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THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY<br />

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

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

JULY <strong>2017</strong><br />

LEAVE A LEGACY<br />

OF VISUAL FREEDOM.<br />

TECNIS ®<br />

PRESBYOPIA-CORRECTING IOLs<br />

TECNIS is a trademark 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.<br />

AMO Australia Pty. Limited (Incorporated in Australia) PO Box 401, Shortland Street, Auckland, 1140. © <strong>2017</strong> Abbott Medical Optics Inc. | PP<strong>2017</strong>CT0286


SPECSAVERS<br />

CLINICAL<br />

CONFERENCE6<br />

<strong>2017</strong><br />

20 free ticket,<br />

flight and<br />

hotel packages<br />

available now!<br />

YOUR ANNUAL INVITATION<br />

MELBOURNE CONVENTION & EXHIBITION CENTRE<br />

SATURDAY 2 ND AND SUNDAY 3 RD SEPTEMBER <strong>2017</strong><br />

With SCC returning to Melbourne after four years on the road in Sydney and Brisbane, we are<br />

expecting 500 optometrists (including more than 100 non-Specsavers optometrists) at the <strong>2017</strong> SCC.<br />

As with previous years, we anticipate delegates will be able to accrue 10+ CD and 2.5 General points<br />

across the day-and-a-half of sessions.<br />

Saturday – Clinical Education Sessions: 4 CD and 2 General Pts anticipated in <strong>2017</strong>. Half-day<br />

focussed session on OCT Best Practice usage and routines covering diabetes, glaucoma and<br />

age-related maculopathy in three one-hour sessions.<br />

Sunday – Clinical Conference & Exhibition: 6.5 CD and 0.5 General Pts anticipated in <strong>2017</strong>.<br />

Full-day session, a mix of seven one-hour clinical and therapeutic talks from some of Australia<br />

and New Zealand’s most respected ophthalmologists.<br />

The SCC Exhibition includes Contact Lens, Ophthalmic Lens and automated equipment sponsors,<br />

Specsavers Support Team and profession-relevant exhibitors.<br />

Non-Specsavers optometrists: to enter the prize draw for 20 free ticket / flight / accommodation<br />

packages, contact Madeleine Curran on +61 401 100 772 or madeleine.curran@specsavers.com<br />

When:<br />

Where:<br />

Detail &<br />

Costs:<br />

Saturday 2nd and Sunday 3rd<br />

September <strong>2017</strong><br />

Melbourne Convention & Exhibition Centre<br />

Saturday: Clinical Education Sessions<br />

12:00pm to 5:00pm<br />

$200 + GST<br />

Saturday: Welcome Event<br />

6:45pm to 10:45pm<br />

Event hosted gratis by the Specsavers Optometry Team<br />

Sunday: Clinical Conference<br />

7:30am to 6:00pm<br />

$350 + GST<br />

FULL DETAILS OF SPEAKERS AND TOPICS AVAILABLE AT SPECTRUM-ANZ.COM<br />

Voted by New Zealanders<br />

Reader’s Digest<br />

Quality Service<br />

Award<br />

<strong>2017</strong><br />

Best Customer<br />

Service in NZ<br />

Optometry<br />

<strong>2017</strong><br />

Millward Brown<br />

Research<br />

No.1 for eye tests<br />

2016<br />

Excellence in<br />

Marketing<br />

Award<br />

2016<br />

Retail<br />

Store Design<br />

Award<br />

2016<br />

Retail<br />

Employer<br />

of the Year<br />

2015<br />

Overall<br />

National<br />

Supreme Winner<br />

2015<br />

Franchise<br />

Innovation<br />

Award<br />

2015<br />

NZ Franchise<br />

System of<br />

the Year<br />

2014<br />

Retail<br />

Innovator<br />

of the Year<br />

2014<br />

FCA Social<br />

Responsibility<br />

Award<br />

2014<br />

2 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>


Alarming results from student<br />

screening<br />

Recent screenings of more than 70 tertiary<br />

students at Massey University revealed<br />

nearly half had undiagnosed vision<br />

conditions. Optometrist Maile Tarsau from Visique<br />

Eye Spy Optometrists, who carried out many of<br />

the screenings, said the results are particularly<br />

concerning as this is significantly higher than the<br />

30% of low decile, primary school students who<br />

were found to have issues in other screenings<br />

organised by the Essilor Vision Foundation (EVF).<br />

“We found the students had a range of conditions<br />

including one student who didn’t realise he was<br />

colour blind which is not uncommon as patients<br />

who are born with the condition and have no base<br />

for comparison can accept it as completely normal.”<br />

One of the most noticeable differences in the<br />

data was the heavy daily use of digital devices such<br />

as mobile phones, which was up to 12 hours per<br />

day and on average 6.4 hours per day, said Tarsau.<br />

“Many of the students presented with<br />

symptomatic complaints such as headaches,<br />

delayed focus and eye fatigue, which can be<br />

associated with prolonged exposure to the blue<br />

light from device screens.”<br />

Tarsau said she has since fitted several of the<br />

previously undiagnosed students with new glasses<br />

and lenses, specially-designed to help relieve the<br />

symptoms of heavy device use. “We’ve had great<br />

success with Eyezen lenses since their launch with<br />

our clients enjoying more comfortable vision”.<br />

One student, 19-year-old Megan Hislop, told<br />

NZ Optics she spends about 17 hours a day using<br />

different screens and was struggling to focus,<br />

which often resulted in headaches. “It was taking<br />

me longer to process information before and now<br />

Malie Tarsau, Visique Eye Spy Optometrists, screening a student in North Palmerston<br />

Dedication and generosity<br />

honoured<br />

Associate Professor Rob Jacobs has been<br />

made a Member of the NZ Order of Merit<br />

for services to optometry and education<br />

after making a significant contribution for more<br />

than 30 years. He was involved in revisions to<br />

the curriculum in 1996 and was a key player<br />

in designing a curriculum that has allowed<br />

optometrists to expand their skills and prescribe<br />

medicines to treat a wide range of eye conditions.<br />

Talking to NZ Optics after learning of the honour,<br />

A/Prof Jacobs said, “I am very appreciative of the<br />

support that I have had from the profession of<br />

optometry in New Zealand since I took up my<br />

position at the University of Auckland in February<br />

1984. I am proud of the position that optometrists<br />

now hold as authorised prescribers and as the<br />

‘primary care/general practitioners for eyes’ and<br />

[with my new glasses] I don’t need to concentrate<br />

as hard and the headaches are less frequent.”<br />

Following a press release, the results of the<br />

Foundation’s first tertiary student screening have<br />

been picked up by a wide range of media, including<br />

a high-profile slot on one of the main Kiwi Chinese<br />

channels, highlighting the problem to other<br />

students and tertiary education providers. EVF<br />

trustee Kumuda Setty said she’s now had a number<br />

of calls from other tertiary providers interested in<br />

testing their students.<br />

Tarsau said she believes these results certainly<br />

am pleased that the university has been part of<br />

that evolution.”<br />

The award came as quite a surprise, he said, as<br />

the development of optometric education in New<br />

Zealand has been the work of many dedicated<br />

people. “I feel privileged to have been nominated.”<br />

But he doesn’t expect the award will change him.<br />

“My goal in life has always been to help people<br />

develop to their full potential and the rewards that<br />

tertiary education provides on a daily basis in this<br />

regard are enough.”<br />

A/Prof Jacobs has also published more than 80<br />

peer-reviewed articles, held more than 34 peerreviewed<br />

conference proceedings and has recently<br />

published a textbook on ocular prosthetics. He<br />

has served as an expert witness in District Courts<br />

and the Supreme Court on issues involving colour<br />

warrant further vision screening testing at the<br />

tertiary level and probably within companies,<br />

where many more are also spending too many<br />

hours on multiple devices.<br />

EVF extended its screening programme to<br />

include tertiary students for the first time in May<br />

(see NZ Optics June issue). The charity is working<br />

with tertiary institutions around the country and<br />

is currently seeking further funding to expand<br />

the programme. It is also evaluating a possible<br />

workplace pilot screening study, though this is yet<br />

to be confirmed. ▀<br />

vision and<br />

motor vehicle<br />

driving and he<br />

has acted as<br />

the academic<br />

director and<br />

head of the<br />

School of<br />

Optometry<br />

and Vision<br />

Science at the<br />

University Associate Professor Rob Jacobs MNZM<br />

of Auckland.<br />

He was made an honorary member of the New<br />

Zealand Association of Optometrists in 2002.<br />

In other eye-related honours, Clarice Lee<br />

Anderson of Waipukurau was awarded the Queen’s<br />

Working<br />

together…<br />

EDITORIAL<br />

Susanne with Mark and Ian from Toomac at RANZCO NZ <strong>2017</strong><br />

The waiting lists debacle has got people<br />

talking. RANZCO NZ (p13-16), dedicated<br />

sessions to it and the chat in the<br />

exhibition hall harboured a spirit of evolution,<br />

with specially-trained optometrists and nurses<br />

and the need for more community-led funded<br />

eye care, dominating debate. It’s great to see<br />

this collaborative spirit in action with the<br />

appointment of three senior optometrists to<br />

the government’s ophthalmology advisory<br />

group (p4) and the encouragement of more<br />

nurse practitioners (p16). This was also NZ<br />

Optics’ Susanne Bradley’s first RANZCO NZ<br />

and first opportunity to meet so many of you.<br />

She thanks all of you who took the time to<br />

help her sort her OCTAs from her wavefront<br />

aberrometers and retinal cameras.<br />

As well as RANZCO NZ, we’ve got all the<br />

news about new research, specs ranges and<br />

conferences, and this month Chalkeyes tackles<br />

the minefield of how short a good optometristpatient<br />

assessment can be?<br />

A belated Happy Helen Keller’s birthday (27<br />

June) everyone.<br />

Lesley Springall, publisher, NZ Optics<br />

Service Medal (QSM) for services to the blind and<br />

seniors.<br />

Anderson helped establish the Central Hawke’s<br />

Bay Support Group for the Blind in 1960, has<br />

been involved with the Guide Dog Association<br />

for 45 years and has organised the annual Blind<br />

Foundation and Red Puppy collections for a<br />

number of years in the region. She also founded<br />

a local singing group called ‘Sing Along With Us’<br />

that regularly entertains at rest homes and other<br />

venues, and she leads regular social events for the<br />

blind and partially-sighted. ▀<br />

SHOW<br />

silmoparis.com<br />

BTP – CARON BOWE 027 566 7552 info@btpid.co.nz<br />

<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

3


News<br />

in brief<br />

UNLOSEABLE GLASSES?<br />

Sydney startup, Tzukuri has launched its range of “unlosable glasses”<br />

in Australia. Founding entrepreneur, 23-year-old Allen Liao told<br />

the Sydney Morning Herald he had the idea when he lost a friend’s<br />

expensive sunglasses. The Bluetooth-equipped Tzukuri frames<br />

connect to an iOS app, which notifies the owner if they are left<br />

behind, the frames’ last location and proximity.<br />

WHOLEGRAINS HALT AMD<br />

A recent study published in Proceedings of the National Academy of<br />

Science on mice showed age-related macular degeneration (AMD) can<br />

be halted by switching from a high-glycaemic (sugar, potatoes, white<br />

rice) to a low-glycaemic (wholegrains) diet. “We hadn’t anticipated<br />

dietary change might repair the accumulated damage in the (retinal<br />

pigment epithelium) so effectively,” said lead author Dr Sheldon<br />

Rowan from Tufts University, Massachusetts.<br />

SPECSAVERS NUZZLES UP TO OPHTHALMOLOGY<br />

Specsavers plans to install an OCT device in all 740 of its UK practices<br />

within the next two years. The multimillion-pound British rollout<br />

began in June. Doug Perkins, optometrist and Specsavers’ co-founder,<br />

said the initiative was, “another major step forward in our journey<br />

to transform eye health, putting hospital-grade equipment in the<br />

community and helping to close the gap between optometry and<br />

ophthalmology.” In separate news, Specsavers opened “a pioneering<br />

ophthalmic diagnostic treatment centre” for people suffering from<br />

age-related eye conditions, in Newport in the UK, in a bid to reduce<br />

waiting times for assessment, diagnosis and treatment.<br />

AMD-TREATMENT BREAKTHROUGHS<br />

Scientists at the University of Birmingham in the UK have developed<br />

an eye drop to treat AMD, which could spell the end to injections.<br />

The drop uses a cell-penetrating peptide (CPP) to deliver the drug<br />

to the relevant part of the eye within minutes, said lead researcher,<br />

biochemist Dr Felicity de Cogan.<br />

In other news, scientists at the John Hopkins University in Baltimore<br />

have shown an experimental gene therapy, that uses viruses to<br />

introduce a therapeutic gene into the eye, is safe and may be effective<br />

in preserving the vision of people with wet AMD. The virus penetrates<br />

retinal cells and deposits a gene, which makes the cells produce a<br />

therapeutic protein called sFLT01.<br />

FRED HOLLOWS’ RECORD RESULTS<br />

During 2016, the Fred Hollows<br />

Foundation performed a recordbreaking<br />

one million eye operations.<br />

It also trained 78,450 surgeons,<br />

nurses and health workers and<br />

equipped 120 medical facilities.<br />

The Foundation has now restored<br />

the sight of more than two million<br />

people in Australia, the Pacific, South and South East Asia and Africa.<br />

WARBY PARKER RELEASES REFRACTION APP<br />

US optometry chain and online prescription glasses retailer Warby<br />

Parker has launched a free refraction app, ‘Prescription Check’,<br />

enabling customers to do a quick eye test at home. The results are<br />

then assessed by an optometrist to see if there’s any refraction<br />

changes and a prescription issued if nothing’s changed. If there are<br />

changes, the optometrist may recommend a more comprehensive eye<br />

exam, said the company.<br />

IDENTICAL TWINS, IDENTICAL VISION?<br />

After studying 69 sets of twins (36<br />

identical), researchers from the UK’s<br />

Anglia Ruskin University confirmed<br />

optical aberrations in healthy<br />

people are caused by genetics rather<br />

than environmental or lifestyle<br />

factors. Published in Investigative<br />

Ophthalmology and Visual Science, study<br />

results showed identical twins shared<br />

identical defects, even in twins over-50 years of age.<br />

BLUE LIGHT CLAIMS COST BOOTS<br />

The UK General Optical Council fined Boots Opticians £40,000<br />

($70,300) for its “misleading” ad for Boots Protect Plus Blue (BPPB)<br />

lenses. The optical regulator said Boots overstated claims about the<br />

harmful effects of blue light and the benefits of its BPPB lenses.<br />

WORLD ORTHOPTIC DAY<br />

The International Orthoptic Association (IOA) celebrated 50 years<br />

of promoting the orthoptic profession on this year’s annual World<br />

Orthoptic Day on 5 June. This year’s annual photo competition to<br />

promote the Day was themed “orthoptic science meets art” and was<br />

won by the University of Liverpool’s Directorate of Orthoptics and<br />

Vision Science, which took all three top prizes.<br />

SILMO SHARES 50TH BIRTHDAY<br />

Silmo, has invited all attendees who are turning 50 this year to<br />

share in its 50th birthday celebrations and “blow out the candles<br />

during their visit” to the <strong>2017</strong> show in Paris. This year’s show also<br />

will feature a special “Xtrashow” celebratory exhibition, showcasing<br />

iconic products, services or collections from participating brands and<br />

companies, that have left their mark on history. The winning Xtraentry<br />

will receive a SILMO d’Or award.<br />

Optometrists named on<br />

government group<br />

Optometrists Geoff Sargent, Andrew Sangster and Wilson<br />

Sue have been appointed to the government’s National<br />

Ophthalmology Service advisory group.<br />

The group, headed by Dr Stephen Ng (see story in June’s NZ Optics),<br />

was established in response to the media outcry about people going<br />

blind while they waited for ophthalmology services. It is charged with<br />

helping district health boards (DHBs) improve their ophthalmology<br />

services to tackle increasing backlogs across the country.<br />

In setting up the group, the Ministry of Health said it was looking<br />

at improvements at the DHB service level to tackle the problems,<br />

including local and regional activities around improved capacity<br />

and demand planning, improved referral management, consistent<br />

Award for<br />

‘endocellmetrics’<br />

Nigel Brookes, technical officer at the<br />

New Zealand National Eye Bank,<br />

(NZNEB) has been awarded the<br />

Velocity Innovation Challenge commercial<br />

prize for his entry ‘endocellmetrics’.<br />

Increasingly eye banks prepare predissected<br />

tissues, thus It’s important to<br />

determine corneal viability before they<br />

are transplanted. Traditionally, measuring<br />

corneal endothelial cell density has<br />

done this. Cell density reduces as we<br />

age and many cells are also lost during<br />

transplantation. It is important that cell<br />

density does not reach critical levels for<br />

the endothelium to function properly and<br />

to avoid corneal blindness, said Brookes<br />

explaining why a better way to measure the<br />

size and shape of corneal endothelial cells<br />

was needed.<br />

This thinking led him to create a new<br />

software solution<br />

called endocellmetrics.<br />

“Measuring corneal<br />

endothelial cell surface in<br />

an organ culture is very<br />

difficult in the eye bank as<br />

we cannot see the apical<br />

surface, only the basal or<br />

paracellular parts.<br />

“By finding the cell<br />

centres rather than<br />

drawing around the<br />

cells you can identify<br />

not just cell density but<br />

also size and shape. This<br />

yields similar results to<br />

Bollé shuts NZ office<br />

Bollé has closed its operations, finance and administration office<br />

in Christchurch in a regional effort to streamline and consolidate<br />

its business.<br />

The company has reduced its three Asia-Pacific operations to two<br />

and centralised regional services, including New Zealand, under the<br />

stewardship of its Melbourne headquarters. Bollé sales personnel<br />

in New Zealand will continue to service customers as usual, said the<br />

Bolle’s B-Rock mountain bike glasses released late last year<br />

A corneal endothelial cell software screenshot<br />

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

traditional methods, however with greater<br />

detail.”<br />

Brookes’ method and subsequent study<br />

of that method has been published in the<br />

journal Cell and Tissue Banking. As part<br />

of this, he analysed 2000 images of 700<br />

corneas – probably the largest analysis of<br />

the human corneal endothelium to date.<br />

His idea is to port the information to the<br />

cloud so it can be used, via a web browser, by<br />

other eye banks, ophthalmologists and eye<br />

researchers across the world.<br />

It’s currently just an idea, he admitted,<br />

and will be challenging to implement. “But<br />

this award gives me the impetus to pursue<br />

it further.”<br />

Brookes said he welcomes anyone in the<br />

industry who’d be interested in learning<br />

more to come and see his software<br />

prototype for themselves at the NZNEB. ▀<br />

prioritisation for access and/or increasing the contribution of<br />

optometrists and ophthalmic nurses.<br />

Sue welcomed the group’s formation and the appointment of<br />

the optometrists as this could signal further change in the DHBs’<br />

acceptance of optometrists as an important community resource<br />

that can be better used to improve the public’s eye health care.<br />

The group’s first meeting is scheduled for <strong>Jul</strong>y. ▀<br />

Ed’s note: see next month’s NZ Optics for coverage of a fascinating<br />

study by medical student Nicolas Theis looking at the Dunedin<br />

situation and how we might better predict demand to improve<br />

patient flow.<br />

1st SOVS<br />

conference<br />

The School of Optometry and<br />

Vision Science (SOVS) is holding<br />

its inaugural conference at the<br />

University of Auckland’s Grafton campus<br />

on 22-23 <strong>Jul</strong>y.<br />

Themed ‘Vision for the Future’, the<br />

conference celebrates more than 50 years<br />

of SOVS’s commitment to educating<br />

primary health care professionals.<br />

Speakers will offer the latest insights<br />

into eye research and case studies will<br />

provide practical examples of how modern<br />

advances in eye care can be incorporated<br />

into everyday practice, said organisers.<br />

“The conference will provide practising<br />

clinicians, educators, vision scientists and<br />

students the opportunity for hands-on<br />

interactive workshops, as well as short<br />

scientific presentations, Grand Round<br />

sessions and clinical seminars.”<br />

Workshops include clinical imaging,<br />

electrophysiology, paediatric vision<br />

assessment and ocular surface<br />

assessment, with other sessions covering<br />

myopia control, amblyopia therapy and<br />

glaucoma. For more, visit: http://sovs<strong>2017</strong>.<br />

org.nz/ ▀<br />

company, though long-service New Zealand business manager Sandy<br />

Caddy’s position was made redundant in June.<br />

“Over the last two years our parent company, Vista Outdoor, has<br />

made significant acquisitions including brands like Giro (helmets and<br />

goggles), Bell (helmets), Jimmy Styks and CamelBak to add to our<br />

growing stable of outdoor brands,” explained John Toouli, managing<br />

director Asia Pacific. “As we continue to expand as an organisation, we<br />

need to streamline our operations to ensure we have the best possible<br />

processes in place to support our growing network.”<br />

All New Zealand product deliveries will now be handled directly by<br />

the Melbourne distribution centre. “Freight shipping has been running<br />

seamlessly for several months prior to the New Zealand office and<br />

warehouse closure, so we are confident we can continue to service our<br />

customers at the highest level,” said Toouli. “We also have a dedicated<br />

customer service representative here, solely to support our customers<br />

during New Zealand business hours.”<br />

Fiona Marty, marketing manager Asia Pacific, is focused on<br />

continuing to grow the Bollé brand and local networks in New Zealand.<br />

“Our brands and product development are entering an exciting phase<br />

and I’m pleased to be able to work closer with the local sales team to<br />

implement some innovative trade and consumer initiatives for the<br />

market,” she said. ▀<br />

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

For editorial, please contact Lesley Springall at lesley@nzoptics.co.nz or +64 27 445 3543<br />

For all advertising/marketing enquiries, please contact Susanne Bradley at susanne@nzoptics.co.nz or +64 27 545 4357 in the first instance, or Lesley Springall at lesley@nzoptics.co.nz<br />

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

NZ Optics magazine is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times a year, by New Zealand Optics 2015 Ltd. Copyright is held by<br />

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<br />

products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The views expressed in this publication are not necessarily<br />

those of NZ Optics 2015 Ltd or the editorial team.<br />

4 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>


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WE ARE LIVING IN AN EXTRAORDINARILY DIGITAL AGE<br />

After only 2 hours in front of screens, many of us start to experience digital eye strain. Digital eye strain can be described as dry eyes, tired eyes, blurred vision,<br />

headaches and neck and back pain caused by spending too much time in front of digital devices.<br />

