratoconjunctivitis (SLK), not nearly
as common as ocular rosacea, and only
first identified as a discrete clinical
condition in 1963. SLK is characterised
as inflammation of the superior
bulbar conjunctiva with predominant
involvement of the superior limbus,
an adjacent epithelial keratitis, and a
papillary hypertrophy of the upper tarsal
conjunctiva.
The patient in Dr Watson’s case study
suffered dry eyes with burning, gritty
sensation, reporting that blinking tended
to make the condition worse, while
lubricants provided only temporary relief.
But, his eyes “looked pretty good, and
nothing seemed to be there” to suggest
MGD, dry eye disease, corneal erosions
or other conditions related to those
symptoms.
“SLK is easy to overlook,” said Dr
Watson. “Some of you want to keep it
in the back of your mind for recalcitrant
cases when you’ve done everything
you’ve thought helpful with no
improvements.”
SLK seems to be a middle-age condition,
commonly found among hyperthyroid
patients. Targeted treatment can
include viscous gel lubricants, tolerated
ointment, punctal occlusion and
supplements to promote tear film health,
such as omega 3. Steroid treatment and
even thermal cautery or conjunctival
resection are necessary in some cases.
“Interestingly, soft contact lenses have
a potential place and best contemplated
in people with no marked problems, if
they’re amenable,” Dr Watson added.
“Nobody knows why, but it’s been
proposed that contact lenses may
facilitate healing of the erosions of the
surface of the conjunctiva, the way that it
interacts on tear dynamics.”
MELANOMAS AND HOPELESS CASES
Dr Peter Hadden led an interactive
session showing a series of eye scans and
asking participants to decide if what they
were seeing was benign or malignant,
and whether it needed to be removed.
While small melanomas at the 2.5mm
thickness did not present problems in 99
per cent of cases in five-year longitudinal
studies, studies conducted over decades saw
small melanoma eventually metastasize at
which time it is too late to intervene.
Still, Dr Hadden said, the effective
treatment of medium sized melanoma
(before metastasis) has not greatly
improved over the last century, making it
more important to treat small melanoma.
Dr Hadden gave many examples of scans
of eyes with suspicious nivae, which will
be thicker than normal flat nivae, and
will be surrounded by fluid that appears
orange in scans. Any growth in the nivae
should raise alarms.
Dr Charles McGhee talked about hopeless
cases he has come across in his practice,
in particular a case study of a middleaged
female, professional photographer
who had suffered a string of bad luck
in her vision: myopia, cataracts, retinal
detachment and corneal deterioration. Her
various conditions led to severe vision loss
which not only kept her from working, but
lost her driver’s license as well. Dr McGhee
conducted a transplant of her right eye
cornea to the left eye where most of her
problems were. Following the operation,
her vision improved, she was able to
return to work and successfully reapply for
her drivers license.
SEEING DOUBLE AND MACULAR
DEGENERATION
Dr Peter Ring gave an overview of
the causes of monocular and binocular
double vision. He reminded optometrists
the first question to ask when someone
complains of seeing double was to ask
in which eye, and to test for monocular
versus binocular diplopia.
Monocular diplopia cases mostly
require optical fixes with sphere
cylindrical corrections, rhinodialysis, and
laser treatment. More serious are the
ramifications of binocular diplopia, which
can be a symptom of five major problems
that can be much more serious, and even
fatal. The first one is third nerve palsy
occurring with papillary involvement,
the eye pointing down and out, and can
present with headache, retro-orbital
pain, stiff nick, nausea and even loss
of consciousness. The symptoms taken
together can be a sign of an aneurism
pressing on the third optic nerve where it
emerges from the brain stem close to the
basilar artery.
“So why is it a warning sign?” Dr Ring
asked. “Because the next thing that can
Jill Mottram and Dr Simon Dean
Wendy Hill, Paul Burchel, Jasha Morarji, Roger
Tepuni, Caroline Perkinson and Jason Dhana
Ilana Gutnik, Niti Todd and Phil Turnbull
happen is a subarachnoid haemorrhage.”
Dr Shanu Subbiah discussed the
variation in size and shape of drusen and
in what context optometrists should take
them for a sign of macular degneration.
“We want to put things into boxes
and to give our patients a diagnosis,
and sometimes we can’t. Macular
degeneration is a very general term,
so we may be putting a problem of the
macular into a broad category.”
While drusen tend to be the hall mark
of age-related macular degeneration,
they are present in patients from 19 years
of age and up, with younger patients’
drusen measuring 34.5 microns.
“It’s acceptable and normal to see the
odd drusen so you have to look at the
drusen in context,” he said. “Generally,
the smaller they are the less you have to
worry about.”
Drusen measuring between 31 microns
and 65 microns, Subbiah said, are
generally acceptable in patients, but
bigger than that, at 65 years old and up,
does suggest macular degeneration.
“For a patient with drusen it’s best not
to put them straight into the category
of age related MD, because there are
other conditions that promise a better
diagnosis. Look at age, distribution of
drusen, the shape and size, and as a
general rule, the smaller the better. “
DIAGNOSING, QUICK AND CORRECT
Dr Nick Mantell spoke about a patient
with acute angle closure, a case that
underscored the necessity of getting
the diagnosis right as soon as possible
and illustrated the importance of giving
a consistent and constant messaging
from all involved. He provided tips for
diagnosis and ongoing management of
such patients.
Dr Simon Dean gave a most descriptive
case study titled Snap Crackle and Pop:
Sight Threatening Orbital Emphysema
centred on a case that illustrated how
trauma around the orbit can result
in multiple injuries to the globe and
periorbital structures. The case-based
presentation focused largely on a man
suffering vision-threatening orbital
trauma during a rugby match, illustrating
the mechanism of orbital blowout
fracture, and covered the therapeutic
and surgical management options and
choices that had to be considered in the
emergency department. ▀
Allergan recalls eye ointments
in US and buys eye care Co.
Pharmaceutical giant Allergan is voluntarily recalling three eye
treatments following complaints from consumers about finding
contaminants in the products.
An announcement from the US Food and Drug Administration
at the end of August said Allergan was recalling specific lots of its
Refresh Lacri-Lube 3.5g and 7g for dry eye, Refresh P.M. 3.5g for dry eye,
FML (fluorometholone ophthalmic ointment) 0.1% (sterile ophthalmic
ointment topical anti-inflammatory agent for ophthalmic use, 3.5g), and
Blephamide (sulfacetamide sodium and prednisolone acetate ophthalmic
ointment, USP) 10%/0.2% sterile topical ophthalmic ointment
combining an antibacterial and a corticosteroid, 3.5g.
The FDA says Allergan initiated the recall based on a small number
of customer complaints which reported “a small black particle” at the
time of use. The particle, which is part of the cap, can be created by the
action of unscrewing the cap from the aluminum tube.
The recall was exclusive to the US market and Australasian representatives
of Allergan would not comment on the problem on a local basis.
In other news, Allergan announced it would purchase AqueSys Inc., a
private medical device company focused on developing ocular implants
that reduce intraocular pressure (IOP) associated with glaucoma.
Under the agreement, Allergan will acquire AqueSys for US$300 million in
an all-cash, upfront payment, with commercialisation milestone payments
related to AqueSys’ lead development programmes, including XEN45.
XEN45 is a soft shunt that is implanted in the subconjunctival space in
the eye through a minimally invasive procedure with a single-use, preloaded
proprietary injector. The XEN45 technology facilitates aqueous
fluid flow to lower IOP while protecting against the potential for
hypotony associated with current subconjunctival procedures.
XEN45 has received a CE mark in the European Union where it is
indicated for the reduction of IOP in patients with primary open angle
glaucoma where previous medical treatments have failed. The CE mark
allows treatment in conjunction with a cataract procedure or as a
standalone procedure. XEN45 is also approved for use in Turkey, Canada
and Switzerland. In the US, final approval for XEN45 is expected by late
2016 or early 2017.
The acquisition builds on Allergan’s efforts to expand its eye care portfolio.
It bought Oculeve Inc., a development-stage medical device company
focused on developing novel treatments for dry eye disease, for US$125
million in July. Allergan’s eye treatment portfolio now ranks second among
its portfolios with the most development candidates. ▀
Big anniversaries see big
donation to Blind Foundation
The Freemasons of New Zealand have donated 125 DAISY players
to the Blind Foundation in recognition of both organisations
celebrating 125 years in the country.
With under five per cent of printed material available to blind
or low vision New Zealanders, thousands have come to rely on the Blind
Foundation’s library to supply them with periodicals and books through
DAISY (Digital Accessible Information System) devices.
Blind Foundation chief executive Sandra Budd, who attended the
Freemasons 125th anniversary celebration, expressed gratitude for the
fundraising programme which saw every Lodge in New Zealand raise
$500 for the purchase of the DAISY players.
“To know that we have your support in such a milestone year is
wonderful,” Budd said at the event. “I see this as a coming together of
two iconic organisations who have stood the test of time and which
both have a great future. This generosity and commitment to bringing
this gift to fruition personifies the Freemasons spirit.”
The Freemasons also recently provided major funding to enable
BLENNZ - the Blind and Low Vision Education Network of New Zealand
- build an outdoor facility at its Homai campus to help children there
develop physical and sensory abilities. The project, called Freemasons
Park, took three years to complete. ▀
Freemasons Grand Master John Litton with Blind Foundation Chief Executive
Sandra Budd and a happy recipient of a DAISY Player
Dior has new distributor
Vision Marketing & Distribution (VMD) has been tapped to act
as the new distributor of Dior frames in New Zealand. The
Safilo Group brand was previously carried by Pacific Eyewear.
Nigel Butler, CEO of VMD, says Dior was a prestigious brand
to add to the company’s portfolio, which includes several other Safilo
licensed brands.
“(Dior’s) new optical collection has arrived and will be offered to select
practices in New Zealand,” says Butler.
Dior unveiled its Montaigne collection in January, marking a change in
direction for the fashion house’s frames category. Dior Montaigne is said
to encapsulate the essence of the couture house, with layers of acetate
reminiscent of the fabric layering in Dior’s ready-to-wear collections.
The Dior oval code is featured on the temple and on the dedicated
hinge, the grosgrain pattern is revealed in the transparency of the
temple, and the Christian Dior plaque inside the temple evokes the label
sewn inside Dior garments. ▀
8 NEW ZEALAND OPTICS October 2015
October 2015.indd 8
9/18/2015 6:43:34 AM

Hoya debuts new
vocational lens line
Ophthalmologist
awarded Churchill
Fellowship
Hoya introduced a new line of
vocational lenses at workshops held in
Auckland and Wellington.
The company’s Workstyle V+ line is
designed to give presbyopic patients a better
option if they frequently switch focus from
screen to desk to general office space through
the workday.
Speaking to a crowd of about 60 optometrists
and DOs at the Langham hotel in Auckland in
September, Hoya’s regional professional services
manager Vivien Chiang presented the company’s
case for offering patients vocational lenses as an
alternative to progressive lenses.
Chiang said that age, and more importantly
the fact that we work and live using multiple
screens, makes a strong case for offering patients
a vocational lens that can accommodate near,
intermediate and distant vision.
“The way we live and play has changed.
Gadgets have gone more sexy, you can put them
in your pocket, so we’re stuck with it. It’s part
of what we do, how we live and work, and that
includes smartphones, tablets and laptops.”
Chiang said the Workstyle V+ line gives patients
choices that Hoya’s internal research says they
want. Workstyle V+ Space is designed for people
who want a large near zone, a wide intermediate
zone and to see clearer beyond their own work
desk. The V+ Screen is specifically for multiscreen
users, and Hoya tested the line on bankers who
often have to switch from screen to screen to
monitor financial data from varied sources, while
V+ Close is for people who want and need the
near zone to be very clear.
“If you don’t remember anything I’ve said,
this is the key point, as an optometrist myself,
even when I was a young optom out of school,
I realized we aren’t telling our patients about
options and many of them tell us they don’t
want options, or they’re too expensive…but
trials conducted with the V+ ranges showed
more than 80 per cent wished they’d been told
about vocationals before.”
Hoya’s occupational options before V+ were
fairly specific. The PC Pro for regular computer
users had a digressive lens that extended
working distance out from 60cm to 80cm
compared to traditional readers. Later the
company modified standard progressives to
create the HoyaLux Desk, improving focus at
near and intermediate distances. The company
has improved on the Desk design by switching
from a conventional, round cutting tool, that
cuts vertically and horizontally along the surface
of the glass, to a free-form cutting tool that
added a Z-axis to cut into the lens to come up
with the Workstyle V+ lines which “visibly
increased” the lenses’ clear zones, said Chiang.
Freeform design gives wearers a wider range
in office settings, she added. The WorkStyle V+
Close at +1.75D add has the potential of clear
vision ranging from 40cm to 1.5m; V+ Screen
from 40cm to 2.5m, and V+ Space from 40cm to
6m and possible more.
Chiang cautioned attendees, however, not to
prescribe the V+ range as a progressive lens as it
is meant for flexible indoor use.
Hoya offers a selection of seven optical corridors
for custom fits to give patients a wider selection
of frames, from shallow to deep, as well as a
standard 22mm corridor for the Space and Screen
models, and 20mm corridor for the close design. ▀
Vivien Chiang presents Workstyle V+
Michael Yip, Paula Farrar and Stuart Whelan
Lee Pittard, Jodie Lawford and Jeremy Wong
Petra Hewitt, Emmaleen Sheriff, Alley Bissett, Katie Smyth and Christine Rae
David Mackey
Australian
ophthalmologist Dr
David Mackey, one of
the world’s leading
researchers in the genetics
of eye disease, has received a
2015 Churchill Fellowship.
Dr Mackey, managing
director of the Lions Eye
Institute at The University of
Western Australia, will use the
fellowship to visit ophthalmic
gene therapy research centres
in London and Oxford next
year. He will determine how
Australian patients with rare
eye diseases might be able to
participate in promising gene
therapy research trials being
conducted overseas.
“I have been working on
the genetics of eye disease for
more than 25 years and have
mainly been involved in the
discovery of genes associated
with different eye diseases,
such as optic nerve diseases,
retinal dystrophies and
glaucoma,” says Dr Mackey.
“In the last decade, several
gene therapy trials have begun
in Europe and North America
for some specific rare eye
diseases. Gene therapy offers
hope to patients with a range
of conditions for which there
have not been conventional
treatments or cures.” ▀
These glasses have
changed my life!
Why?
“
I can now concentrate well beyond what I was previously
capable of. When wearing my conventional multifocal lenses,
I didn't realise how much of my attention was diverted into
maintaining my posture. I spent so much subconscious energy
keeping my head, neck and body in the exact position to maintain
focus that my concentration span was compromised.
My new WorkStyle V+ lenses allow me to relax and read and read
and read! I love it. An added bonus is that I don't need to take them
off all the time, and they don't look like bottle glass!
I would not hesitate recommending them to others.”
− Donna, Pharmacist at
The Royal Children’s Hospital, Melbourne
Donna is a customer of Scoogle Optometrist in Melbourne, VIC Australia
NZOptics_V+Secret_180x280mm_OCT15.indd 1
October 2015
14/09/2015 10:25:25 AM
NEW ZEALAND OPTICS
9
October 2015.indd 9
9/18/2015 6:43:38 AM

