Dec 2017

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY 

PO BOX 106 954, AUCKLAND CITY 1143 

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

DECEMBER 2017 

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3 NZ ‘Suture Future’ team wins Velocity Challenge 

6 A practical approach earns plaudits at EI conference 

26 Tackling tech frustrations and a lack of images in our DHBs 

RANZCO 2017: NEW TECH, AWARDS AND SO MUCH MORE (10-17)

OPEN TO ALL 

OPTICAL 

PROFESSIONALS! 

THE ULTIMATE PATHWAY TO 

ACHIEVING YOUR AMBITION 

CALLING ALL EXPERIENCED OPTOMETRISTS, OPTICAL 

DISPENSERS AND RETAIL MANAGERS 

In the last ten years, we have opened more than 375 current stores across Australia and New Zealand, 

creating business ownership opportunities in every store – with at least one optometry partner and one 

dispensing partner in every location being the standard Specsavers recipe for success. 

Now, as our network of locations grows and as individual stores continue to 

expand, a greater number of partnership roles are being created, while some of 

our longer-term partners are in succession-planning mode. And that all adds up 

to one thing: opportunity. 

So, if you are an experienced and ambitious optometrist, dispenser or store 

manager and you are thinking of taking the next step – towards business 

ownership – we would like to talk to you about how we can help you turn that 

opportunity into a partnership role with Specsavers. 

Our Pathway program has established a well-travelled route that, partner by 

partner, delivers exactly that. It’s an intensive six-month development program 

that adds much-needed business management and development skills to 

participants’ clinical, dispensing or retail skills. In short, Pathway’s job is to set up 

future store-owners for success. 

So, whether you currently work for Specsavers or have built an impressive 

career elsewhere, we’d love to talk to you about the Pathway to your future. 

Please contact Kimberley Hannan on +61 429 566 846 or at kimberley.hannan@specsavers.com for a confidential discussion. 

Voted by New Zealanders 

Reader’s Digest 

Quality Service 

Award 

2017 

Best Talent 

Development 

Program 


Best Customer 

Service in NZ 

Optometry 


Millward Brown 

Research 

No.1 for eye tests 

2016 

Excellence in 

Marketing 

Award 

2016 

Retail 

Store Design 

Award 

2016 

Retail 

Employer 

of the Year 

2015 

Overall 

National 

Supreme Winner 

2015 

Franchise 

Innovation 

Award 

2015 

NZ Franchise 

System of 

the Year 

2014 

Retail 

Innovator 

of the Year 

2014 

2 NEW ZEALAND OPTICS December 2017

New glaucoma stent 

now in NZ 

The Xen Gel Implant, 

a new innovation 

in glaucoma 

management for patients 

whose condition is not 

being well managed with 

drops, is now available in 

New Zealand. 

Talking to NZ Optics 

at RANZCO 2017, new 

RANZCO fellow (see p13) 

Dr Nic Johnston says the 

innovation is an exciting 

addition to the glaucoma 

armamentarium. 

Dr Johnston was 

particularly interested 

to see the stent in action 

having worked with 

its inventor, Australian 

ophthalmologist Professor 

Bill Morgan, in Perth as part of his fellowship. 

The 6mm, biocompatible, collagen-derived 

gelatin Xen stent technology is based on the 

same principle as a trabeculectomy, creating a 

new outflow channel bypassing trabecular and 

scleral resistance forming a diffuse, low-lying 

bleb. It is inserted using a specially-designed, 

pre-loaded disposable 27-gauge injector via a 

small, self-sealing corneal incision. According 

to Allergan’s studies, approximately three Xen 

procedures can be done in the time required for 

one trabeculectomy, with less intensive and timeconsuming 

follow-up required. 

Professor Helen Danesh-Meyer, who chairs 

Glaucoma New Zealand, was the first Kiwi 

surgeon to be fully certified to use the new Xen 

technology and since then has performed about a 

dozen surgeries. She says she welcomes the new 

technology as there’s been a significant gap in the 

treatment spectrum for glaucoma patients who 

need surgical intervention to help manage their 

glaucoma. “The Xen offers a less invasive surgery 

option in that it is ab interno, the operation occurs 

through two incisions less than 2mm each, with no 

sutures. This provides the opportunity for more rapid 

recovery of vision and less complications. Because of 

these potential advantages, new procedures such as 

Xen will provide new treatment opportunities.” 

Allergan’s Brock Flowers and Dr Nic Johnston trying out the new Xen injectable gel implant at RANZCO 2017 

Xen has been available in Europe for about three 

years and more recently in the US and Canada, 

giving rise to a growing body of evidence that 

supports its effectiveness, with minimal risks 

and complications, said Prof Danesh-Meyer. “We 

need to see more surgical options which are both 

better tolerated and more efficient. This may 

have the dual benefit of decreasing the morbidity 

and recovery time following surgery as well as 

increasing availability of clinic times so that more 

patients can be seen in an appropriate timeframe 

to minimise the risk of life-changing consequences 

due to delayed treatment.” 

Results from a 12-month, interim analysis of an 

ongoing clinical trial (APEX) found 70% of patients 

with Xen achieved equal to or less than 15mm 

Hg IOP, with the mean IOP at 13.8mmHg, from a 

treated baseline of 21.4mmHg and, at 12 months, 

56% of patients were drop-free. There was also no 

symptomatic hypotony or major complications. 

Globally and locally, glaucoma is the leading 

cause of irreversible blindness. It affects 10% of 

New Zealanders over the age of 70 and 2% of 

the population over 40, with primary open angle 

glaucoma being the most common form. ▀ 

For more about Xen and the latest advancements 

in ophthalmology, see the special feature on 

RANZCO 2017 on pages 10-17. 

A bumper-packed 

holiday issue! 

EDITORIAL 

Our last issue of the year is a cracker, with all the views 

and exciting developments from the ADONZ, Eye 

Institute and RANZCO 2017 conferences, and our 

annual wallplanner, so you can start picking out your 2018 

conference destinations. Plus, Christmas has come early to 

the New Zealand eye care world with news about an exciting 

new glaucoma stent, Xen (this page); a new evaporative 

dry eye treatment, Novatears (p4); funding for Ozurdex, a 

new treatment for diabetic macular oedema (p16); and the 

welcome news that Pharmac’s reviewing Eylea again (p18), 

which should please many Kiwi ophthalmologists. 

Our RANZCO coverage (p10-17) is packed with pictures, the highlights of the 49th Scientific Congress, 

the parallel practice managers’ conference and the Association of Australian Ophthalmic Nurses 

annual get together, which welcomes Kiwi participants, whose keynote this year was our own Dr Elissa 

McDonald from the University of Auckland. 

We also have a welcome update about Ophthalmologists New Zealand (ONZ) which is being 

transformed by new executive director (well-known to many of us), Moira McInerney, and a supportive 

board (p18). Dr Stuti Misra reviews the latest “bible” for anyone who works with ophthalmology, but 

isn’t an ophthalmologist (p18) and Chalkeyes presents how one Kiwi ophthalmologist is attempting to 

force our DHBs into the 21st Century for the benefit of all in New Zealand’s eye health world. 

More on the optometry side, we’ve got all the pictures and coverage from Eye Institute’s annual 

scientific conference (p6) and Auckland Eye’s last Insight evening (p21), and an amusing look at bandage 

contact lenses by our wonderful speciality lens 

columnist, Alex Petty (p8), who’s in the news himself 

this month (p8). Plus, check out the costumes from 

ADONZ’s annual gala dinner (p22) and news about its 

two new life members (p23). 

You’ve got the whole holidays to digest and mull 

over the following packed pages and the 2018 

Wallplanner as this is our last issue for 2017. Your 

2018 OIG will also be arriving shortly. So, have a 

fabulous Christmas, a wonderful New Year and a 

great, relaxing holiday and we’ll see you back at the 

end of January with our February issue. 

Happy holidays from all the NZ Optics’ team! 

NZ Optics’ Lesley Springall and Susanne Bradley in Christchurch 

for ADONZ 2017 

Lesley Springall, editor, NZ Optics 

© 2017 Allergan. Used with permission 

The Xen Gel Stent connecting the anterior chamber to the subconjunctival space 

© 2017 Allergan 

© 2017 Allergan 

A first for ‘Suture Future’ 

Joevy Lim, an honours student in Auckland 

University’s ophthalmology department, and 

her team ‘Suture Future’ have won first prize in 

the 2017 Velocity 100k Challenge, winning a total 

of $25,000 to support the development of their 

new business venture. 

Suture Future is developing a new surgical 

stitching device which will significantly improve 

the efficiency of stitching, says Lim, with the 

time saved during stitching directly translating 

into lower rates of morbidity (complications) 

and mortality (deaths). This will, hopefully, also 

contribute to a reduction in health care costs 

through better clinical outcomes, adds Lim, who 

was unable to go into more detail as her fledgling 

company is currently bound by a non-disclosure 

agreement, adding to the excitement. 

Rachel Yeu, Joevy Lim and Adrian Ng accepting their award 

Lim says winning was surreal: “I was elated, 

thankful and proud that all the hard work our 

team put in to this venture paid off in the end. We 

had very tough competitors, many of whom were 

university researchers and working individuals. 

Winning the challenge was a major validation of our 

idea and has motivated us to keep moving forward.” 

The team: Lim, final year medical student, Adrian 

Ng, and economic and psychology major, Rachel 

Yeu, all worked extremely hard balancing their 

studies with work on the start-up, which would 

not have been possible without the support of 

Lim’s supervisor, Associate Professor Jennifer Craig, 

says Lim. 

The Velocity 100k Challenge is an 

entrepreneurship programme run by the Centre 

of Innovation and Entrepreneurship at Auckland 

University. All finalists get a mentor 

and go through a six weeks intensive 

Launchpad programme designed 

to turn ideas into reality, creating a 

business plan and presentation for their 

venture. 