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DID YOU KNOW?<br />

Campus study finds high rate of eye strain from screen use<br />

Simon Collins<br />

Almost half of students who had their<br />

eyes tested at Massey University are<br />

suffering headaches and vision problems<br />

— mainly due to looking at<br />

cellphones and computer screens for<br />

up to 12 hours a day.<br />

The study of 70 students at the<br />

university’s Palmerston North campus<br />

found that students were spending<br />

an average of 6.4 hours a day<br />

looking at mobile phones and other<br />

digital devices.<br />

Many, such as accountancy<br />

student Megan Hislop, 19, said most<br />

of their study resources were now<br />

online, so they were both reading and<br />

writing on<br />

screens.<br />

She estimates<br />

that she spends<br />

seven hours a<br />

day working on<br />

Megan Hislop her studies on<br />

her laptop, plus<br />

about 10 hours a day checking her<br />

cellphone.<br />

“When I get up I check the weather<br />

on my cellphone, I check Facebook<br />

and Snapchat and emails, and then<br />

go to university and look at projector<br />

screens,” she said.<br />

“By about lunchtime I’m on my<br />

phone again, then on the computer<br />

for studying afterwards, and then the<br />

cellphone throughout [that] process.”<br />

She has been prescribed glasses<br />

that have “a very slight prescription<br />

element” but are mainly aimed at<br />

reducing the “blue light” absorbed<br />

from cellphones, computers and television<br />

screens.<br />

“My eyes took so much longer to<br />

focus, which led to them getting dry,<br />

and then I’d get headaches,” she said.<br />

“Initially I was thinking ‘oh gosh it’s<br />

going to be expensive to get glasses’,<br />

but [with the glasses] I feel like I’m<br />

not so strained throughout the day.”<br />

The optometrist who did the study,<br />

Maile Tarsau, said teenagers were<br />

now having problems reading small<br />

print due to the blue light emissions<br />

from digital devices. “Younger people<br />

these days are telling me they have<br />

problems seeing those types of things,<br />

when it used to be a 40- or 50-yearold<br />

that was complaining of those<br />

things,” she said.<br />

Tarsau donated her time to test the<br />

Massey students for the Essilor Vision<br />

Foundation, a charity run by the<br />

French-based Essilor Group, the<br />

world’s largest manufacturer of ophthalmic<br />

lenses.<br />

The foundation registered as a<br />

charity in New Zealand last year and<br />

has done eye tests on 2800 children<br />

in low-decile primary schools, finding<br />

31 per cent with previously<br />

undiagnosed vision issues.<br />

Although the Massey students selfselected<br />

by volunteering to have their<br />

eyes tested, Tarsau said the finding<br />

that 45 per cent had undiagnosed eye<br />

problems confirmed the widespread<br />

effects of increased use of digital<br />

devices.<br />

“Tired eyes, watery eyes, gritty<br />

eyes and headaches are very, very<br />

common,” she said.<br />

Even major problems such as<br />

macular degeneration and cataracts,<br />

which used to affect people in their<br />

60s and 70s, are now affecting<br />

younger people.<br />

Tarsau said her practice, Visique<br />

in Palmerston North, offered filters to<br />

reduce blue light for about $20.<br />

A Nationwide survey of New Zealand optometrists found that nine in ten (87%) expressed concerns about the number of people presenting with eye damage,<br />

some as young as five years old, as a result of heavy digital device use.<br />

Eight in 10 (80%) of optometrists believed those patients most affected were aged between 30 and 40 and one in five (19%) said in their experience, teenagers<br />

This press clip was produced under license and a copyright fee paid. If you intend to copy this clipping (including digital conversion or storage) you must obtain a license from the<br />

Print Media Copyright Agency. Ph: (04) 498 4488 or email info@pmca.co.nz<br />

were also a high risk demographic. AUS: 1300 1 SLICE NZ: 0800 1 SLICE service@slicemedia.com<br />

Ref: 664721261<br />

This press clip was produced under license and a copyright fee paid. If you intend to copy this clipping (including digital conversion or storage) you must obtain a license from the<br />

Print Media Copyright Agency. Ph: (04) 498 4488 or email info@pmca.co.nz<br />

AUS: 1300 1 SLICE NZ: 0800 1 SLICE service@slicemedia.com<br />

Ref: 787542840<br />

The most frequent symptom of excessive device use was dry eyes with almost eight in 10 (77%) of optometrist’s saying patients were presenting with this<br />

condition frequently. Eyestrain and headaches were seen almost as often at 72% and 52% respectively.<br />

Other common symptoms were stinging/tired or itching eyes, discomfort caused by the glare of the screen, and a progressive difficulty in staring at the device.<br />

Talk to your Essilor Territory Manager to run your local EyeZen Consumer Campaign<br />

<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

5


Kiwis adopt new DO course<br />

The Association of<br />

Dispensing Opticians in<br />

New Zealand (ADONZ)<br />

is endorsing the Certificate IV<br />

in Optical Dispensing course<br />

provided by the Australasian<br />

College of Optical Dispensing<br />

(ACOD).<br />

“This course meets the new<br />

rigorous requirements for our<br />

scope of practice under the<br />

Health Care Practitioners Act<br />

(HPCA),” said Peggy Savage,<br />

ADONZ president. Unlike in<br />

Australia where the profession<br />

is deregulated, in New Zealand<br />

the terms ‘dispensing optician’<br />

and ‘optical dispenser’ are<br />

protected so course content is<br />

rigorously assessed.<br />

“We have just begun with<br />

our new provider, ACOD, and<br />

are extremely happy with them. A record enrolment<br />

cohort of 54 students from New Zealand have enrolled<br />

in the course this year,” said Savage.<br />

The course, which is currently being accredited by the<br />

Optometrists and Dispensing Optician Board in New<br />

Zealand, is flexible in structure and can be completed<br />

in 18 to 24 months part-time. Each student must be<br />

employed in an optical practice and have the support<br />

of their workplace supervisor. The course is a blended<br />

delivery, incorporating online elements, comprehensive<br />

practical workshops, as well as 20 hours work per week<br />

in their optical practice. As well as ADONZ, Specsavers<br />

has also said they will now use ACOD as their preferred<br />

training partner on both sides of the Tasman.<br />

James Gibbins, teacher and director at ACOD says,<br />

“The optical dispensing association in New Zealand<br />

is active, vibrant and successful and ACOD is very<br />

excited to be partnering with both ADONZ and<br />

Specsavers NZ to train dispensing opticians in New<br />

Zealand. Previously, ADONZ and Specsavers had relied<br />

upon different colleges, with different delivery and<br />

SPECS + FEATURES<br />

assessment programmes, but with both now opting<br />

for ACOD this will result in an agreed and consistent<br />

level of training and assessment throughout New<br />

Zealand, to the benefit of all parties.”<br />

ERAGE Gibbins has HIGHLIGHTS<br />

been involved with dispensing for 20 See story about the latest Kiwi DO graduates on p19.<br />

diameter years and has seen • Fluorescence the training course based change structured vastly light<br />

diameter topographer with more than 22mm range<br />

and 360 o scleral coverage<br />

F VIEW<br />

• Under the eyelid scleral measurements<br />

x V17mm<br />

x V22mm<br />

• Over 1 million measurement points with<br />

a 10 micron precision<br />

A sneak peek<br />

POINTS • Integrated software for fitting and<br />

32,400 customizing Europa Scleral lenses with direct<br />

POINTS at our new collection<br />

ordering capabilities<br />

• Unbeatable Price<br />

,000,000+<br />

WEIGHT<br />

x 14” x 12”<br />

m x 30cm)<br />

lb. (6.8kg)<br />

3.5” x 7.5”<br />

x 19 cm)<br />

b. (5.44kg)<br />

10.5” x 3”<br />

cm x 8cm)<br />

b. (2.26kg)<br />

” x 14” x 3”<br />

cm x 8cm)<br />

lb. (3.2kg)<br />

TPRINT<br />

13.5” x 6”<br />

m x 15cm)<br />

t to doctor<br />

17” (43cm)<br />

m - 53cm)<br />

ully raised]<br />

WEIGHT<br />

head only)<br />

MENTS<br />

5V DC 3A<br />

LIED PC<br />

nvy 15” i7<br />

8GB RAM<br />

sMap3D SPECS + FEATURES<br />

FEATURED MAPS<br />

• Sagittal Elevation<br />

• Texture-mapped image COVERAGE elevation<br />

Single: up to 17mm diameter<br />

• Lens Elevation Stitched: up to 22mm diameter<br />

• Mean curvature<br />

FIELD OF VIEW<br />

• Simulated fluorescein Single: H22mm pattern x V17mm<br />

Stitched: H22mm x V22mm<br />

• Corneal and Scleral Elevation (Best-fit<br />

sphere)<br />

MEASUREMENT POINTS<br />

32,400<br />

• Polar display<br />

• Full 3D display<br />

ANALYZED POINTS<br />

1,000,000+<br />

SHIPPING DIMENSIONS/WEIGHT<br />

Head: 14” x 14” x 12”<br />

(36cm x 36cm x 30cm)<br />

15lb. (6.8kg)<br />

Manipulator: 14” x 13.5” x 7.5”<br />

(36cm x 34cm x 19 cm)<br />

12lb. (5.44kg)<br />

Chinrest: 21” x 10.5” x 3”<br />

(53cm x 27cm x 8cm)<br />

5lb. (2.26kg)<br />

Base: 20” x 14” x 3”<br />

(51cm x 36cm x 8cm)<br />

7lb. (3.2kg)<br />

FOOTPRINT<br />

Width: 9.5” x 13.5” x 6”<br />

(24cm x 34cm x 15cm)<br />

varied width from patient to doctor<br />

Depth: 17” (43cm)<br />

Height: 19”-21” (48cm - 53cm)<br />

[with head fully lowered and fully raised]<br />

WEIGHT<br />

Est. 11lb. (5kg) (head only)<br />

POWER REQUIREMENTS<br />

5V DC 3A<br />

SUPPLIED PC<br />

HP Envy 15” i7<br />

8GB RAM<br />

TOOLS<br />

• Principle toricity display at varying diameters<br />

• Distance measurement<br />

• Mean sagittal height at varying diameters<br />

• Lens and sagittal height cross-section display<br />

• Customizable Data tips<br />

• Customizable color scales<br />

• Brightness and contrast adjustments<br />

• Customizable for multiple users<br />

• Online storage<br />

CONTACT LENS FITTING<br />

• Scleral Lenses<br />

- Normal Corneas<br />

- Irregular Corneas<br />

• Customized Soft Lenses<br />

• Customized Back Surfaces<br />

HVID/VVID MEASUREMENT<br />

Chedy Kalach and James Gibbins, ACOD directors and senior trainers<br />

in this time, incorporating now what he calls a “wide<br />

and cost effective application” of online learning. “We<br />

have liaised closely with employers and the optical<br />

dispensing boards to customise the course and cater<br />

to specific market requirements.”<br />

The ACOD dispensing course is currently at<br />

Certificate IV level, added Savage. “In time we would<br />

like to lift the level of the qualification to a diploma<br />

level. As optometrists increase their scope of practice,<br />

the value of dispensing opticians is ever increasing.<br />

The future looks very positive for dispensing opticians<br />

as the progression of technology and skills required to<br />

accurately dispense becomes more crucial.”<br />

Previous plans to work with the Waikato Institute of<br />

Technology (Wintec) for a NZ Qualification Authorityregistered<br />

course that would more closely mirror the<br />

more stringent British courser, proved too difficult to<br />

put together, which is why ADONZ approached ACOD.<br />

ADONZ conference<br />

This year the ADONZ National Conference is being<br />

held at the Rydges Latimer hotel in Christchurch from<br />

Friday 13 to Sunday 15 October. See future issues of<br />

NZ Optics or the ADONZ website for more details. ▀<br />

HIGHLIGHTS<br />

• Fluorescence based structured light<br />

topographer with more than 22mm range<br />

and 360 o scleral coverage<br />

• Under the eyelid scleral measurements<br />

• Over 1 million measurement points with<br />

a 10 micron precision<br />

• Integrated software for fitting and<br />

customizing Europa Scleral lenses with direct<br />

ordering capabilities<br />

• Unbeatable Price<br />

FEATURED MAPS<br />

• Sagittal Elevation<br />

• Texture-mapped image elevation<br />

• Lens Elevation<br />

• Mean curvature<br />

• Simulated fluorescein pattern<br />

• Corneal and Scleral Elevation (Best-fit<br />

sphere)<br />

• Polar display<br />

• Full 3D display<br />

TOOLS<br />

• Principle toricity display at varying diameters<br />

• Distance measurement<br />

• Mean sagittal height at varying diameters<br />

• Lens and sagittal height cross-section display<br />

• Customizable Data tips<br />

• Customizable color scales<br />

Launching at ODMA <strong>2017</strong><br />

• Brightness and contrast adjustments<br />

• Customizable for multiple users<br />

• Online storage<br />

Visit us on the Tiger Vision stand<br />

to view this exciting new release<br />

CONTACT LENS FITTING<br />

• Scleral Lenses<br />

- Normal Corneas<br />

- Irregular Corneas<br />

• Customized Soft Lenses<br />

• Customized Back Surfaces<br />

HVID/VVID MEASUREMENT<br />

ODMA<br />

Stand<br />

D20-24<br />

www.dynamiceyewear.com<br />

www.corneal-lens.co.nz<br />

“Breakthrough” lens<br />

coating now in NZ<br />

Tangible<br />

Hydra-PEG, a<br />

lens coating<br />

from Silicon<br />

Valley-based<br />

Tangible Science,<br />

is now available<br />

in New Zealand<br />

from Corneal Lens<br />

Corporation (CLC)<br />

in Christchurch.<br />

The company<br />

claims this<br />

“breakthrough”<br />

lens coating<br />

improves wearing<br />

time for patients<br />

by improving lens<br />

wettability and<br />

lubricity, reducing<br />

friction and<br />

prolonging tear<br />

break-up time.<br />

“While there has been much innovation<br />

in contact lenses over the years, many lens<br />

wearers still complain about discomfort and<br />

the inconvenience that comes with it,” said<br />

the company at the new lens coating’s launch<br />

at the Global Specialty Lens Symposium<br />

in Las Vegas in January. “This includes red,<br />

painful eyes, foggy vision, multiple cleanings<br />

throughout the day to reduce deposit buildup<br />

on the lens, repeated re-fittings and<br />

lens returns. Eye care practitioners remain<br />

frustrated by the lack of solutions for their<br />

patients.”<br />

Supporting the launch, Dr Melissa<br />

Barnett, US Scleral Lens Education Society<br />

president and principal optometrist at the<br />

University of California’s Davis Eye Center,<br />

said her patients “love” the new coating.<br />

“It’s especially helpful for my patients with<br />

Sjogren’s syndrome or meibomian gland<br />

dysfunction, multifocal scleral lens patients,<br />

or those with dry eye and a history of wetting<br />

Dr Melissa Barnett backs the new lens coating<br />

Reimagine<br />

Reimagine<br />

How<br />

How<br />

Custom<br />

Custom<br />

Contact<br />

Contact<br />

Lenses<br />

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Can<br />

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Feel<br />

Feel<br />

Introducing Tangible Hydra-PEG, a Breakthrough<br />

Polymer Introducing Coating Tangible for Contact Hydra-PEG, Lenses a Breakthrough<br />

Polymer Coating for Contact Lenses<br />

Tangible Hydra-PEG is designed to solve the problem<br />

of Tangible contact Hydra-PEG lens discomfort designed by: to solve the problem<br />

of contact lens discomfort by:<br />

• Improving wettability<br />

• Improving wettability<br />

• Increasing surface water retention<br />

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• Increasing lubricity<br />

• Increasing lubricity<br />

• Minimizing protein and lipid deposits<br />

• Minimizing protein and lipid deposits<br />

www.corneal-lens.co.nz<br />

butor of the sMap3D.<br />

looksharp@dynamiceyewear.com<br />

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Visionary Optics is the exclusive US Distributor of the sMap3D.<br />

+64 (0)3 366 6247 | 2 Ballarat<br />

+64 (0)3 366<br />

Way<br />

6247<br />

Wigram<br />

| 2 Ballarat<br />

8042<br />

Way Wigram<br />

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New<br />

New<br />

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s this device to sale<br />

Zealand<br />

CAUTION: by or Federal on the (USA) order law restricts of a licensed this device practitioner.<br />

to sale by or the order of a licensed practitioner.<br />

issues. It has been an<br />

incredible technology to<br />

have in my practice over<br />

this last year.”<br />

CLC is just the 13th<br />

lab in the world to<br />

have this technology<br />

installed, added CLC<br />

director Graeme Curtis.<br />

“Corneal Lens has again<br />

invested in the latest<br />

technology to ensure<br />

the company is at the<br />

forefront of contact<br />

lens development. The<br />

Hydra-PEG coating is<br />

the new kid on the<br />

block. It has a special<br />

surface nano-coating,<br />

which binds water and<br />

repels protein – a must<br />

for patients suffering<br />

dry eye, wetting and<br />

depositing issues.”<br />

According to the company, Tangible Hydra-<br />

PEG is a high-water polymer coating that<br />

is permanently bonded to the surface of a<br />

contact lens. It creates a wetting surface that<br />

encapsulates the underlying lens material<br />

and enables it to integrate easily into the<br />

ocular environment without disrupting the<br />

tear film. It can be applied to all contact<br />

lens materials, including hydrogel, silicone<br />

hydrogel, gas permeable, hybrid and smart<br />

contact lenses, and is being promoted as<br />

being particularly beneficial to patients who<br />

experience ocular dryness or discomfort<br />

associated with contact lens wear, moderate<br />

or heavy depositors and scleral lens wearers<br />

who experience fogging.<br />

The Hydra-PEG coating is now available<br />

on all Contamac lenses from CLC. It will be<br />

available with other materials in the near<br />

future. ▀<br />

6 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong><br />

N127121.01F<br />

MKT6010A_GSLS_PartnerFlyer_Final3.pdf<br />

N127121.01F<br />

Jan MKT6010A_GSLS_PartnerFlyer_Final3.pdf<br />

16 <strong>2017</strong> 8:28:02


BOP’s new education<br />

evening<br />

The first Bay of<br />

Plenty Eye Care<br />

Professionals’<br />

Education Evening<br />

was held in June.<br />

Organiser and ortho-k<br />

specialist Alex Petty<br />

said the idea for the<br />

evenings was inspired<br />

by the long-running<br />

Manawatu optometry<br />

forums, organised by<br />

Siok Khim Taylor.<br />

“Those evenings<br />

were always<br />

interesting. I<br />

frequently came<br />

away with a new way<br />

of thinking about a<br />

particular condition.<br />

They also inspired<br />

great collegiality<br />

amongst colleagues<br />

in both optometry<br />

and ophthalmology, which is so important with<br />

all the other pressures on our industry at the<br />

moment.”<br />

With the swelling population in the Bay<br />

and the increasing number of optometrists in<br />

the area, having a local educational forum to<br />

discuss the management of tricky cases, learn<br />

new techniques and treatments and liaise with<br />

colleagues in a social setting was well overdue,<br />

he said.<br />

The inaugural event attracted three<br />

ophthalmologists and 20 optometrists from<br />

as far afield as Taupo and Whakatane, who<br />

gathered in Tauranga to listen to four structured<br />

talks on specialty areas followed by some active<br />

discussion on interesting case studies presented<br />

by attendees.<br />

Petty, a self-confessed myopia-control crusader,<br />

kicked things off with an in-depth look at the<br />

international myopia epidemic in children and<br />

the different treatment options to slow its<br />

progression. Dr Mike O’Rourke from Tauranga<br />

Alex Petty focuses on myopia at the first BOP education evening<br />

Eye Specialists followed with a discussion on<br />

intraocular telescopes. Dr O’Rourke works closely<br />

with local low vision specialist Lynley Smith from<br />

Tauranga Eyecare (previously Langford Callard,<br />

see story p12) to assess an individual’s suitability<br />

for the operation. Realistic expectations are key<br />

for patient satisfaction, he said. Beverley Stowers,<br />

a Blind Foundation rehabilitation instructor,<br />

provided an overview of the foundation’s<br />

community services, stressing the importance of<br />

collaboration between eye care professionals and<br />

the foundation and referring patients early. Local<br />

contact lens (CL) specialist Penny Adams, closed<br />

the formal presentations with some interesting<br />

cases and discussion about prosthetic CLs.<br />

The first evening, sponsored by Device<br />

Technologies, was a great success, said Petty. A<br />

further two evenings have also been planned, the<br />

next in September, sponsored by Corneal Lens<br />

Corporation (CLC) and another four months later,<br />

sponsored by Ophthalmic Instruments Company<br />

(OIC). ▀<br />

GNZ Symposium <strong>2017</strong><br />

Glaucoma New<br />

Zealand (GNZ)<br />

will be holding<br />

its second Glaucoma<br />

Symposium at<br />

Alexandra Park in Auckland on 13 August.<br />

“The inaugural GNZ Glaucoma Symposium was<br />

a tremendous success last year and we are even<br />

more excited about the programme this year,” said<br />

Professor Helen Danesh-Meyer, GNZ chair who is<br />

overseeing the programme.<br />

One of the key mandates of GNZ is glaucoma<br />

education and the online GNZ Professional<br />

Education Programme has been hugely supported<br />

by the optometry profession. This Symposium is<br />

an extension of GNZ’s commitment to glaucoma<br />

education and it also signifies how important<br />

the role of optometry is in the management of<br />

glaucoma.<br />

Optometrists have a pivotal role in the diagnosis<br />

of glaucoma and care of glaucoma patients.<br />

With therapeutic optometry, optometrists<br />

are increasingly involved in the complete care<br />

of glaucoma patients and are independently<br />

prescribing glaucoma medications. The more<br />

ophthalmology and optometry interact and<br />

communicate, the better the outcomes for our<br />

patients.<br />

This symposium is a full day of optometry<br />

education focused solely on glaucoma, consisting<br />

Correction<br />

In our story last month, about Corneal Lens<br />

Corporation’s new building and renovations<br />

– “CLC, Curtis Vision’s expanded home”, we<br />

wrongly stated that Michael Curtis still owns<br />

Curtis Vision, which is incorrect as he sold the<br />

practice to Barbara Shaw in 2010, who then sold<br />

it to Brian Denny and Chris Clark in 2014.<br />

Chris Clark is currently managing director, ably<br />

assisted by practice manager Shelley Endacott.<br />

Curtis Vision now has four practices: Armagh<br />

Street, Fendalton, New Brighton and Wigram.<br />

BY THE TEAM FROM GNZ<br />

of a number of short<br />

lectures covering<br />

clinical glaucoma<br />

management, tricks<br />

of the trade and<br />

paradigm shifts in glaucoma management and,<br />

new for <strong>2017</strong>, a focus on interactive cases and<br />

panel discussions. The panels will comprise both<br />

optometrists and ophthalmologists. Challenging<br />

cases will be presented leading to discussions<br />

regarding shared-care, diagnosis and treatment<br />

strategy, in what should be an exciting and<br />

thought-provoking day!<br />

The conference has the support of glaucoma<br />

specialists from around the country and will<br />

include speakers from both optometry and<br />

ophthalmology, including Professors Charles<br />

McGhee and Helen Danesh-Meyer, Associate<br />

Professor Gordon Sanderson, Drs Sonya Bennett,<br />

Alex Buller, Shenton Chew, Sam Kain, Hannah<br />

Kersten, Jay Meyer, Hussain Patel, Graham Reeves,<br />

Jim Stewart and Kristine Jensen. Our keynote<br />

speaker is Professor Steven Dakin, head of the<br />

School of Optometry and Vision Science.<br />

Prof Danesh-Meyer says she hopes the <strong>2017</strong> GNZ<br />

Glaucoma Symposium will provide both depth and<br />

breadth in glaucoma care. GNZ is looking to apply<br />

for six clinical diagnostic CPD points for this one<br />

day event. To register visit www.glaucoma.org.nz/<br />

symposium_form.asp ▀<br />

The new Wigram building is owned by a<br />

separate company belonging to CLC director<br />

Graeme Curtis. It was Graeme Curtis’ idea for the<br />

new build and to include an optometrist on the<br />

premises, rather than a combined decision as<br />

stated in the article. When Denny and Clark took<br />

over Curtis Vision they decided to take up the<br />

opportunity offered to them by CLC and move to<br />

the new building in Wigram. Curtis Vision lease<br />

the downstairs offices and CLC’s office team are<br />

based upstairs. ▀<br />

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customers’ eyes<br />

for better vision.<br />

ZEISS Lenses for Digital Life<br />

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<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