Speciality
Contact Lens Forum
Bailey Nelson
expands to
Auckland
Incorporating front surface toricity to correct residual
astigmatism in a mini-scleral lens for monocular
keratoconus
BY ALEX PETTY*
These days, more of our keratoconic patients
are demanding improved levels of vision
so that they may go about their days
unhindered by blur and distortion. This is
especially true in someone with monocular corneal
disease, as these patients typically have a fellow
eye with excellent vision, enabling sometimes
unfair comparison. Fortunately with technological
updates to contact lens technology, excellent vision
is obtainable especially in patients with only mild
to moderate levels of corneal ectasia and clear
ocular media. This case describes how troublesome
residual astigmatism in a non-rotationally
symmetrical scleral lens can be alleviated with the
use of a toric front optic-zone in a patient with
moderate monocular keratoconus.
The patient in question, a male in his mid 20s,
presented to our practice after living in another
part of the country for several years. He has an
interesting case of monocular keratoconus in his
left eye and has worn a KATT scleral lens from
Capricornia in the past. However he lost this lens
a year prior and has been getting by with using a
spherical monthly silicone hydrogel lens to correct
the low myopia in his normal right eye.
Refraction was R -2.00/-0.25 x 90 (6/5), L -1.25/-
6.50 x 132 (6/20+). Corneal topography revealed
an essentially normal pattern in the right eye
and a steep central area with surprisingly regular
astigmatism in the left eye. Keratoconus was
confirmed with pachymetry showing relative
thinning in the left eye: R 562µm, L 530µm. Slitlamp
examination revealed no corneal opacity in
either eye.
Axial maps of the right and left eye showing the
significant curvature difference between the two eyes.
Trial-fitting with the Eyespace Scleral lens was
carried out with the aid of anterior OCT to assess
central clearance and landing zone alignment.
Despite his large corneal diameter (HVID) the lens
size of 16.5mm was chosen as the larger 17.5mm
size decentered inferiorly following insertion. This
also matched the size of the KATT lens he has used
in the past. I always assess flexure of the lens with
over-topography during trial fitting as this gives
me an idea of the level of scleral toricity. The Scleral
Shape Study from Pacific University showed us that
the majority of sclera are asymmetrical and tend
to be flatter in the nasal aspect. Fitting a spherical
scleral lens to an asymmetrical sclera often results
in lens flexure, leading to residual astigmatism. In
moderate-severe cases it can also cause the lens to
be unstable on the eye.
There are different schools of thought in
scleral lens circles about how to deal with flex.
Traditionally lenses were just made thicker to
nullify the tendency to bend. However as shown
by Michaud et al 2012 thicker lenses decrease the
transmission of oxygen to the cornea. This means
that theoretically only lenses with a thickness
of 250µm and low clearance of 100µm satisfy
the Holden-Mertz criteria for a material with a
Dk of 100. It follows that trying to keep the lens
thickness to a minimum is sensible.
In my view a more elegant way to control flex is
by using a lens with a higher sagittal height in the
steep meridian (much like a toric-periphery corneal
lens), thus evenly distributing the bearing of the
peripheral scleral landing zone. A rule-of-thumb
to estimate the degree of sagittal difference is
200µm for every diopter of flex found with corneal
topography. Of course some may point out that a
thick spherical lens that does not flex may promote
more tear exchange behind the lens, however that
is a discussion for another day.
Clinically, I find that most eyes that I fit with a
scleral lens require a toric periphery to eliminate
residual astigmatism and best stabilise the lens.
Eef van der Worp’s excellent review of scleral lenses
(now in it’s second edition and free to download
from Pacific University) also comments that longer
wearing time and better comfort is evident in wellfitted
back surface designs.
Anterior OCT of the lens showing 160µm of central
clearance and well-aligned base curve.
OCT of the inferior scleral landing zone showing limbal
clearance and well-aligned landing angle.
Using the data from the trial fitting process the
patient’s first custom lens was designed with
200µm of sagittal difference between meridians
and a spherical base curve and power of 7.8mm
and -3.50D respectively. On delivery the lens had
even scleral alignment and after settling 160µm
of central clearance. The lens was quick to align
with the ‘flat’ meridian’s marking along 30 degrees,
matching the principal meridians of flexure on the
over-topography of the trial lens.
Slit-lamp images of the lateral landing areas of the scleral
lens showing the marking indicating the ‘flat’ meridian of
the lens at 30 degrees.
Vision however was only 6/12, improving
significantly with refraction of plano / -1.25 x 85.
No flexure was seen in this lens and no significant
spherical aberration was present with retinoscopy.
As the axis of lens stabilisation and residual
astigmatism did not match up it is unlikely that
modification of the peripheral lens parameters
would assist here. Instead it was decided to
incorporate front-surface toricity to correct the
residual astigmatism.
There are several ways to stabilise the rotation of
a front surface toric scleral lens including double
slab off prism (superior and inferior thin zones),
inferior prism ballast and use of pinguculae
notching. These techniques typically rely on
a patient inserting the lens with the correct
orientation (a nightmare for many visuallyhandicapped
keratoconics) and in the cases I have
witnessed, may still rotate during wear. The beauty
of using a lens with a toric periphery is that, like a
toric soft contact lens, the patient can insert the
lens at any orientation and it will quickly rotate
into the correct position.
A new lens was ordered with a power of -3.50
/ -1.25 x 55 and otherwise identical parameters.
After delivery the lens once again rotated to 30
degrees, bringing the axis of the front optic zone
neatly to 85 degrees - the exact axis of the initial
lens’ residual astigmatism.
Axial over-topography of the final front-surface toric
lens, nicely showing the -1.25D of astigmatic correction
incorporated sitting with axis of 85.
Vision in this eye had now improved to 6/5 and
no residual refraction was found. The patient
commented this was the best quality of vision he
had seen with his left eye, and pleasingly noted
similar acuity when compared to his right eye (now
refitted into a -2.00D daily).
Stay tuned for the next edition of Specialty
Contact Lens forum where I will discuss a case of
large diameter scleral lens for the management of
debilitating dry eye. This case can be found online,
along with other specialty lens reports, at
www.eyespace.com.au/blog. ▀
ABOUT THE AUTHOR
Alex Petty is a Kiwi optometrist
who graduated from the
University of Auckland in
2010. He has an interest in
specialty contact lenses,
orthokeratology and myopia
control. He has no financial
interest in the products
mentioned.
Global contact lens
community ‘comes
together’
Attendees at the 39th British Contact
Lens Association (BCLA) Clinical
Conference & Exhibition described the
event as “an exceptional conference”
with a “fantastic buzz”.
The May conference saw the global contact
lens community “Come Together” in Liverpool
for three days of education, networking and
brainstorming.
Optometrist Brian Tompkins was installed as
BCLA president, and contact lens optician Keith
Tempany as president elect.
At the conference, Associate Professor Jennifer
Craig presented a course titled “Effective lid
therapies for tackling evaporative dry eye in
practice,” developed with Dr Simon Dean.
Eyelid conditions such as meibomian gland
dysfunction (MGD) and anterior blepharitis
are leading causes of evaporative dry eye that
result in debilitating discomfort symptoms and
contribute to unsuccessful contact lens wear.
Craig told the delegates that optometrists can
play a key role in managing lid margin disease
by being proactive with their clients.
The session also covered the
pathophysiological changes that occur in lid
margin and associated ocular surface disease,
how these relate to the development of
symptoms, and possible interventions to reduce
the impact of these conditions. A full lid margin
work up, including assessment of lid parallel
conjunctival folds, lid wiper epitheliopathy
and lid margin hyperkeratinisation, was
Bailey Nelson’s Christchurch store
Australia-based eyewear designer
Bailey Nelson is on track to open two
new locations in New Zealand after
establishing its first site in Christchurch
in July.
The company, founded in Bondi Beach in 2012,
now has more than 20 practices (which they call
“boutiques”) in Sydney, Melbourne, Brisbane,
Christchurch, the Gold Coast, London and Canada.
Bailey Nelson sells eyewear of its own design,
shunning fashion labels, and sourcing materials
from around the world, working directly with
particular manufacturers and material suppliers.
The company opened its first New Zealand
boutique in the Westfield Riccarton Shopping
Centre in Christchurch. It is now looking for staff
for its Ponsonby boutique, which is expected to be
open by mid-November, according to New Zealand
country manager, James Hinsley. The company is
aiming to open a third boutique in Wellington by
the end of 2015.
“For each boutique, we typically hire a team of
five to seven people,” says Hinsley. “This includes at
least one optometrist, a dispensing optician, a store
manager and a team of passionate and genuine
eyewear stylists.”
Hinsley says the company sited its first New
Zealand boutique in Riccarton because “we
wanted to be a part of the exciting growth and
expansion of the city as it rebuilds.
“We felt that the timing was fantastic, and found
our boutique at the Riccarton Mall to be one of
the best places to be located. Bailey Nelson will
continue to expand across New Zealand over the
next couple years.” ▀
A/Prof Jennifer Craig
discussed. Lid cleansing, debridement and other
therapeutic techniques were demonstrated
with video footage, with instructions provided
to encourage practitioners to adopt these
diagnostic procedures within their own
practices following the conference.
Therapies for the condition were divided into
three categories: optimising the lid margin;
facilitating meibum release; and improving
meibum quality. The presentation aimed to
encourage practitioners to adopt a wider range
of management strategies for evaporative
dry eye caused by lid disease and to consider
concepts such as the introduction of a trained
ocular hygienist in practice. ▀
10 NEW ZEALAND OPTICS October 2015
October 2015.indd 10
9/18/2015 6:43:39 AM

Job market toughens as new
optometry programmes in Oz open for business
Students want to
begin their optometry
career with an
independent who will
mentor them, preferably
near where they want to live,
with exposure to a variety
of patients. That’s the ideal,
anyway, says Ceecee Zhang,
president of the New Zealand
Optometry Student Society,
and a fifth-year at University
of Auckland. But with only
so many practices in New
Zealand, graduation time
means students have to
Ceecee Zhang
make some hard decisions.
“We talk about this a lot,” says Zhang. “Many want to stay in
a metropolitan area, and a lot of us want to stay near family. But
there is a limited number of jobs available in these locations.
“A lot of it is finding the balance between what you want and
what you’re willing to compromise: location, mentorship or
therapeutics. As you go on the job hunt, you realise you don’t get
everything you want.”
Those kind of choices aren’t anything new. But, with two new
optometry programmes recently launched in Australia, some New
Zealand year-five students may soon find themselves with one
avenue blocked or at least more difficult to take.
Stu Allan, whose OpticsNZ business specialises in placing
New Zealand graduates with independents and corporates here
and in Australia, says he may place six-to-eight graduates with
optometry practices across the ditch, in any given year.
“A large part of their rationale is the adventure, and the wages
are higher as well,” Allan says.
Starting salaries in New Zealand can range from $65,000 to
$70,000, higher in places like Dunedin. Students won’t find big
pay packages in Melbourne, Sydney or Adelaide, but the more
remote they are willing to go, the better the pay: upto $10,000 as a
relocation bonus, especially for those heading to Western Australia.
Allan says graduates are not motivated by money as much as the
kind of practice they start out in.
“They are looking for good mentors, two or three examination
rooms. They’re looking for [good colleagues], because the first two
years are the establishment of their career.”
Allan’s suspicion is that there will be an excess of optometrists
in 24 to 36 months, as the two new Australian programmes begin
to turn out graduates, creating more competition in the overseas
avenue for new, adventurous optometrists.
Deakin University in Victoria and Flinders University in South
Australia, have both launched optometry programmes in the
last few years, and while the additional graduates have not yet
created more competition, they will in the next two to three
years, says Allan.
The 320 optometry practices--both independents and corporates-
-in New Zealand, meanwhile, will continue to be the prime
placement targets for Kiwi graduates. The natural succession of
optometrists retiring continues to open slots, but, as in Australia,
the perfect job may not be in the bigger cities, Allan says.
“My recommendation is to take opportunities as they open.
From a business practice perspective, I’d say look in the provinces,
because you’ll see the whole thing from paediatrics to gerontology.
You’ll have a wider patient base, examination time will be longer
and you’ll develop more of a relationship with your patients.”
Students will continue to find opportunities among corporates.
Charles Hornor of Specsavers says his company has recruited 130
students in New Zealand over the past five years, placing them
predominantly in their 50 plus New Zealand sites. Hornor does not
foresee a glut of optometrists in New Zealand, but the opposite.
“We are actually seeking more graduates than ever because we
are experiencing an increasing level of demand in all our practices.
With the average New Zealand Specsavers store now turning
over $2.1 million plus each year, we are also forecasting demand
will continue to rise. That is why we have stated that across
New Zealand and Australia combined, we will look to enrol 200
graduating optometry school students into our Graduate Program
for each of the years to 2020.”
Specsavers’s website describes the two-year developmental
Graduate Program as an opportunity to participate in professional
events, courses and experiences while developing optometry skills
with maximum support from mentors and the clinical team, along
with ongoing training opportunities and the chance to refine and
grow your clinical and business skills.
While Allan foresees a potential downward pressure on starting
salaries in the coming years, from Specsavers ‘ point of view there
isn’t anything to indicate the supply of optometrists is adequate.
“For some years now every graduating optom who wants to
work in practice has been able to pick and choose between roles
– and nothing has changed in that regard because there are just
not enough graduates to go round. In our view the kind of starting
salaries being offered will continue to favour the graduate, as
competition for their signatures continues.”
Zhang, who sits her final exams in November and graduates in
May, has time to decide where she wants to go. She says she’d
like to work in Australia for a few years, and come back to New
Zealand to continue her studies.
While she admits there is a business aspect to making such
decisions, Zhang isn’t convinced that is something an optometry
programme needs to teach its students.
“They’ve trained us well to treat our patients with the services
they need. But they don’t prepare us for the business world. At the
same time I don’t think that’s what a programme should be about.”
OPSM also recruits graduates, but as of this writing, the
company was unable to provide us with answers to our particular
questions about the jobs market. ▀
Charmant wins award
XL 2063 GP is available in gold, black and purple
The International Optical Exhibition OPTA 2015 in Brno,
Czech Republic awarded Line Art Charmant the top
award for the category: Optical frames - Design and
Material Innovation.
Model ‘XL 2063 GP’ was selected as the best exhibit in the
hotly contested field. The model comes in three sizes—51/17
135—and was lauded for beauty in design that is both elegant
and 3-dimensional. The entire lightweight Line Art collection is
made from high-grade titanium.
The prestigious prize is awarded once a year. This was
the first time that the competition has been held under
the auspices of the Association of Czech Opticians and
Optometrists and the Slovak Optical Union. ▀
11th Annual Scientific Conference
Thanks to our Conference Sponsors:
CONFERENCE
Sunday
8 th November 2015
8.00am - 5.00pm
Venue:
Waipuna Hotel &
Conference Centre,
58 Waipuna Rd,
Mt Wellington, Auckland
Registration:
8.00am - 8.30am
Light Meal & Beverages
provided
Margaret Lam, is our 2015 International Invited
Lecturer, she is a highly sought-after speaker at
conferences throughout the Asia-Pacific and is an
owner/optometrist of a small group of successful
independent optometry practices in Sydney,
collectively called “theeyecarecompany”.
Margaret's practice-enhancing lectures will include:
• Ocular therapeutics and contact lenses - two peas in a pod
• From Little Things, Big Things Grow - Practice Growth Strategies
• Update on keratoconus management: optimal care guidelines
for keratoconus patients, CL management of keratoconus
and working with ophthalmologists
Registrations:
Phone. 09 522 2125 Fax. 09 522 5770
Email. conference@eyeinstitute.co.nz
Register Online. eyeinstitute.co.nz/optometry
BOOK NOW!
for your 2015/2016 CPD Credits
(including Therapeutics)
GOLD SPONSORS
SILVER SPONSORS
CORNEAL LENS
CORPORATION N.Z. LTD
ideas into practice
October 2015
NEW ZEALAND OPTICS
11
October 2015.indd 11
9/18/2015 6:43:40 AM