In other University news, Lim’s 

ophthalmology department colleague, 

Dr James Slater has been awarded 

a $172,482 Pacific Clinical Research 

Training Fellowship grant by the Health 

Research Council of New Zealand (HRC) 

for his ‘CHOCS and TOFU projects: 

Ophthalmic changes in diabetes’. ▀ 

SESSION 1 PRESCRIBING, DRUG 

INTERACTIONS AND SIDE EFFECTS 

º Oral medications for ocular conditions 

º Toxicity of common systemic 

medications to the eye 

º Interactions of common eye drops with 

other prescribed medications 

º Optometrist prescribing trends in NZ 

º The Pharmacist’s role in eye care 

Sunday 11th March 

Full Day of CPD points will be applied for 

Waipuna Conference Centre, Auckland 

Topics will be delivered in an entertaining 12 min rapid fire fashion, along 

with interactive panel discussions. Topics include: 

SESSION 2 THERAPEUTICS FOR 

POSTERIOR SEGMENT DISEASES 

º Targeting the inflammasome pathway - 

an oral treatment for AMD and DR 

º Topical medications for posterior 

eye diseases 

º Gene therapeutics in the treatment 

of retinal diseases 

º Nutrition and supplements for posterior 

segment diseases 

º The role of OCT in the management of macular 

disease: A case based review 

SESSION 3 ANTERIOR 

SEGMENT THERAPEUTICS 

º Surface modification of contact lenses 

for improved properties 

º Corneal cross-linking in children - 

a small window of opportunity 

º Treating the rising scourge of 

acanthamoeba keratitis 

º Avoiding and managing 

corneal transplant rejection 

º Challenging glaucoma cases 

SESSION 4 DRY EYE SESSION 

ACCORDING TO TFOS DEWS II 

º Dry eye re-defined and classified 

º Dry eye diagnostic methods 

º The role of iatrogenic dry eye in refractive surgery 

º The science behind ocular lubricants 

º Current and future management and 

therapy of dry eye 

For more topics, speaker programme and to register visit: 

www.regonline.com/oculartherapeutics2018 or call 06 833 6160 

With thanks to our sponsors already onboard 

PLATINUM SPONSORS 

PREMIUM SPONSORS 

December 2017 

NEW ZEALAND OPTICS 

3

News 

in brief 

LIPOXINS FOR GLAUCOMA? 

Vision scientists at UC Berkeley 

and Toronto University have 

discovered that naturally 

occurring molecules, known as 

lipoxins, have the potential to 

halt the progression of glaucoma. 

At 16 weeks, researchers 

found lipoxin B4, in particular, 

stopped cell degeneration 

in mice with glaucoma and 

neurodegeneration. The team’s 

findings could lead to remedies 

for glaucoma and other 

neurodegenerative diseases, said 

senior author, Professor Karsten Gronert. 

Retinal ganglion cells (green) connecting 

with astrocytes (red) and blood cells (white) 

in the inner retina. 

PATIENTS WANT SPECS ALTERNATIVES 

A qualitative Flinders University study, published in RANZCO’s 

Clinical and Experimental Ophthalmology, has found many patients 

are upset with being prescribed glasses for their refraction error, 

claiming it affects their quality of life. “Patients want eye specialists 

to have a broader perspective and present more options… (including) 

some who voiced a clear preference for laser surgery, calling it a ‘life 

changing solution’,” said lead researcher Dr Jyoti Khadka. 

HOKI FISH SCALE CORNEAS 

Massey University scientists have developed artificial corneas for 

human transplant using a 3D printer and collagen from hoki fish 

scales. Lead researcher, Associate Professor Johan Potgieter said the 

aim was to make something affordable from a renewable resource 

for a world market, and hoki fish scale corneas are accepted by 

the human body. 3D printing has been used to create simple body 

structures, like bladders and skin, but this is the first time it’s been 

used for corneas, he told Stuff, adding he hoped a mass production 

process would be ready for testing by the end of next year. 

DEEP-SEA FISH REVEALS TWILIGHT VISION TRICK 

In other fishy news, scientists have discovered a new type of cell 

in the eyes of deep-sea pearlside fish, which have an unusual 

visual system adapted for twilight conditions. The Queensland 

Brain Institute’s Dr Fanny de Busserolles said, instead of using a 

combination of rods and cones, Pearlsides combine aspects of both 

cells into a single and more efficient photoreceptor, a “rod-like 

cone”, tuned perfectly to the pearlsides’ specific light conditions. 

NEW PHARMAC CEO 

Pharmac’s director of operations, Sarah Fitt, a 

former Auckland Hospital chief pharmacist, has 

been appointed CEO, effective from January 

2018. Pharmac chair Stuart McLauchlan said, 

“Sarah is one of the most outstanding clinical 

leaders in New Zealand. Her experience is 

going to be vital for the continuity of Pharmac 

and we wanted to ensure we retained that 

talent.” Fitt replaces Steffan Crausaz who’s 

Sarah Fitt 

moving to the private-sector. 

GENE THERAPY TO REVERSE BLINDNESS 

A team at Oxford University has shown it might be possible to 

reverse blindness using gene therapy to reprogramme cells at 

the back of the eye to become light sensitive. Researchers used 

a modified virus to inject a new gene, which expresses the light 

sensitive protein, melanopsin, into the residual retinal cells in mice 

which were blind from retinitis pigmentosa. The mice were able to 

demonstrate a high level of visual perception for more than a year. . 

G&M EXPANDS RAPIDLY 

George & Matilda has acquired its 40th practice, just two years 

after starting up. Chris Beer, G&M CEO, told local media the 

Australian optometry chain’s growth is a credit to its business 

model. “We have found by working closely with our partners to 

maintain their independence while supporting them with their 

back-office needs… is a winning formula for success”. 

ALCON SPIN-OFF IN 2019? 

A Novartis’ strategic review concluded a standalone Alcon, formed 

via a capital markets exit, could create additional shareholder value, 

but was “not likely before the first half of 2019”. Novartis said it 

hopes to list Alcon, but will focus on a financial turnaround before 

making a final decision. 

OPTOMETRY IN AUSTRALIA SNAPSHOT 

According to ODMA’s Eye Talk, a total of 3,884,835 pairs of spectacles 

were dispensed in 2016/17, at an average price of A$305.65 a pair, 

down from A$320 two years ago, with prescription spectacle sales 

for the 2016/2017 year amounting to A$1.373 billion. 

SOLUTION FOR NIGHT BLINDNESS 

Hoya Surgical Optics has developed a wearable device to assist 

night blindness patients in low light conditions. The wearable 

glasses-type device, provisionally called Hoya MW and developed in 

collaboration with Kyushu University and Tokyu Corporation, uses 

image processing software, capturing images on a miniature highsensitivity 

camera and projecting them on a display in front of the 

wearer’s eyes. The device is undergoing trials in Japan. 

PHOTOGRAPH: JEREMY SIVAK 

Major honour for Kiwi doctor 

Auckland-based 

medical retina 

specialist Dr Dianne 

Sharp was honoured 

at the 49th annual 

Royal Australian and 

New Zealand College 

of Ophthalmologists 

(RANZCO) Scientific 

Conference in Perth for her 

distinguished service to 

ophthalmology. 

Dr Sharp, pictured here 

receiving her Distinguish 

Service Award from 

RANZCO president, 

Associate Professor 

Mark Daniell at the 

RANZCO 2017 graduation 

celebration, said the award 

was a huge honour. 

For full story and all the 

news from RANZCO’s 49th 

Congress turn to p10-17. 

CR invests large in Perfection 

Christchurch and Australia-based optical laboratory, CR 

Surfacing is gearing up for growth with a complete overhaul 

of its technology and processes to ensure it remains at the 

cutting edge of lens production in today’s high-tech world. 

Linton Dodge, CR Surfacing’s New Zealand general manager, says 

it’s an exciting time for the company, which has grown significantly 

in the last year and is banking on growing far more due to recent 

changes in the industry. 

To this end, after months of investigation and deliberation, CR 

Surfacing has unveiled details of a million-dollar plus investment in 

its future, with the company installing a new state-of-the-art lens 

processing manufacturing suite, from German company Schneider, 

at its headquarters in Melbourne. Dodge, who went to see the new 

installation and be briefed on its capabilities in October, said it was 

amazing. “It’s just crazy. All automated conveyor belts… just very, very 

advanced.” 

The new Schneider installation marks the end of CR Surfacing’s 

long-standing Signature brand of lenses, which will be phased 

out and replaced by its new Perfection Lens Series over the next 

year. The new Perfection range is completely compatible with the 

Schneider machinery and will ensure the company can offer the 

highest accuracy possible for progressive lenses, said Dodge. “It’s all 

about the end result. You can pretty much get a freeform lens from 

anywhere. You can get one from China or Germany; you can buy the 

best freeform lens in the world, but if it’s designed on a lower quality 

machine, you are not going to get the result you want.” 

CR Surfacing’s tech investment has been driven by two factors: 

first, and foremost, it’s commitment to being entirely independent to 

best serve the needs of the independent optometry market in New 

Zealand and Australia; and the looming Essilor-Luxottica merger, 

which is creating opportunities in the market, said Dodge. 

The company was selected as the preferred lens supplier to Australia’s 

largest network of independents, ProVision, at the beginning of this 

year, he said. “Doors, that in the past, we thought would be shut to us 

forever are now opening… and it’s that independence that drives us. 

Right from day dot, CR Surfacing 

has been 100% independent, 

that’s why the Signature series 

came about years and years ago 

because we said if we’re going to 

be truly independent we need to 

have our own product. It was a 

bold move at the time, but we’ve 

never looked back and now we’re 

looking forward again.” 

In July, Eyepro, the New 

Zealand independent 

optometry group run by Chris 

Clark, also announced CR 

Surfacing would be its preferred 

lens supplier (see story in NZ 

CR Surfacing’s Linton Dodge 

Optics’ August issue). 

CR Surfacing’s Kiwi HQ in Christchurch is also undergoing some 

changes to accommodate the changes, with Dodge and his team 

welcoming a new state-of-the-art Mei Ezfit all-in-one edger. The 

EZfit allows the operator to control the power and cut of a lens 

without the use of centring blocks, reducing production costs and 

increasing the accuracy of lens centring. Fully automated, E3fit uses 

a patented vacuum system to hold the lens in place, reducing the risk 

of breakage during milling. 

It’s a massive job changing from one production system to another, 

but CR Surfacing hopes to have all the bugs ironed out and the new 

Perfection Lens Series range in place to begin showing to selected 

customers by the beginning of December, said Dodge. “CR Surfacing 

is investing millions of dollars for the growth and success of the 

independent market. That’s why we are so excited, and the interest is 

there for us to do it.” ▀ 

For details about CR Surfacing’s new Perfection Lens Series range, 

please refer to the Lenses Rx section of the 2018 OIG, out soon. 

NovaTears launches in NZ 

NovaTears, a new treatment for evaporative 

dry eye disease (DED) has been launched 

in New Zealand and Australia. 

NovaTears manufacturer, German speciality 

pharma company Novaliq, described the new 

product as “the first and only water-free topical 

eye drop treatment specifically developed to treat 

patients with DED. (It) immediately stabilises 

the lipid layer without causing vision blurring. 

Clinically validated in four clinical trials… showed 

that NovaTears is safe and efficacious for treating 

the signs and symptoms of DED and meibomian 

gland dysfunction (MGD).” 

NovaTears will be distributed by Kiwi company AFT 

Pharmaceuticals in Australasia under an exclusive 

licensing arrangement. 

“We are thrilled to be able to offer patients a 

novel ophthalmic treatment that addresses signs 

and symptoms of evaporative DED and MGD,” 

said Hartley Atkinson, AFT CEO. “NovaTears is a 

first-in-class, water-free and preservative-free 

treatment that strengthens the lipid layer of the 

tear film thereby preventing evaporation. It is a 

welcome addition to our eye care line, one that 

will provide superior benefits to patients.” 