7


OTC strikes again<br />

Just some of the speakers at this year’s conference: Drs Trevor Gray, Ilva Rupenthal, Mohammed Ziaei, Rachael Niederer and Narme<br />

Deva, Samantha Simkin, Olga Bochner and Drs Hannah Kersten and Jie Zhang with Professor Charles McGhee<br />

Peter O’Hagan. Frank Snell and Heather O’Hagan<br />

Sandy Ng, Jade Chen and Andy Ho<br />

BY ELLA EWENS*<br />

The second annual ocular therapeutics<br />

conference was held at Waipuna<br />

hotel and conference centre in<br />

Mount Wellington, Auckland on Sunday 21<br />

May. A fantastic turnout of optometrists,<br />

ophthalmologists, trainee ophthalmologists<br />

and pharmacists from across New Zealand<br />

enjoyed a series of lively lectures on a wide<br />

array of ocular therapeutics topics. Delegates’<br />

interest was maintained with the popular<br />

15-minute lecture format returning this year.<br />

Return of the red eye<br />

Professor Charles McGhee opened proceedings<br />

and chaired the morning session, introducing<br />

a range of talks on topics from inflammatory<br />

eye disease to the application of telemedicine.<br />

Dr Narme Deva gave a very practical<br />

summary of the use of drugs for the treatment<br />

of acute uveitis. You could be forgiven for<br />

thinking she was giving advice to rugby<br />

players, not optometrists as she summarised:<br />

“have courage, hit hard, hit fast and don’t<br />

taper too soon.”<br />

Olga Brochner, an ophthalmic nurse,<br />

provided some interesting insight into treating<br />

neovascular age-related macular degeneration<br />

(AMD), while Dr Mohammed Ziaei delivered a<br />

fascinating, video-heavy presentation about<br />

surgical therapeutics – quite a lot of corneal<br />

gore so close to breakfast!<br />

15 minutes of fame<br />

After some much-needed coffee, Dr Rasha<br />

Altaie introduced the next few speakers.<br />

Clinical nurse specialist Olga Brochner discussing AMD<br />

treatments<br />

Dr Simon Dean took an interesting peak at<br />

nutritional therapies and alternative therapies<br />

including Teatree oil and its application<br />

in blepharitis; Dr Andrew Thompson, a<br />

pharmacist-turned-ophthalmologist, provided<br />

his unique insight into the off-label use of<br />

pharmacologic agents in ophthalmology; and<br />

Dr Trevor Gray offered some very practical<br />

advice on the safe prescribing of oral drugs for<br />

optometrists, including contraindications for<br />

the use of oral antibiotics and anti-virals.<br />

Other highlights included Dr Zie Zhang’s<br />

presentation on cells as therapeutics. She<br />

outlined several applications for the use of<br />

stem cells including chemical injury, Stargaats<br />

disease and AMD.<br />

During the breaks, there was a buoyant<br />

atmosphere in the air as delegates caught<br />

up with old colleagues, drank coffee in the<br />

autumn sun and watched the sailing boats on<br />

Panmure basin.<br />

Glaucoma breakthroughs<br />

Alex Petty, DFV’s Ralph Thompson and David Haydon<br />

After lunch, Dr Gray chaired a session on<br />

glaucoma. Optometrist Dr Hannah Kersten<br />

looked at glaucoma collaborative care and<br />

the advanced training that optometrists can<br />

now undertake. Dr Ainsley Morris used a<br />

very entertaining dam analogy to describe<br />

glaucoma treatment and looked at side effects<br />

from several commonly used glaucoma drugs,<br />

while Professor Charles McGhee discussed the<br />

application of Rho kinase (ROCK) inhibitors in<br />

glaucoma and corneal disease. ROCK inhibitors<br />

use four to five mechanisms to reduce<br />

intraocular pressure, however they are not<br />

commercially available yet.<br />

Dr Ilva Rupenthal, director of the Buchanan<br />

Ocular Therapeutics Unit at the University of<br />

Auckland, which runs the conference, continued<br />

the glaucoma treatment theme, outlining some<br />

exciting new drugs in the approval pipeline<br />

for glaucoma and new drug-delivery methods.<br />

The aims of the new delivery methods were<br />

to overcome patient non-compliance and<br />

preservative toxicity, and they including new<br />

drug-loaded punctual plugs, a silicon ring, a<br />

biodegradable pellet and a titanium implant.<br />

New drugs and tips<br />

The final session of the day was chaired by<br />

Dr Rupenthal and included Associate Professor<br />

Jennifer Craig’s insights into dry eye treatment<br />

– A/Prof Craig is vice-chair of the recently<br />

concluded DEWSII (the second international<br />

dry eye workshop). New dry eye treatments<br />

include drugs Restasis and Xiidra, and a<br />

fascinating new contraption that tickles the<br />

inside of your nose to produce more tears in<br />

patients with aqueous deficiency.<br />

Dr Jay Meyer provided some practical tips<br />

on which topical antibiotic to use where and<br />

when, while Dr Altaie concluded the day by<br />

explaining the characteristics of keratoconus in<br />

children and why it’s such a different condition<br />

in children compared with adults. She stressed<br />

the importance of timing in corneal crosslinking<br />

treatment and provided some useful<br />

guidelines on when to refer patients.<br />

In conclusion…<br />

After each lecture session, the session chair<br />

led an interactive and engaging question and<br />

answer session with the audience, which was<br />

also highly informative as the audience shared<br />

some of its own experiences.<br />

Overall, this year’s conference, drew an<br />

audience of almost 200 different practitioners<br />

from across New Zealand who appreciated<br />

the broad range of topics and clear take home<br />

messages, with many practitioners saying<br />

they had picked up important key points that<br />

would change the way they practice.<br />

The next ocular therapeutics conference<br />

will be held at Waipuna hotel and conference<br />

centre on 11 March 2018.<br />

*Ella Ewens is a New Zealand-trained, therapeuticallyqualified<br />

optometrist who has worked in New Zealand<br />

and overseas in a number of different roles within the eye<br />

industry.<br />

Raewyn Hart, Leith O’Connor and Cecilia Turnbull Catherine van Paassenn and Supreme Health’s Celeste Peh Nafisa Slaimankhel and Erin Tan<br />

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8 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>


Hana Namik, Eva Astuti, Khyati Garg, Persephone Cheng and John Boyle<br />

Sandhya Mathew, Hayley Sowry, Joy Hoshek and Simon Little<br />

Donning the livery<br />

BY DONALD CRICHTON*<br />

On a recent trip back to the UK, I attended a ceremony<br />

where I and four others were clothed in the Livery of the<br />

Worshipful Company of Spectacle Makers (WCSM).<br />

On completion of my qualification as a dispensing optician (FBDO)<br />

in the early 1990’s in the UK, I was encouraged to become a Freeman<br />

of the WCSM by Professor Mo Jalie who had been my ophthalmic<br />

lens lecturer and principle of City and East London College. The<br />

following year I was granted Freedom of the City of London. These<br />

are the two pre-requisites to becoming a Liveryman.<br />

Situated within Apothecaries Hall, Black Friars Lane, in the shadow<br />

of St Paul’s Cathedral, the Worshipful Company of Spectacle Makers<br />

Dinner at the WCSM<br />

is the oldest optical body still in<br />

existence, having been founded<br />

by Royal Charter in 1629.<br />

It remains one of the largest<br />

Livery Companies in the City<br />

of London providing education<br />

for its members and funding<br />

and support for both charities<br />

and academic research. The<br />

Company’s membership includes<br />

ophthalmologists, optometrists,<br />

orthoptists, optical nurses,<br />

Donald Crichton in full livery<br />

dispensing opticians, optical<br />

technicians and assistants and other allied professionals.<br />

The ceremony itself is carried out behind closed doors in front of<br />

the master, wardens and assistants of the court as it has been for the<br />

last four centuries. A drinks reception was followed by lunch for 120<br />

members and guests in the grand hall.<br />

I had a truly memorable day, which I was able to share with my<br />

brother, Alistair, and where I was joined by Association of British<br />

Dispensing Opticans (ABDO) colleagues and fellow Liverymen Sir<br />

Anthony Garrett CBE, ABDO general secretary; Fiona Anderson,<br />

ABDO and International Opticians Association (IOA) president;<br />

Elaine Grisdale, head of professional services and international<br />

development, and well known now to many Kiwi Dos; and WCSM<br />

past-master Professor Mo Jalie. ▀<br />

*Donald Crichton is a fellow of the British Dispensing Opticians (FBDO), vice president of<br />

the Associating of Dispensing Opticians NZ, a sales consultant with Hoya Lens NZ and<br />

now a liveryman of the Worshipful Company of Spectacle Makers<br />

Louise Edwards, Jessica McDowell, <strong>Jul</strong>ia Walker and Jenna Edwards<br />

Ocular Therapeutics Conference sponsors<br />

Gold sponsors<br />

• Corneal Lens Corporation<br />

• Ophthalmic Instrument<br />

Company<br />

• Novartis<br />

Bronze sponsors<br />

• Device Technologies<br />

• Bausch + Lomb<br />

• Designs for Vision<br />

• Supreme Health<br />

NZAO’s <strong>2017</strong><br />

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Registration is now open for the New Zealand Association<br />

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conference will be held at the Novotel Tainui, overlooking<br />

the Waikato River in the heart of Hamiliton, from Friday 13 to<br />

Sunday 15 October.<br />

Keynote speakers include: Michael Yapp, head of clinical<br />

services at the Centre for Eye Health in New South Wales, who<br />

has a special interest in ocular imaging and glaucoma; and<br />

Associate Professor Sharon Bentley, director of clinical services<br />

at the Australian College of Optometry, who’s current interests<br />

include the impact of low vision on functional performance and<br />

quality of life, vision and driving, the development of patient<br />

reported outcomes for use in clinical trials,<br />

the evaluation of eye care services and public<br />

health optometry, and optometry education.<br />

“Join us for a weekend of quality CPD while<br />

simultaneously catching up with colleagues<br />

from around New Zealand,” said the NZAO. For<br />

more visit www.nzao.co.nz ▀<br />

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<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

9


SPECIALITY CL FORUM BY ALEX PETTY*<br />

ORTHO-K: TACKLING THE EPIDEMIC<br />

97%, drastically reducing the instance of myopiaassociated<br />

ocular disease. The majority of these<br />

studies use ‘standard’ ortho-k lenses intended for<br />

adults, with clear vision being the main design<br />

consideration. Clear vision means a wide treatment<br />

zone with minimal aberrations present in the<br />

optical system. However, it’s the aberration that<br />

is created by ortho-k lenses that we believe is<br />

responsible for the slowing of eye growth.<br />

IMAGE COURTESY OF VISIQUE ROSE OPTOMETRISTS<br />

At the tender age of nine I developed a<br />

blinding eye disease. This bombshell<br />

was dropped on my world at my first eye<br />

examination in 1996. My optometrist at the time<br />

was quick to point out that my symptoms could be<br />

treated, but they would most likely worsen as I got<br />

older. “Surely something can be done?!” pleaded my<br />

concerned parents. A solemn shake of the head was<br />

the only answer we received.<br />

As a child, living with my eye disease was a daily<br />

challenge. My symptoms were present as soon as<br />

I woke up and would only abate when the next<br />

night’s sleep begun. The treatments I was provided<br />

with helped me significantly, but they were far<br />

from ideal. Worst of all, most of the other kids in<br />

my class had ‘normal’ eyes. I’m sure they teased me<br />

mercilessly when I wasn’t looking.<br />

As the years went by my disease rapidly<br />

progressed and the treatments required became<br />

stronger and stronger. Finally, at the end of my<br />

teenage years, there was a blurry light at the end of<br />

the tunnel. My disease had slowed and somehow,<br />

it’s relentless march had faltered!<br />

My gusto was short-lived. One morning, during<br />

Auckland Anniversary weekend, my disease awoke<br />

from its dormancy with a vengeance. I consider<br />

myself very fortunate that at the time I was halfway<br />

through my optometry studies, so when the subtle<br />

new symptoms of my disease became apparent,<br />

I knew something serious was going on. I rushed<br />

myself to hospital and underwent an urgent eye<br />

operation that night. The surgeon did a superb job,<br />

but recovery was slow and painful. That wasn’t the<br />

end of it either. Over the next five years I needed<br />

another two more sight-saving operations when my<br />

disease reared its ugly head again.<br />

Fortunately, nowadays I can still see to work and<br />

drive a car but there are no guarantees; my blinding<br />

eye disease will be with me for the rest of my life.<br />

My name is Alex Petty and I have myopia.<br />

A picture of my eye following one of my three sight-saving operations.<br />

Looks pleasant huh!<br />

Many optometrists still don’t consider myopia<br />

a disease, merely an inconvenient refractive<br />

error. Admittedly my personal case of progressive<br />

axial length growth and resultant bilateral<br />

rhegmatogenous retinal detachment is an extreme<br />

example, but worldwide we are likely to be dealing<br />

with similar instances more and more.<br />

Currently 23% of the earth’s population are<br />

short-sighted and this percentage is increasing<br />

due a complex range of factors related to genetics,<br />

lifestyle and environmental influences. Professor<br />

Brien Holden is one who recognised that the<br />

myopia epidemic is likely to be the big issue facing<br />

eye care professionals in the future. His research<br />

group predicts that by 2050 approximately half<br />

the world will be myopic, a fifth being in the<br />

high-myopia category. These individuals with<br />

long eyeballs are the ones at much greater risk of<br />

glaucoma, cataract, retinal detachment and myopic<br />

maculopathy during their lifetime.<br />

Scarily Ian Flitcroft’s research shows there is no<br />

‘safe’ level of myopia: even low myopes have an<br />

increased risk of ocular disease. When you consider<br />

the social, economic and personal sequelae of the<br />

myopia epidemic it is understandable that people<br />

are embracing prevention, rather than just dealing<br />

with the symptoms and ocular effects as they<br />

eventuate.<br />

The increased risk of various ocular conditions with higher levels of<br />

myopia (courtesy of OSO)<br />

Fortunately, unlike when I was a young myope,<br />

we now have a much better understanding of what<br />

can be done to slow axial eye growth. Contact lens<br />

practitioners have been at the forefront of myopia<br />

control for some time now as, along with atropine<br />

drops, orthokeratology and soft multifocal contact<br />

lenses have been the main treatments that have<br />

proven efficacy at slowing myopia progression in<br />

the literature.<br />

At the CCLS New Zealand conference earlier this<br />

year (see May’s NZ Optics), I gave a presentation<br />

about the myopia control options that are available<br />

for general practices without a topographer (NB: if<br />

anyone would like a copy of this presentation please<br />

let me know). However, in my specialty practice the<br />

majority of young progressing myopes elect to use<br />

orthokeratology lenses to slow their eye growth. I<br />

recommend ortho-k to patients and their families<br />

for two reasons:<br />

1. Young patients love ortho-k. From a purely<br />

lifestyle perspective ortho-k has a compelling<br />

argument: kids can see clearly throughout the day,<br />

there is no risk of their specs or soft contact lenses<br />

getting damaged/dirty/scratched/irritable during<br />

the day, they can swim and play with no restrictions<br />

from their optical correction, all the handling/<br />

cleaning/insertion/removal is done at home in a<br />

controlled space with parental supervision and, in<br />

my experience, ortho-k lenses are a safe contact<br />

lens modality for children.<br />

2. Ortho-k lenses have a tremendous ability to<br />

control axial elongation, especially if fitted as a<br />

customised-myopia control application for children,<br />

rather than a conventional ‘adult’ ortho-k lens<br />

design.<br />

Let me elaborate on this last point. In the<br />

literature, the average myopia control effect is<br />

around 50% with ortho-k. As an aside, Fabian<br />

Conrad’s mathematical model showed that slowing<br />

myopia by only 50% in all myopes will reduce<br />

the incidence of myopia over 5D by a whopping<br />

A comparison of orthoK lens designs. Left: An ‘adult’ ortho-k lens (BE,<br />

Capricornia, AUS). BOZD >6mm, e=0. Right: A customised lens for<br />

myopia control (Eyespace Forge design, CLC, NZ) BOZD 5.5mm, e=0.99<br />

Normal spectacles and spherical contact lenses<br />

focus light accurately at the fovea but tend to<br />

exhibit hyperopic defocus in the peripheral retina,<br />

somehow signalling the eye to elongate. Because<br />

ortho-k lenses induce a central corneal flattening<br />

and para-central corneal steepening, peripheral<br />

light rays are instead focused at or in-front of<br />

the retina, resulting in decreased stimuli for<br />

axial elongation. It follows, therefore, that if the<br />

paracentral area of ortho-k steepening is enlarged<br />

or enhanced then a better myopia control effect can<br />

be achieved. This is due to a larger area of peripheral<br />

retina receiving a stronger ‘stop growing’ signal.<br />

When fitting an adult with ortho-k we want<br />

to minimise this paracentral steepening as it<br />

negatively affects vision due to spherical aberration<br />

and increased halos and glare at night when the<br />

pupil enlarges. Normal orthokeratology lenses tend<br />

to have a large spherical back-optic zone radius of<br />

6mm or greater to facilitate this.<br />

In the case of a rapidly progressing myopic<br />

10-year-old this aberration is what we can use<br />

to prevent further eye growth. It’s also useful to<br />

remember that these patients tolerate aberration<br />

in their vision very well; they are not driving at<br />

night and are typically just pleased they can see<br />

their friends at the other end of the playground!<br />

Lately most ortho-k experts around the world<br />

are using customised myopia control ortho-k<br />

lenses with the primary design consideration being<br />

to maximise the plus power of the peripheral<br />

pupillary zone. This typically involves smaller back<br />

optic zone diameters of 5-5.5mm (or smaller if<br />

the child has a small pupil) with aspheric basecurves.<br />

These lenses create a highly aspheric,<br />

small diameter treatment zone with a steeper<br />

paracentral ring. Amazingly vision is still great with<br />

these lens designs, in a similar way that centredistance<br />

multifocal soft contact lenses are well<br />

tolerated by adults.<br />

Many of these practitioners describe excellent<br />

myopia control effects from these specialised<br />

designs with complete halting of axial eye growth<br />

in many cases. Still, clinical anecdote is not a very<br />

powerful proof of effect. But studies are starting<br />

to emerge revealing a higher myopia control effect<br />

with special myopia control ortho-k designs. A<br />

poster presented by Dr Eddie Chow from Canada<br />

analysed five-year axial length data from two<br />

groups: one using a traditional ortho-k design<br />

and the other group wearing a customised lens<br />

with a smaller aspheric BOZ. The axial eye growth<br />

was markedly less in the custom lens group<br />

compared to the standard lens, especially so for<br />

the low myopes (traditional ortho-k lens designs<br />

can be difficult to slow myopia progression for<br />

low corrections, due to the limited paracentral<br />

steepening created for small amounts of myopia).<br />

A retrospective study from the University of<br />

Auckland’s orthokeratology patients (Turnbull<br />

The effect of orthokeratology lenses on peripheral lights rays.<br />

Focusing light at or in-front of the retina is believed to be protective<br />

against myopia progression.<br />

The tangential difference map of a myopia control ortho-k lens design<br />

for a -3.75D young myope. Note the small, highly aspheric treatment<br />

zone and the position of the paracentral ring of steepening within the<br />

pupil zone<br />

2016), some of which were using a customised<br />

Falco myopia-control lens design from Switzerland,<br />

showed an average 92% slowing of eye growth,<br />

much less than the ~50% myopia control effect of<br />

ortho-k commonly quoted.<br />

Our world is changing and as our children’s lives<br />

become more and more screen-centric I predict<br />

that in New Zealand myopia is not going to remain<br />

the exception to the rule; it will affect many more<br />

kids than just the bookworms and the genetically<br />

unfortunate. As eye professionals, we need to<br />

recognise myopia as the disease it is. Fortunately,<br />

with proactive management it doesn’t need to rule<br />

our patients’ lives like it used to. I challenge you<br />

to stop offering single vision spectacles/contact<br />

lenses to your young myopes and instead embrace<br />

atropine, multifocal soft lenses or the elegance of<br />

orthokeratology. Your patients will thank you later.<br />

Tune in next time to the Specialty Contact Lens<br />

Forum as we look at fitting dead people’s corneae<br />

with small bits of computer-designed plastic! ▀<br />

ABOUT THE AUTHOR:<br />

*Alex Petty is a New Zealand<br />

optometrist based in<br />

Tauranga with a particular<br />

interest and knowledge in<br />

speciality contact lenses,<br />

ortho-k and myopia control.<br />

This test could save your sight<br />

0800 622 852 mdnz.org.nz<br />

New GM for Southern Eye<br />

Southern Eye Specialists has appointed Shayne Te Aika<br />

as general manager to bring “a fresh and focused set<br />

of eyes (no pun intended) into the business”, it said.<br />

Te Aika was selected from a strong field of candidates,<br />

said ophthalmologist and director Dr Sean Every. “Shayne<br />

won the directors over with his common sense, practical<br />

approach and, when combined with his focus on team<br />

and organisational effort, we felt a strong alignment to<br />

our desired business outlook.”<br />

Though new to the health sector, Te Aika has held a<br />

number of management and leadership roles in the<br />

New Zealand Defence Force and in a Christchurch legal<br />

practice. He is also a current member of the University of<br />

Canterbury Council.<br />

“The attraction to this role, was simply about the<br />

challenge and opportunity to assist the directors and<br />

staff to grow their business and profile,” he said. “I have<br />

been fortunate to learn alongside some really talented<br />

people and teams.<br />

Fundamental elements<br />

to my management and<br />

leadership philosophies<br />

are looking after people,<br />

providing them with<br />

the right resources and<br />

direction, and giving<br />

them the space to lead<br />

their own success.”<br />

With both of his<br />

children having now<br />

departed the family<br />

home, Te Aika says in his<br />

Shayne Te Aika<br />

spare time, he enjoys<br />

spending more time with<br />

his wife Karyn travelling or tending “their one acre of<br />

paradise” in Selwyn. ▀<br />

10 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>


Zeiss unveils new R&D HQ<br />

Zeiss has unveiled plans to move to its regional headquarters to a<br />

new, A$6 million ($6.27m) purpose-built, state-of-the-art office<br />

and research and development (R&D) facility within the Tonsley<br />

Innovation Precinct in South Australia.<br />

Unveiling the 3,950m² site and the company’s plans in a joint<br />

press conference with South Australian manufacturing and<br />

innovation minister, Kyam Maher, Zeiss ANZ managing director Hilke<br />

Fitzsimons said with more than 165 years of innovation behind<br />

it, Zeiss is committed to supporting the Australian, New Zealand<br />

and international markets with solutions for vision care, medical<br />

technology, microscopy and measurement systems, and this new<br />

facility will be key to that.<br />

“Our new facility at Tonsley will provide a more centrally-located,<br />

state-of-the art environment for our staff and customers. It will<br />

also provide the space to grow staff numbers and the opportunity<br />

to collaborate with other like-minded businesses and research and<br />

education institutions at Tonsley.”<br />

Over the next year, Zeiss will also be strengthening its presence<br />

directly in New Zealand, said Fitzsimons, including significant<br />

technology upgrades within the company’s Auckland Vision Care<br />

laboratory. “We will also strengthen our local Zeiss team and increase<br />

our local presence in New Zealand.”<br />

In Australia, Zeiss will bring 120 permanent staff to Tonsley when<br />

it relocates from its current location in Lonsdale after construction<br />

is completed in early 2018. The new facility will combine a sales and<br />

service centre for the Australasian market, a prescription laboratory,<br />

a global R&D team for vision care and a global business solutions<br />

team delivering digital and knowledge-based services across the<br />

world, said Fitzsimons.<br />

“Zeiss runs a global US$130 million ($180m) strategic business unit<br />

from South Australia,” said Karen Roberts, Zeiss’ vice president, global<br />

business solutions. “Globalisation and digitalisation are changing<br />

customer requirements and markets rapidly. We are accelerating<br />

innovation that delivers current and future value for our customers<br />

and our company.”<br />

The company will join other Tonsley anchor tenants, Siemens, Sage<br />

Automation, Flinders University and training organisation TAFE SA.<br />

The site is now home to more than 112 businesses and 1000 workers,<br />

and a number of other businesses are now expressing interesting in<br />

moving into the technology park, said Maher.<br />

The Zeiss Group was founded in Germany more than 170 years<br />

ago. Today it is a leading<br />

developer, producer and<br />

distributor of measuring<br />

technology, microscopes,<br />

medical technology, eyeglass<br />

lenses, camera and cine lenses,<br />

binoculars and semiconductor<br />

manufacturing equipment. It is<br />

now represented in more than<br />

40 countries, has more than<br />

30 manufacturing sites and 25<br />

R&D facilities, which will include<br />

Tonsley, when it opens. ▀<br />

Zeiss’ Hilke Fitzsimons and Karen Roberts at the<br />

site of Zeiss’ new ANZ HQ<br />

Safarro, now<br />

in NZ<br />

Handmade<br />

Italian<br />

designer<br />

frames brand Safarro<br />

is now available in<br />

New Zealand through<br />

Trish Orr and her<br />

team at BTP Designz<br />

International.<br />

Orr says she came<br />

across Safarro in<br />

New York at Vision<br />

Expo East earlier<br />

this year and was so<br />

impressed with the<br />

brand and the people<br />

behind the brand,<br />

she approached<br />

Safarro, designed and made in Italy<br />

them about BTP<br />

representing them in New Zealand.<br />

“BTP is very well known for the point of difference in their ranges.<br />

We are always looking for those ranges with the X factor. With<br />

Safarro, there is no cross over with our other brands and it gives us<br />

funky, different and wear-ability all in one.”<br />

Safarro has ranges for both men and women, all in a number of<br />

different finishes and colour combinations. Orr says BTP’s new sales<br />

representative, dispensing optician Caron Bowe (see story p19) has<br />

just started showing the new range to great response.<br />

Based in Rome, the company says it wants to offer customers<br />

an authentic ‘Made in Italy’ experience with an attractive value<br />

proposition. “The philosophy of the brand stems from the influence<br />

of Italian elegance, quality and craftsman ship. Safarro means ‘a<br />

journey’ and the notion that it embodies is one of a cosmopolitan<br />

style broadening around the globe…. (The) focus on design, choice of<br />

materials, colour trends and attention to fine details are considered<br />

through to the packaging. The result is eyewear of character, intended<br />

to create an emotional journey that leaves a distinctive mark.”<br />

Each pair of Safarro frames are hand-crafted and come with a soft<br />

case, resembling a passport holder, entwined with a moleskin string.<br />

The cleaning<br />

cloth is decorated<br />

with a compass<br />

to symbol<br />

“discovery.”<br />

See ad p3. ▀<br />

Safarro<br />

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©<strong>2017</strong> ROSE K IS A TRADEMARK OF MENICON CO, LTD. US-RK426-NZO5 06/<strong>2017</strong><br />