Google eyes OphthalmicDocs’
3D printable retinal camera
Google X, the semi-secret facility
run by Google, dedicated to major
technological advancements such as
the driverless car and contact lenses
that monitor diabetics glucose levels, may soon
be considering better ways to test the health of
people’s eyes in developing countries if the local
Google team have anything to do with it.
Dr Sheng Chiong Hong, an ophthalmic
registrar at Gisborne Hospital, and co-founder
of OphthalmicDocs (oDocs), a Kiwi-based social
enterprise determined to bring better eye care
to developing nations, says he was completely
taken by surprise when Google contacted him
last month asking if he could talk about his work
at a Google NZ corporate gathering.
“I thought I’d infringed a patent or something,”
he laughs.
The Google NZ team had actually tracked Hong
down after hearing his TEDx talk in May on how
he’s hoping to combat preventable blindness in
the world with $5 and a smartphone.
“They wanted speakers who have a vision
of changing something, but doing it in an
innovative way… and the aim is now to fly me
to the States to connect me with the Google X
team, who are interested in identifying global
health problems and whether we can solve those
problems with technology.”
Whether Hong actually meets the Google X
team remains to be seen, but oDocs’ Fundus,
a 3D printable adapter that converts any
smartphone into a retinal camera, is creating
quite a stir in developing countries with more
than 4,000 downloads since it was made
available online in May.
Talking at a recent Auckland dinner, supported
by Alcon Surgical, Hong was able to relate
numerous case studies and testimonials from
health and eye care professionals in developing
countries who were now able to better diagnose
eye diseases using the affordable 3D printable
The oDocs 3D printable Fundus
device. “It’s not just a toy or a hobby anymore.
This is pretty much making a change in eye care
all over the world.”
The oDocs Fundus and associated app that
Hong and his oDocs co-founder, Ben O’Keeffe,
a senior house officer in ophthalmology at
Wellington Eye Clinic, have developed basically
provide a very cheap and easy to produce
alternative to a portable slit lamp microscope
and a fundus camera, that can be downloaded
and printed by anyone with access to a 3D
printer.
And it doesn’t just have applications for
better diagnosis and thus treatment in
developing countries, others are interested in
the technology closer to home for GPs and other
primary care providers to help them quickly
discover if someone needs to be referred to
an ophthalmologist or optometrist for further
diagnosis and treatment, with studies showing
that even here, around 40 per cent of eye
problems are misdiagnosed by GPs.
oDocs is currently carrying out and planning
further studies with optometrists and GPs in
Gisborne using the Fundus and a new app
designed to locate the nearest ophthalmologist
on call, with the hope of helping people far
more quickly to reduce the number of “too late”
referrals, says Hong.
Though providing help to people in developing
countries and combating the burden of
preventable blindness is at the heart of oDocs’
being, Hong and O’Keeffe are investigating more
commercial options for their product in order
to provide a sustainable income stream for the
business.
One day Hong says oDocs may replace
the “very, very old” and inefficient direct
ophthalmoscope, which is the bane of GPs and
eye professionals’ lives, he says.
For more visit: www.ophthalmicdocs.com ▀
From left to right, Ben O’Keeffe, oDocs co-founder, Jonathan Spencer, surgical account manager, Alcon, and
oDocs co-founder Sheng Chiong Hong
New Zealand’s first
trainee ophthalmologist referee
If developing a revolutionary new eye disease
diagnostic tool for the developing world (see
accompanying story) and completing your
ophthalmological training wasn’t enough,
OphthalmicDocs co-founder Ben O’Keeffe is
the country’s first ophthalmologist to become
a professional referee, and at 26, one of the
country’s youngest trainee.
O’Keeffe made the decision to focus on
refereeing (instead of playing) seven years ago
while studying at Otago and realising he wasn’t
going to go much further in his playing career.
The decision was bolstered by his father, Peter
O’Keeffe, also a referee, who said if he wanted to
become a professional referee he’d have to start
early rather than waiting until his playing career
had ended.
“I just wanted to continue to be involved in the
game…so that’s what I did,” says O’Keeffe.
Since then O’Keeffe, has worked his way up
through club, Heartland and ITM Cup ranks,
gaining experience as a Super Rugby assistant,
and refereeing the final of the 2014 Junior World
Championship, before making his international
debut in Argentina in June this year, when
Argentina took on the notorious French
Barbarians, and lost 28-22.
Currently a senior house officer at
ophthalmology at Wellington Eye Clinic, O’Keeffe
says he’s often away at weekends, flying out at 4
pm on a Friday to referee an international match
or one of the Super Rugby games.
“I like to be busy, but the great thing for me
is they really complement each other… I deal
oDocs in running for NZ Innovation award
OphthalmicDocs (oDocs), is a finalist in three
categories of the New Zealand Innovators
Awards 2015.
Dr Sheng Chiong Hong, oDocs co-founder,
says it’s very exciting to be nominated and he’s
hoping that support from the Kiwi ophthalmic
community will tip the balance in the People’s
Choice award.
As well as being up for the People’s Choice
award, oDocs is a finalist in Innovation in Health
& Science, Excellence in Social Innovation,
and Export Innovator of the Year. Hong is also
personally nominated as a finalist in the Most
Inspiring Individual category.
Organised by the NZ Innovation Council and
supported by Bayer NZ, the awards aim to
recognise and celebrate innovative, high-growth
New Zealand organisations.
In a press release announcing the finalists,
organisers says 2015 saw a 24 per cent increase
in entries. “The finalists represent game
with patients during the week, telling them
things they often don’t want to hear about their
vision and then on Saturday I’m also dealing
with people and giving them bad news if I’m
penalising them,” he laughs.
As for the pink strip, O’Keeffe says it’s taken a
bit of getting used to. “The first time I walked
out in it, I felt like everyone was looking at me.
But it does help us not be hit on the field.”
O’Keeffe, won’t be donning the pink for this
year’s world cup, however, as he’s fully occupied
with Super Rugby and the ITM Cup competition,
but he is aiming to be at the 2019 world cup in
Japan, he says. ▀
Ben O’Keeffe swaps white coat for pink shirt
changing innovation from every corner of
the country…these are ordinary Kiwis doing
extraordinary things.”
NZ Innovation Council CEO Louise Webster
says one of the biggest changes this year was a
rise in entrants focused on making the world a
better place. “We saw a new wave of innovative
businesses focused on solving social issues.
These organisations are still profit making
entities, but are driven by a purpose to help solve
the world’s problems and have a global impact.”
Bayer New Zealand managing director Holger
Detje says the quality of entrants is impressive.
“The aim has always been to recognise great
Kiwi talent and the commercialisation of
innovative New Zealand products and services,
and the awards certainly achieve that.”
The winners of the 2015 awards will be
announced at a cocktail evening on October 21 at
The Cloud on Queens Warf in Auckland. ▀
Change of Leadership
at Save Sight Society
The Save Sight Society’s last AGM saw
a host of changes to the 49-year-old
organisation’s leadership.
Attendees bid farewell to Gordon
Sanderson, associate professor in the Department
of Ophthalmology at the University of Otago,
Dunedin, who stepped down as a director for the
Society. Dr Heath Wilms also stepped down as
Society treasurer.
Dr Stephen Ng stepped down from his role
as chair, remaining a director, and passing
the baton to Associate Professor Dipika Patel.
Additional changes included the appointment
of Dr Shuan Dai as a new director and Stephanie
Ward as treasurer.
AGM attendees expressed a desire for greater
engagement with optometrists in the society,
with a plan to recruit a new director with a
background in optometry.
The meeting highlighted the Society’s recent
successes over two days at the Waikarei Resort
in Taupo at the end of May. A range of delegates
attended, including nurses, optometrists,
ophthalmologists and vision scientists. The event
raised approximately $50,000 to go towards
funding research and education in New Zealand.
The 2016 Save Sight Society conference will be
held in Tauranga and will be convened by
Dr Sam Kain. ▀
Dipika Patel
NEW OFFICERS ELECTED AT THE SAVE SIGHT
SOCIETY AGM.
Postions are held four years.
Chairperson: Dipika Patel
Treasurer: Stephanie Ward
Directors: David Dalziel, Charles McGhee,
Shuan Dai, Mary Jane Sime, Bronwyn Ward,
Sam Kain, Hussain Patel and Stephen Guest.
12 NEW ZEALAND OPTICS October 2015
October 2015.indd 12
9/18/2015 6:43:41 AM

11th Annual Scientific Conference
Focus on
Eye Research
Cataract Surgery and AMD
REVIEWED BY DAVID WORSLEY*
d
s
E
Cataract and AMD often coexist. When considering cataract
surgery for a patient with AMD there are several important
unresolved issues which include:
• Does cataract surgery increase the risk of progression of early
Thanks to our Conference Sponsors:
to late AMD?
Eye
• Is cataract surgery safe for patients with wet AMD?
Margaret Lam,
Institute
is our 2015 International
conference
Invited
to
GOLD SPONSORS
• Will cataract surgery improve vision for low-vision patients
with bilateral late AMD?
Lecturer, she is a highly sought-after speaker at
Three recent publications have provided some useful guidance on
these questions.
examine
conferences throughout the
everyday
Asia-Pacific and is an
practice
For patients with early AMD and co-existent cataract, there has
owner/optometrist of a small group of successful
been concern that cataract surgery may increase the risk of
progression to late AMD and in particular to wet AMD. There are
independent optometry practices in Sydney,
theoretical reasons for this. For example, there is strong evidence
collectively called “theeyecarecompany”.
of a pathogenic role for inflammation in AMD. So, could the
The Eye Institute’s 11th Annual Scientific Conference happy is close, confidential, friendly consultation, nipping
normal inflammatory response due to routine cataract surgery
will be held in November with the focus: Diagnostics & problems in the bud.”
SILVER SPONSORS
hasten progression to late AMD? Another popular unresolved
Margaret's Therapeutics practice-enhancing in everyday practice. lectures will include: Finally, Lam will give an update on keratoconus management, concern is that permissive absorption of blue light following
The conference aims to expose optometrists to advances with optimal care guidelines for keratoconus patients, CL
removal of the crystalline lens may accelerate AMD.
in diagnostics, therapeutics, shared-care management and surgical management of keratoconus and working with ophthalmologists.
• Ocular therapeutics and contact lenses - two peas in a pod
• From Little Things, Big Things Grow - Practice Growth Strategies
• Update on keratoconus management: optimal fantastic care collaboration.” guidelines
for keratoconus patients, CL management of keratoconus
and working with ophthalmologists
advances in New Zealand.
It will be held at the Waipuna Hotel and Conference Centre
in Auckland on Sunday 8th November. Delegates will receive
CPD points and for the first time will also include a parallel
conference for dispersing opticians and support staff.
At the main conference special guest Margaret Lam, founder of
the Eye Care Company in Australia, will give three presentations,
including her keynote address on ocular therapeutics, looking at
compliance strategies in reduction of infiltrative and infective
events with CL wear, CL related infiltrative keratitis and
Registrations:
management.
innovative materials, advancement in reduction of discomfort and
reduction of infiltration, but on the other side of the fence, we
also have CL wearing habits slipping,” says Lam. “CLs are very fast
becoming a de facto OTC commodity, which wearers feel they can
get whenever they want. The concern is that the more CLs become
a commodity,
BOOK
the more we will
NOW!
see complications because of a
laissez faire attitude where people self-prescribe. It can grow or
diminish based on what we do now.”
Lam is a contact lens specialist, an educator and lecturer and
works in an advisory capacity for several CL companies. She also
serves as the New South Wales chapter president of the Cornea
and Contact Lens Society of Australia.
Lam will also give a short presentation titled From Little Things,
Big Things Grow—Practice Growth Strategies, a discussion on
utilising CL as a practice growth tool.
Online purchasing of contact lenses is a competitive threat to
brick-and-mortar optometry practice, but the bigger concern is that
CLs are perceived by patients as an over the counter commodity,
which can lead to lax habits and potential eye problems when
patients avoid seeing optometrists regularly, she says.
“What optometrists need to realise is sometimes we don’t give
ourselves enough credit. What is essential to keep a CL wearer
Snowvision scholarship
winners announced
The Snowvision Charitable Trust announced the winners of
this year’s scholarship programme, which pays their way
for a research trip to the State University of New York
(SUNY) School of Optometry in the heart of New York City.
As in previous years, the Trust committee selected one graduate
and one experienced practitioner to spend four weeks in research
and study. This year’s Snowvision scholarship recipients are
final year student Alyssa Lie and Callum Milburn, a partner with
Milburn & Neill Optometrists in Dunedin.
A third recipient was selected this year due to additional financial
support from the New Zealand Association of Optometrists (NZAO).
For this scholarship, the committee selected Lily Chang, a doctoral
candidate in optometry at the University of Auckland.
Hamish Caithness, who co-manages the Snowvision Charitable
Trust, says the trustees of the charity pick the scholarship winners
in consultation with the University of Auckland Optometry and
Vision Science programme for student applicants and referees for
experienced optometrist applicants.
“The criteria include whether the applicant is a suitable person
to travel to New York and spend time at SUNY; whether they
will benefit from the experience; whether they will be a good
ambassador for New Zealand optometry; and whether they
practice optometry in a professional and ethical manner.
“I’ve found New Zealand optometrists have a wonderful depth
of knowledge and a really good co-management relationship with
ophthalmologists. They work synergistically with each other. It’s a
With more than 270 optometrists attending last year, the
conference is one of the more popular educational events on the
optometric calendar. Last year the conference was awarded 5.50
CPD and 0.25 general points. Eye Institute plans for just as many
to be awarded for this year’s event.
An industry exhibition is being held in conjunction with the
event and will include Alcon, Abbott Medical Optics, Bausch
+ Lomb, Corneal Lens Corporation, Designs for Vision, Device
“Contact Phone. lens technology 09 522 is 2125 improving at Fax. such a fast 09 rate 522 with 5770
Email. conference@eyeinstitute.co.nz
Register Online. eyeinstitute.co.nz/optometry
The Eye Institute’s 11th Annual
for your 2015/2016 CPD Credits
(including Therapeutics)
Scientific Conference now includes
a parallel conference for dispensing
opticians and support staff
Technologies, Humanware, Ophthalmic Instrument Company,
Optimed, Optrex, Toomac Ophthalmic, Glaucoma NZ and MDNZ. ▀
Time: 8.00am to 5.30pm. Light meal and beverages
provided.
Venue: Waipuna Hotel and Conference Centre, 58
Waipuna Rd, Mt Wellington, Auckland
Cost: $80 incl. GST
To register or find out more, visit: www.eyeinstitute.
co.nz or email: conference@eyeinstitute.co.nz
CPD available for both optometrists and dispensing
opticians
“The aims of the Trust are to improve the clinical skills of
New Zealand optometrists and we take the applicants’ likely
contribution to the aims of the Trust into account when reaching
our decision.”
The programme commenced in 1997 and since then 39
scholarships have been awarded. The value of the scholarship is
currently at $7000, which covers SUNY tuition, return airfare and
part of the attendee’s accommodation costs.
The programme’s track record attracted the NZAO to add its
support this year.
“The Snowvision Charitable Trust under the management of
Hamish Caithness and Dave Robinson does an excellent job,” says
NZAO Executive Director Lesley Fredrickson. “If funding were
available from NZAO, the feedback from NZAO members was
to spend it on educational opportunities that might otherwise
be unobtainable. Funding the NZAO Snowvision Scholarship is
therefore a practical way for NZAO to support an outstanding
educational opportunity for practitioners that might otherwise be
unobtainable.”
Applications for the 2016 Snowvision Scholarship will open at
the end of March and close at the end of June. Recipients will be
announced at the popular, biennial Snowvision conference, which
is scheduled to be held from the 4th to the 6th August 2016 in
Queenstown. ▀
CATARACT SURGERY AND AGE-RELATED MACULAR
DEGENERATION: AN EVIDENCE-BASED UPDATE
Kessel L et al. Acta Ophthalmol. 2015 [Epub ahead of print]
The authors performed a systematic literature search of studies
on the risk of AMD progression following cataract surgery. Quality
of the studies was assessed using a risk of bias tool, data extracted
and meta-analysed. The authors conclude that cataract surgery
doesn’t increase the 6 to 12 month risk of progression to wet AMD.
However, the quality of the evidence is only moderate as the few
available studies provide an insufficient number of subjects. There
remains a need for more research, however the current evidence
provides some reassurance.
Patients may present with co-existent wet AMD and cataract
or cataract may develop at some point during ongoing anti-
VEGF therapy. There are very reasonable concerns that cataract
surgery may have a negative impact on the wet AMD, perhaps
worsen choroidal neovascularization, lead to geographic atrophy,
increase anti-VEGF therapy requirements or lead to a specific postoperative
adverse outcome such as macular haemorrhage.
CORNEAL LENS
CORPORATION N.Z. LTD
ideas into practice
THE EFFECTS OF CATARACT SURGERY ON PATIENTS
WITH WET MACULAR DEGENERATION
Saraf S. et al. Am J Ophthalmol. 2015 Sep;160(3):487-492
This retrospective review compared outcomes in patients with
active wet AMD on anti-VEGF therapy who had cataract surgery
with those who did not have surgery. The authors found that
cataract surgery significantly improved vision, didn’t increase the
risk of an adverse outcome and didn’t significantly increase anti-
VEGF treatment requirements. However, the authors recommend
careful monitoring post surgery as they found a trend toward
increased central macular thickness as well as the presence or
worsening of intraretinal cysts in the three months following
surgery. This appears to be a transient issue, is amenable to
increasing the frequency of anti-VEGF therapy and doesn’t appear
to compromise the visual gain from surgery.
The authors conclude that in controlled wet AMD, cataract
surgery appears to be safe and the visual acuity gain is maintained
on continued anti-VEGF therapy. To avoid a worsening of OCT
features, a temporary increase in the frequency of anti-VEGF
therapy is recommended.
Late AMD with low vision is often considered a negative
predictor for visual outcome after cataract surgery. Most
publications have used an improvement in central visual acuity as
their endpoint. This is unfortunate as visual acuity is a very poor
tool for the assessment of visual function in low vision patients.
Vision-related quality of life (VQOL) is now the gold-standard
measure and should be used to measure effectiveness of cataract
surgery in patients with low vision due to macular disease.
CATARACT SURGERY IN PATIENTS WITH BILATERAL
ADVANCED AGE-RELATED MACULAR DEGENERATION:
MEASUREMENT OF VISUAL ACUITY AND QUALITY OF LIFE
Ma Y. et al. J Cataract Refract Surg. 2015 Jun;41(6):1248-55.
The authors conducted a prospective case series measuring
change in visual acuity and vision-related quality-of-life factors
after cataract surgery in low-vision patients with bilateral late
AMD and cataract. Corrected distance visual acuity (CDVA) and
vision-related quality of life measured by a Low Vision Quality of
Life (LVQOL) questionnaire were measured.
Both the CDVA and LVQOL scores improved significantly
following surgery. The worse the preoperative CDVA, the greater
the chance of cataract surgery results in an improvement in VQOL.
The authors conclude that low-vision bilateral late AMD patients
with coexistent cataract benefit from cataract surgery with both
VA and VQOL improving significantly.
*About the author: Dr David Worsely is an
ophthalmologist, a visiting specialist at Waikato
Hospital and is in private practice at Hamilton Eye
Clinic. He is currently involved in research into
automated retinal imaging with colleagues at the
University of Waikato. ▀
October 2015
NEW ZEALAND OPTICS
13
October 2015.indd 13
9/18/2015 6:43:42 AM