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

For general enquiries or classifieds please email info@nzoptics.co.nz 

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

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 

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

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

NZ Optics 2015 Ltd. As well as the magazine and the website, NZ Optics publishes the annual New Zealand Optical Information Guide (OIG), a comprehensive listing guide that profiles the 

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

those of NZ Optics 2015 Ltd or the editorial team. 


for Evaporative Dry Eye 

NOVATEARS ® 

NovaTears ® is a unique 

preservative-free eye 

lubricant and tear film 

stabiliser in a multi-dose 

bottle, specifically designed 

for the relief of Evaporative 

Dry Eye Disease. 

months 

Clinically validated with 

significant improvement in signs 

and symptoms with Evaporative 

Dry Eye Disease and Meibomian 

Gland Dysfunction patients 1,2 

6 

shelf life after 

opening 

NovaTears ® utilises patented EyeSol technology to provide an innovative water-free mode of action that 

acts as a lubricating lipid layer substitute and evaporative barrier for improved tear film stability and quality. 

Lipid layer 

deficiency 

Apply 

NovaTears ® 

Spreads 

quickly and 

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lipid layer 

References: 1. Steven, Philipp, et al. “Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease – A Prospective, Multicenter Noninterventional Study.” Journal of Ocular Pharmacology and Therapeutics 31 (8), 498-503 (2015). 2. Steven, Philipp, et al. 

“Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease Due to Meibomian Gland Disease.” Journal of Ocular Pharmacology and Therapeutics. 33(9), 678-685 (2017). NovaTears® Eye Drops (Perfluorohexyloctane 100% v/v, 3mL) are for the lubrication 

and relief of dry and irritated eyes. Do not use NovaTears® with contact lenses. If using any other eye medication, allow at least 15 minutes between using the other product and applying NovaTears®. NovaTears® should not be used in children under 18 years. 

NovaTears® should not be used while pregnant or breastfeeding. AFT Pharmaceuticals Ltd, Auckland. www.aftpharm.com TAPS: PP1560 

For product enquiries contact: 0800 954 536 

CORNEAL LENS 

CORPORATION N.Z. LTD 

www.corneal-lens.co.nz 



5

A practical approach earns plaudits 

BY ELLA EWENS 

Back by popular demand, Eye Institute’s 2017 

Annual Scientific Conference once again 

included some in-depth workshops on the 

Saturday, followed by the conference proper on the 

Sunday. 

Hands on with gonio and more 

A gonioscopy refresher was highlighted as an 

additional education need after the inaugural 

workshops on OCT in 2016. Unsurprisingly then, 

there was a significant increase in the turnout for 

Saturday’s workshops on gonioscopy and indirect 

ophthalmoscopy, where delegates were given the 

opportunity to gain valuable experience on these 

different clinical techniques. 

Drs Shanu Subbiah and Jay Meyer ran the 

gonioscopy refresher, sharing practical tips and 

tricks on how to perform the technique. A video slit 

lamp with a large viewing screen, kindly provided by 

the Ophthalmic Instrument Company (OIC), allowed 

presenters to show delegates the elusive anterior 

chamber angle structures. While in the other 

workshop, Dr Peter Hadden treated delegates to 

an insightful session on how to view the peripheral 

retina and perform indirect ophthalmoscopy with 

indentation. 

CL pearls, lasers and corneal implants 

Numbers jumped from about 70 delegates to more 

than 250 for Sunday’s main conference, which 

included overseas keynote speaker, Associate 

Professor Mark Roth, a Melbourne-based clinical 

optometrist with a degree in pharmacology and 

clinical editor of Optometry Pharma. 

A/Prof Roth kicked off proceedings with a lecture 

on the management of contact lens problems. 

Amongst his clinical pearls was the importance 

of taking a thorough history before jumping to 

the slit lamp. “Ask your patient about potential 

water contamination.” Then, he recommended 

using a systematic approach to examining the 

patient’s eyes, starting with white light before 

using fluorescein, and always looking at the lids and 

both eyes. A/Prof Roth reminded his audience that 

microbial keratitis is rare and painful and usually 

associated with mucopurulent discharge and a 

single lesion. “Care should be taken, however, to 

cover yourselves for the worse case scenario – a 

gram-negative bacterial infection.” 

Dr Nick Mantell was next with an interesting 

update on refractive laser and how far it’s come 

over the last 20 years. “Good outcomes are the 

norm now.” While the newer small incision lenticule 

extraction (SMILE) technique shows great promise, 

with faster recovery and less chance of ectasia, he 

said. 

The Eye Institute has a new excimer laser, which 

is one of the fastest on the market, said Mantell. At 

1050 pulses per second, the laser takes only eight 

seconds for a +3.00 DS correction, which previously 

took more than 30 seconds. This fancy new 

gadget also features ‘seven-dimensional tracking’, 

incorporating all positions of gaze plus the seventh 

dimension of time by predicting where the eye will 

move next. 

Later in the day, Dr Adam Watson, discussed 

surface laser vision, used where a patient has a 

thin cornea or where corneal scarring means a flap 

cannot be made. Newer techniques only remove 

the epithelium that’s required, resulting in quicker 

healing for the patient, he said. He also discussed 

the use of Keraring implants for keratoconus. These 

corneal implants work by adding bulk to the cornea 

and shortening the central arc. They are suitable for 

moderate keratoconus and can be combined with 

cross-linking in 80% of cases. 

Grappling with glaucoma 

Dr Graham Reeves looked at biomarkers and 

surrogate endpoints in understanding glaucoma, 

and why we should be careful interpreting clinical 

trials. In glaucoma, the clinically relevant endpoint 

could be a loss of vision, reduced quality of life and 

Cullen Szeto and Chris Earnshaw 

Dr Narme Deva and Grace Lang 

functional disability. He then discussed the benefits 

and shortcomings of using intraocular pressure and 

visual field imaging as surrogates to the endpoint 

for glaucoma. 

In a later session, Glaucoma NZ chair Professor 

Helen Danesh-Meyer, with trademark clarity, 

provided some practical tips about angle closure 

glaucoma and its risk factors. If it’s wide you 

probably don’t need gonioscopy and, if its closed, 

gonio might not provide much information; it’s the 

cases in between where it can be useful, she said. 

Disc swelling, or not, and a tumour test 

Prof Danesh-Meyer also tackled optic disc swelling, 

asking: “Is it really swollen? Are both nerves really 

swollen? Is there any optic nerve dysfunction? 

Is the cause local or systemic disease?” She 

explained how to pick from an armoury of tests, 

some available to optometrists, such as a CT scan, 

fundus autofluorescence, OCT and B-scans, before 

concluding an urgent referral is always required for 

a bilateral disc swelling. 

Dr Peter Hadden, meanwhile, led us on a 

fascinating journey through rare intraocular 

tumours, reminding us that lung and breast cancer 

are the most common types of cancer and lung can 

show up first in the eye. He advised practitioners 

who spot an intraocular lesion to describe it – 

colour, location etc. – photograph it, OCT it, B-scan 

it, consider systematic associations and then refer 

or follow it. 

Cornea, cataracts, paediatrics and dry eye 

Dr Simon Dean shared some cases of cataract 

surgery complications, dispelling the myth that 

cataract surgery is a quick and simple procedure 

that Fred Hollows can do for 20 bucks! “If the 

cataract is very dense and brunescent, it’s like a 

chunk of leather.” 

Later Dr Dean discussed the importance of corneal 

sensation and its receptors for heat, chemicals, 

cold and osmolarity. He introduced his non-contact 

corneal aesthesiometer (NCCA), which uses an air 

puff and a cooling stimulus to measure corneal 

sensation, and may yield more information about 

nerve fibre pathways involved in ocular surface 

health and disease (see NZ Optics’ Dry Eye Special 

Feature in the September 2017 issue). 

Dr Shanu Subbiah presented on paediatric red eye 

providing some useful tips on examining children. 

Make eye contact with the child as they enter the 

room and see if they look at you; have the parent 

hold the child; take a careful history; take note of 

recent trauma or even a sore throat for potential 

adenoviral conjunctivitis, he said. He recommended 

viewing the New Zealand formulary (nzfchildren.org. 

nz) if considering eye drops on patients under three. 

One of the big topics of the year, dry eye, and its 

diagnosis was tackled by A/Prof Roth, who also 

introduced the concept “pain without stain” where 

neuropathic ocular pain is over represented. He 

suggested using a dry eye questionnaire such as 

McMonnies or the Ocular Surface Disease Index 

(OSDI). He didn’t recommend Schirmer’s test, unless 

you particularly dislike the patient, suggesting 

instead the phenol red test. Lissamine green is also 

Karen Moulton and Debra So 

Amanda Shepherd and Bruce Keighley 

useful for identifying dead and devitalised cells 

and he suggested examining with white light first 

before blue light. 

The latest recruits on MIGS, bacteria and 

uveitis 

Dr Watson introduced the Institute’s latest recruits, 

Drs Narme Deva, Jay Meyer, Graham Reeves and 

William Cunningham, all of which now share in the 

ownership of Eye Institute to ensure better teamwork, 

a sharing of skills and increased subspecialist 

areas to maximise patient outcomes, he said. These 

latest recruits then took to the podium presenting 

talks on their areas of interest and specialism. 

Dr Reeves discussed current and up and coming 

minimally invasive glaucoma surgery (MIGS) 

techniques, where he touched on the latest, exciting 

development in the world of glaucoma, the Xen Gel 

Stent (see p3). While Dr Meyer tackled the tricky 

problem of what to do when chloramphenicol 

doesn’t work. “Acute viral or bacterial conjunctivitis 

should resolve in three weeks. If greater that that, 

it’s usually something else,” and you should rule 

out chronic follicular chlamydial conjunctivitis if the 

condition is grumbling on for weeks, he said. 

While optometrists can now prescribe oral 

azithromycin, Dr Meyer recommended this should 

be managed by the patient’s GP, who can confirm 

diagnosis and treat partners as well. “Always 

look at the eyelids” was a recurring theme, as Dr 

Meyer explained differentials for papillae; vernal 

keratoconjunctivitis takes two forms, the arcusesque 

limbal type or the palpebral form. 

Dr Deva discussed ‘Anterior Uveitis (and) things 

that make you go hmmmm?’ Her first red flag is 

patients outside the normal age range of 20-50 

years. She reminded optometrists to remember 

to quiz the patient about anything that may 

affect their immune system, such as chemo and 

immunosuppressant drugs, and provided examples 

of systemic conditions and their clinical appearance. 

Poppers maculopathy, MD and a cure for dry 

eye? 

Dr Nick Mantell returned with a look at popper 

maculopathy – the acute or chronic form of toxicity 

associated with yellow foveal spots caused by the 

recreational akyl nitrate family of drugs. 10% of 

the population have used this drug, with use more 

prevalent in those over 40, he said, with 10% of 

users developing visual problems. Of those, 60-70% 

get better, however 25-30% remain vision affected 

and do not improve. 