<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

11


Focus<br />

on Business<br />

Are you ready for<br />

retirement?<br />

Let’s start with some questions…<br />

1. What do I want? Answer: ‘To<br />

maintain my current standard of living<br />

my whole life and be confident that’s on<br />

track’<br />

2. How much do I need? Answer: ‘I have<br />

no idea’<br />

3. What’s my plan to get that much?<br />

Answer: ‘Does hope qualify here? It<br />

would help if family stopped being so<br />

expensive…’<br />

4. How reliant am I on making a big<br />

payday with my practice to achieve it?<br />

Answer: ‘Very reliant!’<br />

If those answers resemble yours<br />

then you are in good company. Most<br />

of your colleagues are in that place. In<br />

my experience, it’s only those that have<br />

developed a niggling internal panic that<br />

have done much about these issues. If<br />

you have that niggly feeling, but have<br />

done nothing, then here’s the way<br />

forward….<br />

The issues<br />

Most business people believe that<br />

“my business is my retirement” and<br />

practice owners be they optometrists or<br />

opticians are no different. That’s their<br />

“Plan A”. After all, you’ve spent years<br />

building a client base and have invested<br />

a great deal of time and energy building<br />

your brand and practice’s reputation. So<br />

naturally, you fondly imagine selling this<br />

for a considerable sum that will fund<br />

your transition into retirement.<br />

Unfortunately, the reality is<br />

increasingly very different. In our<br />

experience working with professionals,<br />

there are considerable risks with this<br />

approach:<br />

• You are your practice. Your clients<br />

have chosen you for personal service.<br />

The “intellectual property” is with<br />

you, the practitioner, and potential<br />

purchasers may see clients simply leave<br />

when you do.<br />

• Reducing pool of potential<br />

purchasers. Sale to younger staff is<br />

a common idea, yet demographic<br />

changes are seeing lessening interest<br />

from younger generations in purchasing<br />

a practice. Many would prefer to<br />

start their own. In addition, younger<br />

purchasers may already be saddled with<br />

significant mortgage debts, reducing<br />

the ability to finance a purchase.<br />

• The lack of liquidity means any<br />

sale can take a long time. It’s therefore<br />

heavily dependent on timing.<br />

• The impact of adverse events may<br />

significantly reduce the business value,<br />

such as your disability, departure of key<br />

staff or market conditions. If you must<br />

sell, a forced sale almost invariably<br />

achieves a much lower sale price.<br />

Are you unique? Sadly, no. In my<br />

experience these common themes arise<br />

time and again. Fortunately, that also<br />

means there are common lessons and<br />

a sound approach has been developing;<br />

we call it “financial resilience”.<br />

Financial resilience – “Plan B”<br />

Financial resilience simply means<br />

having a plan and strategy that will<br />

cope with events and maximise your<br />

chances of achieving your goals, such<br />

as financial independence and being<br />

able to choose when to reduce or<br />

cease working. The heart of your Plan<br />

B is very simple: create an alternate<br />

source of wealth by setting aside funds<br />

that are separate to you and your<br />

practice. Extracting value along the<br />

way significantly reduces the risks of<br />

BY PETER LEE*<br />

relying on your practice as your primary<br />

and possibly only source of long-term<br />

funding. In effect, you treat yourself<br />

as if you were an employee, reliant on<br />

your savings and other means to build<br />

a pool of funds. Thus, your financial<br />

independence plan should have three<br />

components:<br />

1. Your own practice – with your<br />

reliance on it reducing over time.<br />

Crucially, the time to start succession<br />

planning is now.<br />

2. KiwiSaver. Surprisingly, most<br />

self-employed professionals are not<br />

KiwiSaver members, yet anyone can join<br />

and take advantage of its benefits.<br />

3. Non-locked-in investments, both<br />

lump-sum and accumulating, in highly<br />

liquid assets to provide flexibility and<br />

hence financial resilience.<br />

Having three legs, not just one,<br />

will make you much more financially<br />

resilient. A great Plan B should also<br />

include:<br />

• Your succession plan, clarifying<br />

what you want to do with your<br />

business. Timeframes? Options? Sale of<br />

business to staff, sale to another optical<br />

practice, franchising, gifting to family?<br />

• What financial independence<br />

means to you – the key factors such as<br />

when you would like to be independent<br />

and the lifestyle you would like to enjoy.<br />

• A plan to get those aims – including<br />

the right mix of KiwiSaver and nonlocked<br />

in investment funds and<br />

milestones to keep you on track to<br />

maximise the likelihood you will achieve<br />

your goals.<br />

• A long-term, evidence-based,<br />

diversified and low-cost approach to<br />

investment – not a short-term ‘chasing<br />

profits’ approach.<br />

• An overview of the key risks<br />

and how to manage them, such as<br />

disablement or death<br />

To achieve all this, the help and<br />

guidance of a great financial planning<br />

professional can be invaluable. They<br />

will work with you, keep you on track<br />

and help you maximise the likelihood<br />

of achieving your goals. But not all are<br />

created equal – the majority of financial<br />

advisers are conflicted, working for<br />

or aligned to product providers. In<br />

addition, many don’t follow longterm<br />

evidence-based planning,<br />

claiming instead to be able to ‘pick<br />

winners’. It’s important to ‘interview’ a<br />

potential adviser and, where possible,<br />

seek recommendations. Look for<br />

independence, a fee-based and an<br />

evidence-based approach and longterm<br />

relationship ‘fit’ with you. ▀<br />

Editors note: For more about<br />

succession planning and retirement<br />

and to hear from some New Zealanders<br />

who’ve been through it, see next<br />

month’s NZ Optics<br />

ABOUT THE AUTHOR:<br />

*Peter Lee is<br />

founder and<br />

principal of<br />

C2C Partners, a<br />

boutique wealth<br />

management,<br />

financial<br />

planning and<br />

employee<br />

benefits practice.<br />

He is a former<br />

chief executive<br />

of the Institute<br />

of Financial Advisers (IFA) and has over 30<br />

years’ experience across funds management,<br />

insurance and financial planning.<br />

All change at Langford<br />

Callard<br />

After more than 50<br />

years at the same<br />

address, in the<br />

iconic Farmers’ building in<br />

Tauranga’s central business<br />

district (CBD), Langford<br />

Callard Optometrists has<br />

moved and is changing its<br />

name to Tauranga Eyecare by<br />

Langford Callard.<br />

Partner Mike Callard says<br />

he had mixed emotions<br />

about the move, as it was<br />

a considerable change, but<br />

he’s now feeling very positive<br />

about the future and loves<br />

the new look store, based<br />

just outside the city at 394<br />

Cameron Road, Tauranga.<br />

The company had been<br />

planning to revamp its old<br />

practice, but held off because<br />

it learned it’s landlord, the Farmers Trading Company, was<br />

planning to demolish the Farmers’ building to rebuild a<br />

bigger and better centre, possibly incorporating apartments,<br />

over the next five years.<br />

“Change is always positive really, and we’d been feeling a<br />

little bit tired and needed to revamp the internal side. The<br />

issue we had was finding somewhere we thought would<br />

work,” says Callard.<br />

It took about a year to find a suitable new site for the<br />

practice, something that was the right size to accommodate<br />

three consultation rooms and outside the CBD to make<br />

parking easy, but not so far as to put off any potential<br />

customers who might want to combine their trip to the<br />

optometrist with a bit of shopping. “We actually asked<br />

customers what was important to them, ‘location or<br />

parking?’ and they all said ‘parking’… with many saying the<br />

main reason they came into Tauranga to see us was to have<br />

their eyes tested, not do any retail shopping. So that was<br />

when we decided we didn’t really need to stay in the CBD.”<br />

After they found the site, Callard and his team bounced design<br />

ideas off Practice by Design’s Elaine Silk and their bespoke<br />

cabinet makers, both of whom provided some invaluable<br />

advice, he says. The re-fit took about four months, with the<br />

company moving in on schedule on Queen’s Birthday weekend.<br />

The best thing about the new design is the flow, says Callard.<br />

“Over the last 50 years there had been a few changes made<br />

Tauranga Eyecare’s Celia Mason, Mike Callard, Lynley Smith and <strong>Jul</strong>ia Walker<br />

at the old practice, walls removed and so on, but it was a long<br />

thin practice that goes up levels because that’s the way the<br />

Farmers’ building was built, and that had been an issue over<br />

the years with some folk’s mobility. We started with a flat base<br />

this time, which is fabulous. All the staff are really looking<br />

forward to not telling people to mind the slopes!”<br />

Another big change with the new practice is the<br />

incorporation of technology, adds Callard. “Lighting is a big<br />

thing…with LED lighting in the cabinets and throughout<br />

the practice. It’s really nice and sharp. And all the staff have<br />

wireless tablets now, so they can walk around with a tablet<br />

rather than being based at fixed work stations.”<br />

Along with the change of name, which brings the<br />

original practice into line with the company’s second store,<br />

Omokoroa Eyecare by Langford Callard, Callard says the team<br />

is also keen to add a couple of new frame ranges to current<br />

stock to offer something different to both new and current<br />

customers to go with the new look. “We’re just focused on<br />

growth now,” he laughs.<br />

A look back…<br />

Tauranga Eyecare’s roots stem back to optometrist Freda<br />

Meadows who opened a practice in Tauranga in 1938.<br />

This was bought by Harold Taylor at the end of WWII, who<br />

was responsible for relocating it to the Farmers’ building<br />

in 1965. Tim and Jane Langford purchased the practice in<br />

1977 after Taylor retired and both still work for the<br />

practice today. Optometrist Mike Callard joined<br />

the practice in 1993 and became an equal partner<br />

in 1996. Another optometrist staff member, Celia<br />

Cutfield, purchasing the Langford’s shares in 2014.<br />

Now co-owners, Cutfield and Callard added a low<br />

vision specialist clinic to the business, opened the<br />

Omokoroa Eyecare branch in 2014 and renamed the<br />

main business Tauranga Eyecare in June <strong>2017</strong>. ▀<br />

OCTA Research at Auckland Uni<br />

Dr Ehsan Vaghefi and colleagues,<br />

Drs David Squirrel, Hannah<br />

Kersten and Catherine Morgan<br />

are embarking on a new two-year<br />

research project at the University<br />

of Auckland on Ocular Coherence<br />

Tomography Angiography (OCTA).<br />

OCTA is a novel technology capable<br />

of structural and functional retinal<br />

imaging. The OCTA functional blood<br />

flow signal is based on inverse noise<br />

reduction ie. moving particles (blood<br />

cells) are detected in a field of view<br />

(the retinal arteries). Compared to<br />

fluorescein angiography, OCTA is<br />

non-invasive, quick to perform, three<br />

dimensional and produces high<br />

Dr Ehsan Vaghefi<br />

resolution images. Currently, OCTA<br />

can generate volumetric blood flow datasets in seconds,<br />

but only a snapshot of retinal blood flow can be obtained.<br />

It cannot image potential leakages of the chorioretinal<br />

vasculature, may miss areas of slow blood flow and<br />

importantly it cannot quantify blood<br />

flow, explained Dr Vaghefi. “This research<br />

aims to minimise OCTA’s disadvantages<br />

while retaining its advantages.”<br />

The researchers plan is to quantify<br />

OCTA by carrying out MRI and OCT<br />

on 100 patients over 40 years of age,<br />

providing a normative database. “We<br />

are in the early stages, but things are<br />

progressing well,” Dr Vaghefi told NZ<br />

Optics. “By analysing the quantitative<br />

OCTA dataset, structural and functional<br />

‘biomarkers’ of onset and progression<br />

of several pathologies of the retina can<br />

be obtained.” This research will likely<br />

have many useful applications in retinal<br />

disease and will also allow the study of<br />

the effects of treatment, he added.<br />

Dr Vaghefi, who is a senior lecturer at the School of<br />

Optometry and Vision Sciences (SOVS), will be showcasing<br />

OCTA at a clinical imaging workshop at the inaugural SOVS<br />

Conference on 22-23 <strong>Jul</strong>y (see p4). ▀<br />

12 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>


SPECIAL FEATURE: RANZCO NZ<br />

From the chair<br />

BY DR BRIAN KENT-SMITH, RANZCO NZ EXECUTIVE CHAIRMAN<br />

We in Northland were proud to host<br />

the annual branch meeting for the<br />

first time, and what better venue<br />

than Waitangi, the birthplace of our nation.<br />

I would like to thank my co-convenors Stuart<br />

Carroll and Graham Wilson for their help in<br />

planning the meeting. Special thanks also<br />

go to Charles McGhee who planned and<br />

coordinated the scientific programme.<br />

Worrying about the weather is of course<br />

futile, but I will admit to losing a bit of sleep<br />

as Cyclone Donna bore down on us in the<br />

days before the meeting. Thankfully the<br />

storm petered out, but not before giving<br />

our international guests a rather bumpy<br />

ferry ride across to dinner at the Duke of<br />

Marlborough in Russell. In true laconic Kiwi<br />

manner, the skipper reassured us that in the<br />

event of a capsize we would wash ashore in<br />

half an hour!<br />

We were most fortunate to have four<br />

highly regarded international speakers in<br />

Ken Nischal, Marian Macsai, Tim Sullivan<br />

and Tien Wong. As much as I enjoy hearing<br />

RANZCO NZ’s tigers and traps<br />

BY DR AARON WONG*<br />

Waitangi is synonymous with important<br />

meetings. Hence, 177 years on from<br />

its first important meeting it was<br />

appropriate that Waitangi played host for the first<br />

time ever to the RANZCO NZ branch meeting.<br />

Waitangi in te reo Maori translates to<br />

‘weeping waters’, although the theme could<br />

have been ‘watery eyes’ in this instance, though<br />

most delegates were thankful for the array<br />

of subspecialty topics on offer in this year’s<br />

programme. Delegates were welcomed not only by<br />

torrential rain (the weeping waters perhaps?), but<br />

also a warm Powhiri.<br />

Dispelling current thinking<br />

The first keynote speaker, Professor Ken Nischal,<br />

director of paediatric ophthalmology, strabismus<br />

and adult motility at the Children’s Hospital<br />

of Pittsburgh, was in such hot demand he was<br />

invited to speak at two meetings in New Zealand<br />

in almost as many months. As a paediatric and<br />

anterior segment subspecialist he was able to tell<br />

us why we should ditch the traditional mnemonic<br />

‘STUMPED’ when describing causes of congenital<br />

corneal opacification (CCO). He argued that terms<br />

such as sclerocornea and Peter’s anomaly failed to<br />

adequately describe the pathology of CCO and that<br />

we should refer to primary and secondary causes<br />

of CCO, as described in his 2012 paper in Current<br />

Opinions in Ophthalmology.<br />

The next keynote, Professor Marian Macsai,<br />

from the University of Chicago Pritzker School of<br />

Medicine, is no stranger to our shores either, having<br />

been invited to speak in Wellington for the 2015<br />

RANZCO Congress. For her first presentation, this<br />

straight-talking anterior segment specialist from<br />

Chicago discussed corneal transplantation trends<br />

in the USA. Data from a large series of American<br />

corneal transplants is challenging traditional<br />

thoughts about donor tissue, suggesting that preoperative<br />

donor endothelial cell density and donor<br />

age don’t predict graft failure.<br />

NZ ophthalmology conundrums<br />

After morning tea, a series of local speakers<br />

highlighted the increasing load on public<br />

ophthalmology services in New Zealand. Dr Sarah<br />

Welch shared her thoughts on overdue follow ups<br />

in Auckland. Interestingly, New Zealand’s ratio of<br />

ophthalmologists of 28 per million population is<br />

lower than that of the UK (52/million), USA (61/<br />

million) and Australia (40/million). More local data<br />

on the increasing demands on ophthalmology<br />

services was also presented by Nick Theis from<br />

Dunedin (see story next month), Dr Pei Wang<br />

from Christchurch and Dr Pragy Jagadish from<br />

Whangarei.<br />

Samantha Simkin, a PhD candidate and<br />

optometrist from Auckland, presented the<br />

findings of her study on universal eye screening for<br />

newborns. Although a newborn hearing screening<br />

programme exists in New Zealand, eye screening<br />

is still limited to the rather clumsy and poorly<br />

sensitive red reflex test. Her project took RetCam<br />

images of 346 healthy newborn babies in Auckland.<br />

Retinal haemorrhages were found in 15.3%,<br />

however, these resolved in all but two babies. More<br />

serious pathology was detected in one case of optic<br />

nerve head hypoplasia and one case of congenital<br />

cataract. Simkin estimated the cost of a nationwide<br />

screening programme to be around $2 million per<br />

year which could be balanced against the cost of<br />

early detection of preventable blindness.<br />

Professor Charles McGhee reflected on the<br />

changes in the Ophthalmology Department at<br />

the University of Auckland over his 18-year tenure<br />

and how this may affect our future workforce.<br />

During his time, the department has trained not<br />

only many ophthalmologists but also specialist<br />

nurses and optometrists. A multidisciplinary-team<br />

approach, and working smarter but not necessarily<br />

harder, were the key ingredients to coping with the<br />

increasing demand on ophthalmology services, he<br />

said.<br />

AMD, NZ studies and pearls from overseas<br />

After lunch, Professor Tien Wong, medical director<br />

at the Singapore National Eye Centre, reflected on<br />

the 10-year journey treating age-related macular<br />

degeneration (AMD) with anti VEGF agents. From<br />

having no effective treatment for AMD to giving<br />

patients a 90% chance of avoiding blindness<br />

and a 30% to 40% chance of significant visual<br />

improvement has been game changing, he said.<br />

The afternoon’s rapid fire session featured<br />

excellent talks from junior doctors from most<br />

about cutting-edge research, for me as<br />

a clinician, I particularly appreciate the<br />

practical tips that will assist my decision<br />

making come clinic time on Monday<br />

morning. For that reason, Tien Wong’s<br />

guidelines on the management of agerelated<br />

macular degeneration and diabetic<br />

maculopathy stand out as highlights for me<br />

from this year’s conference.<br />

Next year’s meeting will be hosted by<br />

Dr Sue Ormonde and Professor Trevor<br />

Sherwin in Auckland (date and venue to be<br />

announced). I look forward to seeing you<br />

New RANZCO NZ branch chair Dr Brian Kent-Smith (2nd left) with fellow convenors of the <strong>2017</strong><br />

branch meeting Drs Graham Wilson (far left), Stuart Carol and, former chair, Stephen Ng with<br />