SPECIAL FEATURE: RANZCO
2015
47th Annual Scientific Congress - Wellington, New Zealand
RANZCO is hosting
this year’s Annual
Scientific Congress
in Wellington from
October 31 to
November 4.
It promises delegates a wealth of networking
and learning activities. There’s a stellar line-up
of international speakers, and a number of social
events--including the black-tie Congress Dinner
at Wellington’s Parliament House. Anyone keen
to rise before five Sunday morning can join the
Rugby World Cup breakfast. There will be a dinner
for younger fellows and one for senior and retired
fellows, plus a day out mountain biking, and the
Registrars Club returns this year.
The congress will be held at Wellington’s TSB
Bank Arena, the largest indoor, pillar-free, flat floor
venue in Wellington’s CBD. A range of programmes
and events will appeal to the variety of delegates
expected, including practice managers (see
separate story), vision scientists, orthoptists and
ophthalmologists.
With topics such as glaucoma, cataract, cornea,
uveitis and surgical retina featured in the packed
scientific programme, delegates will be able to
explore cutting-edge scientific developments
and leave with a wealth of knowledge, promise
the organisers.
Key speakers and topics include:
• Associate Professor John Grigg, head of the
Discipline of Ophthalmology at The University
of Sydney’s Save Sight Institute, will give
the Council Lecture on Childhood vision
impairment: helping children see the future.
• Professor Peter McCluskey, the current chair
of ophthalmology at the University of Sydney
and director of the Save Sight Institute at
Sydney Eye Hospital, and an inflammatory eye
disease specialist with 30 years’ experience, will
present Getting the red out: 30 years of scleritis
research.
• Professor Dao-Yi Yu, director of the Physiology
and Pharmacology Centre in the Centre for
Ophthalmology and Visual Science at the
Lions Eye Institute, the University of Western
Australia, will give the Ida Mann Lecture
Research discoveries to clinical application:
developing a new glaucoma filtration surgery.
• Dr Neil Murray from The Fred Hollows
Foundation in New Zealand, will be giving the
Hollows Lecture: Progress through innovation –
the Hollows effect.
• Ike Ahmed from Credit Valley EyeCare in
Canada, a fellowship-trained glaucoma,
cataract, and anterior segment surgeon with
a practice focus on the surgical management
of glaucoma, complex cataract and intraocular
lens complications, will be giving the Cataract
Update Lecture.
• Dr Randall Olson, chair of the department of
ophthalmology and visual sciences, University
of Utah School of Medicine, author of more than
300 professional publications, will be giving the
Cornea Update Lecture: Phaco vs The Cornea:
the saga. (See separate interview p18).
• Professor Tin Aung, director of the Singapore
Eye Research Institute, whose main research
interests include angle closure glaucoma and
the molecular genetics of eye diseases, will be
giving the Glaucoma Update Lecture: Current
updates in Angle Closure Glaucoma. (See
interview p22).
• Dr Douglas Jabs, professor of ophthalmology
and medicine, and chair emeritus of
ophthalmology at the Icahn School of Medicine
at Mount Sinai, USA, will be presenting: Longterm
drug-free remissions in Uveitis. (See
interview p16).
• Professor David Wong, a consultant
ophthalmologist at the Royal Liverpool University
Hospital and honorary chair to the University of
Liverpool, and inaugural chair to the department
of ophthalmology at Hong Kong University, will
be giving the Surgical Retina Update Lecture:
Which silicone oil should we use? New evidence
to shed light on our choices.
• Chai Chuah, director-general of Health NZ,
will deliver the RANZCO Plenary: Ethics and
Professionalism.
As well as the main scientific programme,
there is a range of other meetings and additional
educational sessions presented by key sponsors
Novartis, Allergan, Alcon and Bayer. Places are
limited for these breakfast-events, however, and
organisers note these are only suitable for fellows,
registrars and other medically-qualified delegates.
The list of other meetings includes workshops for
registrars; an international development workshop
on diabetic eye disease in a low resource setting; a
CPR refresher course; a commercial business skills
session; an ANZSRS retinal satellite meeting; risk
management workshops for fellows on Caring for
Our Colleagues and Looking forward-Looking back:
communication and complaints; as well as a host
of other topics.
For the full scientific programme, visit:
http://www.ranzco2015.com.au/images/2015/
RANZCO%202015%20Preliminary%20Program.pdf
A list of other meetings can be found at: http://
www.ranzco2015.com.au/program/other-meetings
While for a list of RANZCO-organised social
activities, visit:
http://www.ranzco2015.com.au/socialevents#CongressDinner
▀
Welcome
to RANZCO
2015
By Dr Brad Horsburgh, president RANZCO
Staying abreast of developments in the complex
and ever-changing world of ophthalmology
requires our diligent attention so that we ensure
our professional standards and commitment to
patient care are always first-class.
That we can stimulate our thinking and challenge
our perceptions in the company of colleagues
and friends at a Scientific Congress makes this
responsibility a very pleasant one. And that we can
do so in the delightful surrounds of Wellington this
year promises a gathering full of warm memories.
We owe a vote of thanks to all those involved
in organising this great event. Their attention to
detail and success in arranging a world-class lineup
of international leaders in ophthalmology will
make this a terrific learning event.
As always, the generosity of our sponsors enables
us to share the benefits of such packed programmes.
On your behalf, I thank them sincerely. ▀
EXPLORE MORE
AND DISCOVER WHAT YOU’RE MISSING
The World’s 1st commercially available
posterior & anterior swept source OCT!!
Penetrates through cataracts
& haemorrhages
Using 1050 nm wavelength
High Speed Scanning
100,000 A-Scans/sec
Wide-field OCT (12-9mm)
One scan for both macula
& glaucoma analysis
NEW Combination Scan
Anterior Segment
3D Wide Scan + 5 Line Cross
/ B-Scan in one capture
Optional Fluorescein &
Autofluorescence photography
16mm Anterior Segment Line Scan
Anterior Chamber angle
Corneal Radial Scan for
CCT & Radius Map
NEW
TRITON
14 NEW ZEALAND OPTICS October 2015
October 2015.indd 14
9/18/2015 6:43:44 AM

Oculo to transform industry communication
Communication between optometrists and ophthalmologists in
Australia and New Zealand is finally being shunted into the 21st
century with a new secure online platform called Oculo.
“There’s been this digital revolution in technologies available to
diagnose, treat and manage eye disease, but communication remains in
the era of fax, paper and letters,” says Kate Taylor, chief executive of Oculo.
Oculo provides a secure, online system for optometrists to identify
ophthalmologists with particular specialities and to safely share with
them clinical records, including patient data, photos and scans for
referrals or requests for opinions.
The system is the brainchild of Professor Jonathan Crowston,
managing director of the Centre for Eye Research Australia (CERA),
and Peter Larsen, director of CERA and Specsavers professional
services director. It was developed by Taylor for CERA, before being
spun out as a newly formed private company.
Larsen and Taylor announced the launch of the Oculo system at
the recent Specsavers Clinical Conference in Brisbane. At the launch,
Larsen said that if Oculo is adopted widely by the industry it will
change the fabric of eye care in Australia and New Zealand. “There’s
all this interaction between optometry and ophthalmology and it’s all
ad hoc; there’s no level of consistency in the communication.”
Even worse, Taylor says, current communication practices often
mean material is lost, duplicated or misinterpreted.
“When you take a visual field, that is a grayscale image, and then
you photocopy it and fax it and you’ve got a grayscale of a grayscale
of a grayscale, so you end with some not very good data. Duplications
are problematic for the patient because it means time and money
and extra anxiety and inconvenience. Duplications are bad for the
health system because it’s just inefficient. But it’s the gaps in the data
that are vision threatening.”
In a statement released at the conference, Crowston says as an
ophthalmologist he often gets referrals that have little detailed
information and arrive with poor quality photocopies or test results.
“This makes triage difficult and it is not easy to provide early feedback
to the referrer who often waits weeks before hearing back. What I
really want is a quality image of the optic nerve and retina and, if
possible, some earlier images that allow me to determine whether
the disease is progressing.”
A survey Oculo ran earlier this year found that 64 per cent of
optometrists thought poor communication among themselves,
ophthalmologists and hospitals was negatively affecting patient
outcomes.
“What is needed to facilitate shared care between our professions
is a practical way to work together and to build trust, focusing on
what is best from a patient perspective,” Larsen says. “Efficient
communication is critical to providing quality shared care.”
Oculo may also facilitate mentoring of junior optometrists, while
more timely and more detailed feedback from ophthalmologists
should aid optometrists’ ongoing education, says Larsen. “The best
ophthalmologists are good teachers and through this they can coach
better practice and optometrists can learn and improve the accuracy
of their referrals, which is better for the patient.”
Oculo is currently being trialled by 14 Specsavers, OPSM and Bupa
Optical stores and five ophthalmic practices in Melbourne, and there
are plans for similar trials in New South Wales, ACT and New Zealand.
“We will be coming to New Zealand very soon,” says Taylor. “We’re
just finishing all of the last touches for compliance so as soon as they
are in place we will be similarly engaging to get it in use across
New Zealand.”
Taylor says optometrists at the Specsavers conference — which
included 50 non-Specsavers practitioners in attendance — responded
positively to the announcement. Oculo’s stand was busy from
beginning to end as people registered their interest, she says.
The Oculo system will retail for A$245 a month for a per store
licence, allowing unlimited data, however many individuals in the
store use it, or patients need it.
Oculo is majority-owned by CERA, with additional shareholdings
owned by Taylor, through an employee share ownership scheme, and
Australian angel investor and logistics business entrepreneur Peter
Gunn, who provided the company with seed capital.
With most profits made returned to CERA, Oculo has big potential
for the future of health research in Australasia, says Taylor. “This
is part of the multi-faceted vision of Jonathan Crowston, solving
a clinical problem and then supporting CERA’s research in a way
that frees it up from dependence on grant cycles in such a difficult
research environment. So it is really exciting… for CERA this is the first
cab off the rank so we really want it to succeed.”
Dr Kate Taylor will be presently Oculo to delegates at RANZO 2015 ▀
OPTOS
SPECIAL FEATURE: RANZCO
Optos’ core devices produce ultrawidefield,
high-resolution digital
images or optomap images.
Our optomap technology captures
200 degrees or approximately 82 per
cent of the retina, allowing eyecare
professionals to see 50 per cent
more of the retina compared with
other imaging devices. Optos is once
again expanding the boundaries
of ultra-widefield imaging: our
Optos’ California, designed
California device is specifically
for vitreo-retinal specialists
designed for general ophthalmologists
and ophthalmologists.
and vitreoretinal specialists. It is the
first retinal imaging device to offer
ultra-widefield indocyanine green (ICG) angiography, in addition
to colour, autofluorescence and fluorescein angiography. Taking
advantage of the latest imaging technology, the California is the
most comprehensive ultra-widefield retinal imaging device on
the market. These new features have been specifically designed
for eye professionals to discover more evidence of disease and
guide their treatment decisions even more effectively.
Visit Optos at RANZCO in Wellington from the 31st October—
4th November. ▀
Dr Kate Taylor explains the benefits of new, online communication platform Oculo
ULTRA-WIDEFIELD RETINAL IMAGING
optomap optomap af optomap fa optomap icg
TECHNOLOGY DESIGNED TO IMPROVE YOUR
ULTRA-WIDEFIELD IMAGING CAPABILITIES
Optos has the only imaging technology that produces ultra-widefield images of 200°
or 82% of the retina in a single capture.
See more, discover more, and treat more effectively
Visit the Optos booths 43 and 44 at this year’s RANZCO Congress in Wellington, NZ
Optos Australia
10 Myer Court, Beverley SA 5009 Australia
P: +61 8 8443 4533 E: auinfo@optos.com
optos.com
October 2015
NEW ZEALAND OPTICS
15
October 2015.indd 15
9/18/2015 6:43:45 AM

SPECIAL FEATURE: RANZCO
Tackling the
uvetides and AMD
— Dr Douglas Jabs
An interview with RANZCO keynote speaker Dr Douglas Jabs,
professor of ophthalmology and medicine and chair emeritus of
ophthalmology at the Mount Sinai School of Medicine in New York.
Are there any controversial views
that challenge the way you think
about uveitis ?
A somewhat contrarian view, of
which I am a big proponent and which
appears to be gaining traction, is that
our traditional approach to diagnosis,
namely the “etiologic diagnosis” of
uveitis in which one looks for the
“cause” of the uveitis, is flawed.
Most diseases in medicine are
“complex disorders” which are
multifactorial in nature and for which
we know risk factors and pathogenesis, but for which we do not know
a singular “cause”. The diseases for which we truly know the “cause”
are Mendelian genetic disorders, infectious diseases and drug-related
toxic or allergic reactions. Diseases such as sarcoidosis and juvenile
idiopathic arthritis are, in fact, idiopathic (ie. of “unknown cause”) so
finding them in a patient with uveitis is important for the patient’s
systemic health, but does not actually tell us the “cause”.
The uveitides are a collection of more than 30 diseases characterised
by intraocular inflammation, each with its own features, risk factors,
course, treatment and prognosis. As such we should be diagnosing the
specific uveitic disease as it is critical to management. The laboratory
should be used to eliminate infections, which would be treated
differently (ie. with antimicrobial agents) and to identify any relevant
associated systemic disease that could affect the patient’s health.
Exhaustive laboratory testing with tests of low positive predictive value
when there is no evidence of end-organ disease is unwarranted.
One area of your expertise is in the ocular complications of autoimmune
disease. What have been some interesting discoveries in this area?
Many of our therapies for the uveitides have been introduced
for treatment of rheumatic diseases first and then adopted by the
ophthalmic community. The success of rituximab for the treatment
of rheumatoid arthritis and for vasculitides, such as granulomatosis
with polyangiitis, has forced us to rethink our ideas about
pathogenesis of these diseases. Traditionally, they were thought to
be cell-mediated immune disorders, but the success of a monoclonal
antibody directed against B cells suggests that the pathogenesis is
more complicated. Furthermore, the apparent response of vasculitisassociated
scleritis to rituximab suggests a role for this approach in
the treatment of some cases of scleritis.
What new surgical techniques will enable treatment to be more
efficient and successful?
The treatment of the uveitides is largely medical and surgery,
typically, is needed for the structural complications of the uveitides
such as cataract and glaucoma. Modern cataract surgery with
intraocular lens placement can result in very good outcomes for
uveitic cataracts if the eye has had inactive uveitis for a sufficient
time (ie. more than 3 months) and a short course of perioperative
systemic corticosteroids, started prior to surgery, is used.
In addition, paracentesis for polymerase chain reaction and
diagnostic vitrectomy for polymerase chain reaction, cytology, flow
cytometry and culture all are an important part of the diagnostic
armamentarium. Modern vitreoretinal surgical techniques have
made diagnostic vitrectomy a reasonable early diagnostic option.
The therapeutic surgical development is long-lasting surgical
corticosteroid implants (such as the fluocinolone acetonide implant),
which last three years, are US Food and Drug Administrationapproved
and appear to be more effective at controlling the
inflammation than systemic approaches for severe, non-infectious
intermediate, posterior and pan-uveitides. However, systemic
approaches are effective in the large majority of patients and local
corticosteroid implants come at a cost of an increased rate of ocular
hypertension and cataract versus systemic approaches.
Are there aspects of uveitis which you would like to investigate
further, to satisfy your professional curiosity?
The Multicenter Uveitis Steroid Treatment Research Group, an
international, US National Institutes of Health-funded multi-centre
clinical trials group is engaged in a long-term follow-up study of the
original Multicenter Uveitis Steroid Treatment Trial to determine the
long-term outcomes of these different treatment approaches (longlasting
local corticosteroid implants vs. systemic corticosteroids and
immunosuppression) and is embarking on new clinical trials of the
management of uveitic macular edema.
We hope to do additional trials on the management of severe
intermediate, posterior and panuveitides.
In addition, I recently have become interested in the immunology of
age-related macular degeneration (AMD), as it appears that chronic
systemic inflammation is a risk factor for AMD. The Studies of the
Ocular Complications of AIDS Research Group recently reported
that antiretroviral-treated, immunorestored patients with AIDS
have a four-fold increased age-adjusted prevalence of intermediatestage
AMD compared to an HIV-uninfected cohort. Antiretroviraltreated,
immune-restored HIV-infected persons have accentuated/
accelerated aging and immunosenescence, and chronic immune
activation and systemic inflammation appear to play a major role in
this accentuated/accelerated aging. We believe that further study
of this population with an increased prevalence of AMD can help
us better understand the roles of immune activation and systemic
inflammation in AMD in HIV-uninfected older persons. ▀
OPTIMED
OptiMed is a New Zealand and Australian owned, fully
independent wholesaler of ophthalmic diagnostic and therapeutic
instruments as well as surgical and pharmaceutical supply.
We are committed to providing quality products and excellent
service. Our slogan “OptiMed, Servicing All Your Ophthalmic
Needs” is what we stand for as it defines us as a company where
service is our strength and focus.
OptiMed represent quality and innovation in our partner
brands such as IRIDEX, CANON, TAKAGI, LIGHTMED, OCULAR
INSTRUMENTS, ACCUTOME, FISO, TOMEY plus many more.
At RANZCO 2015 we will have a great range of equipment on
display and invite you to come and view our booth along the
entrance wall. ▀
ABBOT MEDICAL OPTICS
Abbott has long been in the business of life, creating more
possibilities for more people through the power of health. People
at their healthiest have the potential to live not just longer, but
better, in mind and body.
Leading an active lifestyle is important to the many people we
serve. We see what a difference taking care of and improving
sight can make to people at all stages of their lives. That’s why
we’re advancing new solutions to help people around the world
protect, improve and restore their sight, allowing them to focus
on enjoying all life has to offer. Our featured products include:
TECNIS family of intraocular lenses; iLASIK laser vision correction
products, including the iFS Femtosecond Laser; and Blink Tears
and RevitaLens OcuTec Multi-Purpose Disinfecting Solution.
We look forward to seeing you at RANZCO. ▀
MI-TEC
Mi-tec Medical Publishing
produces high-quality and
extensively peer-reviewed
patient education publications
for RANZCO and other medical
colleges, societies and associations
in Australia and New Zealand.
The objective of the publications is to reduce the medico-legal
risk of “failure to inform” by assisting the informed-consent
process and helping to establish a process of communication
between doctors and their patients. For more visit us at RANZCO ▀
• Anti-Bacterial Action
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DOSAGE:
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example, propolis water extracts that is normally used,
holds 0.5% phenols and Oculocin -1-1.5%. Because of
natural origin chemical components which are important
in product activity are more than 50 active Ingredients
ZEISS
RANZCO this year will give clinicians the
opportunity to see some new and exciting
technologies from ZEISS.
With its recent clearance from the US Food and
Drug Administration (FDA), ZEISS is soon to release
AngioPlex OCT Angiography on the CIRRUS HD-
OCT and will have it on show at the conference,
both on the stand and during a symposium
on Monday November 2. Using a single scan,
AngioPlex OCT Angiography takes just seconds
to produce OCT images for the assessment of the
retinal vasculature — without the need for an
injected contrast dye.
Other new instruments on show will be the
new Humphrey Field Analyzer 3 (HFA3), the SL220
tower-style slit lamp and the new software for
the IOLMaster 700 swept-source biometer.
ZEISS will be represented by the surgical team
who will be holding discussions about the proven
outcomes and stability achieved with the ZEISS
MICS range of IOLs including the innovative AT
LISA trifocal. ▀
AFT PHARMACEUTICALS
Hylo-Fresh and Hylo-Forte eye drops provide a
systematic approach to dry eye treatment through
the patented Comod multi-dose application
system. This ingenious airless system protects the
sodium hyaluronate solution from contaminated
ambient air for up to six months after opening, and
ensures the precisely measured delivery of at least
300 sterile drops without the use of preservatives.
Hylo-Fresh (sodium hyaluronate 0.1% w/v,
10mL) offers long-lasting lubrication for dry eyes
of moderate or medium severity, while Hylo-Forte
(0.2% sodium hyaluronate w/v, 10mL) is suitable
for the treatment of severe or chronic dry eye. Both
are also phosphate-free, suitable for use postsurgery,
and can be used with all contact lenses.
AFT Pharmaceuticals will be showcasing our
preservative-free range of eye treatments at
RANZCO 2015. Visit our stand and discover more
about our dry eye range: Hylo-Fresh and Hylo-Forte
eye drops, and VitA-POS eye ointment, along with
Cromo-Fresh for itchy allergic eyes. ▀
AngioPlex image of branch retinal vein occlusion
16 NEW ZEALAND OPTICS October 2015
October 2015.indd 16
9/18/2015 6:43:46 AM