Dr Deva said she struggled to pack everything 

she knows about macular degeneration (MD) into 

a 15-minute presentation so she formatted her 

approach into three pairs of shoes. First, her ‘go-to 

shoes’; well-trialled and go with everything. This 

trusty pair is the evidence-based approach to MD 

– ‘treat and extend’ with Avastin for a maximum 

of three months, considering a switch if there’s 

no response. Next were the ‘the shoes you should 

never have bought’; the ones that remind you of 

an error once made. These, explained Dr Deva, 

are the inflammatory lesions, vitelliform macular 

dystrophy and central serous choroidopathy, those 

differentials which will not respond to Avastin. 

Lastly, were her ‘trending shoe section’ where she 

touched on the use of retinal prostheses and future 

anti-VEGF drugs that may be beneficial, especially if 

they are required less often. 

A/Prof Roth concluded the lectures for the day, 

confessing the ‘cure to dry eye’ that he had offered 

earlier was a false promise to keep delegates until 

the end of the day! He redeemed himself, however, 

by providing numerous tips on how to manage the 

episodic, early chronic phase of dry eye, explaining 

his preferred treatment was a short-term ‘rescue 

dose’ of steroids, ciclosporin and concurrent lipidbased 

lubricants. He also discussed new treatments 

looming, such as combined doxycycline and 

omega-3 treatments, hormonal compounds and 

autologous serum drops, made from a person’s own 

blood components. Exciting stuff, indeed. 

In summary 

What made this conference stand out was not only 

the full schedule of varied and informative talks, 

but also the warm and approachable style of the 

presenters. It’s reassuring to know that even after 

all their years of training, ophthalmologists still 

refer to things as ‘pale dots in the retina’ and admit 

they too can sometimes ‘freak out’ when there’s a 

tricky patient in the chair. This conference showed 

that we should be really proud of our optometry– 

ophthalmology relationship in New Zealand. 

Next year’s conference will be held on 3-4 

November, 2018, including the now popular 

in-depth practical workshops on the 3rd and the 

optometry and parallel dispensing opticians/ 

practice managers conferences on the 4th. ▀ 

46,000 patients and… 

Eye Institute (EI) 

celebrated a big 

milestone in October 

for founding ophthalmologist 

Dr Peter Ring, who has 

helped 46,000 patients, and 

is still going strong. Dr Ring 

co-founded EI with Drs Bruce 

Hadden and Anthony Morris 

in 1995, was instrumental 

in bringing intraocular 

lenses into New Zealand and 

introduced the first laser for 

vision correction. 

An honorary clinical senior 

lecturer in the department of ophthalmology, Dr 

Ring says one of his career highlights was starting 

the Eye Institute in 1995. “It was a turning point 

in my career – the first private out-patient eye 

hospital and clinic in New Zealand.” 

After four decades at the forefront of eye surgery 

and specialist eyecare in New Zealand, Dr Ring 

says cataract surgery and clear lens extraction 

are still his favourite surgeries. “Giving someone 

independence from spectacles both for distance 

and near is a great plus for many of today’s baby 

boomers. 

Jasha Morarji and Dr Peter Ring 

Dr Peter Hadden checks out Alex Petty’s peripheral retina in the binocular indirect 

ophthalmoscopy workshop 

“My favourite part of 

being an ophthalmologist 

is the mix of medicine, 

surgery and technological 

advancements, meeting 

my patients, helping them 

to see better and making 

a meaningful difference in 

their lives with great visual 

outcomes. This is very 

satisfying. Many patients 

say that surgery has been, 

‘life changing – nothing 

short of a miracle’. And, 

of course, I cannot overlook the 

pleasure of working with my highly skilled team 

at Eye Institute.” 

Jasha Morarji, EI technician and vision correction 

teacher, has been working with Dr Peter Ring for 

33 years and was instrumental in organising Dr 

Ring’s 46,000th patient celebratory morning tea, 

complete with large cake, in October. 

Keeping up to date with the latest techniques 

and technology is key to success, says Dr Ring, 

who recently travelled to Bengaluru in India 

with Morarji to upskill on small incision lenticule 

extraction (SMILE) surgery. 


Bailey Nelson’s first NZ 

partner 

Bailey Nelson’s first New Zealand partner, 

under its new shared ownership model, is 

Kiwi optometrist Andrew Brady, who has 

opened his new co-owned Bailey Nelson store in 

High Street, Auckland. 

Previously a wholly-owned chain, stocking its 

own brand of frames and lenses, Bailey Nelson 

announced proposed changes to its ownership 

structure in July this year, throwing the door open 

to those who wanted more than just a job. The 

company’s new partnership model requires a capital 

contribution from each partner in return for a share 

of the profits, proportionate to the partner’s capital 

investment and in addition to their salary. Under the 

agreement, partners can choose locations, designs 

and equipment for their new store, in consultation 

with Bailey Nelson, while Bailey Nelson manages 

the administration functions. 

“Partners are invited to buy-in to a store and share 

in the financial success of this growing brand,” says 

Bailey Nelson eyecare director Robyn Weinberg. 

“Bailey Nelson provides all of the back-end support, 

including a business and clinical coach, as well as 

a world class supply chain, so that partners can 

concentrate on giving exceptional clinical service 

and growing their store.” 

Andrew Brady, co-owner of Bailey Nelson’s new central Auckland store 

Andrew Brady, previously with Bailey Nelson 

Takapuna, says he was drawn in by Bailey Nelson’s 

unique approach. “The culture of the company 

is a huge plus, with the team displaying genuine 

enthusiasm, friendliness and passion for the 

brand.” 

Having practised in New Zealand, Australia and 

Dublin, Brady says he needed a change of pace. 

“I was at the point in my career and personal life 

where I needed to make a strong commitment and 

I saw a real opportunity with Bailey Nelson.” 

He’s excited to be the first partner in New 

Zealand and says he committed because he 

believes Bailey Nelson has a durable competitive 

advantage and an eye care and eyewear 

philosophy he is proud to be associated with. 

“I also appreciate the professional autonomy, 

support and technology that Bailey Nelson is 

providing for their optometrists.” 

Since expanding from simply selling frames 

in the markets of Bondi, Sydney in 2012, Bailey 

Nelson has grown to own 40 stores in New 

Zealand, Australia, the UK and Canada. It is seeking 

further expressions of interest for co-owned stores 

in New Zealand and Australia. ▀ 

Zeiss unveils UWF 

imaging 

Bringing competition to the growing ultrawidefield 

(UWF) imaging space, Zeiss’ medical 

technology division has unveiled its Clarus 

500 UWF fundus imaging technology. 

On show publicly, for the first time in Australasia 

at RANZCO 2017 in Perth (see feature p10-17), 

Hartmut Becker, Zeiss’ head of global market 

development, ophthalmic diagnostics, said the 

Clarus 500 is the first UWF imaging device that 

delivers true colour by bringing the three main 

wavelengths of light, red, blue and green, into 

the back of the eye. The Clarus 500 combines this 

true colour view, said to be comparable to direct 

observation, with high-resolution clarity down to 

seven microns in an UWF view from the macula to 

the far periphery, to better detect early signs of eye 

disease. 

Colour accuracy is important in the diagnosis, 

documentation and management of ocular diseases 

for both ophthalmologists and optometrists, 

especially when evaluating optic disc, nevi and 

lesions in which subtle colour differences may lead 

to a change in diagnosis and management, added 

Dane Moloney, Zeiss’ Australasian medical division 

manager. Specifically, accurate coloration and 

resolution is important for evaluating focal change 

in rim tissue, nerve pallor, dry age-related macular 

degeneration RPE pigment changes and drusen. 

“Traditional fundus imaging systems have been 

the gold standard for macular disease diagnosis 

and optic nerve evaluation for many years,” said Jim 

Mazzo, Zeiss’ global president ophthalmic devices. 

“Now, ultra-widefield is starting to change this. 

Clinicians are finding that by imaging a larger area 

of the retina, they have the possibility of uncovering 

more pathology, aiding in earlier disease diagnosis 

and better patient management.” 

The Clarus 500 produces 133° HD widefield 

images, which are then automatically merged to 

achieve a 200° UWF of view in a single exam, while 

providing annotation and calliper measurement 

tools to provide an in-depth analysis of eye health. 

The Clarus is also fully-integrated with Zeiss’ other 

Zeiss’ Dane Moloney with Dr Angelo Tsirbas at RANZCO 2017 

Zeiss Clarus 500 

technology systems for efficient multi-modality 

analysis, said Moloney. “From Zeiss’ perspective, we 

pride ourselves on being able to sell the solution 

for the optometrist or the ophthalmologist. For 

example, we see a great space for the Clarus to 

complement our OCT-A, Angioplex technology, 

and then bring all that data together in our image 

management platform, Forum, to provide a full 

solution for the disease clusters that exist, especially 

glaucoma, macular degeneration and diabetic 

retinopathy.” ▀ 

Thank you 

Please mark your calendars for 

next year’s series 

for attending Eye Institute’s Seminars, Workshops 

and 13 

th Annual Conferences this year. 

Seminars May and August 2018, date tbc 

Conference 3rd and 4th November 2018 

Register online or email: conference@eyeinstitute.co.nz 

Eye Institute 2015.indd 1 


20/11/14 4:18 PM 


7

etter! The epitheliopathy had mostly resolved (Fig 

5) and crucially the patient found the lens easy to 

wear all day long with only occasional lubrication. 

Interestingly this patient had been told that due to 

his MGD he could not wear contact lenses for his low 

myopia. We have now fitted this patient successfully 

into daily contact lenses (Proclear 1 day), that he 

removes for sleep. I received an email from him 

the other day: “Both of my eyes have been feeling 

excellent since I last saw you. I have been wearing 

the daily contacts most days and have felt relief even 

without the contact lenses.” 

SPECIALITY CL FORUM BY ALEX PETTY* 

BANDAGE CONTACT LENSES 

As contact lens fitters, too often we find 

ourselves fixated over obtaining the very 

best visual results for our patients. These 

days we can specify a dizzying array of toric 

powers and axes into our soft daily lenses. We can 

incorporate spherical aberration correction and 

multifocal optics into our scleral lenses. Heck we 

can even customise an orthokeratology lens to 

match a child’s pupil size. It is all very empowering. 

Still, there is an important application for contact 

lenses where the power and vision through the 

lens is largely irrelevant: bandage contact lenses. 

Bandage contact lenses (BCL) refers to the 

application of contact lenses, typically soft silicone 

hydrogel extended-wear lenses, for therapeutic 

reasons such as facilitating corneal healing or 

protecting a fragile corneal surface. The key concept 

of a bandage contact lens is the relentless shearing 

forces of our blinking lids is nullified during wear, 

often offering immediate relief to patients (and 

practitioner!) as soon as they are inserted. 

The concept of a protective eye bandage 

originated several millennia ago when a smart 

chap called Celsus reportedly applied a honeysoaked 

linen to the site of a pterygium removal 

to prevent symblepharon development. Last 

century the technique of pressure-patching had 

traditionally been used when an eye needed 

protection to heal. Interestingly, a study several 

decades ago showed patients with traumatic 

corneal abrasions healed significantly faster, had 

less pain and had fewer reports of blurred vision 

when they were not wearing a pressure patch. 