there. ▀<br />

Keynote speakers Professors Ken Nischal and Marian Macsai with<br />

Dr Tahira Malik (centre)<br />

centres in New Zealand. Dr Ellen Wang shared the<br />

results of a 25-eye study looking at the potential<br />

benefit in femtosecond laser assisted cataract<br />

surgery (FLACS) in post-vitrectomised patients.<br />

Although there was no statistically significant<br />

difference in complication rates, there was a<br />

suggestion that FLACS patients were less likely to<br />

have posterior capsular rupture or dropped nuclei.<br />

The final session of the day featured talks<br />

from all the international speakers. Professor<br />

Wong shared his principles of managing diabetic<br />

macular oedema, warning of the perils of under<br />

treating with anti-VEGF agents in the first year but,<br />

conversely, not to over treat in the second year.<br />

Professor Tim Sullivan, an oculoplastics specialist<br />

special guest, GP and poet, Dr Glenn Colquhoun (centre)<br />

Sylvia Hewson, Nadine Smith and Shelby Heyworth (front)<br />

trying out equipment on the Zeiss stand<br />

from Brisbane, ran through a series of fascinating<br />

cases illustrating the surgeon’s dilemma of when<br />

to cut and when to observe. Professor Nischal<br />

provided some tips about paediatric cataract<br />

surgery, including a nifty two-incision push-pull<br />

capsulorhexis technique to avoid anterior capsular<br />

tears. While Professor Macsai, tackled the thorny<br />

question we’ve all had to ask (hopefully only about<br />

a patient’s cornea) – is this Herpes? – by presenting<br />

a case series demonstrating the key features of<br />

herpes keratitis and how to differentiate it from<br />

mimics such as limbal stem cell deficiency and<br />

acanthamoeba.<br />

CONTINUED ON PAGE 14<br />

Don’t believe<br />

everything you hear!<br />

Contrary to the rumours…<br />

Drs Aaron Wong, Robert Weatherhead and Anthony Suter<br />

Dr Rob Jones, Jo Anderson, Justine Miller and Suzy Scorer<br />

… the authentic strip,<br />

always available at<br />

Liz Kupa, Optimed’s Craig Norman and Sally Caldwell<br />

Drs Graham Reeves, Kevin Taylor and Peter Hadden<br />

0508 4435347<br />

<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

13


SPECIAL FEATURE: RANZCO NZ<br />

Drs John Beaumont, Priya Samalia and Paul Baddeley<br />

CONTINUED FROM PAGE 13<br />

New treatments for old problems<br />

The weeping waters finally eased off on day two, but<br />

thankfully the international guest speakers did not.<br />

Intra-operative OCT is a cutting edge new surgical<br />

tool, and Professor Nischal discussed its use in<br />

endothelial corneal transplants in opaque corneas.<br />

Recurrent corneal erosions can be a recurring<br />

nightmare for both patients and clinicians but<br />

Professor Macsai reassured the audience there are<br />

a range of treatment options to suit each case. One<br />

such option, not frequently mentioned, is YAG laser<br />

to Bowman’s layer which works in a similar way to<br />

anterior stromal puncture.<br />

Professor Sullivan spoke about the latest<br />

innovations in thyroid eye disease, including<br />

Teprotumumab, a monocloncal antibody which<br />

has been shown to be effective in a recent trial<br />

published in the New England Journal of Medicine.<br />

Auckland oculopalstic surgeon Dr Paul Rosser<br />

shared a technique he has developed; a scar-less<br />

surgery for mild to moderate medial ectropion. The<br />

internal lateral canthoplasty involves removing the<br />

lateral part of the canthal tendon and reattaching<br />

the remaining canthal tendon to the periostium all<br />

through a conjunctival wound.<br />

Changing views from around NZ<br />

Before lunch, Dr Bia Kim, a training registrar from<br />

Auckland, discussed her work on the second<br />

iteration of the Auckland Cataract Study. The<br />

Nurses: sharing the load<br />

BY RACHEL COOK AND FIONA BAMFORTH*<br />

The New Zealand Ophthalmic Nurses Group<br />

Meeting, held alongside RANZCO NZ’s<br />

meeting, in Paihia this year was a blast and<br />

a half! Despite threats from Cyclone Donna, clear<br />

blue skies prevailed (eventually) making Waitangi<br />

an idyllic location for this year’s conference.<br />

As part of the nurse’s conference organising<br />

committee, it was an eye-opener for both of us<br />

to see how much work everyone puts in to make<br />

the conference a success. It was also interesting<br />

to note that not many nurses submitted abstracts<br />

to present. Curious, as we all know nurses love to<br />

talk, but perhaps not so much in front of a crowd!<br />

Hopefully Olga Brochner’s dynamic talk on ‘The<br />

Presentation Taniwha’ may have given some more of<br />

us some tips and the confidence to get up and give<br />

it a go next year? Congratulations to the nurses who<br />

did get up to present for the first time. It is always<br />

valuable to hear how services are run in other parts<br />

of the country, giving us a chance to reflect on our<br />

own practices.<br />

Some interesting case studies at this year’s<br />

conference included retinal vein occlusion,<br />

polypoidal choroidal vasculopathy, hypertensive<br />

uveitis and, that tongue-twister, juxtapapillary<br />

capillary haemangioma of the optic disc – phew!<br />

The images used in these presentations packed a<br />

punch, as did the telling of the incredible success<br />

of using stem cells to reconstruct an ocular surface<br />

after an alkali burn.<br />

Ophthalmic nurse, Lions Eye Donation Service<br />

project officer at CERA in Melbourne and Fred<br />

Hollows Foundation NZ consultant, Heather Machin<br />

was welcomed back as the nurses’ keynote speaker.<br />

As well as talking about her work in developing<br />

areas, Heather also discussed the ethical dilemmas<br />

involved with global eye banking, challenging many<br />

of the audience’s own beliefs.<br />

A focus this year was how the role of ophthalmic<br />

nursing is developing so rapidly. It was interesting<br />

(and at times humorous) to hear from Sue Raynel<br />

on the historical duties of the ophthalmic nurse.<br />

Her talk provided a stark contrast to how we are<br />

advancing nursing practice today, a point illustrated<br />

in a number of talks about our growing role in<br />

prescribing. Sue also highlighted the need to plan<br />

our career paths – where do we want to go and how<br />

do we get there? David Garland’s journey towards<br />

nurse practitioner (see story p16) was rather<br />

sobering and illustrates how you should take the<br />

Danni Gourdie, Dr Mike Mair, Debbie O’Driscoll, Jodi Welsh and Jane Hawthorn<br />

Drs Shenton Chew, Narme Deva and Stuart Carroll<br />

Kate Foss, Patti Simonsen and Rachel Cook<br />

most direct path whatever your goal may be.<br />

Oringa Barach, a Northland diabetic nurse<br />

specialist updated us with the latest in diabetes<br />

management and the importance of collaborative<br />

patient care. This married well with David’s case<br />

study of a patient he managed with diabetic<br />

retinopathy.<br />

The Blind Foundation presenters from Whangarei<br />

highlighted the importance of providing visual aids<br />

to the blind to enable them to live a fulfilling life<br />

and to maintain their independence. Hopefully this<br />

talk will result in more patients being registered<br />

with the Blind Foundation.<br />

Two nurses from the Solomons’ presented an<br />

interesting talk on delivering eye care in the Solomon<br />

Islands. It was great to see that with support from<br />

countries like New Zealand they are able to deliver<br />

effective ophthalmic care to their communities.<br />

We were fortunate to be able to have some<br />

combined sessions with the specialists and hear<br />

about some of the most recent advances in<br />

ophthalmology treatment, including some very<br />

interesting sessions with international keynotes<br />

Professors Ken Nischal and Tim Sullivan as well as<br />

other interesting talks from our own New Zealand<br />

doctors and budding ophthalmologists.<br />

One of the highlights of the conference is the<br />

Annual Scientifc Meeting Dinner at the conclusion<br />

of the conference. The entertainment for this year’s<br />

evening included wonderful GP and poet Glenn<br />

Colquhoun and, with more than 80 nurses and<br />

140 doctors, the local “That Band” had no trouble<br />

packing the dance floor till well after midnight.<br />

Networking at events like this can’t be<br />

underestimated and we’re pleased to say this<br />

has continued following the conference with<br />

the development of the Facebook page,<br />

‘Ophthalmic Nurses NZ’, which has already<br />

over 100 followers. It provides a forum for<br />

nurses to discuss relevant topics to assist<br />

them in their practice.<br />

At this stage, there hasn’t been a<br />

confirmed venue for next year’s RANZCO<br />

conference but we are already eagerly<br />

anticipating the next Ophthalmic Nurses<br />

Group Meeting for 2018. ▀<br />

*Rachel Cook and Fiona Bamforth are both<br />

ophthalmology clinical nurse specialists and were<br />

both on the organising committee for this year’s<br />

nurses’ programme. Rachel is based at the Eye<br />

Clinic at Gisborne Hospital and Fiona is based in<br />

Northland.<br />

introduction of a risk stratification system reduced<br />

the rate of intra-operative complications during<br />

cataract surgery by 40%. Encouragingly, the study<br />

found no statistically significant difference in the<br />

complication rates when comparing registrars,<br />

fellows and consultants.<br />

Once again the afternoon rapid fire session did<br />

not disappoint, featuring short and sharp talks from<br />

clinicians from around the country. Dr Lucy Lu, a<br />

non-training registrar from Auckland presented a<br />

10-child case series in which timolol gel was used<br />

topically for infantile capillary haemangioma.<br />

There was complete resolution in nine of the<br />

10 cases, in an average time to resolution of six<br />

months. Dr Ellen Wang, a PhD candidate from<br />

Auckland, gave us a whirlwind tour of confocal<br />

microscopy in systemic disease. Amazingly, confocal<br />

microscopy can detect corneal nerve changes early<br />

in diabetes and potentially early in chemotherapyrelated<br />

neuropathy. Dr Brian Kent-Smith, an<br />

ophthalmologist from Whangarei (and one of the<br />

meeting’s organisers) shared his musings on the role<br />

of the general or comprehensive ophthalmologist.<br />

Although there seems to be a trend towards<br />

increasing subspecialisation, a large proportion<br />

(42%) of Kiwi ophthalmologists who were involved<br />

in his survey still considered themselves ‘generalists’.<br />

In the final session, Dr Kathleeya Stang-Veldhouse<br />

an oculoplastic specialist from Auckland presented an<br />

unfortunate case of vision loss after a cosmetic-filler<br />

injection. Hyaluronate filler injections to the nose and<br />

glabella have been documented to cause retrograde<br />

embolisation and occlusion of the ophthalmic artery.<br />

Orthoptists, tackling issues<br />

together<br />

BY NIA STONEX*<br />

Orthoptists from across New<br />

Zealand gathered in the<br />

beautiful Bay of Islands<br />

for their annual meeting, held in<br />

conjunction with the RANZCO New<br />

Zealand Annual Scientific Branch<br />

Meeting in May.<br />

This year’s theme was ‘Nga Taniwha<br />

Tigers and Traps – problems and pearls<br />

in ophthalmology’ and the orthoptic<br />

group certainly covered a lot of ground<br />

in both areas.<br />

Christchurch-based paediatric<br />

ophthalmologist Dr Antony Bedggood<br />

opened the meeting with a great<br />

overview of progressive myopia, its<br />

diagnosis and management. This was<br />

followed by an insight into the world of<br />

dispensing opticians thanks to Donald Crichton, vice<br />

president of the Association of Dispensing Opticians<br />

of New Zealand (ADONZ). We then got stuck into<br />

nystagmus, which was followed by the first of<br />

many interesting cases presented over the two-day<br />

conference. This session also provided a springboard<br />

for two recurrent themes of the meeting – thyroid<br />

eye disease (TED) and vision screening.<br />

Oculoplastics ophthalmologist Dr Kenneth Chan<br />

begun his presentation of thyroid eye disease<br />

on the Saturday with a general discussion of<br />

its management. Our memory was tested as<br />

Dr Chan picked up the topic again on Sunday,<br />

where he shared current medical and ophthalmic<br />

management practice along with some interesting<br />

case studies.<br />

On vision screening, Dr Logan Mitchell presented<br />

the findings of an audit into the B4 School Check<br />

in Southern and Tairawhiti DHB’s. While the<br />

demographics were slightly different, there was an<br />

overall true positive rate of 57%, which compares<br />

favourably with other countries screening data.<br />

Miriam Langeslag-Smith gave us an insight into<br />

VHT (vision and hearing technicians) conditions<br />

and training while Carly Henley provided data from<br />

an audit of a combined-orthoptic and optometric<br />

clinic in Auckland DHB, concluding VHT’s are doing a<br />

Orthoptists Carly Henley, Nia Stone and Tammy Miller with speaker Donald Crichton<br />

Prize winners and other highlights<br />

The prize for the best junior presentation went<br />

to Dr Bia Kim with special commendation to Dr<br />

Pragy Jagadish and Dr Ellen Wang. The best overall<br />

presentation went to Samantha Simkin.<br />

Two other highlights occurred at the enjoyable<br />

conference dinner: a poetry reading from Dr Glenn<br />

Colqhoun and the speech from outgoing RANZCO<br />

branch president Dr Stephen Ng.<br />

Dr Glenn Colqhoun is a GP and poet who lives on<br />

the Kapiti Coast. Although he has little to do with<br />

ophthalmology, his witty and honest poems about<br />

interactions with patients struck a chord with the<br />

entire audience. It was no surprise that he left to a<br />

standing ovation.<br />

In Dr Stephen Ng’s last action as branch<br />

president he reflected on how far ophthalmology<br />

in New Zealand has come in recent times –<br />

from Commerce Commission investigation to<br />

successfully lobbying the government to provide<br />

additional funding for delayed follow ups,<br />

reminding us all, in a heart-felt manner, that our<br />

job was simply to help our patients, whatever<br />

it took. The weighty chains of office were then<br />

handed to Dr Brian Kent-Smith. Perhaps a third<br />

highlight of the dinner was the enthusiasm for the<br />

dance floor on display that evening! Let’s not leave<br />

it another 177 years Waitangi! ▀<br />

*Dr Aaron Wong is a registrar working at Palmerston<br />

North Hospital until December when he will be moving to a<br />

Hamilton. His most significant contribution to this conference<br />

was his baby son’s participation in Samantha Simkin’s prizewinning<br />

research.<br />

A great time was had by all at the orthoptics’ dinner, sponsored by DFV<br />

good job though ongoing training and regular data<br />

review is required.<br />

Drs Shuan Dai, Simon Dean, Justin Mora and Vishal<br />

Bhambhwani presented a wide range of interesting<br />

cases, reflecting the scope of orthoptic involvement<br />

in different ophthalmic sub-specialities. From ptosis<br />

to topography, strabismus surgery to diplopia postcataract<br />

surgery (our favourite taniwha), they guided<br />

us through murky waters!<br />

Orthoptic presentations ranged from unusual<br />

paediatric conditions, such as Ehlers-Danlos<br />

syndromes (a group of connective tissue disorders<br />

that can be inherited) and Rett syndrome (a rare,<br />

severe neurological disorder that affects mostly<br />

girls) to interesting causes of diplopia (ectropion?<br />

pterygium?) and included discussion on best<br />

management for the cases presented.<br />

Several orthoptic presenters discussed the<br />

importance of communication with our ophthalmic<br />

colleagues and delving into a patients’ history to<br />

really get to the bottom of what’s going on.<br />

To make our brains work a little harder, Sunday<br />

afternoon was a workshop session covering the use<br />

of the Sbisa bar, Bangerter foils, measuring DVD<br />

(dissociated vertical deviation) and torsion. Plenty<br />

of tigers and traps there, though I think we all came<br />

away learning a pearl or two.<br />

This review would not be complete<br />

without a big thanks to all of those who<br />

made the conference a success: thanks to<br />

Miriam and Noirin, the organisers, for all<br />

their hard work pulling the programme<br />

together; thanks to all the speakers<br />

who gave up their time and provided<br />

their expert opinions; and finally, a<br />

huge thank you to Designs for Vision<br />

for sponsoring our dinner at Charlotte’s<br />

Kitchen – a great night out at the place<br />

to be seen in Paihia. ▀<br />

*Nia Stonex is vice president of the NZ Orthoptic<br />

Society, holds a Diploma of British Orthoptics and<br />

works at Greenlane Clinical Centre.<br />

14 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>


A busy exhibitors’ hall<br />

The Copthorne Hotel’s stunning waterfront location in the<br />

Waitangi National Trust Reserve, provided a serene backdrop to<br />

the exhibition and refreshment area of the <strong>2017</strong> RANZCO New<br />

Zealand Annual Scientific Meeting. The conference enjoyed healthy<br />

support with 18 exhibitors present at this year’s event.<br />

The exhibitors’ hall was busy during the staggered, but overlapping<br />

break times of the main scientific programme and the concurrent<br />

ophthalmic nurses’ and orthoptists’ programmes. Here’s some of the<br />

highlights from the exhibitors’ in Paihia.<br />

Toomac Ophthalmic<br />

The highlight of the Toomac stand this year was the latest LS900<br />

Lenstar from Haag Streit. The LS900 provides highly accurate laser<br />

measurements for every section of the eye − from the cornea to the<br />

retina. Lenstar was the first optical biometer to consider lens position,<br />

thus allowing accuracy never seen before using the Olsen formula,<br />

explained Mark Taylor, Toomac’s national manager. Intergrating the<br />

Olsen formula, the Barrett Toric Calculator and the Hill RBF method,<br />

the LS900 gives users outstanding IOL prediction, added Taylor. “The<br />

LS900 is very much the Swiss army knife of IOL prediction.”<br />

Also on display was the latest Haag Streit BQ 900 LED slit lamp with<br />

14mm slit and imaging, ready mounted on the new HSM 600 electric<br />

table (fully wheelchair accessible). The finish of the slit lamp is updated<br />

from the old Hammerscale colours to a new shade of diamond silver.<br />

“You only have to buy one Haag Streit slit lamp. You will use it your<br />

entire career as your primary diagnostic tool,” said Toomac director Ian<br />

MacFarlane.<br />

Johnson & Johnson Vision, surgical<br />

Johnson and Johnson Vision, formerly Abbott Medical Optics (AMO),<br />

was hard to miss as the company’s stand welcomed guests into<br />

the exhibitors’ hall with a bright red space right by the entrance.<br />

Showcasing the Tecnis Symfony family of lenses, the team from<br />

Johnson & Johnson Vision enjoyed the opportunity to talk to and<br />

assure New Zealand’s ophthalmic community that it’s business<br />

as usual, albeit under a new name. AMO’s acquisition by J&J is an<br />

opportunity for the organisation to help patients as their eye health<br />

needs change throughout their life, as one company, said the J&J team.<br />

Tecnis Symfony offers a full range of intraocular lenses (IOLs),<br />

including the extended range of vision option, described as a<br />

revolution in lens designs, offering continuous focus without blurring.<br />

Zeiss<br />

Zeiss’ busy team were happy to talk to visitors about the company’s<br />

new IOLMaster 700, recently launched in Los Angeles. Zeiss’ product<br />

specialist, Chris Money said what’s special about this machine is the<br />

integrated Barrett suite (Barrett Universal II, True-K and Toric) providing<br />

accurate IOL calculations, especially in complicated cases. The<br />

IOLMaster 700’s 99% cataract penetration rate makes it efficient and<br />

its increased accuracy means fewer refractive surprises, he added.<br />

Also attracting attention on Zeiss’s stand was the Cirrus HD-OCT<br />

5000, which provides a far better field of view (36° W x 30° H; 36°<br />

W x 22° H), a higher frame rate (> 20 Hz > 1.7 Hz) and a transverse<br />

resolution of 25μm vs 45μm (in tissue) compared to the 500 model.<br />

Device Technologies<br />

Device’s stand was dominated by the latest version of the posterior<br />

and anterior swept source Topcon Triton OCT (including FA and FAF),<br />

sparking considerable interest among delegates. This new generation<br />

of OCT allows retinal specialists to see retinal layers in more detail; it<br />

gives a better view and deeper images, explained Diego Sonderegger,<br />

Device’s product specialist. The Triton models feature swept source<br />

OCTA resulting in more economical and safer tests as in many cases<br />

fluorescein dye injection won’t be required, he said. “Ultimately<br />

we’re reaching a point where an advanced OCTA algorithm combined<br />

with the deep layer swept source scan makes a large proportion of<br />

fluorescein angiograms superfluous.”<br />

Sharing the spotlight was Quantel’s Aviso S high-resolution A<br />

and B-scan for posterior and UBM anterior segment. It comes with<br />

a standardised A-scan ultrasound and software providing internal<br />

reflectivity analysis and characterisation of tissues. It’s available with B<br />

mode, UBM and biometry modes, said Sonderegger.<br />

Designs for Vision<br />

For the first time in New Zealand, Designs for Vision (DFV) showcased<br />

its Tomey OA-2000 Swept-source FD-OCT biometer with built-in<br />

topography, 3D tracking and the Barrett Universal Formula, designed<br />

to identify all the relevant measurements required for cataract<br />

surgery faster and more accurately than competing products. “Put<br />

simply, the new Tomey biometer is one of the best machines available<br />

in the market for measuring cataracts, especially dense cataracts,<br />

demonstrating one of the highest measuring success rate to date,” said<br />

DFV product manager, Ignatios Koukouras..<br />

RANZCO NZ Branch officers<br />

Following the AGM in Paihia the following individuals were named<br />

as branch officers<br />

Chair: Dr Brian Kent-Smith<br />

Treasurer & secretary: A/Prof Andrea Vincent<br />

Vice chair: Dr Keith Small<br />

Executive committee: Drs Stephen Best, Graham Wilson,<br />

Peter Hadden and Derek Sherwood<br />

Ex officio: Dr Stephen Ng<br />

Qualifications & education committee: Drs Michael Merriman<br />

and Jo Sims<br />

Continuing professional education: Dr Kolin Foo<br />

International medical graduate committee: Dr Ainsley Morris<br />

RANZCO director: Dr Neil Murray<br />

RANZCO councillor: Dr Jim Borthwick<br />

Registrar representative: Dr Cheefoong Chong<br />

Dr Jina Han (left) and Professor Trevor Sherwin with conference organisers<br />

Cassandra Snow and Paula Armstrong<br />

Drs Lucy Lu, Shuan Dai, Dean Corbett and Stephen Ng<br />

ZEISS<br />

NZ: 0800 334 353<br />

med.au@zeiss.com<br />

Humphrey ® Field Analyzer 3 (HFA3)<br />

The best just got better.<br />

The HFA3 provides a streamlined workflow with new features to<br />

save time and improve confidence.<br />

• Reduce set-up time with Liquid Lens technology, that delivers<br />

each patient’s refractive correction with the touch of a button.<br />

• Improve efficiency with an intuitive new SmartTouch interface.<br />

• Improve confidence in test results with RelEYE by instantly<br />

reviewing your patient’s eye position at any stimulus point.<br />

www.zeiss.com/HFA3<br />

Dr Ellen Wang, Professors Marian Macsai and Charles McGhee with Samantha Simkin, Dr Bia Kim and Jane McGhee<br />

Solomon Island ophthalmic nurses Lorana Lekezoto (left) and Lily Sere (3rd left) with Dena D’Souza, Kushma Ravindra,<br />