TECNIS
®
EXTENDED RANGE
OF VISION IOL
A NEW ERA HAS BEGUN,
AND IT LOOKS AMAZING.
INTRODUCING TECNIS SYMFONY ® IOL,
THE FIRST AND ONLY PRESBYOPIA-CORRECTING
EXTENDED RANGE OF VISION IOL.
At last, your patients can enjoy increased spectacle independence with a true
extended range of vision. 1
• A full range of continuous, high-quality vision in all light conditions. 2
• TECNIS Symfony® Toric IOL also available.
The world will never look the same.
Visit us at the Abbott booth to learn more about TECNIS Symfony®
1. 166 Data on File_Extended Range of Vision IOL 3-Month Study Results (NZ). 2. TECNIS Symfony® DFU. TECNIS Symfony® Extended Range of Vision Lenses are indicated for primary implantation for the
visual correction of aphakia and preexisting corneal astigmatism in adult patients with and without presbyopia in whom a cataractous lens has been removed by extracapsular cataract extraction, and aphakia
following refractive lensectomy in presbyopic adults, who desire useful vision over a continuous range of distances including far, intermediate and near, a reduction of residual refractive cylinder, and increased
spectacle independence. These devices are intended to be placed in the capsular bag. For a complete listing of precautions, warnings, and adverse events, refer to the package insert.
TECNIS and TECNIS SYMFONY are trademarks owned by or licensed to Abbott Laboratories, its subsidiaries or affiliates. AMO Australia Pty. Limited. Level 3, 299 Lane Cove Road, Macquarie Park, NSW
2113. AMO Australia Pty. Limited (Incorporated in Australia) PO Box 401, Shortland Street, Auckland, 1140. ©2015 Abbott Medical Optics Inc. www.AbbottMedicalOptics.com PP2015CT1013. WH AMO19938
October 2015
NEW ZEALAND OPTICS
17
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SPECIAL FEATURE: RANZCO
A passion of the
profession
— Dr Randall Olsen
An interview with RANZCO keynote speaker Dr Randall Olsen,
chair of the department of ophthalmology and visual sciences
at the University of Utah School of Medicine and of the John A.
Moran Eye Center.
In your long career, what stands
out as the single most important
innovation?
What advice would you give to young ophthalmologists looking to
specialise in cornea?
Make sure you get the best training possible, and never lose your
fascination with the field nor your curiosity about what we know.
Questioning the accepted rationale is the only way we advance and
get better.
How do you continue to learn in your professional life?
Read all the literature and always be open-minded. The perceived
authority of the old guard continues to be a major barrier to needed
advancements. IOLs and phaco fought a huge battle with the authority
figures of the time, and it was all so needless. So be open-minded and
sceptical. I see many exciting breakthroughs on the horizon and feel our
true golden days as a field are still in front of us. ▀
HEIDELBERG ENGINEERING
New from Heidelberg Engineering: the Spectralis Widefield OCT and
Fundus Imaging Module.
Heidelberg’s Spectralis Widefield Images
Practice managers’
conference to focus on
current issues
The Practice Managers’ annual conference is being held in
conjunction with the RANZCO congress in Wellington and will
take place from November 1-3 in the Featherston Room at the
InterContinental.
The aim of this year’s event is to provide information to
help managers manage and enhance their career in practice
management, says Lisa Hartley, chair of the Practice Managers
Group. “Practice management has come a long way and in today’s
healthcare practice, the practice manager plays a key role in the
success and sustainability of the practice.”
Sponsored by Southern Cross Healthcare, the conference is
expected to attract delegates from across Australia and NZ.
A number of RANZCO fellows will present to the conference from
a doctor’s perspective; back by popular demand, an open forum
discussion will take place with an emphasis on sharing ideas and
experiences; and Simon Thiessen from The Real Learning Experience
will facilitate an interactive session ‘One of the team or leading the
team?’.
Healthcare practice consultant Colleen Sullivan will present on ‘Is
The delivery of the Spectralis Widefield Imaging Module has
begun and will be exhibited at RANZCO. It provides an expanded
By far it would be phaco, followed by
field of view for all Spectralis fundus and OCT imaging modalities,
foldable IOLs. I was trained in the days
simplifying diagnostic protocols and facilitating the detection of
of ICCE with aphakic spectacles where
our cataract patients spent three
peripheral pathology.
days of absolute bed rest in hospital.
The Widefield Imaging Module provides a 55° field of view for all
It was about the only way we did it
Spectralis fundus imaging modalities including MultiColor, BluePeak,
back then. My first bilateral patient,
infrared reflectance, angiography, and also OCT. Covering the macula, the
after waiting four months to finally
optic nerve head and areas beyond the vessel arcades in a single image,
get her aphakic spectacles, was so
the Widefield Imaging Module facilitates comprehensive diagnostics. The
disenamoured she asked if I could put
high-resolution, high-contrast scanning laser images captured with this
her cataracts back.
®LenSx® LenSx®
Spectralis module offer diagnostic capabilities superior to conventional
No wonder we made patients wait a long time to consider a
treatment almost as bad as the disease. Our great success today is
fundus photography.
taken for granted by too many.
E-Learning Module: for doctors and other operators to familiarise
themselves with the Widefield Imaging Module, Heidelberg Engineering
What inspires you to continue to work in this field? ®
there a career path for a practice manager and what are the steps
Academy has just launched an interactive video tutorial at
We are all about quality of life and have so many exciting things to
to achieve this?’ This session will explore the opportunities available
LASER
www.heidelbergengineering.com/international/academy/
cover I find it hard to not consider being involved. My biggest focus is
▀
maintaining the team that is aggressively working on the core disease
triggers of macular degeneration. It has been a fascinating journey
and it is clear that there will be two totally different treatments for
OIC
the two major genetic underpinnings of this awful disease. Also,
seeing the John A. Moran Eye Centre blossom from a one person
division of surgery to a centre with over 50 faculty and 500 employees
has been a dream literally come true. Most of my day-to-day activity
goes into building this institution and seeing that it has the resources
to continue to thrive and survive.
Belinda, Kevin, Chris and Tim look forward to welcoming you on
to the Ophthalmic Instrument Company (OIC) stand at RANZCO
where we will have many exciting new items of equipment and
instrumentation on display from our international partners.
Come and view EVA, the revolutionary new phaco and vitrectomy
system from D.O.R.C, the new hand held auto refractor/
keratometer HandyRefK and RS-330 Duo Combined Retinal
Camera and OCT from Nidek. We will also have the new VUPad
Combined A/B Scan from Sonomed and Spot Vision Screener
from Welch Allyn on display along with new instruments from
Katena and MST.
RANZCO will also double as our ophthalmology launch for
Avenova, the innovative new solution for daily lid and lash
hygiene, blepharitis and dry eye.
See you in Wellington. ▀
for a career as a practice manager and will include how to raise your
qualification and experience levels to demonstrate this.
Tanya Parsons, RANZCO Professional Standards and CPD Manager,
along with Moira McInerney, CEO of Auckland Eye and Professional
Standards Committee Member, will present an important update
from the RANZCO Professional Standards Committee on the current
progress of the practice accreditation project, future plans and how
your practice can get involved.
Other sessions include an insight into the role of ophthalmology
practice staff in reducing risk and optimising patient care; a practice
issues forum; a keynote address from Southern Cross Health Society
on the systems they use to process claims and the support services
available to practices; RANZCO CEO David Andrews sharing his
insights on developing a strong HR function in a medium-sized
business; and Julie Heraghty from Macular Disease Foundation
Australia and Phillippa Pitcher from Macular Degeneration New
Zealand team up to present the latest news on MD within an
Australian and New Zealand context.
There will also be some open-forum sessions where practice
managers get a chance to ask experienced managers difficult
questions, such as “what would you do in this situation?” ▀
An evolution in medical software
183880_bp_RANZCO_AD_280X190.indd NEW ZEALAND OPTICS October 1 2015
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October 2015.indd 18
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Alcon NZ

Advan
REFRACTIVE SU S
UltraSert
PRE-LOADED DELIVERY SYSTEM
Advancing
CATARACT SURGERY
October 2015
NEW ZEALAND OPTICS
19
Alcon NZ Optics UltraSert-ORA single page 420x297_099-15_4 outlines.indd 1
October 2015.indd 19
15/09/15 9:48 AM
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SPECIAL FEATURE: RANZCO
Fighting glaucoma
— Professor Tin Aung
An interview with RANZCO keynote speaker Professor Tin Aung,
executive director of the Singapore Eye Research Institute, deputy
medical director (research) and head of the glaucoma department
at the Singapore National Eye Centre and Professor at the
department of ophthalmology at Yong Loo Lin School of Medicine,
National University of Singapore.
What type of new thinking is leading the way in glaucoma
management and research?
There is a lot of interest in several exciting areas of glaucoma research.
For instance, genetics of glaucoma, new medications and sustained
drug delivery, better methods of imaging to diagnose and monitor
glaucoma, new forms of surgery (such as minimally invasive glaucoma
surgery) and patient related disability and outcomes.
Why are you inspired to work in this field?
I am driven by the blindness and visual disability I see in the
patients under my care. It is a tragedy to have people with advanced
undiagnosed glaucoma today or have patients go progressively blind.
What has been the main inspiration in your career?
I am inspired by my mentors who have advised me and pointed me in
the direction of being a clinician scientist in glaucoma. ▀
CLC
Oculocin Propo is a new product to the NZ and Australian markets
targeting two key areas: chronic conjunctivitis and periodic
inflammation; and dry eye.
It’s a sterile, natural pharmaceutical grade extracts-based eye drop,
which contains no preservatives. Other key points are:
• Contains glycerin, propolis, aloe vera and chamomile extracts; is
rich in phenols, aloins, amodins, alfa-bisabolols and its oxides and
azulenes;
• Composition is dedicated for proper lubrication, antibacterial,
antiviral, antifungal, pain relief, immune boost and faster healing
effects;
• Works like soft wide range antibiotic and NSAID together covering a
lubrication and easy pain and spasmolytic relief properties
• Can be used long term with no potential side effects and other
harm, but it provides symptomatic relief together with light
antibacterial and anti-inflammatory action
• Can be used in the period after antibiotic or anti-inflammatory
treatment when prolonged use of chemical drug puts patient at risk
• Can be used inconjunction with antibiotic or anti-inflammatory
treatment (drop time may differ) for better effect and irritation
relief; and
• Due to its antibacterial properties it is a effective product for long
term dry eye antiseptic management ▀
DEVICE TECHNOLOGIES
Device Technologies is celebrating 15 years as a NZ-based independent
supplier of medical equipment and is proud to showcase the following
products at RANZCO Wellington:
• New and unique Swept Source OCT: Topcon Triton; scans through
haemorrhages and increased depth scanning helps show full
choroidal detail
• Topcon Maestro OCT on a new space saving instrument column
table Topcon IC-1
• Multispot Micropulse 577nm retinal laser: Quantel Supra Scan (Slit
Lamp and Bio mounted)
• Compact 532nm retinal laser: Quantel Vitra
• Combo laser YAG/SLT: Quantel Fusion
• Compact Ultrasound devices from Quantel: Compact Touch A&B +
UBM scan & Nano A Scan
• Topcon KR-1W 5 in 1 Wavefront analyser with Auto refractor,
Keratometer, Pupillometer, topographer & Aberrometer
We look forward to seeing you at RANZCO ▀
Top 10 medical
advances over the
past 20 years for
ophthalmologists
International medical information company, Medscape,
polled medical experts and advisors about what they thought
the biggest healthcare advances have been over the past two
decades.
The following is a list of the top 10 compiled with regard to
their relevance to ophthalmologists:
10. Ophthalmology: anti-VEGF therapy for macular
degeneration
9. Oncology: Cancer Genome Atlas
8. Public health: advancement of palliative care
7. Diabetes: medications and monitoring
6. Allergy and immunology: biologics
5. Emergency medicine: ultrasound
4. Paediatrics: vaccines as cancer prevention
3. Primary care: the rise of corporate healthcare
2. Business of medicine: the information revolution meets
healthcare
1. Neurology: genomics ▀
Source: www.medscape.com
ALCON
Today’s patient has different needs and visual goals. At Alcon we
are proud to be your trusted eye care partner every step of the
way from glaucoma, dry eye management and contact lens care
to the latest in surgical and refractive technology. Join us on
the Alcon stand at RANZCO 2015 as we advance together. Learn
about the latest advancements in presbyopia correcting and IOL
delivery systems technology with the AcrySof IQ PanOptix lens
and UltraSert pre-loaded delivery system. Book a demonstration
of the ORA System with VerifEye+ technology, the world’s first
Intraoperative wavefront aberrometer; and register for the
Alcon dinner on Monday the November 2 to hear about the latest
“Strategies for Today’s Cataract Refractive Needs.”
Together we can go further than ever before.
OA-2000
SWEPT SOURCE OCT
OPTICAL BIOMETER &
TOPOGRAPHY-KERATOMETER
Optical biometry can be that good!
The OA-2000 integrates topography, axial length, lens
thickness and pachymetry to yield the perfect data set
for ray tracing. This assures best results even in
exceptional eye conditions or toric IOL calculation.
Handheld Tonometer
THE measurement system for
• Corneal Topography
• Contact lens fitting
• TF-Scan, tear
meniscus height
• Imaging
• Oxi-Map
Complete Dry Eye assessment
From the only authorised
ICARE dealer in NZ
DV758-0615
www.designsforvision.co.nz
0800 338 800
phone: 09 443 0072
email: info@oic.co.nz
20 NEW ZEALAND OPTICS October 2015
October 2015.indd 20
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The moment you benefit from the latest medical technology.
ZEISS Innovations: Trusted and Proven.
Visit
ZEISS at
RANZCO
2015
// INNOVATION
MADE BY ZEISS
Visit ZEISS at the 2015 RANZCO Annual Scientific Congress to discover our range, featuring:
ZEISS AngioPlex OCT Angiography –
New Generation of Vascular Imaging
• With a single scan that takes just seconds, ZEISS AngioPlex OCT
Angiography on the CIRRUS HD-OCT delivers high-resolution, depthresolved
visualisation of the retinal layers with a clarity never before
achieved – all without the need for an injected contrast dye.
ZEISS AT LISA ® Tri Family – Proven Clinical Results
• The innovative preloaded trifocal platform from ZEISS is highly
esteemed by surgeons for its proven outstanding results for cataract,
presbyopic and astigmatic patients. Confidence for you and your
patients.
Scan here to receive
a free IOL USB at RANZCO
www.zeiss.com.au/ranzco2015
October 2015
NEW ZEALAND OPTICS
21
October 2015.indd 21
9/18/2015 6:43:50 AM