Corneal abrasions due to removal of foreign bodies 

showed similar results¹. 

Contact lenses were first used as an alternative 

to pressure patching following the development 

of hydroxyethyl methacrylate (HEMA) soft contact 

lenses in the 1970s. Bandage contact lenses were 

superior to patching for a number of reasons: 

vision could be maintained during wear, topical 

medications could continue to be instilled, and the 

cosmesis was far better. Let’s be honest, not too 

many people enjoy stepping out into the world 

with half a roll of gauze taped to their face! Today’s 

modern bandage contact lenses provide the same 

benefits as their predecessors – but with enhanced 

convenience, improved healing and better corneal 

health due to the high Dk materials we now use 

– an important consideration if extended wear is 

required. 

The choice of lens design depends on a few 

factors but, typically, a lens with a low modulus is 

preferred as these will drape onto the underlying 

tissue better and theoretically provide less 

mechanical interaction. My preferred lenses are 

those with a modulus below 0.8 MPa such as 

Biofinity (Coopervision) for a monthly lens and 

the fortnightly CAir (Coopervision) or Acuvue 

Oasys (J&J) if a shorter duration of wear is 

expected. For comparison, the Air Optix (Alcon) 

and Purevision (Bausch + Lomb) lenses are made 

of stiffer materials with a modulus above 1.0 MPa. 

I have spoken with several clinics using these high 

modulus lenses as BCLs and they report few issues. 

If a custom bandage lens is required the SiHg 

Definitive 74 material has a reasonable Dk of 60 

Fatt units and a nice low modulus of 0.4 MPa. 

There are a number of reasons to use a BCL: 

• Protection: BCLs can offer convenient protection 

of the ocular surface in the case of entropion, 

trichiasis, tarsal scars, recurrent corneal erosion and 

in the presence of exposed surgical sutures or knots. 

• Pain relief: Reducing patient discomfort is a 

useful application for a therapeutic contact lens. 

Conditions like bullous keratopathy, epithelial 

erosion or abrasion and filamentary keratitis can 

be debilitating without a contact lens in place. 

In the case of bullous keratopathy failure of the 

endothelium leads to swelling of the cornea and 

formation of epithelial blisters that can painfully 

rupture over time. A BCL reinforces the damaged 

tissue and protects the nerve endings from the 

abrasive actions of the eyelids. They can also make 

the wait for an endothelial graft more tolerable. 

• Healing: The use of a BCL to improve the 

healing response of the cornea is particularly 

valuable in a number of conditions including 

chronic epithelial defects, neurotrophic keratitis 

and chemical burns. BCLs also play an important 

role following corneal surgery, particularly 

photorefractive or phototherapeutic keratectomy 

(PRK/PTK), and following corneal cross-linking. 

In these procedures, the epithelial is chemically 

removed and can take up to a week to heal. A BCL 

provides a protective scaffolding for the limbal 

epithelial cells to redistribute centrally. 

Let us also not forget the role the fluid reservoir 

of a rigid scleral lens can play in protecting and 

healing the fragile ocular surface in chronic dry 

eye conditions. A study led by Romero-Rangel² 

described the therapeutic benefits of scleral 

contact lenses to patients with conditions 

including Stevens-Johnson syndrome, ocular 

cicatricial pemphigoid and Sjögren’s syndrome. 

Improvement in quality of life as a result of a 

reduction in photophobia and discomfort was 

reported by 92% of the patients studied. At contact 

lens conferences, I have come across reports of 

extended wear scleral lenses being used effectively 

to rehabilitate non-healing corneal ulcers. Sleeping 

in these lenses, however, created significant 

hypoxic oedema, requiring careful consideration of 

the risk-benefit in extreme cases. 

• Sealing: BCL also play a role in sealing leaky 

wounds. A leaking bleb following trabeculectomy 

surgery is a serious complication and has been 

reported to be more likely with the popularity of 

anti-fibrotic agents like 5-FU and mitomycin-C, 

occurring in 5-30% of surgeries 3,4,5,6 . Blebs can 

be sealed with a BCL although customised 

larger diameter lenses are typically required 

to cover the area. At Greenlane Clinical Centre, 

optometrist Reuben Gordon tells me the team 

use the amusingly nick-named ‘Floppy Johnson’ 

(presumably named after its pendulous designer) 

custom soft lens for this purpose. The Floppy 

Johnson has a flat base curve of 8.9mm and 

large diameter of 16mm and is well loved by the 

glaucoma surgeons as a bleb sealer. Literature 

results are favourable demonstrating a 92% 

success rate using 17.50mm soft bandage contact 

lenses for this purpose 7 . 

Several good examples of the benefits of 

bandage contact lenses have arisen in my clinic 

in recent months. The first was the case of an 

electrician in his thirties who flicked a coil of wire 

into his eye the day before presenting to me (Fig 

1). Unsurprisingly, the eye was sore, watery and 

photophobic, but it felt like it was improving as 

the day went on. Examination revealed an anterior 

stromal laceration to about 50% thickness with 

a narrow, almost dendritic, epithelial defect 

that appeared to be healing already. Vision 

was excellent, there was no infiltrate and the 

anterior chamber was quiescent. The patient was 

prescribed regular prophylactic chloramphenicol 

ointment with a review planned later in the week. 

Unfortunately, the patient returned the next day 

as, on waking, his eye suddenly felt significantly 

worse. On re-inspection, the epithelial defect had 

widened, presumably due to the actions of the lids. 

A bandage SiHg soft contact lens (CAir +0.25D) was 

inserted which gave immediate relief. He was asked 

to use this lens for extended wear with prophylactic 

chloramphenicol drops four times a day. One week 

later the eye was feeling much better. On removal 

of the bandage lens (taking care to lubricate the eye 

and the lens with a drop of artificial tears before 

removal to avoid re-aggravating the fragile surface) 

the epithelial defect had healed beautifully (Fig 2). 

The stromal laceration was still evident as we would 

expect this tissue layer to take longer to heal fully. 

My second example is a young chap in his 

twenties with severe meibomian gland dysfunction 

and secondary evaporative dry eye (Fig 3). He 

was referred to my clinic by ophthalmology for 

dry eye management. After treatment with oral 

azithromycin, intense-pulsed light treatment, 

omega-3 supplements and regular hot compresses 

and digital meibomian gland expression we were able 

to wean him off the FML drops he was dependent on 

at presentation. His eyes felt less dry and he did not 

need to use his non-preserved lubricants as often. 

However, his right eye still had a significant area of 

confluent corneal epitheliopathy inferiorly that had 

not improved over the course of six weeks (Fig 4). His 

tarsal conjunctiva had a very inflamed appearance, 

which was most likely contributing to the chronicity 

of the epitheliopathy, in much the same way a shield 

ulcer forms in vernal keratoconjunctivitis. 

I applied an extended wear bandage contact 

lens (CAir) to the eye and reviewed him one week 

later. The patient reported his eye had never felt 

So, next time you are confronted with a 

troublesome ocular surface, consider reaching for a 

trusty bandage contact lens. You will be impressed 

how successful this management can be for your 

patients. Always be mindful of the risk of infection, 

however, especially in a case with a significant 

epithelial defect. 

That’s all from me for another year. Thank 

you to those with positive comments about the 

columns, it is always nice to hear that people have 

learnt something or changed how they practice 

to ultimately help their patients. I look forward to 

bringing you more thrilling specialty contact lens 

escapades in 2018. Happy holidays and happy 

contact lens fitting! ▀ 

References 

1. Kaiser PK A comparison of pressure patching versus no 

patching for corneal abrasions due to trauma or foreign 

body removal. Corneal Abrasion Patching Study Group. 

Ophthalmology. 1995 Dec;102(12):1936-42. 

2. Romero-Rangel T, Stavrou P, Cotter J, et al. Gas-permeable 

scleral contact lens therapy in ocular surface disease. Am 

J Ophthalmol 2000;130(1):25-32. 

3. Mandal, AK. Management of the late leaking filtration 

blebs. A report of seven cases and a selective review of 

the literature. Indian J Ophthalmol. 2001;49:247 

4. Schuman, JS. Zaltas, MM. Management of the leaking 

bleb. In:Ritch R, Shields, MB. Krupin, T. editors. The 

Glaucomas. 2nd edition. St. Louis; C.V. Mosby Company 

1996, pp 1737-44. 

5. Ticho, U. Ophir, A. Late complications after glaucoma 

filtering surgery with adjunctive 5-fluorouracil. Am J 

Ophthalmol 1993;115:506-10. 

6. Katz, GJ., Higginbotham, EJ. Lichter, PR, et al. Mitomycin 

C versus 5-fluorouracil in high risk glaucoma filtering 

surgery: Extended follow-up. Ophthalmology 

1995;102:1263-69. 

7. Shoham, A. Tessler, Z. Finkleman, Y. Lifshitz, T. Large soft 

contact lenses in the management of leaking blebs. CLAO 

J 2000 Jan;26(1):37-39. 

ABOUT THE AUTHOR: 

*See box story about Alex Petty this page 

Petty awarded CCLS scholarship 

Tauranga-based Bay Eye Care 

optometrist, Alex Petty, has been 

awarded the 2017 Cornea and 

Contact Lens Society (CCLS) Scholarship 

to further his knowledge in rigid 

contact lenses. 

Petty, a therapeutic optometrist 

and contact lens (CL) specialist, with 

interest in orthokeratology, myopia 

control, dry eye and glaucoma, has 

lectured locally and internationally 

on contact lenses and ocular disease, 

writes a popular column on specialty 

CLs in NZ Optics and has published 

several articles and case reports in 

clinical optometry journals. In 2016, he 

was one of the first New Zealanders to 

become a fellow of the International 

Academy of Orthokeratology and 

is currently a board member of the 

Fig 1. Beware malevolent coils of wire 

Fig 2. The epithelial defect resolving with extended wear use of a BCL 

Fig 3. Severe meibomian gland dysfunction with lid wiper 

epitheliopathy and tarsal inflammatory conjunctivitis 

Orthokeratology Society of Oceania 

and the Fellowship Committee 

of the International Academy of 

Orthokeratology. 

Alex has been awarded $1,000 by CCLS 

to learn more about the manufacturing 

process of rigid lenses – how they are 

made and modified and what can be 

done with coatings, edge and thickness 

profiles and material properties – to 

further his knowledge to benefit his 

often, quite unique patients. 

Graeme Curtis and his team at Corneal 

Lens Corporation in Christchurch will be 

helping Petty achieve his goal. 

The annual CCLS Scholarship is 

worth up to $2,500 to cover the costs 

of upskilling and education in either 

cornea and or CL specialty fields. For 

more, visit www.contactlens.org.nz. 