Sarah Piluden and Michael Macaso<br />

Streamlining your<br />

clinic workflow.<br />

ZEISS Humphrey Field Analyzer 3<br />

CONTINUED ON PAGE 16<br />

Ask about<br />

our special<br />

trade-in<br />

offer!<br />

<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

15


SPECIAL FEATURE: RANZCO NZ<br />

CONTINUED FROM PAGE 15<br />

Molteno Ophthalmic<br />

Nina Molteno, CEO of Molteno Ophthalmic and<br />

a former GP, was happy to chat about Molteno’s<br />

purpose-built glaucoma implants designed to help<br />

patients with moderate to severe and complicated<br />

cases of glaucoma. Molteno highlighted their<br />

unique focus; delivering a long-term solution for<br />

patients. “Ideally we want our patients to only<br />

ever need one procedure and one implant and to<br />

help make that happen we’re constantly on the<br />

lookout for improvements to make surgery easier<br />

and safer, with better outcomes for patients.”<br />

Molteno’s research partnerships were also<br />

attracting attention, especially the Vicryl tie<br />

question for occluding the tube. University of<br />

Canterbury final-year engineering student Donald<br />

Sinclair spent his summer finding answers to this<br />

and several other “knotty” questions in his study<br />

comparing techniques and suture materials. One<br />

conclusions from his research is how thicker suture<br />

material, 5.0 Vicryl, is significantly less likely to<br />

damage the tube compared to finer suture material<br />

(P


ARVO in America’s charm city<br />

BY DR STUTI MISRA*<br />

No wonder America’s first umbrellas were<br />

produced in Baltimore in 1828. After<br />

a long flight hiatus, due to weather, I<br />

finally arrived in America’s charm city, Baltimore,<br />

to attend the <strong>2017</strong> Association for Research in<br />

Vision and Ophthalmology conference, more<br />

affectionately known as ARVO. And, to my surprise<br />

(not!), the weather was cold and wet.<br />

This year’s conference was held from 6 to 11<br />

May and the theme was ‘Global connections<br />

in Vision Research’ and aptly so! There were<br />

several meetings taking place to instigate new<br />

collaborations and to foster existing ones with the<br />

intent to advance vision science. ARVO attracted<br />

about 11,000 attendees from 75 countries this<br />

year, 45% of which were from outside the United<br />

States of America. At any one point in time,<br />

symposia, mini-symposia, workshops, special<br />

interest group meetings and poster presentations<br />

were taking place. In total, over five-and-a-half<br />

thousand oral/poster and panel discussions were<br />

held. Since time-travel is not an option yet and<br />

as it’s impossible to be in two places at the same<br />

time, it was extremely difficult for most of us to<br />

decide on which sessions to attend.<br />

This year, only a small contingent of Kiwi<br />

clinicians, scientists and clinician-scientists<br />

travelled to America’s east coast for ARVO.<br />

Associate Professors Jennifer Craig and Andrea<br />

Vincent and doctoral student Di Huang and I were<br />

the only ones from this part of the world who<br />

presented their research. All female scientists!<br />

Speaking of female scientists, this year for the<br />

first time in the history of ARVO, the opening<br />

keynote speaker was a female professor, Professor<br />

Mary-Claire King who heads up medical genetics<br />

at the University of Washington. Professor King<br />

discussed her cancer work and inherited-genetic<br />

disorders affecting eyes.<br />

Homegrown presentations<br />

Our very own expert on genetic eye diseases, A/<br />

Prof Andrea Vincent presented on the genetic<br />

mistakes that cause x-linked inherited retinal<br />

diseases within a New Zealand population; while<br />

Di Huang discussed her work on an ultrasoundmediated<br />

nanoparticle delivery system across the<br />

retina after intravitreal injection. I, meanwhile,<br />

presented on the ‘Automated analysis of in vivo<br />

confocal microscopy images of corneal nerves’. This<br />

project was a collaborative effort by researchers<br />

from The University of Auckland, Johns Hopkins<br />

University in Maryland and image analysis<br />

technology company Voxeleron from California.<br />

In vivo confocal microscopy of the cornea<br />

was very much a topic of discussion at ARVO.<br />

After being around for almost two decades, it is<br />

now being used not only in ophthalmology but<br />

increasingly for endocrinology and neurological<br />

disorders. Representatives from Heidelberg,<br />

manufacturer of the microscopes, said they had<br />

received multiple enquires about this increasingly<br />

popular technology at the conference.<br />

A/Prof Jennifer Craig presented her research<br />

comparing efficacy of a commercial eyelid<br />

cleanser and diluted baby shampoo. She<br />

concluded the eyelid cleanser reduced eye surface<br />

inflammation and improved quality of the tear<br />

film lipid layer and was better tolerated by<br />

participants.<br />

DEWSII<br />

As vice chair of the Tear film & Ocular Surface’s<br />

Dry Eye Workshop II (TFOS DEWSII) A/Prof Craig<br />

also co-chaired the much-awaited DEWSII results<br />

symposia, alongside workshop chair Dr Daniel<br />

Nelson and organiser Dr David Sullivan. This was<br />

one of the most highly-anticipated special interest<br />

group symposia of the annual conference. A/<br />

Prof Craig presented the updated definition and<br />

classification of dry eye to an audience of about<br />

500. The new ‘Dry Eye’ definition was generally<br />

well received, but instigated several intense<br />

discussions amongst audience members and<br />

presenters. Other ocular surface experts: Drs<br />

Fiona Stapleton, Mark Wilcox, David Sullivan<br />

and Anthony Bron; presented final conclusions<br />

and recommendations from the TFOS DEWSII<br />

report including pathophysiology, diagnosis,<br />

epidemiology, sex differences, pain/sensation and<br />

management/therapy of dry eye.<br />

Ocular imaging<br />

Ocular imaging was, by far, the highlight of<br />

this year’s ARVO conference. Everything from<br />

‘Noncontact quantitative optical coherence<br />

elastography of the cornea’ and ‘3D multiphoton<br />

microscopy to study central corneal nerve<br />

fiber loss’ to ‘Isolated<br />

elevation of intraocular<br />

pressure and its impact<br />

on ocular aberrations<br />

in healthy eyes’, was<br />

discussed.<br />

Other highlights<br />

The most exciting part<br />

of any ARVO conference<br />

are the poster sessions.<br />

Dedicated poster<br />

sessions and ‘All poster<br />

sessions’ allow attendees<br />

Baltimore Harbour<br />

to have one-on-one<br />

chats with researchers.<br />

The poster sessions also meant you got to<br />

complete over 11,000 steps every single day. So<br />

the posters kept everyone on their toes, both<br />

literally and figuratively!<br />

I was also invited (thanks to A/Prof Craig) to the<br />

6th Lid and Meibomian Gland Working Group<br />

dinner meeting. The plenary lecture was delivered<br />

by ocular surface and dry eye disease authority Dr<br />

Donald Korb. Having dinner with such a legend<br />

was as much a delight as an honour.<br />

ARVO also provided the opportunity to catch-up<br />

with old Auckland colleagues who are working in<br />

the northern hemisphere now. It was great to see<br />

Drs Chi-Ying Chou and Christina Grupcheva who<br />

also presented their respective research at the<br />

conference.<br />

Finally, ARVO <strong>2017</strong> attendees raised over<br />

US$32,000 ($44, 500) for the ARVO Foundation<br />

thanks to a generous $15,000 matching gift from<br />

members, US-based neuroscientists and eye<br />

researchers, Nic and Haydee Bazan. A very kind<br />

gesture indeed.<br />

Visiting Baltimore, also provided an opportunity<br />

to strengthen our ties with collaborators Professor<br />

Joseph Mankowski and his team at the School of<br />

Medicine at Johns Hopkins University. So watch<br />

this space for some more research papers in<br />

Honolulu at the 2018 ARVO meeting! ▀<br />

*Dr Stuti Misra is an overseas-trained optometrist and a<br />

Stevenson research fellow in the ophthalmology department<br />

at the University of Auckland. Her research interests include<br />

corneal imaging and she is currently investigating the effects of<br />

bariatric or weight loss surgery and chemotherapy on corneal<br />

nerve microstructure and retinal wide-field imaging and ocular<br />

abnormalities in the paediatric population.<br />

Associate Professors Andrea Vincent and Jennifer Craig with Dr Stuti Misra at<br />

ARVO <strong>2017</strong><br />

Collaborators dinner: (from left) Rachel Weinberg and Prof Joseph Mankowski<br />

from Johns Hopkins University, Dr Jonathan Oakley (Voxeleron), Megan McCaron<br />

(Johns Hopkins) and Dr Stuti Misra<br />

Hunt’s first<br />

RANZCO NZ<br />

Behind the<br />

scenes, but<br />

celebrating<br />

her first RANZCO<br />

NZ branch<br />

meeting was<br />

Helen Hunt, the<br />

only Wellingtonbased<br />

RANZCO<br />

employee and<br />

the RANZCO NZ<br />

branch officer.<br />

Hunt replaced<br />

Cameron McIver,<br />

who retired in<br />

Helen Hunt, RANZCO’s representative in<br />

Wellington<br />

June last year, in a newly expanded role as part of<br />

RANZCO’s Policy and Programmes Team to help<br />

RANZCO better support its members and lobbying<br />

efforts in New Zealand. The position has been<br />

expanded from one to three days per week and a<br />

physical office space has been established in the<br />

Wellington CBD on Lambton Quay in the offices of<br />

the Royal Australian and New Zealand College of<br />

Radiologists.<br />

Hunt is a senior policy analyst, who spent 12 years<br />

working for the Ministry of Health. Her passion<br />

is public health and non-communicable disease<br />

issues, she says. “I have undertaken policy work<br />

on alcohol and illicit drug harm minimisation,<br />

problem gambling, mental health promotion, suicide<br />

prevention as well as working on improving service<br />

delivery for forensic mental health, oral health,<br />

maternity and child health.”<br />

A year in, she says she’s “really enjoying” working<br />

with the New Zealand fellows to raise awareness<br />

about the demands on ophthalmology services due<br />

to the growing number of patients with chronic eye<br />

disease. “I am also looking forward to continuing<br />

work with the Ministry of Health to find national<br />

solutions to build the capacity of ophthalmology<br />

departments.” ▀<br />

ASCRS <strong>2017</strong><br />

BY DR DEAN CORBETT*<br />

The American Society of Cataract and<br />

Refractive Surgery (ASCRS) conference<br />

returned to Los Angeles in <strong>2017</strong> for the first<br />

time since 1990 in May. Having been held there<br />

regularly in the ‘80s and ‘90s, it was a departure<br />

from the regular mega-conference venues of<br />

San Diego, San Francisco, New Orleans, Boston,<br />

Chicago and Washington DC.<br />

For me, the “City of Angels” lived up to its<br />

reputation of traffic congestion and homeless<br />

people, but failed to deliver the balmy dry weather<br />

it is renowned for. In fact, the temperature was<br />

only about equal to New Zealand at the same time<br />

and it rained for two of the 5 days I was there!<br />

As for the Congress, the conference centre was<br />

reasonably user friendly but, consistent with<br />

the US mega meetings with more than 6000<br />

attendees and 300+ companies displaying their<br />

latest wares in the massive trade hall, it was<br />

spread out over a very large campus, including<br />

eight hectares of exhibit space and no less than 64<br />

meeting rooms.<br />

The Congress is regularly attended by<br />

ophthalmologists from around the globe and New<br />

Zealand ophthalmologists and their support staff<br />

are well represented.<br />

The focus of the meeting is the latest thinking<br />

in cataract and refractive surgery but, as is typical,<br />

there are speakers giving perspectives on a range<br />

of topics including vitreoretinal and glaucoma.<br />

Highlights: MIGS<br />

This year, for the first time, there was a significant<br />

presence, including some data presentations, on<br />

the coming of age for modern glaucoma surgery.<br />

MIGS (minimally-invasive glaucoma surgery) is<br />

poised to make a major entry into the repertoire<br />

of the cataract and refractive surgeon. From more<br />

traditional trabecular bypass stents, such as iStent<br />

and iStent Inject (Glaukos’ second generation<br />

device) and the Ivantis’ Hyrdus microstent to the<br />

ab interno subconjunctival approach of the Xen<br />

gel stent and the suprachoroidal shunts, such<br />

as Cypass, there is now a literal smorgasbord of<br />

choices for the competent<br />

anterior segment surgeon.<br />

Three-year data for iStent<br />

was presented showing a<br />

10mmHg reduction of IOP,<br />

which brings these devices<br />

into direct competition with<br />

eye drops and challenges<br />

trabeculectomy, the current<br />

gold standard.<br />

Femtosecond laser vision<br />

correction using the SMILE<br />

technique from Zeiss,<br />

attracted a significant<br />

amount of attention.<br />

In the US, an early FDA<br />

recognition of the safety<br />

and effectiveness of this<br />

technique has fuelled<br />

interest, but this is not<br />

unexpectedly attenuated by the limitation of the<br />

procedure to 3-8 dioptres of spherical myopia<br />

only. This leaves LASIK as the better treatment<br />

option in the US, for all patients with more than<br />

0.75D of astigmatism. Elsewhere in the world, the<br />

range of treatment for SMILE crosses all levels of<br />

myopia, from up to -11D with astigmatism to 5D.<br />

There were also presentations of some excellent<br />

outcomes for hyperopic SMILE treatment that is<br />

under investigation at several sites around the<br />

world, including London under Professor Dan<br />

Reinstein.<br />

Captain Scott Kelly<br />

Astronaut Captain Scott Kelly delivered an<br />

hour long keynote presentation in the Walter<br />

E Washington Convention Centre’s Grand<br />

Hall, which was interesting, stimulating and<br />

entertaining; off-topic (ophthalmology), but<br />

bringing together the concepts of progress by<br />

small and consistent steps of improvement<br />

leading to achievement of a goal. As a school<br />

dropout, his determination to plan and achieve by<br />

measurable and achievable small goals led him<br />

to be in the unique position of having spent the<br />

longest time in space of any human. With others,<br />

Astronaut Scott Kelly delivered the Science, Medicine and Technology Lecture at the <strong>2017</strong> ASCRS and<br />

ASOA Congress<br />

Captain Kelly has led scientific discoveries that<br />

will ensure positive progress for medicine and<br />

technology, and data collected from research into<br />

astronauts and glaucoma may well challenge the<br />

current dogma in the understanding of glaucoma.<br />

Dry Eye, cross-linking and in conclusion<br />

Dry eye also received significant coverage, with<br />

several competing technologies coming together<br />

to hopefully begin to deliver improvement in<br />

a tangible way for patients with mixed and<br />

evaporative dry eye.<br />

Corneal collagen cross-linking, in particular with<br />

the Avedro platform, shows possible applications<br />

for the remodeling of shape to treat refractive<br />

errors, as well as ectatic corneal disorders.<br />

Overall ASCRS was a familiar meeting at an<br />

unfamiliar venue. Good for the content typical of a<br />

major American meeting. I Always enjoy meeting<br />

with colleagues there, but would be happy to not<br />

have to attend in LA again. ▀<br />

*Dr Dean Corbett is a specialist in refractive and glaucoma<br />

surgery, a clinical lecturer, chair of the CPAC steering group and<br />

has been instrumental in the introduction of new devices and<br />

surgical techniques for the improvement of vision. He’s based in<br />

Auckland at Greenlane Hospital and Auckland Eye.<br />

<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

17


for optometrists and eye care professionals<br />

with<br />

Prof Charles McGhee<br />

& A/Prof Dipika Patel<br />

Series Editors<br />

Glaucoma: Has it progressed?<br />

BY DR JAY MEYER*<br />

This is a key question that should be answered<br />

at follow-up evaluations of patients with<br />

glaucoma. It can be a difficult question to<br />

answer for many patients, particularly based on<br />

measurements taken at a single point in time.<br />

Readily available evaluation techniques include<br />

both structural testing (ophthalmoscopy, optic<br />

disc photography/imaging) and functional testing<br />

(perimetry).<br />

When apparent progression has occurred, the<br />

examiner must determine whether there has been<br />

real, or true, progression. There are a number of<br />

potential causes of false progression that must<br />

be ruled out before progression can be considered<br />

“real”. Three questions can help determine<br />

whether progression is real:<br />

• Is the exam reliable?<br />

• Has there been significant change?<br />

• Is the change repeatable?<br />

Repeatable change over time is the hallmark of<br />

progression in glaucoma. This article will focus<br />

on the three most commonly used techniques to<br />

evaluate and monitor for progression in glaucoma:<br />

Optic disc ophthalmoscopy and photography, Ocular<br />

Coherence Tomography (OCT) and perimetry.<br />

Optic disc ophthalmoscopy and<br />

stereophotography<br />

As retinal ganglion cell axons are lost, changes<br />

occur in the structure and appearance of<br />

the retinal nerve fibre layer (RNFL) and optic<br />

disc. These changes may be detected using<br />

ophthalmoscopy and optic disc photography.<br />

Optic disc stereo-photographs are ideally obtained<br />

during an initial evaluation to provide an objective<br />

baseline to which future examinations and photos<br />

may be compared. Documentation of optic disc<br />

appearance includes subjective (disc drawings) and<br />

objective (photographic or imaging) methods.<br />

Is the exam reliable? Stereo optic disc<br />

photographs have traditionally been considered<br />

the gold standard for documentation and<br />

monitoring optic disc appearance. If stereoscopic<br />

photos cannot be obtained, monocular<br />

photographs may be used. Optic disc drawings<br />

(even detailed) and documentation of cup/disc<br />

ratios are insufficient to detect mild to moderate<br />

progression, particularly when recorded by<br />

different examiners. Image quality can be affected<br />

by media opacity, ocular surface irregularities<br />

and patient cooperation. Differences in the focus,<br />

colour, illumination or magnification can influence<br />

the comparison between photographs and result<br />

in false-positive or false-negative progression.<br />

Has there been significant change?<br />

Glaucomatous optic disc changes are characterised<br />

by thinning of the neuroretinal rim, cupping<br />

of the optic disc and thinning or defects of the<br />

RNFL. Progressive generalised or focal thinning<br />

(notching) of the neuroretinal rim indicates<br />

progression. RNFL loss can occur in diffuse,<br />

localized or mixed patterns. Localised RNFL<br />

loss appears as a (subtle) wedge-shaped dark<br />

area emanating from the optic disc and the<br />

development or enlargement of a defect can be<br />

evidence of progression.<br />

Signs that suggest risk for progression include<br />

the development of an optic nerve pit and<br />

beta zone peripapillary atrophy changes. Disc<br />

haemorrhages may presage progression and<br />

can occur at the neuroretinal rim (frequently at<br />

the edge of a notch), adjacent nerve fibre layer<br />

or lamina cribrosa. Disc haemorrhages may be<br />

small and can easily go undetected prior to their<br />

resolution within 2 to 6 months.<br />

Limitations: The interpretation of<br />

ophthalmoscopy and photographs is subjective<br />

and dependent on examiner skill level.<br />

Ocular coherence tomography (OCT)<br />

OCT allows quantitative measurements of the<br />

structural properties of the optic nerve and<br />

retinal nerve fibre layer (RNFL). OCT has gained<br />

popularity for detecting glaucomatous damage<br />

and monitoring progression owing to the speed<br />

and ease of examination and objectivity of the<br />

measurements.<br />

Is the exam reliable? The image quality must<br />

be critically evaluated. OCT can easily mislead<br />

the examiner as up to a third of scans have been<br />

shown to have artefacts 1 .Poor signal strength and<br />

18 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong><br />

Fig 1. The RNFL thickness map appears relatively normal. However, review of the RNFL image shows that the software incorrectly traced the<br />

posterior hyaloid instead of the RNFL (white arrow) for half of the disc<br />

image quality can result from high axial length,<br />

media opacity or surface irregularity and can result<br />

in artefactual thinning of the RNFL 2 .Measurement<br />

errors may occur due to misalignment or<br />

segmentation errors where the software<br />

incorrectly traces the RNFL. Artefacts may be<br />

induced by many causes, including: vitreopapillary<br />

traction (Fig 1), uveitis and epiretinal membranes.<br />

Has there been significant change? Serial trends<br />

in the overall or regional RNFL thickness can<br />

be used to determine whether there has been<br />

progressive thinning. The minimal amount of<br />

change required to represent true progression<br />

depends on the test-retest variability of the<br />

instrument and on the location/area of testing.<br />

The amount of change due to test-retest variability<br />

in less than 5% of eyes is approximately 4-5 µm for<br />

average RNFL thickness on the Cirrus HD-OCT. The<br />

tolerance limit increases when specific locations<br />

are examined with up to 8 µm of variability seen at<br />

individual quadrants and 12 µm at individual clock<br />

hours 3 . Event or trend-based analyses are available<br />

on some commercially available OCT machines.<br />

Limitations: OCT has decreased sensitivity to<br />

detect progressive optic disc and RNFL changes<br />

in the late stages of disease when there is<br />

little remaining RNFL. Utility is also limited for<br />

evaluation of anomalous discs or those with<br />

significant peripapillary atrophy.<br />

Perimetry<br />

Ultimately, the<br />

preservation of visual<br />

function is the goal of<br />

glaucoma management<br />

and thus visual field<br />

testing is essential for<br />

monitoring.<br />

Is the exam reliable?<br />

Fixation losses greater<br />

than 20% indicates poor<br />

reliability. Gaze tracking<br />

allows for more accurate<br />

interpretation of patient<br />

fixation stability. False<br />

positives are a key<br />

reliability index and<br />

indicate a “trigger happy”<br />

patient who has pressed<br />

the response button<br />

in the absence of a<br />

stimulus. If false positives<br />

are >15%, the test<br />

should be invalidated or<br />

repeated. False negatives<br />

represent variability in<br />

patient responses and are<br />

seen at increasing levels<br />

in depressed visual fields.<br />

In a patient without a<br />

significant field defect,<br />

a false negative value of<br />

10% to 15% or more is<br />

suggestive of inattention.<br />

Improper lens<br />

selection or placement,<br />

uncorrected astigmatism,<br />

or astigmatism corrected<br />

at the wrong axis can<br />

induce artefacts. A patient’s refraction can also<br />

change, particularly after cataract surgery and a<br />

lens used at previous visits may not be the best<br />

lens for the current test. An off-centre lens can<br />

restrict the visual field and a lens sitting far from<br />

the eye can cause constriction of the visual field<br />

(rim artefact).<br />

Has there been significant change? It is<br />

important to establish a baseline of visual fields<br />

when a diagnosis of glaucoma is made. Where<br />

resources are available to do this, testing should<br />

be performed until two tests that are reliable and<br />

consistent are obtained. Eyes with glaucomatous<br />

visual field damage show marked variability which<br />

makes it difficult to determine whether there has<br />

been significant progression or whether changes<br />

seen are due to test-retest variability. Variability in<br />

moderately damaged visual field locations can be<br />

up to 300-400% greater compared to visual field<br />

areas with normal sensitivity 4 . In addition, the<br />

further from fixation, the greater the variability<br />

(fluctuation of the threshold sensitivity) at a<br />

specific location. More peripheral field defects<br />

may be expected to show more fluctuation than<br />

central defects. In fact, in the Ocular Hypertension<br />

Treatment Study (OHTS), over 80% of abnormal<br />

visual fields were false positives when retested 5 .<br />

As a rule, visual field testing should be repeated if<br />

there is suspicion that progression has occurred.<br />

Fig 2. This patient stopped taking drops for two years and had uncontrolled IOP with progression. A superior<br />

nasal step developed (red arrow), correlating with inferotemporal thinning (by 21µm, black arrow) on OCT<br />

There are many ways to approach the evaluation<br />

of progression of visual field testing and there is<br />

no widely accepted gold standard or consensus<br />

regarding the best method. The most commonly<br />

used approach is subjective evaluation, or clinical<br />

judgement, where a clinician determines whether<br />

it “looks worse”. This subjective method can result<br />

in wide variation in clinical practice between<br />

practitioners and progressive visual field changes<br />

may be overdiagnosed 6 .<br />

There are two general statistically-based<br />

approaches to determine whether progression has<br />

occurred: event-based and trend-based analyses.<br />

Event-based methods define progression based<br />

on the occurrence of change from one time point<br />

to another by comparing a single evaluation to<br />

prior results (usually the baseline fields). Trendbased<br />

methods determine whether a statisticallysignificant<br />

downward trend in some particular<br />

measure of the visual field, such as mean<br />

deviation, has occurred using linear regression<br />

techniques. An advantage of trend-based methods<br />

is that it provides information about the rate of<br />

change. Multiple visual fields must be performed<br />

over time before these analyses can provide useful<br />

information. Event-based analyses may detect<br />

progression earlier, while trend based analyses<br />

may take longer to detect progression but are<br />

more useful in later stages of disease.<br />

Limitations: There are many potential ocular and<br />

non-ocular masquerades of glaucomatous visual<br />

field defects. Some ocular causes include: retinal<br />

vein or artery occlusion, macular pathology and<br />

optic neuropathy due to other causes (ischemia,<br />

demyelination).<br />

Clinicians should confirm suspected<br />

glaucomatous change by repeating the test<br />

at another time and comparing it to other<br />

diagnostic and clinical results. One way to assess<br />

for masquerading conditions is to correlate<br />

structural and functional changes (ie. thinning of<br />

neuroretinal rim and RNFL inferiorly should result<br />

in a matching superior VF defect) (Fig 2). However,<br />

it is also important to recognise that structural<br />

and functional changes produced by glaucoma<br />

often may not correlate, further complicating the<br />

clinical dilemma of progression determination 7 .<br />

This discordance may be due to the development<br />

of structural and functional changes at different<br />

time intervals.<br />

Visual field data is compared to a normal<br />

database and in the case of the Humphrey<br />

database, grouped in 10-year intervals. A patient’s<br />

field may falsely improve when moving into an<br />

older age group (ie. from 69 to 70) as the more<br />

recent test would be compared with a different<br />

database than the previous tests. ▀<br />

References<br />

1. Asrani S, et al. Artifacts in spectral-domain optical<br />

coherence tomography measurements in glaucoma. JAMA<br />

Ophthalmol. 2014;132:396-402.<br />

2. Wu Z, et al. Signal strength is an important determinant<br />

of accuracy of nerve fiber layer thickness measurement by<br />

optical coherence tomography. J Glaucoma. 2009;18:213-<br />

216.<br />

3. Mwanza JC, et al. Reproducibility of peripapillary<br />

retinal nerve fiber layer thickness and optic nerve<br />

head parameters measured with Cirrus HD-OCT<br />

in glaucomatous eyes. Invest Ophthalmol Vis Sci.<br />

2010;51:5724-30.<br />

4. Johnson CA. Detecting functional changes in the patient’s<br />

vision: Visual field analysis. In: Samples JR, Schaknow PN,<br />

eds. Clinical Glaucoma Care. New York: Springer, 2014;142.<br />

5. Keltner JL, et al. Confirmation of visual field abnormalities<br />

in the Ocular Hypertension Treatment Study. Arch<br />

Ophthalmol. 2000;118:1187-94.<br />

6. Shulzer M. Errors in the diagnosis of visual field<br />

progression in normal-tension glaucoma. Ophthalmology.<br />

1994;101:1589-94.<br />

7. Hood D, Kardon RH. A framework for comparing<br />

structural and functional measures of glaucomatous<br />

damage. Prog Retin Eye Res. 2007;26:688-710.<br />

Dr Jay Meyer<br />

About the author<br />

* Dr Jay Meyer is an anterior<br />

segment and glaucoma<br />

specialist and Senior Lecturer<br />

at the University of Auckland.