SPECIAL FEATURE: RANZCO
Spotlight on
Wellington
Often called the world’s “coolest little capital,” Wellington is known
for its vibrant arts scene, world class café and restaurant culture,
and active outdoor lifestyle.
Set around an attractive waterfront, you’ll be hard pressed to find
a city in the world that’s easier to navigate. Wellington enjoys more
cafes, bars and restaurants per capita than New York City, and its
coffee and craft beer producers are internationally recognised. A
creative, cosmopolitan city, Wellington combines the sophistication
of a capital with the warmth and personality of a village.
Whether you’re into shopping, eating, sight-seeing or relaxing,
Wellington has a host of treats on offers for RANZCO delegates who
have a little extra time on their hands. ▀
Houses on Mt Victoria
Eat and drink Wellington
Wellington is said to have more bars and restaurants per capita than New York City. Tucked between
two of New Zealand’s finest wine regions, the City also sits at the heart of the Classic New Zealand
Wine Trail, and is home to some of New Zealand’s top craft beer brewers, including Garage Project,
ParrotDog and Tuatara.
Some of the City’s top restaurants include:
Ortega Fish Shack & Bar - Focusing on fresh New Zealand seafood, the highly awarded chef and
owner creates dishes of quality, flavour and integrity.
Logan Brown - Housed in a stunning 1920s banking chamber, Logan Brown’s food is innovative,
generous and full flavoured, with emphasis on cooking perfection and seasoning; the bar is also a
salt water fish tank.
Whitebait - This elegant and refined restaurant has a seafood-focused menu, which is translated
into Maori to pay homage to the regional kai moana (seafood) used.
The Bresolin - The newest restaurant venture from Wellington food personalities Lorenzo and
Leonardo Bresolin. Focusing on shared dining, the Bresolin’s menu features small plates and large
feasts.
WBC - The newest restaurant from the Capitol restaurant team, WBC focuses on local, seasonal fare
and specialises in seafood and shellfish.
Prefab - An all in one eatery, coffee roastery, community hub, events facility and showcase for New
Zealand design. The ACME & CO’s breads and bakery items are baked and served warm from the
Prefab oven throughout the day
Zibbibo - The food is a fusion of styles from around the Mediterranean, including rustic cuts of
meat from a rotisserie and a much-feted tapas platter. Zibbibo recently took out the coveted DINE
Wellington award in 2015’s Visa Wellington On a Plate festival.
RANZCO NZ Optics 1/4 AD 2015_Layout 1 10/09/2015 2:17 pm Page ▀
1
RANZCO Patient Education
The Gold Standard in Treatment Information
online orders
www.mitec.com.au
Top things to do in
Wellington
1.Discover New Zealand’s stories at Te Papa
The national museum of New Zealand, Te Papa’s
exhibits are innovative and interactive, telling
stories of New Zealand’s unique geological,
biological, cultural and social history. The brand
new Gallipoli: The Scale of our War exhibition tells
the story of New Zealand’s involvement in historic
conflicts with complex digital and visual effects.
2.Enjoy 360-degree views from the top of
Mt Victoria
Discover a panoramic view of city and harbour at
the Mount Victoria Lookout.
3.Ride the historic Wellington Cable Car
The Cable Car is a Wellington icon. It runs from
Lambton Quay up to Kelburn, with a lookout,
the Cable Car Museum and Space Place at Carter
Observatory at the top. Come back down to earth
(and the city) through the beautiful Botanic
Garden.
4.Visit the Zealandia sanctuary in Karori
Just a 10-minute drive from downtown
Wellington you’ll find Zealandia, a 225 hectare
section of bush being returned to its pre-human
state. Take a walk and hear the songs of the
flourishing native bird population or book a night
tour for a bit of kiwi spotting.
5.Tap Wellington’s movie-making magic
Get a behind-the-scenes glimpse into the
artistry behind some of the world’s most
spectacular movies at the Weta Cave mini-museum
or put yourself in the picture with a The Lord of the
Rings location tour.
6.Wander the waterfront to Oriental Bay
Wellington’s waterfront is a beautifully
walkable public space, dotted with cafes, parks,
sculpture, bars and ice cream vendors.
7.Cruise down Cuba Street
Home to hipsters, artists and lovers of
vintage, Cuba Street is a bohemian haven with
some of the city’s most colourful shops, bars and
cafes. Street entertainers play percussive guitar, put
on a marionette show, or play with fire and then
there’s the Bucket Fountain.
8.Pause at the Pukeahu National War Memorial Park
Officially opened in April, the park is a place of
remembrance. The War Museum within the park,
houses Sir Peter Jackson’s Great War Exhibition,
which tells the story of World War I, honouring the
role many Kiwis played. ▀
BEST PRACTICE SOFTWARE
Since acquiring the New Zealand and Australian
operations of Houston Medical’s VIP Software
in April, Best Practice Software has continued
to evolve as a leading Australasian medical
software provider. VIP Software is widely used by
ophthalmologists in New Zealand and Australia,
and Best Practice has been engaging with users to
discuss their current and future needs.
Chief operating officer Craig Hodges said:
“We’re relocating to brand new state of the art
premises in Hamilton which will become our
New Zealand operations centre, and expanding
our team of highly skilled IT professionals. We’re
excited to provide locally developed software and
support to our existing and future ophthalmology
specialist customers. Best Practice Software
directors, Dr Frank and Mrs Lorraine Pyefinch will
be attending the Congress in Wellington and
they look forward to introducing delegates to
members of our Best Practice Team.” ▀
Cataract
surgery
benchmarks
proposed
The International Consortium for Health
Outcomes Measurement (ICHOM) is calling for
a proposed minimum standard set of outcome
measures for cataract surgery that enables
global comparisons.
Dr Stephen Best, a cataract surgeon,
glaucoma specialist and neuro-ophthalmology
specialist from Auckland Eye, says cataract
benchmarking and audit is an excellent idea.
“RANZCO has recognised this and has created
RCAT as part of CPD. The potential beauty of
such data sets, provided anonymity is carefully
preserved, is that it will allow comparison to
preserve standards that can be measured by
way of benchmarking. I would encourage all
NZ RANZCO fellows to participate in the RCAT
programme.”
Ideally, this should be done at a professional
and collegial level rather than having an
external agency, he says, as an external agency
would simply add compliance requirements.
“However, one must recognise that there will
be additional data input required that may
need additional resourcing.”
The ICHOM committee members published
their recommendations in JAMA Ophthalmology
in August.
The ICHOM standards include two dozen
points that could be used to evaluate the
success of phacoemulsification, sutured
manual extracapsular cataract extraction,
sutureless manual extracapsular cataract
extraction, and intracapsular cataract
extraction.
Doctors, patients or administrators
would gather information about the
patients’ demographics, ocular history and
comorbidities, preoperative visual acuity,
and patient-reported visual function prior
to surgery. They would report capsulerelated
problems, dislocation of lens nucleus
fragments into the vitreous, and other
complications that occur during surgery, and
they would note refractive error, patientreported
visual function, and early and late
complications for up to three months after
surgery.
The new standards could be useful for
payers and patients who want to more
accurately rank physicians, wrote Dr Bonnie
An Henderson, a clinical professor at Tufts
University School of Medicine in Boston, in an
editorial accompanying the study.
Already many insurance companies use
limited data, such as the cost of care, to
create tiered provider plans. If they had more
complete data, they could evaluate physicians
more appropriately, she said. Training
programmes could also use the standards
to evaluate how well they are preparing
ophthalmologists to do cataract surgery,
while residency programmes would be able
to compare applications from prospective
residents trained abroad to those from
residents trained domestically and researchers
could more easily gather data to study diseases
and treatments, especially for rare diseases
such as endophthalmitis, she said.
“In today’s global world, collaboration
between countries to create a universal set of
guidelines is an honourable pursuit.”
The ICHOM committee also suggested the
data could be used as part of an approval
process for devices used in cataract surgery.
The International Consortium for Health
Outcomes Measurement (ICHOM) is a nonprofit
organisation founded by Harvard
Business School’s Institute for Strategy &
Competitiveness, the Boston Consulting Group
and the academic medical research centre, the
Karolinska Institutet in Stockholm, Sweden, to
transform health care systems worldwide by
measuring and reporting patient outcomes in a
standardized way.
For more information visit: http://www. ichom.
org/download/cataracts-reference-guide/ ▀
O
M
22 NEW ZEALAND OPTICS October 2015
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Info_ad-

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October 2015
NEW ZEALAND OPTICS
23
October Info_ad-v3 2015.indd 3.indd 23 1
9/18/2015 14/09/15 6:43:510:13 AM AM

with
Prof Charles McGhee
& A/Prof Dipika Patel
Series Editors
Causes of optic nerve head oedema —
from the benign to the sight and life threatening
BY AARON WONG AND HELEN DANESH-MEYER*
L
R
INTRODUCTION
Optic nerve head swelling has a wide range of causes; from the sinister to the benign. In this
article we briefly review some of the diagnoses that should come to mind when faced with a
patient with optic nerve head swelling and ways to differentiate between them. To highlight
the importance of testing visual acuity, colour vision and visual fields we have separated these
causes by their propensity to cause optic nerve dysfunction.
CAUSES NOT ASSOCIATED WITH PROMINENT OPTIC NERVE DYSFUNCTION
i. Optic nerve head drusen
Optic nerve head drusen (ONHD) are calcific deposits found in the anterior portion of the optic nerve. They
are present in approximately 0.3-2% of individuals and are bilateral in 65 to 90%. 1 Buried ONHD represent
a diagnostic challenge as their clinical appearance can easily be mistaken for optic nerve swelling and
papilloedema. Patients have preserved visual acuity (VA) with mild visual field (VF) defects. Using B-scan
echography, drusen can be identified as highly reflective rounded shadows at the optic nerve head. ONHD
are autofluorescent and hence fundus photography with fluorescent filters can reveal buried ONHD not
obvious on fundoscopy (Figure 1a and 1b)
1a
Not associated with prominent
optic nerve dysfunction
Pseudopapilledema
-Optic disc drusen
-Tilted optic discs
Vascular
-GCA
-NAION
-CRVO/CRAO
-Behҫet’s disease
Optic nerve head swelling
Inflammatory
-Anterior or
Intermediate Uveitis
-Posterior Scleriti
-VKH
Infiltrative
-Sarcoidosis
-Tumours of the
optic nerve
Associated with
optic nerve dysfunction
Raised ICP
-Idlopathic intracranial
hypertension
-Secondary intracranial
hypertension
Inflammatory
-Optic neuritis
-Neuromyelitis Optica
-TINU
- White dot syndromes
Figure 1. Fundus photograph of a left optic disc with drusen (a) and autofluoresence imaging of the same optic disc (b)
ii. Tilted optic discs
A tilted optic disc refers to the fundoscopic appearance of an oblique entrance to the optic nerve that can
occur in 0.4-3.5% of the population.2 Angulation of the optic nerve head gives an elevated appearance to one
side of the disc. There is a positive relationship between increasing myopia and the presence of tilted discs.2
iii. Anterior or Intermediate Uveitis with disc oedema
Disc oedema occurs in between 1.2-8.3% of cases of anterior and intermediate uveitis. 3 Children are
particularly at risk, approximately 29% of all cases of paediatric uveitis are associated with disc oedema. 4
iv. Posterior scleritis
Posterior scleritis refers to inflammation of the sclera posterior to the insertion of the rectus muscles.
Approximately 13-18% of patients have associated disc oedema. 5 Typically patients are in their fourth
decade and there is a preponderance for females.
A prominent symptom is severe periocular pain which can wake patients from sleep. They may also
report pain on eye movements. Very few patients have visible anterior segment inflammation. B-scan
echography is a key adjunct, showing thickening of the slcera and fluid in the subtenons space. When this
is around the optic nerve it is referred to as the ‘T-sign’.
CAUSES ASSOCIATED WITH PROMINENT OPTIC NERVE DYSFUNCTION
Normal ICP
Infectious
-Taxoplasmosis
-Cat Scratch Disease
-Syphillis
i. Raised intracranial pressure
Papilledema refers to optic disc swelling due to raised intracranial pressure (ICP). Symptomatically,
patients can present with headache, nasuea, pulsatile tinnitus and diplopia. Transient visual obscurations
are an ominous symptom as they are thought to represent transient ischemia of the optic nerve. Severe
papilledema can result in disc haemorrhages, choroidal folds radiating from the optic disc (Paton’s lines),
obscuration of disc vessels and macula oedema. 6
A normal VA may not reflect the severity of papilledema and decreased colour vision and VF defects are
better indicators of optic nerve function. OCT of the RNFL may be useful in confirming swelling as well as
monitoring progression.
Patients require neuroimaging to investigate secondary causes of raised ICP such as tumours, infection
and vascular malformations. Specific imaging of the blood vessels is often included for central venous sinus
thrombosis which can obstruct the outflow of cerebrospinal fluid (CSF). A lumbar puncture is required to
confirm the presence of raised ICP and also to evaluate for markers of infection or malignancy in the CSF.
If no secondary causes are identified, patients may be diagnosed with idiopathic intracranial
hypertension (IIH), previously known as benign intracranial hypertension and pseudotumour cerebri. IIH is
4-8 times more common in women and the mean age of onset is 30. 6 Obesity is also associated with IIH;
weight gain is associated with a worsening in VF defects and weight loss associated with improvement
of papilledema. Medications including oral contraceptives, tetracyclines, isotretinoin and corticosteroids
have been associated with IIH. 6
ii. Giant cell arteritis
All patients with disc swelling over the age of 50 should have giant cell arteritis (GCA) excluded as it
is a life and sight threatening vascular inflammatory condition. Typical symptoms include: temporal
headache, scalp tenderness, fevers and weight loss. Jaw claudication, often described as a cramping pain
increasing with continued mastication or speech is highly specific for GCA. 7
Vision loss in GCA is often profound with between 60-80% having a VA worse than 6/60. Colour vision
and VFs are severely compromised. Although findings at the optic nerve are variable, ‘chalky white’
oedema is highly suggestive of GCA and disc haemorrhages are uncommon. 7
1b
Figure 2. Fundus photos of chalky white swelling of the left optic disc in giant cell arteritis with a normal right disc for comparison
Blood inflammatory markers such as an erythrocyte sedimentation rate and C-reactive protein are
particularly useful for ruling out GCA, and when used in together have a reported sensitivity of 99%. 8
Temporal artery biopsy is the gold standard for diagnosis of GCA.
iii. Non-arteritic ischemic optic neuropathy
Non-arteritic ischemic optic neuropathy (NAION) is the most common cause of an acute optic neuropathy in
patients over the age of 50 but unlike GCA can present in patients younger than 50. Patients typically present
with an acute decrease in vision, have a moderate to severe VF defects and colour vision is mildly impaired. 9
Approximately 75% of eyes affected by NAION will have either diffuse or focal disc swelling and unlike
GCA is often associated with disc haemorrhage (72%). 9 A small optic disc size and a small or absent
physiological cup are risk factors for NAION.
iv. Central retinal vein occlusion and central retinal artery occlusion
Both central retinal vein occlusions (CRVO) or central retinal artery occlusions (CRAO) can present with
concomitant disc oedema. Disc oedema is more common in CRVOs (81-93%) compared to CRAOs (22%). 9 In
ischemic CRVO 99% present with VA worse than 6/60 compared to only 22% of non-ischemic eyes. In CRAO
74% of patients present with a VA of counting fingers (CF) or worse, and 90% had VF defects. 9
v. Sarcoidosis
Sarcoidosis is a multisystem granulomatous disorder which can be associated with uveitis and/or optic
neuropathy. Evidence of active or previous uveitis is present in 42% of cases. 10 Granulomas at the iris,
choroid or optic disc are relatively rare but highly specific for sarcoidosis. Diagnostic workup for suspected
sarcoidosis should include a chest X-ray and serum ACE level.
vi. Demyelinating optic neuritis
In young adults, demyelinating disease is a common cause of an acute optic neuropathy. After an episode
of isolated optic neuritis, around half of patients will progress to develop multiple sclerosis (MS) over 15
years. 11 The median age of onset is 29 years and females are affected twice as often as males.
Patients often present with a rapid decrease in VA and painful eye movements. As well as oedema of
the optic nerve head, examination may reveal decreased colour vision, variable VF defects and a relative
afferent pupillary defect. Investigation of an isolated episode of optic neuritis should include an MRI of
the brain to evaluate for demyelinating lesions. The presence of these increases the patient’s likelihood of
progression to MS to around 72% at 15 years. 11
vii. Neuromyelitis optica
Previously thought of a as a variant of multiple sclerosis, neuromyelitis optica (NMO) or Devics disease is
being increasingly recognised as a distinct entity since the identification of the causitive antibody (NMO-
IgG). 12 The median age at presentation is 39 years and women are affected nine times more commonly.
Non-caucasian ethnicities are more likely to be affected. 12 Patients can present with optic neuritis with or
without neurological symptoms. The diagnosis can be confirmed by a blood test for NMO-IgG or evidence
of demyelinating spinal cord lesions on MRI.
viii. Ocular Toxoplasmosis
Ocular toxoplasmosis is the most common cause of posterior uveitis worldwide. Due to infection by
the protozoan Toxoplasma Gondii, studies have shown that this pathogen is present in 25-30% of
the population. 13 Age, immune status, and genetic factors contribute to the risk of developing ocular
toxoplasmosis. 13 Approximately 5-13% of patients develop disc swelling. 14 This often associated with
vitritis, an area of chorioretinitis or neuroretinitis (disc swelling and a macula star). Most cases with optic
nerve swelling have a VA worse than 6/12 and arcuate or a central scotomas to VF testing. The diagnosis is
often made clinically and confirmed with serological testing for antibodies against Toxoplasma.
ix. Cat Scratch Disease
Cat scratch disease (CSD) is a systemic illness caused by the bacteria Bartonella henselae. CSD is the most
common cause of neuroretinitis. In patients with CSD and optic disc oedema, initial VA is often poor; in
one study half of the patients presented with a VA worse than 6/48. 15 Serological testing for antibodies
against Bartonella are used for confirmation of the diagnosis.
x. Syphilis
Syphilis is a sexually transmitted infection caused by the spirochaete Treponema Pallidum. In the past decade
there has been resurgence in the incidence of syphilis and worldwide, coinciding with advent of antiretroviral
therapy for HIV. 16 Syphilis is also known as the ‘great imitator’ and ocular syphilis can present with almost any
form of ocular inflammation. Serological testing is effective in identifying active and past infections.
CONCLUSION AND IMPORTANT POINTS
Optic nerve swelling is associated with a wide spectrum of diagnoses. A thorough history and examination
including testing optic nerve function is key to identifying potentially life or sight threatening causes and
appropriate triage of the referral to an ophthalmologist.
REFERENCES
1. Auw-Haedrich, C., F. Staubach, and H. Witschel, Optic
disk drusen. Survey of Ophthalmology, 2002. 47(6): p.
515-532.
2. Witmer, M.T., C.E. Margo, and M. Drucker, Tilted Optic
Disks. Survey of Ophthalmology, 2010. 55(5): p. 403-428.
3. Wakefield, D. and J.H. Chang, Epidemiology of uveitis.
International ophthalmology clinics, 2005. 45(2): p. 1-13.
4. Rosenberg, K.D., W.J. Feuer, and J.L. Davis, Ocular
complications of pediatric uveitis. Ophthalmology,
2004. 111(12): p. 2299-2306.
5. McCluskey, P.J., et al., Posterior scleritis - Clinical features,
systemic associations, and outcome in a large series of
patients. Ophthalmology, 1999. 106(12): p. 2380-2386.
6. Chan, J.W., Optic nerve disorders. 2007: Springer.
7. Chew, S.S.L., N.M. Kerr, and H.V. Danesh-Meyer, Giant
cell arteritis. Journal of Clinical Neuroscience, 2009.
16(10): p. 1263-1268.
8. Parikh, M., et al., Prevalence of a normal C-reactive
protein with an elevated erythrocyte sedimentation
rate in biopsy-proven giant cell arteritis.
Ophthalmology, 2006. 113(10): p. 1842-5.
9. Hayreh, S.S., Ocular vascular occlusive disorders:
Natural history of visual outcome. Progress in Retinal
and Eye Research, 2014. 41: p. 1-25.
10. Frohman, L.P., et al., Sarcoidosis of the anterior
visual pathway: 24 new cases. Journal of Neuro-
Ophthalmology, 2003. 23(3): p. 190-197.
11. Toosy, A.T., D.F. Mason, and D.H. Miller, Optic neuritis.
Lancet Neurology, 2014. 13(1): p. 83-99.
12. Wingerchuk, D.M., et al., The spectrum of neuromyelitis
optica. Lancet Neurology, 2007. 6(9): p. 805-815.
13. Maenz, M., et al., Ocular toxoplasmosis past, present
and new aspects of an old disease. Progress in Retinal
and Eye Research, 2014. 39: p. 77-106.
14. Bowermaster, R., et al., Application of the Aviation
Black Box Principle in Pediatric Cardiac Surgery:
Tracking All Failures in the Pediatric Cardiac Operating
Room. Journal of the American College of Surgeons,
2015. 220(2): p. 149-+.
15. Chi, S.L., et al., Clinical Characteristics in 53 Patients
with Cat Scratch Optic Neuropathy. Ophthalmology,
2012. 119(1): p. 183-187.
16. Almdahl, S.M., et al., Postoperatively Increased Serum
Alanine Aminotransferase Level Is Closely Associated
with Mortality after Cardiac Surgery. Thoracic and
Cardiovascular Surgeon, 2015. 63(1): p. 67-72.
ABOUT THE AUTHOR
* Aaron Wong is the Allergan
Optic Nerve Clinical Research
Fellow at the University of
Auckland. He has previously
worked as an ophthalmology
non-training registrar at
Auckland and Waikato DHBs
and studied medicine in
Dunedin and Wellington.
24 NEW ZEALAND OPTICS October 2015
October 2015.indd 24
9/18/2015 6:43:52 AM