Alex Petty, 2017 CCLS scholarship awardee 

Fig 4-5. Resolution of a significant patch of confluent epitheliopathy in 

an MGD patient with a BCL 


Jason Kirk flies in for opening 

UK frame designer, Jason Kirk, from Kirk and Kirk Eyewear, 

flew in from the UK to help open Michael Holmes 

Premium Eyewear’s second practice in St Heliers, 

Auckland. Nearly 100 people attended the October opening 

event, including local retailers, Michael Holmes’ customers and 

local ophthalmologists, who joined in the celebrations with 

co-owners Michael Holmes and Kay McFarlane, their team and 

Kirk. 

Best known for their award-winning Teed Street practice in 

Newmarket, Michael Holmes is the exclusive licensee for Kirk 

and Kirk frames in Auckland. McFarlane said they chose to work 

with Kirk and Kirk because they are independent designers who 

work with independent businesses. “The Kirk and Kirk range is 

a unique offering with exciting colour options and styles. The 

range has been extremely well received by our customers in 

Newmarket and, now in, St Heliers.” Several fans could not resist 

purchasing new K&K spectacles on the opening evening, she 

added. 

Talking to NZ Optics, Kirk said his family has been creating 

eyewear for three generations, since Sidney and Percy Kirk 

opened their first London workshop in 1919. Jason’s own 

optical career took off, when he left his job to sell a case full of 

his fathers’ old vintage frames to London fashion designers. He 

never looked back. 

“I am passionate about glasses, it’s an area that really excites 

me. Glasses should not be a grudge purchase, they should make 

people feel great. When you feel good in your glasses, you sit up 

a bit taller and smile. That is what we are after.” 

Kirk works with wife, K&K creative director Karen. “We have a 

saying, ‘try to start with something impossible’ which is about 

doing something truly new.” Kirk and Kirk produce their eyewear 

from start to finish in one factory in France, using special grade 

Italian acrylic, he said. “Acrylilc like this had never been done 

before. We saw some materials from the ‘50s and ‘60s which 

behaved in a similar way and were inspired. We got some acrylic 

and took it to a manufacturer who said ‘no way’. We went to 

another one, same thing… it was worth it.” 

Acrylic is really light-weight, a third of the weight of acetate, 

explains Kirk. “Our frames are made the old fashioned way – 

hand pinned, hand polished – they stay put once adjusted and 

come in a truly unique selection of colours.” 

Kirk’s other passion is independent optometry, he said, 

adding that he lectures and works closely with independent 

optometrists to help improve their offering. He’s excited about 

the partnership with 

Michael Holmes and 

the positive reception 

his frames have had in 

New Zealand. 

“We produce 

eyewear that people 

are excited about 

wearing, and work 

with people that share 

that passion. We work 

really hard to identity 

people that give us 

that chance.” ▀ 

Dr Shuan Dai 

honoured 

Auckland-based paediatric ophthalmologist, Dr Shuan Dai has been 

honoured for making a significant contribution to the development 

of paediatric ophthalmology and strabismus in China by the 

Chinese Ophthalmology Society and Chinese Paediatric Ophthalmology 

Society in Shanghai. 

Dr Dai was in Shanghai as a speaker and chair for the American 

Association of Paediatric Ophthalmology and Strabismus (AAPOS) 

and Chinese Paediatric Ophthalmology Society Joint Congress. Prior 

to the Congress, he attended and spoke at the Asia Pacific Paediatric 

Ophthalmology and Strabismus Society Conference in Hong Kong 

and after was a keynote speaker at the Beijing University Paediatric 

Ophthalmology Seminar in Beijing. 

Given his busy schedule, he said he was completely surprised, as were 

the other four foreign scholars (three from the US and one from Moorfields 

in London) who were also honoured at the AAPOS gala dinner. The only 

hint there was something on the cards was the five awardees had been 

sat together at the VIP table, he said, adding this was the first time these 

awards have been made, and was probably prompted by the combined 

and concurrent meetings in the region. “We didn’t know about it. They just 

said, at the gala dinner, they wanted to present an award to those foreign 

friends who have made a contribution to their Societies’ development and 

collaboration with international ophthalmological communities.” 

It’s always very nice to be recognised, said Dr Dai, but that’s not what 

drives his passion for paediatric ophthalmology. ▀ 

Dr Dai talked to NZ Optics about his award at the Eye Doctor’s last Grand 

Round seminar in November, which will be covered in the February issue. 

Kirk and Kirk’s 

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Jason Kirk and Michael Holmes celebrating the new practice opening 

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Michael Holmes St Heliers practice 

Dr Shuan Dai receiving his unexpected award at the Shanghai AAPOS meeting 

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9

SPECIAL FEATURE: RANZCO 2017 

RANZCO 2017: A wealth of learning and fun 

BY SAMANTHA SIMKIN* 

The stunning expanse of Western Australia 

was visible from the plane window as we 

descended into the tranquil city of Perth at 

the end of October to join the delegates of the 49th 

Annual Scientific Congress of the Royal Australian 

and New Zealand College of Ophthalmologists 

(RANZCO). We convened at the Perth Convention 

and Exhibition Centre, where delegates from across 

Australia and New Zealand, together with others 

from further afield, came to listen, learn, teach 

and discuss the latest ophthalmological thinking, 

developments and discoveries. 

The RANZCO Congress is renowned for 

presenting cutting-edge research alongside 

sub-specialty specific clinical learning, together 

with the latest innovative products, and the 49th 

Congress was no exception. See p3, 14 and 16 for 

news from the exhibition floor. 

Keynotes share a wealth of knowledge 

This year, delegates were lucky to experience 

the teaching and knowledge of some incredible 

keynote speakers. 

Dr Bonnie Henderson, clinical professor at Tufts 

University School of Medicine in Boston and an 

internationally recognised expert in cataract and 

Drs Casey Ung and Shuan Dai with DFV’s Brad Grills (centre) 

refractive surgery, graced us with her expansive 

knowledge of the anterior segment, particularly in 

relation to cataract surgery. In the Cataract Update 

Lecture, she challenged the audience to think of 

the potential causes of negative dysphotopsias 

following cataract surgery and then explored 

potential prevention or treatment modalities. 

The Glaucoma Update Lecture was presented by Dr 

Anne Coleman, the Fran and Ray Stark Professor of 

Ophthalmology at the Jules Stein Institute in UCLA. 

She took us beyond the typically-thought about 

glaucoma risk factors, presenting large population 

data in a simple and clinically applicable manner. We 

learned how glaucoma may be linked to the pets we 

own, the food we eat, and even the way we sleep! 

Professor Michael Brodsky from the Mayo 

Clinic in Rochester, Minnesota, updated the 

Congress on neuro diagnostic malformations of 

the optic disc. A complex topic made simple by 

his concise explanations and clinical tips. The 

audience was then dared to find and consider 

new solutions to problems in oculoplastics 

by Professor Don Kikkawa from the Shiley Eye 

Institute at the University of California in San 

Diego, who also addressed the on going debate 

of an external versus an endoscopic approach to 

dacryocystorhinostomy. 

Professor Lyndon da Cruz from Moorfields Eye 

Hospital in London presented 

the Retina Update Lecture, 

which seemed like science 

fiction as it jumped from 

stem cell to gene therapy and 

from bionic eyes to robots. 

He shared the latest research 

and cutting-edge scientific 

breakthroughs with an 

enthralled auditorium. 

The named lectures, with 

one of our own 

As well as these amazing 

invited speakers, delegates 

to the 49th Congress were 

overwhelmed by the talent 

and experience from each 

of the named lectures. My 

personal favourite was the 

Dr Geoffrey Cohn gives The Fred Hollows Lecture on teaching and learning in a resource-poor world 

Dame Ida Mann Lecture which was given by 

our very own Professor Trevor Sherwin from the 

Department of Ophthalmology at the University 

of Auckland. He presented on the work his clinical 

group has and is doing on regenerative medicine 

using stem cells and how today’s understanding of 

stem cells and how they work has been completely 

revised, providing incredible potential for the 

treatment of corneal disease and, possibly, myopia. 

We were also honoured to hear about the Alpins 

Method for planning cataract surgery from the 

original source of this development, Melbournebased 

ophthalmologist Dr Noel Alpins himself, in 

the Sir Norman Gregg Lecture. 

The Fred Hollows Lecture is always an inspiring 

reminder of the impact that clinicians and 

scientists alike can have on individuals around 

the world. Dr Geoffrey Cohn, honorary medical 

coordinator of the Myanmar Eye Care Project and 

Cambodia Eye Care, took everyone on a journey 

through his many years of establishing eye health 

programmes around the world and how important 

it is to make ourselves dispensable through 

the training of local people. Dr Cohn’s work 

encapsulates what Fred Hollows was all about. 

Plus, from RANZCO updates to AI 

If all these amazing speakers weren’t enough, 

there was a plethora of interesting symposia and 

rapid-fire presentations run as concurrent sessions 

to choose between. The biggest problem with the 

Congress was not being able to be in two places 

at once. Sessions ranged from how RANZCO is 

helping to drive collaborative care and improve 

ophthalmological training in Australasia to the 

latest surgery techniques in a plethora of eye 

conditions, for patients from the very young to the 

very old, to how artificial intelligence (AI) is and 

will continue to make an increasing impact on the 

practice of ophthalmology. 

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11


Drs Michael Merriman, Phil Macdonald and Muhammad Khalid Bhav Solanki and Samantha Simkin Drs Shong min Voon, Lewis Lam and Nishanthan Ramachandran 

Dr Simon Dean and Richard Grills 

Dr Jina Han, Prof Helen Danesh-Meyer and Samantha Simkin at 

the Congress dinner 

CONTINUED FROM PAGE 10 

Dr Stuart Keel, a post-doctoral research fellow at 

the Centre for Eye Research, Australia (CERA) shared 

CERA’s work into AI and how it’s developed. One 

recent study he discussed, showed a similar level 

of accuracy between ophthalmologists and an AI 

system in identifying and classifying age-related 

macular degeneration images, but an incredible 

speed difference, with the AI system taking just 

68 minutes compared with three days for the 

ophthalmologists to work through 5664 images. 

Key takeaways and personal highlights 

I thoroughly enjoyed all the sessions I attended, 

however, a few stick in my memory with key 

Dr Jeffrey Kai Chun Mak with Optos’ Jason Martone Drs Justin Mora and Stephen Best Drs Peter Ring and Brian Sloan with Jasha Morarji 

takeaways for both everyday practice and 

potential for future research. The session ‘Double 

vision after cataract surgery’ discussed the 

multitude of reasons, causes and the confusion 

around double vision post-operatively. Patients 

who opted for monovision, intraocular lenses 

have been reported to have decompensation 

up to two years post-surgery, indicating that a 

one-hour contact lens trial of monovision may be 

insufficient. Communication to the patient about 

the potential need for glasses for finer clarity is 

key to patient satisfaction. I think this is important 

for both optometrists and ophthalmologists 

to know, so that patient expectations can be 

appropriately set, with support for longer-term 

contact lens trials offered, allowing patients to 

make fully-informed decisions for their vision. 