New Kiwi DOs<br />

Congratulations to the 23 New Zealand<br />

students graduating at the 36th Australian<br />

Dispensing Opticians Association (ADOA)<br />

optical graduation held at Darling Harbour in<br />

Sydney on 26 May.<br />

The Association of Dispensing Opticians of New<br />

Zealand (ADONZ) president Peggy Savage was<br />

invited to celebrate the occasion alongside her<br />

Australian counterpart Martin Kocbek, with both<br />

welcoming the graduates and their guests to the<br />

celebratory evening.<br />

“It was a proud moment for me to see our<br />

The ADOA graduates<br />

students at their graduation, the highlight<br />

of their achievements,” said Savage adding<br />

the venue overlooked Vivid Sydney’s light<br />

displays and fireworks, which all added to the<br />

wonderfulness of the evening.<br />

The gala evening included a mix of speeches<br />

and awards with Libby Boschen, CEO of<br />

Optometry South Australia, as the guest of<br />

honour. Optical dispensing educator Steve Daras<br />

received the John Jackson ADOA Award, for his<br />

“passionate teaching of optics.” ▀<br />

Presidents Peggy Savage, ADONZ and<br />

Martin Kocbek, ADOA<br />

Tasmania: a focus on<br />

low vision<br />

Registration is now open for Tasmania’s<br />

Lifestyle Congress (TLC) on 25-27 August<br />

in picturesque Hobart, which includes<br />

a comprehensive Low Vision Seminar on the<br />

Saturday morning.<br />

Auckland-based low vision specialist optometrist,<br />

Naomi Meltzer, says after a number of years<br />

of including a low vision specialist part of the<br />

programme, the annual TLC is fast becoming the<br />

number one conference for anyone interested in<br />

low vision in Australia and New Zealand.<br />

This year’s congress will, once again, be held at<br />

the impressive, waterfront Hotel Grand Chancellor,<br />

which boasts some of the best views in the city,<br />

and continues Optometry Tasmania’s tradition of<br />

inviting a high calibre of international and domestic<br />

speakers, said Meltzer.<br />

Keynotes include:<br />

• Associate Professor Lori Vollmer, director of<br />

residency programs with Nova Southeastern<br />

University, USA, who has a special interest in ocular<br />

disease and nutrition; and<br />

• Professor Joseph Sowka, an American Academy<br />

of Optometry (AAO) fellow, Optometric Glaucoma<br />

Foundation president and vice-chair of AAO’s<br />

Neuro-ophthalmic Disorders in Optometry Special<br />

Interest Group<br />

A unique experience of the annual congress is<br />

the conference dinner where delegates are ferried<br />

from the Hobart waterfront to the world famous<br />

(or infamous) Museum of Old & New Art (MONA)<br />

located within the Moorilla winery for an exclusive<br />

visit and dinner.<br />

For more information visit: www.optometry.org.<br />

au/tas/tlc/ ▀<br />

Specsavers ships<br />

25 million<br />

Specsavers’ Port Melbourne manufacturing facility dispatched<br />

its 25-millionth pair of glasses at the end of April, just over<br />

a year after passing the 20 million mark in March 2016. The<br />

regional milestone pair of specs came from the company’s highlypromoted<br />

new Kylie Minogue range, launched earlier this year.<br />

Specsavers dispatched its first pair of glasses for the Australia and<br />

New Zealand (ANZ) region in March 2007, when it was testing a<br />

range of lenses and frames on a wholesale basis with independent<br />

practices. Within eight years, the business had completed 15 million<br />

orders, and just over a further two years to finish its next 10 million.<br />

“The expanding Specsavers retail network continues to push the<br />

boundaries regarding customer value with record-breaking volumes<br />

throughout 2016,” said Ian Lindsey, Specsavers’ manufacturing<br />

head for Asia Pacific. “Total record order volume through the Port<br />

Melbourne hub during the year saw a total of 4,434,724 pairs of<br />

spectacles completed and dispatched. A staggering 95,000 orders<br />

were also generated during the last four trading days of the year –<br />

beating the previous year’s record by some distance.<br />

“We have seen numerous records come and go, but over 28,000<br />

jobs leaving the facility in one day was very scary, requiring nearly<br />

140 sacks to enable the courier to transport the spectacles.” ▀<br />

Biof inity Energys <br />

With Digital Zone Optics lens design<br />

A breakthrough for sphere lens wearers<br />

3<br />

3<br />

ONLY AVAILABLE<br />

FROM OPTOMETRISTS<br />

IN AUSTRALIA & NEW ZEALAND<br />

Digital Zone Optics <br />

lens design<br />

Combining the natural wettability of Aquaform® Technology<br />

with the innovation of Digital Zone Optics lens design.<br />

Port Melbourne’s team has now shipped more than 25 million pairs of glasses<br />

BTP appointment<br />

Dispensing optician (DO) Caron<br />

Bowe has joined the BTP<br />

International Designz team.<br />

Director Trish Orr, says she’s excited<br />

about the appointment and Safarro,<br />

the new handmade, Italian frame<br />

brand Bowe will be introducing to the<br />

New Zealand market (see story p11).<br />

Bowe’s experience as a DO will also be<br />

very useful for the development of the<br />

market for Rodenstock lenses, added<br />

Orr. “We know that her passion and<br />

Caron Bowe now part of the BTP team dedication to the optical industry will<br />

be an asset to our company.”<br />

After working in optics for 15-plus years Bowe qualified as a DO in<br />

2011. She said she is looking forward to the challenges her new role<br />

with BTP will bring and is excited about promoting the Rodenstock<br />

lens range and introducing Safarro to New Zealand.<br />

As a BTP representative, Bowe will also be responsible for the<br />

following frame ranges: Rodenstock, Vera Wang, Furla, Empire,<br />

Rocco, Oliviero Contini, Random and Porsche. ▀<br />

Digital Zone Optics <br />

lens design<br />

• Helps ease the accommodative burden without<br />

impacting distance visual acuity<br />

• Multiple front-surface aspheric curves<br />

- across the entire optical zone<br />

- distribute power evenly to simulate more<br />

positive power in the centre of the lens<br />

Aquaform ® Technology<br />

• Biofinity Energys lenses are made with<br />

Aquaform® Technology for natural moisture and<br />

breathability to help dryness symptoms associated<br />

with digital device use.<br />

• Long silicone chains and compatible hydrogen<br />

bonds lock water within the lens for a smooth,<br />

naturally wettable surface.<br />

All the benef its of Biofinity ® enhanced with a unique lens design ideal for both<br />

on-screen and off-screen activities.<br />

Why prescribe anything else for your monthly and two-weekly contact lens wearers?<br />

Contact your CooperVision ® Agent of Optomism for more information.<br />

<strong>Jul</strong>y <strong>2017</strong><br />

© CooperVision <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

19


Many can still remember the days when<br />

glasses were for nerds or girls passed<br />

over in the romance stakes.<br />

Huge unflattering frames and thick lenses<br />

seriously damaged<br />

your street cred and<br />

were certainly no<br />

style statement.<br />

In contrast,<br />

today glasses<br />

are one of the<br />

hottest must-have<br />

accessories, with<br />

the fashionable<br />

and famous<br />

unashamedly<br />

Seinfeld epitomising “the nerd”<br />

sporting specs and<br />

even launching<br />

their own frame ranges. Some notable names<br />

even have glasses as an essential part of their<br />

signature look; so how did they go from being<br />

a visual aid to a fashion item?<br />

A look back<br />

Historically, glasses have been around for a long<br />

time; but it wasn’t until the early 1920s that<br />

plastics allowed cheaper production and the<br />

mass manufacturing of spectacle frames<br />

took off.<br />

Early spectacles were made specifically<br />

for reading purposes so there was a greater<br />

likelihood that the person wearing them was<br />

educated. It was then a perception that glasses<br />

wearers were more intelligent was born, yet<br />

also inferior as<br />

they ruined their<br />

eyesight to the<br />

point of requiring<br />

medical apparatus<br />

to see clearly.<br />

“No matter how<br />

clever you think<br />

you are, reading<br />

all of those books<br />

has made you<br />

weak-eyed,” explains Dr Neil Handley, the curator<br />

of the British Optical Association Museum at the<br />

College of Optometrists and one of the foremost<br />

historians on all things spectacle related, about<br />

the thinking at that time. “People thought you<br />

could damage your eyes by being too bookish.”<br />

In 2012, Handley analysed the changing social<br />

norms toward glasses wearers throughout<br />

history and discovered that while Hitler wore<br />

reading<br />

glasses,<br />

images of<br />

him doing<br />

so were<br />

censored<br />

by the Nazi<br />

Party for<br />

fear of his<br />

authority<br />

being<br />

weakened.<br />

Thankfully glasses are no longer a sign of<br />

inferiority, instead they are now firmly associated<br />

with the academic giants of the world and just<br />

as important as a hairstyle in forming a distinct<br />

personal image. To thank for this dramatic shift is<br />

a combination of celebrity, societal subcultures,<br />

technology and good old fashioned money.<br />

Celebrity first impressions…<br />

Style-Eyes<br />

Cashing in on spec style<br />

History of eyewear authority, Dr Neil<br />

Handley<br />

A censored picture of Hitler wearing reading<br />

glasses<br />

Know that old ‘first impressions’ saying? When<br />

you see a wearer-of-glasses superficial judgments<br />

begin formulating and whatever takes place<br />

afterwards is filtered through<br />

these. No one sees a person with glasses and<br />

thinks nothing!<br />

And nowhere is the need for instant recognition<br />

and ‘branding’ more important than in the world<br />

of the celebrity. With an increasing number of<br />

celebs embracing the glasses trend to silently<br />

project certain messages about themselves, they<br />

have laid the groundwork to influence those that<br />

admire them.<br />

BY MIRANDA LIKEMAN*<br />

Renowned<br />

television<br />

documentarian<br />

Louis Theroux<br />

acknowledges<br />

this. “For<br />

publicity<br />

purposes<br />

everything gets<br />

simplified and<br />

the fact that I<br />

wear glasses and<br />

am somewhat<br />

bookish makes<br />

me a geek,” he<br />

says. “That’s<br />

fine; there<br />

needs to be a<br />

shorthand.”<br />

…plus a bit of cash<br />

Milena Cavicchioli, vice president of marketing<br />

for the Milan-based eyewear giant Luxottica<br />

told the LA Times that because people look to<br />

celebrities to see what the latest trends are,<br />

“their wearing frames is a huge support<br />

and endorsement.”<br />

Add to that the fact that eyewear is a lucrative<br />

business and celebrities like money and it’s a<br />

match made in heaven.<br />

According to the UK Telegraph, the estimated<br />

worth of the global market (which includes<br />

frames, contact lenses and sunglasses) is<br />

US$90 billion ($125 billion) and projected to<br />

reach US$140 billion ($194 billion) by 2020.<br />

The premium fashion segment is occupied by<br />

a handful of firms, the biggest being Luxottica,<br />

who registered an 18% increase in profit in 2014<br />

after generating more than €7.6 billion ($12<br />

billion) in revenue.<br />

Fashion comes full circle<br />

Louis Theroux: glasses aid his celebrity<br />

personality<br />

In a twist no one could have predicted, current<br />

trends hark back to the uncool, retro styles of<br />

former decades, with thick frames and larger<br />

lenses. Much to their chagrin, the reason for<br />

this is the hipster – originally embracing ‘ugly’<br />

glasses as an important part of expressing their<br />

identity. But as is inevitable in fashion, the look<br />

of those who buck trends is quickly emulated by<br />

the masses, making classic thick black frames the<br />

forefront of popular culture.<br />

All of this begs the question: what happens if<br />

Kate Winslett sporting the black-frame retro look<br />

or when the fashion of wearing glasses goes<br />

out of style? This is unlikely now technology<br />

and optometry are intrinsically linked; the<br />

majority of us staring at screens for long<br />

periods; plus an aging, though still fashionconscious,<br />

population.<br />

There will always be a need for prescription<br />

lenses for one reason or another, no doubt<br />

ensuring that glasses, and the increasing number<br />

of celebrity-backed ranges (think<br />

Kylie), will remain in popular culture for a long,<br />

long time. ▀<br />

CREDIT: @BAFTA<br />

*Miranda Likeman has<br />

commented on style and the<br />

stylish as a fashion journalist<br />

for 15 years, including seven<br />

years running a successful<br />

designer clothing and<br />

accessories PR agency in<br />

New Zealand.<br />

Fashion update<br />

Marni<br />

Italian brand Marni launched its first eyewear<br />

collection at the Milan fashion week 2016 and is<br />

now available for the first time in New Zealand.<br />

The collection includes prescription frames and<br />

sunglasses. In true Marni spirit, all models offer a<br />

strong design and play with contrasting colours and<br />

materials. Featured here is model ME2613_414 in blue.<br />

The collection will be on display at ODMA17 and is<br />

distributed by VSP Australia (formerly General Optical).<br />

Oliviero Contini<br />

Stars and their eyes … Larry King<br />

The iconic talk-show host was the<br />

face of Larry King Live on CNN for<br />

25 years, and it was consistently<br />

the network’s most-watched show. In<br />

2009, a year before his retirement from<br />

the talk-show, King underwent cataract<br />

surgery. He was 75.<br />

Caught out with his seventh wife,<br />

former singer Shawn Southwick, at the<br />

Boa Steakhouse in West Hollywood,<br />

wearing a patch over his left eye<br />

following the surgery, King joked he was<br />

auditioning for the new Pirates of the<br />

Caribbean movie.<br />

A few years later, King hosted an<br />

episode of documentary series<br />

‘In View’ on Fox, which witnessed a<br />

Tennessee eye surgeon performing laser<br />

cataract surgery. ▀<br />

Phone 0800 750 750 or Fax 09 282 4148<br />

info@eyesurgeryassociates.co.nz or<br />

Dr Patel at: patel@glaucoma.co.nz<br />

Blackfin<br />

www.eyesurgeryassociates.co.nz<br />

Jono Hennessy<br />

Oliviero Contini’s new collection flaunts a<br />

vintage style with a modern appeal, says the<br />

company adding, the collection is elegant with<br />

clean lines for him and extravagant touches and<br />

fine details for her. The men’s frames are typically square or a roundeddesign<br />

using a mix of materials like titanium and acetates. The OV4250<br />

model pictured here is designed with metal details at the front. It is available in<br />

classic colours such as grey, black, blue and havana (cigar brown). Distributed by<br />

BTP International Designz.<br />

For more personalised eye care<br />

talk to Dr Hussain Patel<br />

Consultant Ophthalmologist<br />

MBChB, MD, FRANZCO<br />

Eye Surgery Associates are a Southern Cross Health Society Affiliated Provider<br />

Jono Hennessy will be featuring new models at<br />

ODMA17: one is the new FABO 8409 offering a<br />

combination of delicate and heavy with a light<br />

metal edge. “We wanted to do a modern take<br />

on a traditional combination,” said the company.<br />

Available in glossy “highland inspired moss” and<br />

“heather tweed acetate”. Distributed by Phoenix<br />

Eyewear.<br />

Blackfin has released four new “Lamina Plus” acetate<br />

and titanium frames; Lockeport BF803 and Jedway<br />

BF804 featured here, the square-shaped Rockland<br />

BF805 and the rounder Roseway BF810. The Jedway<br />

has longer temples; 150mm to 160mm compared to<br />

the standard 135mm to 145mm. Available in a range<br />

of colour options from conservative grey and black to<br />

bright red. Distributed by Beni Vision. ▀<br />

SERVICES INCLUDE:<br />

Glaucoma Specialist / Refractive Cataract Surgery<br />

General Ophthalmology / Acute & Emergency Eye Care<br />

Clinics on the North Shore, Central<br />

and South Auckland<br />

20 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>


Testing times…<br />

how short is too short?<br />

by<br />

Chalkeyes<br />

What is the ideal duration for an eye<br />

examination? How much of the eye<br />

examination can be delegated to<br />

other staff members? How can practice owners<br />

maximise their income while still respecting<br />

the clinical expertise of the optometrist and<br />

allowing them to perform a thorough clinical<br />

examination?<br />

Chalkeyes has been mulling over these<br />

controversial and oft discussed conundrums and<br />

has undertaken a little bit of undercover research<br />

among colleagues. After speaking with more than<br />

40 practices from across the country, the average<br />

examination time was found to be approximately<br />

40 minutes; the shortest 20 minutes and the<br />

longest 60 minutes. Generally speaking, the<br />

shorter eye exam cost less and the longer eye<br />

exams cost more, but this was not always the<br />

case; one practice charged $90 for a 20-minute<br />

eye examination!<br />

Some practices delegate tests such as<br />

lensometry, visual fields, retinal photos,<br />

auto-refraction, non-contact tonometry,<br />

auto-keratometry and even ocular coherence<br />

tomography (OCT) to support staff. Support staff<br />

receive training varying from months to just a<br />

few hours, which got me thinking. With all the<br />

technology we now have available and with<br />

optometric instruments becoming increasingly<br />

Which brings me to<br />

the elephant in the room –<br />

does reducing eye exam<br />

time mean the clinician<br />

is more likely to make a<br />

clinical error or miss an<br />

ocular pathology?<br />

accurate and user-friendly – shouldn’t we be<br />

empowering support staff by delegating as much<br />

of the data collection as possible? This can freeup<br />

time to spend with the patient on more skilled<br />

aspects such as eye health assessment, analysis<br />

and consultation.<br />

Having worked in a number of practices in a few<br />

different countries, my eye exam durations have<br />

differed considerably. I’ve performed eye exams in<br />

20 minutes, where patient chitchat had to been<br />

kept to a bare minimum (a personal challenge for<br />

me!) and others in high-end practices where I had<br />

a full hour to complete my tests and fully discuss<br />

recommendations with a patient. I have worked<br />

in practices where many tests were carried out by<br />

support staff and others where I completed each<br />

pain-staking, long, threshold field test. I have<br />

worked with clinicians who move between two<br />

rooms and have their support staff work-up each<br />

patient, completing pre-tests including visual<br />

acuities, histories, stereopsis and colour vision.<br />

The clinician would then spend 15 minutes with<br />

the patient, checking their ocular health and<br />

summarising their management options.<br />

What do Kiwi practice guidelines say? The<br />

Optometrists and Dispensing Opticians Board<br />

(ODOB) which governs the clinical standards for<br />

optometrists in New Zealand does not give any<br />

recommendations for eye exam durations. The<br />

‘Standards of Clinical Competence Guidelines<br />

1.6’, however, states the optometrist must<br />

‘schedule patient appointments according to<br />

the time required’ and they must complete the<br />

following tasks; patient history, examination<br />

of eye and visual system, assessment of central<br />

and peripheral vision and the visual pathway,<br />

refraction, assessment of binocular vision and<br />

visual information processing. In addition to this<br />

a therapeutically-qualified optometrist must<br />

ascertain which prescribed medication, if any,<br />

will be most effective for treating any conditions<br />

diagnosed. Phew! That seems like a lot to<br />

complete in an hour, let alone 20 minutes.<br />

Shorter-eye exams can be a challenge for<br />

some clinicians to complete, especially with<br />

a patient who is challenging to communicate<br />

with. I’m thinking ‘Mr Nervous’ who asks lots of<br />

questions and requires constant reassurance or<br />

‘Mrs Verbose’ who wants to tell you all about her<br />

hobbies and her grandkids. Shorter eye exams<br />

can also be a challenge when a complex patient<br />

presents with multiple ocular pathologies.<br />

Which brings me to the elephant in the room –<br />

does reducing eye exam time mean the clinician<br />

is more likely to make a clinical error or miss an<br />

ocular pathology?<br />

There is a risk that an optometrist who is<br />

pushed for time could make an error and miss<br />

a vision-threatening or even life-threatening<br />

condition. There have been instances in the past<br />

of optometrists<br />

having to<br />

apologise for not<br />

completing the<br />

required tests on<br />

patients and, the<br />

ultimate failure,<br />

of patients losing<br />

vision due to<br />

optometrist error.<br />

In the UK last<br />

year, there was<br />

the appalling and<br />

unprecedented<br />

case of an<br />

optometrist being<br />

found guilty of<br />

manslaughter by<br />

gross negligence<br />

after allegedly<br />

failing to spot<br />

what the<br />

prosecution called “obvious” signs of a lethal<br />

build-up of fluid on a young boy’s brain. News<br />

that shocked optometrists around the globe, but<br />

we don’t know if eye examination duration was<br />

a factor in this or any other cases that hit the<br />

media spotlight, unfortunately.<br />

Engaging in some further, ahem, research,<br />

Chalkeyes was down the pub recently with an<br />

independent practice owner who said, “…Support<br />

staff delegation has a key role in today’s practice.<br />

Shorter eye exams keep me on my toes and help<br />

keep my staff interested. I can always rebook<br />

further checks or tests later if need be.” However,<br />

another optometrist buddy said, “It’s important<br />

to have enough time to really get to know the<br />

patient and develop trust. The patient needs to<br />

trust you to tell you what you need to know in<br />

order for you to do your job well.’’<br />

Both valid viewpoints in Chalkeyes’ mind.<br />

We must allow adequate time with the<br />

patient so all the essential clinical tests can be<br />

performed and the optometrist can review the<br />

results and present their recommendations to<br />

the patient. But if some of the data collection is<br />

done prior to the examination, the optometrist<br />

can spend more time reviewing and analysing<br />

the clinical information, rather than collecting<br />

it and, importantly, develop a greater rapport<br />

with the patient. In Chalkeyes’ mind these longduration<br />

eye examinations are only necessary<br />

if the optometrists are carrying out all the data<br />

collection themselves. As a practitioner, I find<br />

that extra time is less important for performing<br />

clinical tests and more important for history<br />

taking to tease out important information from<br />

the patient (especially where therapeutics are<br />

concerned) and to discuss treatment and educate<br />

the patient at the end of the exam.<br />

Support staff-delegation and using the latest<br />

technology has a convincing place in today’s<br />

practice. That said, I am not suggesting we train<br />

our technicians to do refraction and histories, but<br />

let’s embrace technology and train up our staff to<br />

use some instruments such as field testers and<br />

retinal cameras. They will love learning an extra<br />

skill and we will be able to spend more time with<br />

the patient discussing the all-important results.<br />

So what’s the ideal eye exam duration?<br />

Well from experience and from talking to<br />

others, this Chalkeyes has come to the conclusion<br />

that shorter is not always worse. With an efficient<br />

patient journey, the effective use of technology<br />

and together with some well-trained support<br />

staff, a standard adult eye examination can be<br />

conducted in around 30 minutes, anything longer<br />

could be unnecessary and under half-an-hour<br />

eats into valuable rapport-building time, and<br />

Chalkeyes does love a good chinwag! ▀<br />

The views expressed by Chalkeyes are his, or<br />

hers, alone and not necessarily the views of NZ<br />

Optics . If you wish to comment on Chalkeyes’<br />

views, please email a brief letter to the editor at<br />

info@nzoptics.co.nz for consideration.<br />

<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

21


Auckland Eye: May Insights<br />

A working holiday<br />

Erin Tan, Helen Heyns and Dr Yvonne Ng Alastair Kyle, Claire McDonald and Peter Stoute James Park and Dr Archie McGeorge<br />