Tempering concerns over VR
An article in the August 2015 NZ Optics
suggested that virtual reality (VR) is a
technology with the potential to have
a serious negative impact on a user’s
vision. As a new consumer technology, there is
a lack of direct evidence about the widespread
adoption of VR. However, a considerable body
of research 1,2 in VR usage, from the early 90s on,
has addressed some of the concerns mentioned
in the article.
Some issues raised—such as diplopia and
headaches—are symptomatic of an imperfectly
calibrated system, or of a binocular vision
disorder that would warrant a trip to your local
optometrist.
Suggestions that VR headsets could increase
myopia progression through prolonged near
accommodation are based on a misunderstanding
of how VR headsets work. Unlike a computer
screen, which is viewed at near distance, VR
headsets use lenses to relax both accommodation
(the distance the eye focuses on) and convergence
(how much the eyes point inwards towards
the nose). Consequently there is less proximal
demand on vision than there would be with
alternative video gaming technologies, such as
VDU, tablets and smartphones.
Another concern raised was exposure to blue
light, which may cause damage to the retina.
VR screens use OLED technology, where each
RGB pixel emits light so that (a) the screen does
not require a backlight, and (b) pixels emit zero
light when black. This enhancement of contrast,
coupled with the fact that the blue pixel spectrum
stops at wavelengths greater than 415nm, means
that a user will be exposed to far more blue light
looking out a window than at a VR screen.
It is certainly true that early VR headsets
were limited in many respects offering a
restricted field of view, long latency of tracking
(meaning the image lagged behind the users’
movements), and poor graphical capabilities all
making for a poor and potentially disorientating
experience. 3,4 These days, even at the lowest
end of the market (such as Google Cardboard—a
$20 virtual headset that exploits smartphone
graphics capability), VR headsets are much more
immersive and capable than even those used in
the literature from five years ago.
VR does produce a mismatch between what
your eye sees and what your body tell you are
doing (vestibular-ocular imbalance) which can
be nauseating to some, but this is no difference
than any other kind of motion sickness, and can
be alleviated almost instantly by removing the
headset. This is also no different to the experience
of many people who are unable to play firstperson
video games presented on traditional
display technology. We would anticipate that
better game design—similar to the maturation
seen in 3D movies—will reduce such issues in
the future. Further, and perhaps surprisingly,
BY STEVEN DAKIN AND PHILIP TURNBULL*
VR systems are being used to improve balance
in patients with multiple sclerosis 5 following
stroke 6,7 as well as improving postural stability
control in those with glaucoma. 8
Certainly the technological improvements
leading to better experiences are ongoing - the
consumer version of the Oculus Rift VR headset,
due to arrive in 2016, has a fast, high resolution
screen, and can track head position with submillimeter
accuracy, which helps to better
translate real world movement into the virtual
environment. To address concerns regarding
binocular systems, it will also have adjustable
eye relief and adjustable interpupillary distance
(IPD) for both the lens optics and the in-game
representation of IPD (the separation of your
“virtual pupils”). This, in combination with
software adjustable convergence, will allow for
comfortable viewing for a wide range of distance
phorias and fusional reserves. However, when
viewing “near” objects in VR, there would still be
a discrepancy between the accommodative and
vergence systems. This however can be reduced
either through user-controlled software or by
periscopic lenses to reduce the effective IPD.
A newer headset, Fove, will additionally
incorporate eye tracking within the headset
to make real time determination of fixation
possible (and focal distance) allowing simulated
accommodation and convergence to dynamically
adjust with fixation.
As vision scientists, we see VR as an exciting
opportunity to provide an immersive setting
to people, while simultaneously being able to
control all aspects of their visual environment.
In terms of clinical application, VR will have
application as a screening tool for detecting
binocular vision disorders.
Coupled with the immersive experience it
provides, VR has huge potential for testing vision
in children. As optometrists, we are unaware
of any compelling evidence that VR poses any
risk to vision that is greater than any consumer
display system. Protracted, daily viewing of any
video-based display is probably not something
we want for our children, but in the sense of
optometric risk we do not judge VR to be worse
than currently-available alternatives. ▀
*Professor Steven Dakin is head of Optometry & Vision Science at
the Auckland University, while Dr Phil Turnbull is a reasearch fellow
in the same school, with a particular interest in virtual reality.
REFERENCES
1.www.nvidia.com/content/GTC-2010/pdfs/2010_GTC2010.pdf
2.static.oculus.com/sdk-downloads/documents/Oculus_Best_
Practices_Guide.pdf
3.10.1111/j.1475-1313.1993.tb00496.x
4.10.1016/S0003-6870(98)00044-1
5.10.1179/1743132815Y.0000000013
6.www.ncbi.nlm.nih.gov/pubmed/25448245
7.cre.sagepub.com/content/29/3/261.abstract
8.www.ncbi.nlm.nih.gov/pubmed/25892017
Research shows choline is important to
eye development and vision
A
US-based
researcher says experiments
suggest a critical link in humans
between choline and eye health.
“This is the frontier of research being
done right now,” says Professor Steven Zeisel,
director of the Nutrition Research Institute at the
University of North Carolina. “Early studies show
that retina development in the foetus depends
on the choline intake of the mother.”
Choline supports stem cell development that
forms the retina, Zeisel says. Insufficient choline,
especially for the developing foetus and infant,
means vision will be less than optimal for the
adult and throughout the aging process. Zeisel
says fewer retinal cells form in foetuses if their
mothers have a relatively low choline intake.
Research indicates most people in the US
population do not meet the recommended intake
for choline: 550 mg/day for men; 425 mg/day for
women. Choline-rich foods include eggs and liver,
while plant sources are relatively low in choline.
For more information visit The Choline
Information Council website:
www.thecholineinformationcouncil.com.
Food sources for choline include:
• One egg yolk contains about 115 mg of
choline.
• 140 gms of raw liver contains 423 mg of
choline.
• 225 gms of fresh milk, yogurt, and kefir
contain about 40 mg of choline.
• Legumes such as lima and garbanzo beans and
lentils have about 70 mgs of choline per cup.
• Sunflower seeds, pumpkin seeds and almonds
have around 60 mgs of choline per cup.
• Cruciferous vegetables such as cauliflower,
cabbage, bok choy and broccoli contain
around 65 mg of choline per cup cooked. ▀
US report shows extent
of bad CL habits
A
study
of contact lens wearers in
the US confirms what optometrists
everywhere know from experience.
People tend to be unhygienic about
their contacts and a lot of them suffer for it.
In a survey of 1,000 contact lens wearers
conducted by the Centers for Disease Control,
at least 50.2 per cent said they have slept
overnight with their CLs on; 55.1 per cent said
they have topped-up their solution instead of
cleaning their cases and replenishing with new
solution; and 84.9 per cent said they showered
without taking out their lenses.
More than 90 per cent of rigid contact lens
wearers reported having rinsed their CLs in
tap water and one-third reported storing their
lenses in tap water.
The consequence seems too obvious. One
third of the same wearers reported suffering
red or painful eyes that required a doctor’s
visit. The CDC, which published the results of
its survey in August, estimates that contact
lens complications cost US$175 million
annually. The problem is significant enough for
the government health organisation to run an
annual contact lens awareness campaign.
Such bad habits are universal, according to
optometrist Greg Nel, a partner with Total
Eyecare in Wellington, who was asked to look
at the CDC’s summary of the most common
examples of unhygienic practices and state
which ones he has seen in his work most often.
“Overwear is generally the worst problem,
but ‘all-of-the-above’ really.”
Nel says the worst case he has seen resulting
from bad contact lens hygiene has been
microbial keratitis.
“It’s bad for everyone concerned,” he says.
“The most complacent patients are generally
the most at risk.”
Complacency may be the key to much of the
bad CL habits. Nel sees the internet supply of
EYLEA ® (aflibercept)
Now approved for wet AMD,
Diabetic Macular Oedema (DME) &
Macular Oedema secondary to CRVO
REVEAL LIFE BEYOND THE LETTERS
REVEAL LIFE BEYOND THE LETTERS
NZ ABRIDGED PRODUCT INFORMATION
EYLEA ® (aflibercept)
EYLEA: Prescription medicine, aflibercept 40 mg/mL solution for intravitreal injection. INDICATIONS: EYLEA (aflibercept)
is indicated for the treatment of neovascular (wet) age-related macular degeneration (wet AMD), visual impairment
due to macular oedema secondary to central retinal vein occlusion (CRVO), diabetic macular oedema (DME). DOSAGE
REGIMEN AND ADMINISTRATION: Injection volume of 50 μL EYLEA (equivalent to 2 mg aflibercept). For wet AMD: one
intravitreal injection per month for three consecutive months, followed by one injection every two months. For CRVO:
one intravitreal injection per month. After the first three monthly injections, the treatment interval may be extended
based on visual and anatomic outcomes. For DME: one intravitreal injection for five consecutive months, followed
by one injection every two months. CONTRAINDICATIONS: Known hypersensitivity to aflibercept or excipients; ocular
or periocular infection; active severe intraocular inflammation. PRECAUTIONS: Endophthalmitis, increase in intraocular
pressure; arterial thromboembolic events, see full Data Sheet for effects on fertility, pregnancy, lactation, effects on ability
to drive or use machines. INTERACTIONS: No formal drug interaction studies have been performed. ADVERSE EFFECTS:
Very common: conjunctival haemorrhage, eye pain. Common: retinal pigment epithelium tear, detachment of retinal
pigment epithelium, cataract, cataract nuclear, cataract subcapsular, corneal erosion, corneal abrasion, intraocular
pressure increased, vision blurred, vitreous floaters, corneal oedema, vitreous detachment, injection site pain, foreign
body sensation in eyes, lacrimation increased, eyelid oedema, injection site haemorrhage, conjunctival hyperaemia,
ocular hyperaemia. Others: see full Data Sheet. FUNDING INFORMATION: EYLEA is not funded, a prescription charge will
apply. FURTHER INFORMATION: Before prescribing, please review full Data Sheet for further information on the risks and
benefits. Full Data Sheet is available from www.medsafe.govt.nz or Bayer New Zealand Limited, 3 Argus Place, Hillcrest
North Shore, Auckland 0627. Telephone 0800 233 988.
Bayer New Zealand Limited
3 Argus Place, Hillcrest, Auckland 0627.
Telephone 0800 233 988
DA1555BI
L.NZ.MKT.07.2015.0228
contact lenses as complicating matters since
buying CLs online allows patients to “side-step
the built-in audit and supervision that normal
supply channels provide.”
“For example, if someone stops ordering
lenses as often, they are probably not wearing
them as often, or are over-wearing them. Both
problems are easily identified when lenses are
purchased through practices.”
Nel says he believes the solution to the
internet supply wrinkle is to develop a model
that re-routes lens supply back through
optometry in an industry-practitioner
collaborative effort, recognising that the
pracitioner-supply chain has been slow to react
to online competition.
But is complacency itself universal? Nel says
he suspects his patients are “self-selected” to
be more proactive in their eye care.
“Most of the patients I see are more on-board
than they’ve ever been and feel that they have
a vested interest in paying for our advice, and
generally take it too. We do have a few ‘hardarses’
who like to come in and shock us with
how they’ve defied our advice, but most of
those have chosen the easy route and accessed
the cheapest eye care options, including
accessing free care and self-prescribing lenses
to themselves.”
So what do you do about those patients who
won’t follow your directions for proper CL
maintenance, wear and hygienic practices?
“I usually laugh,” says Nel. “Look them in
the eye and explain that statistics and luck are
different things. Because they’ve rolled a five,
doesn’t mean they’re always going to roll a
five, there are other numbers on the die. It’s
actually been a while since the sale of contact
lenses has core to practice profitability and
at the moment, selling good advice is more
profitable.” ▀
October 2015
NEW ZEALAND OPTICS
25
October 2015.indd 25
9/18/2015 6:43:54 AM