Another favourite, was ‘Paediatric retina in 

a nutshell’ – a session designed to update 

generalists on the current trends and 

breakthroughs in paediatric retina. It was a fastpaced 

session yet still only scratched the surface 

of all the interesting developments in this area, 

from Avastin for retinopathy of prematurity to 

the further classification and gene identification 

now occurring for many retinal dystrophies. 

This session left me in awe of the opportunities 

for further research to help individual patients. 

With better understanding of a disease, more 

treatment options can be developed; with more 

treatment options, more children can be helped. 

The passion of all the presenters to search out 

answers where there are currently questions, 

left me hopeful and inspired for the future of 

paediatric retinal disease outcomes. 

NZ wins at a challenging conference 

The sessions challenged me as a clinician and a 

researcher and spurred my thought process for 

further research and collaborations, but most of all 

they amazed me at the breadth and depth of work 

being completed in our little corner of the world. In 

particular, I’d like to extend huge congratulations to 

Dr Reid Ferguson from the Greenlane Clinical Centre 

on his Best Paper Presentation, entitled ‘Childhood 

eye injuries in New Zealand: a 10-year national 

review of incidence, aetiology and visual outcomes’. 

I’d also like to congratulate Jane McGhee from 

Rethink glaucoma management 

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Reference: 1. Allergan XEN directions for use. 

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Dr Dianne Sharp honoured 

New Zealand medical retina specialist 

and well-known macular degeneration 

awareness champion, Dr Dianne Sharp, 

was awarded the RANZCO Distinguished Service 

Award at the 49th Congress for her services to 

ophthalmology and the community. 

In his citation at the awards’ ceremony in Perth, 

fellow Kiwi ophthalmologist Dr David Worsley 

praised Dr Sharp’s “tireless endeavours to effect 

nationwide improvements in retinal healthcare” 

in New Zealand. 

“Dianne has organised and led our profession 

in lobbying government agencies and politicians 

for public funding of new therapies. She has 

prepared submission papers, appeared before 

committees and skilfully rallied colleagues to the 

cause. 

“In 2009, having recognised a yawning gap 

in public awareness and advocacy for macular 

degeneration in New Zealand, Dianne undertook 

her biggest challenge. With her trademark 

boundless, infectious enthusiasm and high 

energy, she brought together a small group of 

volunteers and colleagues to set up Macular 

Degeneration New Zealand (MDNZ). There 

have been major challenges – finding financial 

backing, garnering professional support, 

engaging with (Parliament) and providing public 

education. That MDNZ is successful, is in a very 

large part due to Dianne. 

“It is an honour for me to deliver this citation 

on behalf of the ophthalmology profession of 

New Zealand and Australia.” 

Dr Sharp said it is a huge honour to receive 

such a prestigious award. “I believe it is a tribute 

to so many people who have been a part of the 

work of establishing MDNZ and have supported 

my endeavours. So, I see this as an opportunity 

to acknowledge them and thank them.” 

The Distinguished Service Award is made 

annually to an Australasian ophthalmologist or 

prominent person within the world of eye health, 

who has exhibited “such exceptional devotion of 

time, effort, thought, and action as to set them 

apart from other contributions.” 

As well as MDNZ, Dr Sharpe, an 

ophthalmologist at Retina Specialists and 

Greenlane Clinical Centre in Auckland, 

established an ophthalmic electrodiagnostic 

unit, which provides a diagnostic service for 

acquired and inherited retinal disorders; and 

helped set up the multidisciplinary visual 

rehabilitation clinic at Auckland Hospital and 

the patient support group, Retina NZ. She is 

knowledgeable about the most current 

and effective medical therapies for 

wet macular degeneration and other 

retinal disorders; co-author of a number 

of scientific publications; a member 

of Retinal International Scientific and 

Medical Advisory Board, Oceania Retina 

Association; and she was a principal 

investigator in two recent international 

trials involved in the treatment and 

management of vision-threatening 

complications of diabetes. 

For another picture of Dr Sharp 

receiving her award, see p4. 

New NZ fellow 

In other RANZCO graduation night 

news, Dr Nic Johnston was made a 

RANZCO Fellow. 

Based in Southland, Dr Johnston is a 

general ophthalmologist with subspecialist 

interests in cataract, glaucoma 

and oculoplastic surgery. He completed 

his undergraduate medical training 

in Otago in 2005 and his subsequent 

ophthalmology training across New 

Zealand and in Perth. 

Distinguished Service awardee, Dr Dianne Sharp, with new Kiwi fellow. Dr Nic 

Johnston. 

SERENA PEARCE, CODE LIME PHOTOGRAPHY 

the University of Auckland’s 

ophthalmology department, 

who took out the top film 

award with the incredible, 

‘Die Another Day or Walking 

with Dying-Spheres’, a mustwatch 

this summer for anyone 

interested in ophthalmology! 

As to the social side… 

Now don’t fret, although 

there was lots of learning, 

thinking, discussing, assessing 

and analysing, there was also 

time to eat, drink, explore 

Perth and enjoy the company 

of our peers. 

Socially, RANZCO 2017 

Professors Helen Danesh-Meyer and Trevor Sherwin 

boasted a beautiful welcome 

reception and a resplendent graduation evening, where our own 

Dr Dianne Sharp was honoured (see p4 and above), and elegant 

Congress dinner. We were well looked after by the wonderful local 

hosts, Associate Professor Angus Turner and Dr Fred Chen. My 

favourite evening was the Congress dinner, which was held in the 

beautiful Kings Park with a stunning view of the glittering lights 

of Perth. It began with champagne on the lawn in the botanical 

gardens and then moved inside, so colleagues, friends, and new 

acquaintances could mix, meet and mingle. Everyone looked 

spectacular sporting bow ties to gold sequins, so the evening 

certainly lived up to its glamourous James Bond theme. 

Thus, the conference concluded which each delegate having a fuller 

belly from the wonderful evening events, a fuller heart from the 

opportunity to spend time with others who share their passion, and a 

fuller mind from the incredible scientific programme put together by 

Professor Helen Danesh-Meyer. 

A huge thank you to all those who gave their time to make the 

RANZCO 49th Annual Scientific Congress such a success! 

*Samantha Simkin is a therapeutically-qualified optometrist currently completing her 

PhD in the ophthalmology department at the University of Auckland. With additional 

reporting by Lesley Springall. 

RANZCO NZ 2018 

The 2018 RANZCO New Zealand Branch Annual Scientific 

Meeting, with the associated New Zealand ophthalmic nurses and 

orthoptics meetings, will be held at the Hilton hotel in downtown 

Auckland from the 11-12 May, 2018. 

For more information, including details about keynote speakers, 

keep an eye on your in-boxes and future copies of NZ Optics, or 

contact event organiser Karen McLean at karen@cml.net.nz 

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AFT’s Peter Stewart and Ben Olsen with Dr Ilva Rupenthal (centre) 

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13 

14/3/17 10:00 am


Dr Andrew Riley tries out the NGenuity 3D system with Alcon’s Greg Englebrecht RANZCO NZ president Dr Brian Kent-Smith with Drs Dianne Sharpe and Ian Elliott OIC’s Chris Malicdem and DORC’s David Maritz 

Innovation at RANZCO 2017 

BY LESLEY SPRINGALL 

As with all RANZCO conferences there was 

an excited buzz from the exhibition floor 

as the world’s ophthalmic companies 

unveiled their latest technological advances and 

encouraged the delegate doctors to try what was 

on offer, often for the first time. Here’s a selection 

of just some of the news from RANZCO 2017. 

Alcon – PanOptix and NGenuity 

Celebrating 70 years of Alcon and 50 years 

of phaco, Alcon was showcasing a number of 

technologies at the RANZCO Congress, but 

attracting the most attention was the company’s 

suite of AcrySof IQ PanOptix intraocular lenses 

(IOLs) and its NGenuity 3D Visualisation System. 

The AcrySof IQ PanOptix Toric IOL was launched 

in June 2017, completing the PanOptix family 

of IOL’s for patients with pre-existing corneal 

astigmatism undergoing cataract surgery. “It is 

a new option for astigmatic patients who seek 

to address their near, intermediate and distance 

vision needs,” said Alcon in a statement. 

Backed up by several clinical studies, and 

referenced throughout Alcon’s material, Alcon 

said the new PanOptix Toric covers cyl corrections 

as low as 1.00 diopter. “(It offers) surgeons the 

Design 

your 

space 

Design 

your 

space 

Tabletop Refraction System 

Tabletop Refraction System 

TS-310 

TS-310 

confidence to deliver spectacle independence 

through Alcon’s proprietary Enlighten (enhanced 

light energy) optical technology… (and) overcomes 

some of the limitations of current trifocal 

technology by manipulating a quadrifocal 

diffractive design. 

“This is the only IOL that delivers an 

intermediate focal point at 60cm, a distance 

preferred by many patients for intermediate vision 

activities, and offers rotational and axial stability 

for consistently predictable outcomes.” 

Alcon’s other latest innovation on show, and 

with its own demo room at RANZCO 2017, was 

NGenuity, a 3D visualisation platform for digitallyassisted 

vitreoretinal surgery. It allows retinal 

surgeons to operate looking at a high-definition 

3D screen, instead of bending their necks to look 

through the eye-piece of a microscope, to improve 

surgeons’ posture which may also reduce fatigue, 

said Alcon. “With the three-dimensional view, the 

surgeon now has depth perception not previously 

available on standard television monitors, often 

used today in the operation theatre. Surgeons may 

also increase magnification while maintaining a 

wide field of view as well as use digital filters to 

customise his or her view during each procedure, 

highlighting ocular structures and tissue layers 

which is imperative to visualise the back of 

■ Simple and reliable refractions 

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head 

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the eye.” The system has also been designed to 

minimise light exposure to the patient’s eye, 

enabling the surgeon to operate with lower light 

levels, said the company. 

Clinical studies and more information on 

both NGenuity and the PanOptix IOL family are 

available on Alcon’s website. 

Device Technologies – endoscopy 

Rich Camarra and Device’s Ryan Heggie 

Amid the multitude of high-tech devices on 

Device Technologies’ stand was a cleverly designed 

artificial eyeball used to help demonstrate Endo 

Optiks E2 Ophthalmic Laser Endoscopy System. 

The system simultaneously offers imaging 

and laser function, providing a minimally 

invasive glaucoma surgery (MIGS) approach 

to glaucoma management using endoscopic 

cyclophotocoagulation (ECP). Backed up by threeyears 

of clinical data, ECP can be done through a 

phaco incision and adds just two to four minutes 

to your procedure time, said Rich Camarra, 

international director for Endo Optiks. 

“Retina surgeons are now beginning to embrace 

endoscopy,” said Camarra, who had travelled from 

Boston to Perth to demonstrate his company’s 

endoscopy system, which has been designed 

specifically for ophthalmology and comes in a 

choice of straight and curved probe designs in 

various gauge sizes. 

Allergan – Xen and Ozurdex 

Allergan’s stand was divided into two with 

one half focused on its newly released Xen Gel 

Implant, for better glaucoma management, and 

the other on Ozurdex (dexamethasone 700mcg), 

which has just been approved in New Zealand for 

diabetic macular oedema. 