Dr Stephen Best welcomed the<br />

pre-dominantly shore-based<br />

crowd of optometrists to Auckland<br />

Eye’s second Insight seminar, held at the<br />

company’s new North Shore premises<br />

in Takapuna on 16 May, while Drs Dean<br />

Corbett and Archie McGeorge were the<br />

evening’s presenters.<br />

ERM and floater problems<br />

Dr McGeorge kicked-off the seminar<br />

with a talk on epiretinal membranes<br />

(ERMs or macular pucker) and associated<br />

issues like flashes and floaters. Most<br />

flashes and floaters aren’t a problem, he<br />

said, however, they could be symptoms<br />

of something more serious, like a torn<br />

retina. Optometrists need to be able to<br />

distinguish between harmless ones and<br />

those indicating an underlying condition.<br />

Patients experiencing flashes and floaters<br />

in combination with a new horse-shoe<br />

retinal tear or vitreous haemorrhage need<br />

to been seen urgently. Non-symptomatic<br />

cases, with occurrences of atrophic retinal<br />

holes (often associated with lattice<br />

degeneration) should be referred, but are<br />

less urgent.<br />

Similarly, ERMs often don’t require<br />

treatment, only causing problems when<br />

they’re either too thick or too contracted.<br />

When mild, with little or no effect on the<br />

patient’s vision, Dr McGeorge recommended<br />

Dr Alison Pereira, Janice Yeoman, Jaymie Rogers and Tracy Thompson<br />

checking the patient every three to four<br />

months. In more severe cases, ERM surgery<br />

may be necessary to remove the membrane<br />

to tackle vision loss. Optometrists shouldn’t<br />

wait too long to treat ERM, however, as<br />

vision lost can’t be fully restored, he said.<br />

Post-ERM surgery, vision is often blurred<br />

and it can take two to three weeks to regain<br />

pre-op vision as the tissue recovers. Vision<br />

can sometimes continue to improve over<br />

months, up to a year after surgery.<br />

Laser and lens options<br />

Dr Dean Corbett’s sometimes amusing<br />

presentation encouraged optometrists to<br />

keep their cool and their humour in clinical<br />

situations. He showed two videos – one of<br />

a guy who could almost pop his eyeballs<br />

and an intriguing game of football where<br />

all the players were kitted out with a pair of<br />

binoculars as their only form of vision.<br />

As for lens options in lens replacement<br />

surgery (a better term than cataract<br />

surgery), he discussed several new<br />

technologies, including the Tecnis Symfony<br />

extended depth-of-focus intraocular<br />

lens (IOL); IC-8 small aperture IOL, a new<br />

class of optics useful for highly-aberrated<br />

corneas; and the Harmoni two-part<br />

modular IOL from Clarivista Medical,<br />

a first-of-its-kind lens still undergoing<br />

feasibility trials. Having seen too many<br />

cases where patients opted for multifocal<br />

Dr Dean Corbett and David Haydon<br />

lenses and ended up with night vision<br />

trouble and halo effects, he also said he<br />

was now an advocate for monofocal or<br />

EDOF (such as Symfony) lenses.<br />

SMILE (small incision lenticule extraction)<br />

is Auckland Eye’s preferred laser procedure<br />

for vision correction surgery, with nearly<br />

100% of patients opting for it and less than<br />

1% needing a second procedure. The real<br />

beauty of the procedure, said Dr Corbett, is<br />

it keeps the cornea near intact.<br />

Dr Corbett also touched on a trial<br />

Auckland Eye is currently running on MIGS<br />

(minimally invasive glaucoma surgery) with<br />

a zero-complication rate to date.<br />

CPAC to monovision<br />

Some time was also devoted to the new<br />

Clinical Priority Assessment Criteria (CPAC)<br />

tools and their advantages for optometrists<br />

(see story in NZ Optics’ June issue). Dr<br />

Corbett is chair of the CPAC Steering Group.<br />

Claire McDonald from McDonald Adams<br />

Optometrists, said she finds the tools quite<br />

useful for assessing a patient’s condition<br />

and helping them form a more realistic<br />

expectation of what can be done.<br />

Closing the seminar, Dr Corbett invited<br />

Grant Dabb from Orewa Optics to talk about<br />

his experience of monovision laser surgery.<br />

Dabb said it’s the best vision he has ever<br />

had. But both pointed out the importance<br />

of conducting a proper trial with contact<br />

lenses before going ahead with monovision<br />

surgery. The optometrist has a crucial role to<br />

play in this, said Dr Corbett.<br />

Dr Stephen Best ended the evening with<br />

a raffle rewarding two lucky guests with a<br />

bottle of wine and an annual subscription<br />

for NZ Optics!<br />

Next Insight<br />

Auckland Eye’s next educational event<br />

will be at Orakei Bay, 231 Orakei Road,<br />

Remuera on 17 October from 5.30-9pm. ▀<br />

“A special place.” Niall McCormack at the Ugandan orphanage<br />

Hawke’s Bay optometrist Niall<br />

McCormack hit the headlines<br />

in his local paper last month<br />

for spending two weeks of his holiday<br />

providing eye care to kids in Africa.<br />

The director of Specsavers Hastings,<br />

says people keep telling him it must<br />

have been so rewarding, but he says<br />

he feels like he’s the lucky one to<br />

have had the opportunity to work<br />

with these kids. “I honestly don’t<br />

know why more professionals don’t<br />

do this sort of thing because it’s just<br />

so cool…. It’s so safe in New Zealand,<br />

we’re so oblivious to what goes on<br />

in these places, it’s a real eye opener,<br />

which is the most rewarding thing. It<br />

just gives me a good grounding. It’s a<br />

great experience.”<br />

As well as checking their eyes,<br />

McCormack says he talked to the<br />

children, and the adults who cared<br />

for them, about eye health and<br />

looking after their eyes, something<br />

he’s familiar with through his work<br />

in the paediatrics unit of the Hawke’s<br />

Bay Hospital and through his own<br />

practice. “Kids’ vision has been a<br />

particular interest of mine over the<br />

years, so it was really cool to be able<br />

to have a kid-themed visit to Africa.”<br />

It was so rewarding that<br />

McCormack says he’s now in the<br />

very early stages of establishing<br />

a charity and collaborating with<br />

a local ophthalmologist to bring<br />

eye care to a much wider group of<br />

children through a more structured<br />

programme. “We’re just in the<br />

early process of seeing how we can<br />

manage things and if we can work<br />

something out to make it a little<br />

more doable on a slightly bigger<br />

scale. In Uganda, for example, there<br />

are 200 orphanages.”<br />

McCormack is no stranger to<br />

volunteering overseas having visited<br />

several places in the Pacific with the<br />

Fred Hollows Foundation. It was this<br />

work that led to a customer asking<br />

him if he’d visit the orphanage<br />

him and his wife had established<br />

in Uganda nearly 18 years ago.<br />

Then, another acquaintance asked<br />

if McCormack would also visit the<br />

children of a Kenyan primary school<br />

on the same visit.<br />

In total, McCormack tested 260<br />

children and 19 adults at the Kenyan<br />

primary school and the Ugandan<br />

orphanage. Though most of it<br />

was a real pleasure, he says, there<br />

was one tough moment when he<br />

discovered one child with cataracts<br />

at the Kenyan primary school, but<br />

was unable to help due to the lack<br />

of support from the child’s parents<br />

and no links with ophthalmologists<br />

on the ground. McCormack says he’s<br />

still hoping to help the child once<br />

he establishes the charity and some<br />

more formal relationships with<br />

ophthalmologists in the region.<br />

If anyone is interested in being<br />

involved and genuinely sharing their<br />

expertise by helping children in<br />

Africa, and aren’t looking for a free<br />

holiday, McCormack says he’d love<br />

to hear from you at niallmc@xnet.<br />

co.nz. ▀<br />

MORE CLASSIFIEDS ON PAGE 24<br />

NEED TO REPLACE YOUR<br />

LETTER CHART?<br />

AUCKLAND PRACTICE FOR SALE<br />

Want to own your own practice or perhaps add another to your<br />

expanding empire?<br />

Due to recent health challenges expressions of interest are<br />

sought helping an old man retire after 37 years of practice in East<br />

Auckland.<br />

Computerized practice management with extensive database and<br />

easy access premises with off-street parking. All equipment and<br />

stock required is at hand. Lease as required<br />

Could be run on a part-time basis if necessary.<br />

Flexible take-over.<br />

To discuss this great opportunity, enquire in confidence in the first<br />

incidence by email to c.earnshaw@gmail.com<br />

Naomi Meltzer BSc, Dip Opt, PostGrad.Dip.Rehab.<br />

Low Vision Optometrist<br />

Ph: (09) 520 5208<br />

0800 555 546<br />

Fax: (09) 520 5515<br />

PO Box 28486<br />

Auckland 1541<br />

info@lowvsionservices.nz<br />

www.lowvisionservices.nz<br />

low vision<br />

services<br />

Low Vision Consultations available at<br />

REMUERA, TAKAPUNA, MANUKAU and PUKEKOHE<br />

An Optometrist dedicated to Low Vision support.<br />

DISPENSING OPTICIAN /<br />

OPTICAL ASSISTANT<br />

We are looking for a motivated and energetic dispensing Optician<br />

or experienced Optical assistant who has exceptional customer<br />

service and sales skills and is committed to upholding our practice<br />

philosophy of developing and maintaining long-term customer<br />

relationships. We are a well-established, busy and successful<br />

independent optometry practice in Wellingotn's CBD.<br />

The successful applicant will:<br />

• Display exceptional customer service skills and be committed<br />

to providing excellent patient care<br />

• Have excellent communication skills<br />

• Have confidence in selling high-end products and have<br />

a proven sales record<br />

• Be motivated, willing to learn and committed to ongoing<br />

learning<br />

• Be well presented and have an eye for fashion<br />

• Be competent in technical side of fitting lenses and fixing<br />

frames and have a passion for technology<br />

• An ability to glaze would be an asset however training<br />

can be given<br />

• Be versatile, friendly and a team player<br />

A dispensing qualification is preferred but we will consider<br />

applicants who are still in training or those who have a strong<br />

retail, sales and customer service background with previous optical<br />

experience and an understanding of spectacle lens designs and<br />

fitting eyewear.<br />

This is a full-time position (Monday-Friday).<br />

If this sounds like you please send your CV with covering letter<br />

to vanessa.sercombe@opticians.co.nz Alternatively you can call<br />

Vanessa on 021 132 6789 if you have further questions.<br />

AcuityKit has a comprehensive range of digital eyecharts for eyecare<br />

professionals. Ideal for low vision and domiciliary work.<br />

Visit our website www.acuitykit.com or email john@acuitkit.com<br />

OPPORTUNITY KNOCKS –<br />

CALLING ALL OPTOMETRISTS<br />

OpticsNZ is currently engaged to recruit 17 Optometrist for<br />

vacancies across the North Island and seven across the South<br />

Island, in both independent and corporate practices.<br />

If you are looking to purchase a practice (or a shareholding<br />

within a practice) we have a wide range of options to discuss and<br />

present, from all corners of the country.<br />

If you are a locum (or considering setting up as a locum), currently<br />

we could keep four to five Optometrists busy year round. We have<br />

an unlimited level of work available, right now.<br />

To discuss any of these opportunities, please call Stu Allan on<br />

(03) 5466 996 or 027 436 9091 or email stu@opticsnz.co.nz<br />

DISPENSING OPTICIAN<br />

WELLINGTON CBD<br />

CapitalEyes Optometrists require a<br />

Dispensing Optician for our city practice.<br />

We work as a team to provide high<br />

quality eyecare, eyewear and customer service. We consider our<br />

dispenser as an integral part of the team.<br />

This role also includes frame stock purchasing and has the<br />

potential for manangment responsibilities to the right applicant.<br />

So if you’re ready for the next step up in your career, then this is<br />

the role for you.<br />

For more info contact Kevin O’Connor on 027 4993451 or email<br />

kevin@capitaleyes.co.nz<br />

All applications treated in strict confidence.<br />

22 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>


YOUR CAREER,<br />

NO LIMITS<br />

ASK US<br />

ABOUT OUR<br />

$150K+ FIFO<br />

PACKAGES!<br />

NEW PACKAGES AVAILABLE WITH MARKET-LEADING SALARY<br />

With Specsavers New Zealand continuing to grow, our store partners are looking to add to their optometry teams – and can<br />

offer an exceptional, fast-paced working environment with great rates of pay and a clinical support team without peer.<br />

If you are looking to elevate your clinical experience, it’s time we talked about the range of opportunities available to you.<br />

Since launching our first practices in the market in 2008, our New Zealand store<br />

network has expanded to more than 50 stores, with annual sales of over $120 million<br />

recorded last year.<br />

With a growing volume of patients in every clinic, we invest in a great range of ophthalmic<br />

equipment – with a visual fields machine in every store and digital retinal photography<br />

performed on every patient. Combined with a deep commitment to professional<br />

development for our entire professional team, we believe there is no better place to<br />

enhance your clinical knowledge and accelerate your career.<br />

We have a variety of options available, including regular locum roles with your choice<br />

of locations, 40-hour week fly-in fly-out (FIFO) opportunities where accommodation<br />

is provided, as well as permanent positions. We also have opportunities for graduate<br />

optometrists and a structured program that can lead you to partnership if you believe<br />

you’re ready for store ownership.<br />

All these options come with the backing of well-trained in-store clinical support teams<br />

and store partners, who will work with you every step of the way to help you achieve<br />

your career goals – whatever they may be.<br />

Call and ask about our $150,000+ FIFO package and special Wellington and Christchurch opportunities today.<br />

Contact Chanelle Coates on 0800 717 350 or chanelle.coates@specsavers.com<br />

VIEW ALL THE OPPORTUNITIES AVAILABLE ON SPECTRUM-ANZ.COM<br />

Voted by New Zealanders<br />

Reader’s Digest<br />

Quality Service<br />

Award<br />

<strong>2017</strong><br />

Best Customer<br />

Service in NZ<br />

Optometry<br />

<strong>2017</strong><br />

Millward Brown<br />

Research<br />

No.1 for eye tests<br />

2016<br />

Excellence in<br />

Marketing<br />

Award<br />

2016<br />

Retail<br />

Store Design<br />

Award<br />

2016<br />

Retail<br />

Employer<br />

of the Year<br />

2015<br />

Overall<br />

National<br />

Supreme Winner<br />

2015<br />

Franchise<br />

Innovation<br />

Award<br />

2015<br />

NZ Franchise<br />

System of<br />

the Year<br />

2014<br />

Retail<br />

Innovator<br />

of the Year<br />

2014<br />

FCA Social<br />

Responsibility<br />

Award<br />

2014<br />

<strong>Jul</strong>y <strong>2017</strong><br />

NEW ZEALAND OPTICS<br />

23


MORE CLASSIFIEDS ON PAGE 26<br />

OPTICAL TECHNICIAN/DISPENSER<br />

AUCKLAND<br />

Shamir Australia Pty Ltd is currently looking for an Optical<br />

Technician/Dispenser to set up and manage a new Customer<br />

Service and fitting office in Auckland. This is a great opportunity<br />

for a highly motivated and enthusiastic Optical Technician/<br />

Dispenser which incorporates edging and fitting, customer<br />

service duties and freight responsibilities.<br />

OPTICAL SALES CONSULTANT<br />

AUCKLAND<br />

Reporting to the National Sales Manager, you will be responsible<br />

for sales with the aim of raising awareness of the Shamir brand in<br />

New Zealand and converting potential interest into credible sales.<br />

You will manage your own diary, spending much of your time out<br />

on the road visiting Optical Practices, industry events and<br />

conferences etc.<br />

Previous optical background (preferably a qualified Dispenser)<br />

and sales experience in the ophthalmic lens industry is essential<br />

To apply for a position, please email your cover letter and resume<br />

attention to The National Sales Manager at<br />

info@shamirlens.com.au<br />

EXPERIENCED LOCUM AVAILABLE<br />

Therapeutically qualified.<br />

Auckland or other regions by negotiation. Please contact Mellissa<br />

Teh on 021 1571136 or hetassillem@gmail.com<br />

NZ OPTICAL FRANCHISEE –<br />

BUSINESS OPPORTUNITY<br />

OpticsNZ is excited to present this UK based (Optom owned)<br />

franchise opportunity.<br />

This online business already has 10 years experience serving direct<br />

customers. The area is NZ and includes first rights to the Australian<br />

market<br />

The suitable franchisee will ideally be from the optical industry, but<br />

this is not mandatory. You will need to have good systems, lots of<br />

drive, good general business knowledge and a desire to succeed.<br />

If you have effective marketing and social media skills as well as<br />

some industry knowledge (especially lenses) you will be well suited.<br />

This opportunity has a low entry level cost and has unlimited<br />

potential. This business is likely to commence part-time and grow<br />

into a full-time role. The initial agreement will be for a three-year<br />

term.<br />

Expressions of interest are welcome from individuals, existing<br />

practice owners or wholesale operations in writing to Stuart Allan<br />

at OpticsNZ, PO Box 1300, Nelson or via stu@opticsnz.co.nz by 5<br />

pm Wednesday 19 <strong>Jul</strong>y <strong>2017</strong>. Phone enquiries are welcome on (03)<br />

5466 996 or 027 436 9091 .<br />

PART-TIME OPTOMETRIST WANTED<br />

SILVERDALE<br />

OPSM Optometrists in Silverdale is a privately owned (franchise)<br />

practice/store with a supportive and experienced team. We are<br />

seeking a caring optometrist to join our friendly team and work<br />

around 18 hours per week (including Sundays) or alternatively to<br />

just do Sundays (10am to 5 pm).<br />

Competitive salary package and generous product allowances<br />

for the right candidate.<br />

To apply, please email your CV and cover letter to<br />

tracy.kendall-jones@opsm.co.nz<br />

All applications will be treated with the utmost confidentiality.<br />

DISPENSING/OPTICAL ASSISTANT<br />

CHRISTCHURCH<br />

If you are confident, strive for excellence, have experience in<br />

dispensing, great at multitasking, enjoy working with children,<br />

then this is your opportunity to build on your skills and join a busy<br />

practice Christchurch. No weekend work, no late nights. Full-time<br />

position.<br />

Please send your CV and expression of interest to<br />

leza@anstice.co.nz<br />

CHOOSE YOUR<br />

AUSSIE ADVENTURE<br />

At OPSM, we are passionate about opening eyes to<br />

the unseen. Our advanced technology enables us to look<br />

deeper to ensure we give the best care to every customer.<br />

OPTOMETRISTS<br />

QUEENSLAND & NORTHERN TERRITORY<br />

WITH ATTRACTIVE SALARY PACKAGES<br />

We are looking for Optometrists who share our passion<br />

and want to make a difference to how people see the<br />

world. Whether you like the city, the surf or the outback,<br />

we’ve got the role for you with our teams in:<br />

• Bundaberg<br />

• Cairns<br />

• Darwin<br />

• Katherine<br />

• Mackay<br />

• Mt Isa<br />

• Toowoomba<br />

• Townsville<br />

JOIN OUR TEAM<br />

You can look to take on a fixed period role or even<br />

consider a more permanent move – who knows,<br />

you might fall in love with the place. Depending on<br />

the location, salary packages up to 175K including<br />

superannuation, accommodation, annual return<br />

flights to visit family and friends and relocation<br />

support for the right candidate. Start your journey<br />

with us today! Graduates or recent graduates<br />

are very welcome to apply.<br />

CONTACT:<br />

Brendan Philp<br />

brendan.philp@luxottica.com.au or call +61 418 845 197<br />

Kim Shepherd<br />

kim.shepherd@opsm.com.au or call +61 408 763 575<br />

OPSM.COM.AU/CAREERS<br />

WE SEE YOUR<br />

FUTURE WITH US<br />

At OPSM, we are passionate about opening eyes to<br />

the unseen. Our advanced technology enables us to look<br />

deeper to ensure we give the best care to every customer.<br />

OPTOMETRISTS<br />

NORTH & SOUTH ISLAND, NEW ZEALAND<br />

Our New Zealand business is looking for passionate<br />

Optometrists to join the team.<br />

• Whangarei, Northland<br />

• Bayfair, Tauranga<br />

• Thames, Thames-Coromandel<br />

• The Plaza, Palmerston North<br />

• Napier/Hastings, Hawkes Bay<br />

• Willis St, Wellington<br />

• Queensgate, Wellington<br />

• Merivale, Christchurch<br />

• The Crossings, Christchurch<br />

• Dunedin, Otago<br />

• Wellington float, Wellington Region<br />

When you join OPSM, you work within a team who<br />

are committed to providing the best possible eyecare<br />

solution with exceptional customer service. You will work<br />

with world class technology including our exclusive<br />

Optos Daytona ultrawide digital retina scanner. You<br />

will have many opportunities for continuing professional<br />

development and can enjoy career flexibility through<br />

our extensive store network. You can also make a<br />

real difference in the way people see the world by<br />

participating in our OneSight outreach program.<br />

JOIN OUR TEAM<br />

Start your journey with us today!<br />

Recent graduates are very welcome to apply.<br />

CONTACT:<br />

Hirdesh Nair<br />

hirdesh.nair@opsm.co.nz or call +64 21 523 282<br />

OPSM.CO.NZ/CAREERS<br />

M<br />

Y<br />

Y<br />

Y<br />

LX21_OPSM_NZOpticsAU_Advert_2.indd 1<br />

21/3/17 11:14 am<br />

Thinking of selling your practice - we have buyers<br />

Considering buying - we’ll give you all the options<br />

OpticsNZ specialises in optometry practice sales,<br />

we've helped dozens of Optometrists buy and sell their practices<br />

For more information contact Stuart Allan on: 03 546 6996<br />

027 436 9091 stu@opticsnz.co.nz www.opticsnz.co.nz<br />

• Locum Service<br />

• Recruitment Services<br />

• Practice Brokering<br />

• Business Consultants<br />

24 NEW ZEALAND OPTICS <strong>Jul</strong>y <strong>2017</strong>

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