Awesome
It’s shaping up to be one of my most hectic
periods of travel, with a few weeks of presenting
behind me and way too much long-haul travel
ahead. Late August involved a Dailies Total1
launch in Singapore, and as I pen this column, I have
just finished a Sunday master-class RGP series of
workshops and lectures at the BHVI in Sydney.
The day was arranged largely by Margaret Lam,
one of Sydney’s successful independent practice
owners and contact lens gurus. Margaret is the
NSW President of the CCLS (AU). She’s fuelled
by the same power source as the sun, and has
incredible drive and passion for optometry and
contact lenses. Despite one of the chains having an
annual conference on the same weekend, we had a
full house of around 100 delegates who seemed to
really enjoy the sessions.
Following my opening talk on corneal RGPs,
the legendary Paul Rose took the podium and, as
always, managed to explain keratoconus fitting
in a really straightforward, logical manner with
interactive Medmont topography. He followed
this up with some live keratoconus fittings, which
always takes balls to do. I was lucky, as I just had
to drive the video slit lamp while Paul did the hard
stuff. It was great to be part of the Kiwi team. Of
course, I did have a go at the Aussies with a few
digs about rugby and the fact that we in NZ fit
around 19 per cent RGP lenses whereas in OZ it is
only six per cent. In general our contact lens market
penetration is around 10 per cent whereas in
Australia it is only about five per cent. I always tell
the Aussies that’s because they are all so one-eyed
they only need half as many lenses. There are of
course many reasons, and the Medicare system
seems to be one of the factors. There were a few
Kiwis in the audience. One or two super-dedicated
practitioners flew over while many Aussies
travelled long distances to be there. It’s great to
see that there are seemingly growing numbers
of practitioners keen to get more involved in RGP
fitting and management, to hone their skills, while
sacrificing their Sunday after a full-on working
week. There were numerous other optometry and
anterior segment ophthalmology lectures with
shared optometry-ophthalmology cases. Great stuff.
There was no peace for the wicked and Margaret
kept cracking the whip. In the afternoon session
we had five clinic rooms in the BHVI with five
complex RGP patients, who also gave up their
Sunday to let 100 people shine bright lights
in their eyes and discuss their complex cases.
Margaret asked me to present one of her RoseK2IC
cases, as I’ve been fitting the RK2IC since its
inception some nine years ago. Generally I don’t
do many of these lenses and remain a committed
“small” lens guy. I have however had some great
successes for some tricky eyes with the 2IC. I don’t
generally like presenting other people’s cases, but
Margaret can be quite convincing. When she asked
her patient if he would mind me presenting his
case he told her he’d be delighted. It turns out I
was his optometrist in Auckland in 1999 and had
fitted his lenses before he moved to Sydney. So it
worked out perfectly.
I took his old records along and demonstrated
how stable his RE keratoconus was. He’d had
an 0.50D K-change in 16 years, and that was
comparing B&L manual keratometry with modern
Oculus topography. We also showed how his bestcorrected
RGP acuity was identical over this period,
and discussed the pros and cons of my 1999,
8.7mm diameter toric RGPs vs the recent, large
11.2mm RK2IC. On balance, he found the comfort
near- identical, and even noted improved night
vision with the RK2IC, which has an optic zone just
over 8mm versus 6.8mm on the smaller RGPs.
After going through the case--with 10 groups of
around seven keen and enthusiastic practitioners
over about two hours--there was still no respite.
Margaret wanted to have another go at me in a
debate on scleral versus corneal RGPs. She and
Brien Holden remain the only people to beat me in
debates. Full credit.
I was pretty hammered after presenting pretty
much all day with no breakfast, but a superb
crayfish in Chinatown for dinner saw me right.
Full credit to Margaret and the CCLS (AU)
organisers, the fantastic BHVI team, industry
sponsors and equipment suppliers, who all
gave up their valuable Sunday to make this RGP
educational day such a remarkable success. Some
optonerds quickly provided enthusiastic feedback
on Facebook with many others verbally expressing
their satisfaction with the format and subject
matter. Here are a few of the first Facebook Posts.
Margaret had this to say:
“Deliriously tired and deliriously happy. Slept
half an hour in the last two days prepping for this
hands (on) and live conference with live patients
and 109 people and coordination... and I’m so glad
it went off so amazingly and that everyone had an
amazingly nerdy great time.”
Others had these thoughts to share:
• “Margaret you are one huge ball of energy!!
Well done it was a complete success!! Xxx”
• “Well done Margaret: Excellent event - fun and
informative! Many thanks to you and all the
fabulous speakers and workshop presenters!”
• “Thank you Margaret for organising such an
amazing event!! We all loved it!!”
The cockles of the heart
Apart from always learning something new at
conferences, what I was very pleased to note was
the enthusiasm, knowledge and passion shown
by the many younger delegates. Of course, the
age range was early twenties to late sixties, but
the median group was probably in the 24 to 36
year age range. Quite a few of the organisers and
speakers are also around the thirty mark, and they
are damn good. They embrace new technologies
and incorporate their TPA skills and more medical
training to enhance outcomes and lift the game.
It pleases me to see a groundswell of enthusiasm
towards RGP lenses and contact lenses in general
as for probably a decade things seemed a bit flat
and the focus was all on TPAs. It seemed to me that
for a while that contact lens subspecialty had lost
the sex appeal it had exhibited from the late 1950s
to the turn of the century.
So it was great to be part of a passionate group
and be able to share the love. That it took place
at the BHVI was also fitting, as Brien was always
one who shared his love for research, contact
lenses and people and enthused those around
him. It does however work both ways and I am also
enthused by the keen young practitioners. Having
a recent graduate join the practice has been
great. Her enthusiasm has rubbed off on me and
discussing fittings and thinking things through has
been great for both of us. #totesamazeballs
Margaret Lam will be presenting as the overseas
keynote at the forthcoming annual Eye Institute
conference so many of you will be able to benefit
from her passionate presentations.
For now I am about to hop on a plane to
Melbourne to present to the final year students.
After that it’s back in NZ for a few days, then
off to Paris for SILMO. Finally it’s off to the AAO
conference in New Orleans in early October and
that’s one massive tick on my bucket list.
More on that in the next edition.
Yeeehah!
“The legendary” Paul Rose by Kelly Hodel
Luxottica reorganisation
impacts NZ
Luxottica Retail Australia and New Zealand
has made some major changes to its
business structure in a move to “adapt
and change to remain relevant in the
market,” according to a statement the company
released in August.
Most of the changes have to do with Luxottica’s
back-office support for its two retail brands
in Australia--OPSM and Laubman & Pank. The
restructure saw the elimination of OPSM’s
national eyecare director, and made state-level
sales managers responsible for state-level
eyecare managers.
Luxottica ANZ president Anthea Muir told NZ
Optics the restructure had impacted New Zealand
staff as well, but without identifying what roles
have been eliminated.
“With these changes, we’ve unfortunately had
to make two redundancies in the New Zealand
head office. However the restructure hasn’t
impacted stores or retail staff,” she said.
Luxottica employs 276 people in New Zealand
and has 50 OPSM stores, overseen by an
executive based in Australia.
Moira McInerney
to leave Auckland Eye
Moira McInerney, Auckland Eye’s chief
executive of more than four years
formally tendered her resignation in
September.
McInerney will be leaving her role in late
October or early November and relocating to
Brisbane, Australia, to be closer to her family.
“Auckland Eye has greatly benefitted from
her huge enthusiasm for our practice,” says
glaucoma and neuro-ophthalmology specialist
Dr Stephen Best. “She has championed sound
governance to encourage better business
practices for our group.”
Under McInerney’s leadership, Auckland
Eye commissioned its Oasis Surgical site, a
comprehensive facility for private surgery
in Remuera. McInerney also reviewed and
restructured its board and governance model,
undertook a three-year refurbishment project of
its central facility, entered a joint venture with Eye
Specialists in Whangarei and enhanced its quality
accreditation, among other new and ongoing
projects.
“Most importantly with Moira’s and Auckland
Eye’s Board input, we have undertaken the
expansion of our Auckland Eye facilities with
the completion of the stage one rebuild and the
stage two renovation of our existing clinic, due
for completion in December 2015,” says Dr Best.
“Moira plans to return to Brisbane to be closer
to her family, but Auckland Eye will always be
indebted to her great contributions to our group.
“Derek Shearer continues to hold responsibility
for heading up operations for Australia and New
Zealand as the VP of Operations,” Muir said.
OPSM will continue to recruit optometrists, she
added, though former recruitment head Cheryl
Nichols is no longer with the company. Muir did
not say whether Nichols’ departure was related
to the restructure.
“The professional services manager in
New Zealand, Hirdesh Nair, will look after all
recruitment. Hirdesh has been with Luxottica
for more than 11 years and comes with a
wealth of experience across the business
including working as a clinical optometrist
in New Zealand, working as an optometry
learning consultant at the Institute of Learning
and working within the product team across
Australia and New Zealand.”
With an increasing number of franchisee
partners, Luxottica’s Institute of Learning was
also closed as part of the restructure, with the
company encouraging optometrists to work with
associations and industry bodies to continue
their professional development. ▀
Moira McInerney, CEO of Auckland Eye
Transitions ad
campaign a success
A
regional
campaign that culminates
in October with a prize draw has
so far generated millions of hits for
Transitions Optical, the lens maker
announced.
The Celebrate life in the best light campaign began
in July through online, television and social
media channels, including the Yahoo network,
and during Channel 7’s Sunrise breakfast show in
Australia.
The campaign uses real-life stories from
three Transitions lens wearers, including hot
air balloon operator Michael Oakley from New
Zealand. In video presentations, the company
shows how Transitions lenses have played a
role in these customers’ pursuits of personal
passions. The videos are meant to encourage
customers to enter a prize draw by writing a
little bit about their own passions.
“Using their stories as inspiration, our major
prize contest asks entrants to tell us about their
passion (in their job, hobby or daily life) and how
As the current chair of Auckland Eye and on
behalf of all our shareholders I wish Moira all the
very best for her ongoing career, recognising her
very significant contribution to our practice.”
McInerney says she regards her role as
Auckland Eye’s CEO as “her best job ever”.
Auckland Eye has already launched the
recruitment process to find a new CEO.
Operations will continue as usual. ▀
seeing through Transitions lenses could help
them to enjoy it even more,” says Stuart Cannon,
Transitions optical general manager, Asia Pacific.
“The campaign is designed to generate more
discussion about healthy vision as a part of
everyday lifestyle, which we hope to promote
further by amplifying stories we receive from real
glasses wearers.”
Transitions says the campaign has generated
more than 30 million online impressions.
The video productions about Oakley, an
architect from Hong Kong and a teacher from Bali
can be found at www.transitions.com/en-au/lifein-the-best-light/
The prize contest for a holiday for two to
Fiji will be drawn on October 14. Entries can
be submitted through www.transitions.com/
en-au/celebratelife/ or www.facebook.com/
transitionsanz.
Eye care professionals can re-fresh Transitions
Optical point of sale materials through their local
lens supplier. ▀
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J&J brings new
multifocal CLs to ANZ market
Johnson & Johnson Vision Care rolled out
the company’s new 1-Day Acuvue Moist
multifocal contact lens at a launch event in
Auckland on September 7.
More than 40 optometrists attended the
event, featuring the head of J&J’s research and
development department in the US, Kurt Moody,
who was on an eight-city tour promoting Acuvue
Moist.
Moody, said the goal of Acuvue Moist, when his
team began work on it in 2010, was to address
the discomfort multifocal CL-wearers reported in
studies.
“Wearers were ok with the lenses they had,
but couldn’t keep them in their eyes past two or
three in the afternoon.”
Research out of the University of Waterloo in
Canada showed that 48 per cent of the people in
the study prescribed multifocal lenses for a year
discontinued use after two months because of
dryness and discomfort.
The team developed the 1-Day Acuvue Moist
combining material J&J has used since the
late 1980s, etalificon A, with a “permanent
wetting agent” known as polyvinyl pyrrolidone
(PVP), which chemically attracts and maintains
moisture throughout the lens. The lenses were
also designed to take into account pupil size due
to both refractive error and age, based on a study
J&J conducted that measured the relationship
of pupil size to age, lighting conditions and
refractive error in 609 patients ranging in age
from 18 to 78 years old.
“The data shows that with age, the pupils
become smaller and less responsive: not a big
‘ah-ha’ moment. But what became important
in the data about pupil diameter, was it gave
our designers a positive correlation in regard to
refractive range: hyperobes have smaller pupils,
myopes, bigger,” explained Moody
This led to the development of a large number
of designs to accommodate the range of
refractive correction needs for people with pupils
of varying sizes. Acuvue Moist’s basic range of
refractive power lenses go from +6D to -9D in
.25D increments, or 61 lenses, each with three
add variations--low, middle, and high--adding to
183 lenses in total.
Coupled with the flexible range of refractive
power in the lenses, optometrists can follow the
Acuvue Moist fitting guide to keep patient “chair
time” to a minimum. Following a subjective
refraction and correction for vertex difference
for greater than +/- 4D, Moody recommended
optometrists use the sensory method, not
the more commonly used sighting method, to
determine dominant eye.
“Once you have the patient’s proper correction,
do a +1D test in front of each eye. This makes
the vision in each eye blurry, and ask the patient
which eye is more comfortable with the change.
If the left is more comfortable, the right eye is
dominant. It’s a more accurate test with our
system.”
The next step is to determine the reading add,
using whatever method your practice typically
employs, and then give the patient settling
time, by making them look out the window, at a
screen, at various distances.
The company accelerated delivery of the
product to the region due to anticipated
popularity, according to Paul Griebel, general
manager of Johnson & Johnson Vision Care for
ANZ. Acuvue launched in the States in May,
which going by previous circumstances would
have meant a May 2016 launch in Australasia.
“We knew we have these highly trained
clinicians here, and there will be a high demand
for this product, so we wanted to get it here as
soon as we could,” Griebel said.
Renee Edgar, of McClellan Grimmer Edgar
in Wellington, was among a small group of
regional optometrists who participated in a prelaunch
programme in Sydney earlier this year,
subsequently trialing Acuvue Moist on a number
of patients. Edgar gave a presentation at the
Auckland launch event discussing the generally
positive results.
“I generally tend to be honest with patients and
say we’re not going to get it perfect all the time,”
she said. “There might be some blurring in the
distance, but I tend to undersell, and the product
ends up over delivering, and the patient is really
happy. Expectation is the biggest thing.”
Of the eight patients Edgar prescribed Acuvue
Moist, six were women aged 48 and over, one
younger female, and one male. The majority were
happy with the purchase, and the fitting process
required minimal chair time, she said. ▀
Angeline Ng, Lynden Mason, Shirley Ip and Trevor Skinner
Paul Griebel, Jeremy Wong, Nicholas Jobson, Sean McKiernan and Rochelle Yukich
Speakers at the JJVC ‘Innovating for multifocal contact lens success’ seminar from left: Dr Kurt Moody, Dr Emma
Gillies and Renee Edgar
Acuvue Moist promotional shot
Ormonde gives
keynote at ACO
conference
Auckland Eye’s Dr Sue Ormonde will
give one of the keynote addresses
at the Australian College of
Optometry’s National Conference
in Melbourne, which runs from October 24 to
October 25.
“Dr Ormonde will fly across the Tasman to
get the ball rolling with her keynote address
on the refractive treatment of keratoconus”
as the first speaker of the event,” said
conference organisers.
“She will be back later to encourage
[attendees] to participate in a discussion on
cutting-edge treatments in anterior segment
surgery. Last but not least, Sue will return Dr Sue Ormonde
to the stage on Sunday afternoon for the
concluding lecture of the conference.”
The conference is being held at the Melbourne Cricket Ground and includes a cocktail party on
Saturday afternoon to launch Barry Cole’s book, History of Australian Optometry.
For more information, visit www.aco.org.au/professional-development/aco-national-conference ▀
October 2015
NEW ZEALAND OPTICS
27
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SPECIALIST SHOPFITTERS & DESIGNERS TO THE OPTOMETRIC PROFESSION
TEL:(09) 486-2070 MOB:(0274) 798-798
Email: tony.maddocks@xtra.co.nz
RARE OPPORTUNITY
We have a lifestyle practice serving a semi-rural community
for sale not far from central Auckland. Ideally suited for an
optometrist wanting to work for themselves and have all the
flexibility that goes with being an owner operator. Could also be
ideal business opportunity for a mum wanting to return from
maternity leave providing the flexibility that is needed. Double
digit earnings with potential for further growth earnings.
If you think this sounds like you, please apply in the strictest
confidence c/- NZ Optics, info@nzoptics.co.nz Code PFSS1.
PERIMETER FOR SALE
Opto AP100 Perimeter for sale. Excellent instrument which came from
our city practice after the Feb 11 earthquake. As-new condition and
complete with table. Perfect for both in depth Visual Field examinations
or for routine screening. $2,600 + GST. Contact Julia Saulsbury,
PH 03-3480008 or js.visioncare@xtra.co.nz
PRACTICE FOR SALE
Long established, fully equipped, independent Invercargill
practice with loyal patient base. Several options open for
ownership of practice and building(s) at sensible Non-Auckland
prices. Merger also an option in which situation optometrist
and manager would assist with transition. For more info phone
Alan on 03 214 5500 or 021 263 1001 or email with your contact
details to greenwelloptom@xtra.co.nz.
EQUIPMENT FOR SALE
Zeiss Lensmeter (old), Maddox unit, Bernell aperture rule, Javal Schiotz
keratometer. Email mollymat@xtra.co.nz
BUSINESS DEVELOPMENT MANAGER
Little Peach is seeking the services of an Auckland based business
development manager.
Little Peach market the following optical frame brands: C-ZONE,
DILEM, EYEFUNC, FACE & CIE, GLARE, JOHN LENNON, PAUL & JOE
and SALT.
The successful applicant will have a strong desire to help our
current and potential customer base of optical outlets grow their
business utilizing certain Little Peach brands.
Based in Auckland the successful applicant would work on
an 8 week call cycle and consequently be out of town for
approximately 7-8 nights per month. A company car and
competitive remuneration package is offered to the right person.
This is a great opportunity to join a progressive, and forward
thinking company. Little Peach, is Christchurch based and we
market some of the finest eyewear available, however we
don’t do conservative we don’t do boring and the successful
applicant will certainly be a extension of this. We are looking for
a driven person with a high work ethic, and a friendly easy going
personality. A high level of self discipline, good fitness with a good
sense of humor, will turn a good job into a sound career.
If this sounds like you then please apply in total confidence to
david@littlepeach.co.nz.
WANT YOUR OWN PRACTICE?
Owner/optometrist Jan Thompson is selling her West Auckland
practice, Westgate Optometrists. Those interested in taking over
an independent practice that has been established in its current
location for over a decade is welcome to send a confidential
enquiry to westopt@ihug.co.nz or stu@opticsnz.co.nz.
LOCUM OPTOMETRIST AVAILABLE
Bharat Raniga. Call 021424253 or Email: bharatraniga@yahoo.com
RARE OPPORTUNITY TO JOIN OUR TEAM!
EXPERIENCED DISPENSING OPTICIAN OR OPTICAL
ASSISTANT - FULL TIME, PERMANENT ROLE
An opportunity has arisen for a dispensing optician to join the
School of Optometry and Vision Science supporting students
participating in the only optometry programme in New Zealand.
The School of Optometry provides the on-site clinical teaching
component for a range of academic programmes, including the
Bachelor of Optometry (BOptom). Graduates of the programme
are able to apply for registration to enable them to work as
optometrists in New Zealand and Australia. We provide a wide
range of assessment, treatment and dispensing services to adults
and children. Services are offered to the general public, staff and
students on a fee-for-service basis.
The optometry teaching clinic operates at the Grafton and Tamaki
campuses. Both locations have modern, well equipped consulting
rooms and large, attractive dispensing areas. It is an independent
practice and stocks a wide range of frames and lenses.
OPT
A full
or ex
The jo
it wo
If you
like to
pleas
This role will ideally suit an experienced dispensing optician who
wishes to combine working in a busy, client-centred practice
with the stimulation and challenge of working in a teaching
environment. We are seeking candidates who are already
registered, or are eligible for registration, as a dispensing optician
with the NZ Optometrist and Dispensing Opticians Board under
the Health Practitioners Competence Assurance Act.
We are also open to hearing from exceptional candidates who
have significant experience in an optical assistant role and wish
to train and become registered as a dispensing optician. These
candidates must be able to demonstrate sound experience
and knowledge together with a commitment to continuing
professional development.
You must be focused on customer service, be highly professional,
interested and experienced in the business aspects of service
delivery and understand the need for ongoing development to
ensure we deliver best practice service to students and clients.
A commitment to the teaching and development of students is
essential. We provide financial support towards professional fees
and continual education.
You will work with a highly experienced, full time dispensing
optician colleague and will work closely with the clinical director
of the BOptom programme and staff at the School of Optometry
and Vision Science.
Please see the website www.optometry.auckland.ac.nz for more
information on the school.
We look forward to hearing from you. Please see the University of
Auckland’s website www.opportunities.auckland.ac.nz for a job
description and to apply for the position.
Closing date: 15 October 2015
TRACEY JONES OPTOMETRIST
Seeking permanent position(s) in Auckland
LinkedIn, 027 225 7112, traceyjonesoptometrist@gmail.com
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