The tiny Xen Gel Stent, is indicated for the 

management of refractory glaucomas, including 

cases where previous surgical treatment has 

failed; cases of primary open-angle glaucoma; 

and pseudoexfoliative or pigmentary glaucoma 

with open angles that are unresponsive to 

maximum tolerated medical therapy. Now 

available in New Zealand, Xen is being welcomed 

by ophthalmologists as a real alternative for 

glaucoma patients. For more, see story on p3. 

Ozurdex is also another welcome addition to 

New Zealand ophthalmologists’ armamentarium. 

A long-acting intravitreal steroid, delivered via a 

sustained-release ocular implant, Ozurdex is now 

funded for the treatment of macular oedema due 

to retinal vein occlusion and non-infectious uveitis 

affecting the posterior segment of the eye. For 

more, see p16. 

J&J Vision (surgical) – iDesign 

J&J’s Hannah Howard and Christian Oster 

Taking pride of place on Johnson & Johnson 

Vision’s (formerly AMO’s) stand was the newly 

updated, iDesign Refractive Studio, the “first and 

only topo-integrated wavefront technology”. 

Hannah Howard, J&J’s regional application 

support manager, surgical, said the new iDesign 

is very exciting as it’s the only device of its kind 

currently on the market. “At the moment, the 

only other options you have are wavefrontguided 

or topography-guided, you don’t have 

a combination of the two. So, what this is 

offering is the customisation of the wavefront 

aberrations, plus if there is any asymmetry or any 

corneal irregularities those are also taken into 

consideration. In just one click, the iDesign gives 

you 18 different diagnostic views.” 

The five-in-one iDesign System captures more 

than 1,200 micro readings of the eye to give a 

precise refraction, said Tom Frinzi, J&J’s worldwide 

president, surgical in a statement. “The shape 

and curvature of the cornea are also precisely 

measured in a single three-second scan... enabling 

surgeons to measure the entire visual pathway 

and create an optical fingerprint unique to each 

patient’s eye… (ushering) in the next level of 

customisation.” 

J&J has also doubled its surgical sales team in 

New Zealand (see story p17). 

Drs Harry Bradshaw, Stephen Best and Hussain Patel 

Dr Nina Molteno and World Glaucoma Association’s 

Thomas Howden 


Getting down to business 

Jane and Professor Charles McGhee 

Zeiss – ultra-widefield imaging 

Dominating Zeiss’ stand was the company’s 

new Clarus 500 ultra-widefield imaging 

device, which is currently being introduced to 

optometry and ophthalmology practices across 

Australasia. For more, see news story on p7. 

OIC – DORC 

Ophthalmic Instrument Company’s (OIC’s) 

Chris Malicdem was on hand on the Dutch 

Ophthalmic Research Center’s (DORC’s) stand 

to help introduce DORC’s brand new 27 gauge 

forceps, for use with DORC’s Enhanced Visual 

Acuity (EVA) Vitrectomy System. 

The new 27 gauge forceps were developed 

in direct response to ophthalmologists’ wishes 

given that 27 gauge surgery is developing quite 

fast now, said David Maritz, DORC’s regional 

director. One of the main drawbacks, however, 

with tools this small has been flexibility as they 

can bend in the eye. But DORC’s 27 gauge forceps 

have been strengthened so they have enhanced 

stiffness, said Maritz, and the grasping platforms 

have also been increased by 60%. “So you get 

a much, much stronger grasping power and 


BY DEB BOYD* 

Practice managers from New Zealand and 

Australia gathered together for their annual 

meeting, held as part and in parallel to the 

49th RANZCO Congress. This year the meeting 

was held in the beautiful city of Perth, which 

despite the longer journey to travel there, never 

disappoints as a destination. 

From accreditation to HR 

Day one started with the welcome and AGM, 

followed by an open session to allow delegates to 

get to know each other and discuss local issues. We 

were seated together by region, which was useful. 

Medicare changes were a shared concern for all 

Australian practices, for instance, but not an issue, 

of course, for the New Zealand team. 

There was a strong focus on accreditation this 

year and Brett Mannison, the founder and director 

of Logicq, presented on his company’s software 

solution for quality management in the health 

sector. He focused on showing us how this solution 

assists with managing all of the requirements 

for achieving accreditation. It includes registers 

for documents, risk management, incidents, 

complaints, patients’ feedback, training and 

development, contracts and accreditation. It’s a 

great tool for assisting practices to manage their 

accreditation and is set up for both New Zealand 

and Australia, referencing the relevant standards 

for both countries. 

Other sessions on accreditation included 

one from Simon Janda, RANZCO’s professional 

development manager, who spoke briefly about 

practice accreditation using RANZCO’s Nucleus 

programme. This is free for all member practices 

and is a wonderful tool for smaller practices who 

are new to accreditation. While Anna Maria Gibb 

discussed PracticeHub, a software solution that 

assists practices in Australia with compliance for 

accreditation. It provides many policy templates 

and references the Australian Healthcare 

Standards, but is not, yet, set up for New Zealand. 

Dave Wenban, managing director of the 

Australian Health Industry Group, delivered three 

sessions covering various human resources (HR) 

topics, including performance management, 

effective interviewing and staffing contracts. 

The sessions were informative and, although the 

examples provided were all based on Australian 

legislation, the principles were still relevant for 

practice in New Zealand. 

The last speaker of the day was Chris Johnson, 

managing director of Horizon HR, who discussed 

the trickier end of HR, including bullying, 

harassment and discrimination in the workplace. 

Again, this session was informative, but the 

references were all to Australian legislation. One 

key takeaway, however, was to act quickly to deal 

with any issues you become aware of in line with 

your country’s legislation. 

Legal pitfalls in social media 

Highlights from day two included a presentation 

from Morag Smith, a senior solicitor from Avant 

Law, on social media. Whilst all of the data was 

Australian, the content was still very relevant for 

all attendees given the influence of social media in 

all realms of our lives today. Facebook remains the 

most used social media platform and can be used 

positively by practices as long as they understand 

the risks and how best to manage their account. 

There are new legislative changes coming in 

Australia in February around privacy, which will 

no doubt be followed by New Zealand at some 

point. Two key points from Morag’s talk was that 

all practices should have a social media policy 

and provide training to their staff on privacy, and 

to ensure you’ve removed the ability for patients 

to write a review or comment directly on your 

Facebook site. 

St John’s, benchmarking and keeping cool 

On day three, Cheryl Bushe-Jones, business 

development manager for St John Ambulance, 

spoke about St John’s community transport service, 

which is now available in Western Australia. It’s a 

wonderful service, particularly relevant for elderly 

ophthalmology patients who need transportation 

support, especially as so many are visuallyimpaired. 

The service is run by volunteer drivers 

who are all professionally trained. St John’s has 

partnered with the Perth Eye Hospital to provide 

pick-up and drop-off services for all their surgical 

patients. The drivers escort patients into their 

Auckland Eye’s Tracey Molloy and Deb Boyd flying the flag for New 

Zealand at the RANZCO practice managers’ conference 

homes and settle them in. Cheryl encouraged 

everyone to go back home and approach their local 

St John’s to see if there are any plans to establish a 

similar service in their regions. 

Another highlight of the last day was Scott 

Bell, from Nexus Hospitals, who gave a talk on 

benchmarking and using metrics to understand 

and grow your practice. He talked about internal 

and external benchmarking and shared key metrics 

with delegates. 

The closing session was run by professional 

speaker Rachel Green, director of The Emotional 

Intelligence Institute and Job Interviews Australia. 

Her session was entitled, ‘Thrive in Your Practice! 

How to be Emotionally Resilient in Changing Times’ 

and it was hilarious; an absolute treat with some 

great tips for managing those stressful days that 

we all encounter from time-to-time. 

The meeting closed on a high and we look 

forward to getting together next year in Adelaide to 

once again share our successes and our challenges, 

and provide that important collegial support. 

*Deb Boyd is chief executive of Auckland Eye, a board member of 

Health Infomatics NZ (HiNZ) and a member of RANZCO’s Practice 

Manager Associates committee. 

OZURDEX ® NOW LISTED ON THE PHARMACEUTICAL SCHEDULE 

1 

FOR YOUR PATIENTS WITH DIABETIC MACULAR OEDEMA (DMO) 1,2 

Targeted 

inflammation 

control 6 

Rapid & sustained 

vision and anatomical 

improvements 3 

Known and 

manageable 

safety profile 2,3 

First & only 

intravitreal steroid 

indicated for DMO 

Substantial decrease in 

treatment burden compared 

to anti‐VEGFs 2‐5 

OZURDEX ® intravitreal implant is a funded medicine on the New Zealand Pharmaceutical Schedule – restrictions apply. 

BEFORE PRESCRIBING, PLEASE REVIEW APPROVED DATA SHEET AVAILABLE ON REQUEST FROM ALLERGAN BY PHONING 0800 659 912 OR FROM THE MEDSAFE WEBSITE 

New Zealand Minimum Data Sheet 

OZURDEX ® 700 µg dexamethasone intravitreal implant is a prescription medicine which contains dexamethasone 700 µg. Indications: treatment of macular oedema due to retinal vein occlusion (RVO); treatment of adult patients with visual 

impairment due to diabetic macular oedema (DMO) who are pseudophakic or who are considered insufficiently responsive to, or unsuitable for non-corticosteroid therapy; treatment of non-infectious uveitis affecting the posterior segment of the eye. Dosage: 

700 µg per eye (entire contents of a single-use OZURDEX ® device). Contraindications: Hypersensitivity to ingredients; active/suspected ocular or periocular infection including most viral diseases of the cornea and conjunctiva, including active epithelial 

herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, mycobacterial infections, and fungal diseases; advanced glaucoma; aphakic eye with rupture of the posterior lens capsule; eyes with an anterior chamber intraocular lens (ACIOL), iris or transscleral 

fixated IOLs, and rupture of the posterior lens capsule. Precautions: Proper aseptic injection techniques must always be used. Patients should be monitored for infection or increased IOP. Patients who had a tear in the posterior lens capsule or who had an 

iris opening to the vitreous cavity are at risk of implant migration, which might lead to corneal oedema. Corticosteroids have been associated with posterior subcapsular cataracts, increased IOP, glaucoma, and may enhance the establishment of secondary 

ocular infections due to bacteria, fungi, or viruses; history of or active ocular herpes simplex; OZURDEX ® is not recommended during pregnancy unless the potential benefits justifies the potential risks to the foetus; not recommended during breast-feeding unless 

necessary; use in children has not been studied; temporary visual blurring may occur after injection of OZURDEX ® , therefore, patients should not drive or use machines until this has resolved; administration to both eyes on the same day is not recommended. 

Adverse Effects (≥1%): cataract, cataract subcapsular, cataract nuclear, lenticular opacities, IOP increased, ocular hypertension, conjunctival haemorrhage*, vitreous haemorrhage*, eye pain*, vitreous detachment*, vitreous floaters*, conjunctival oedema*, 

vitreous opacities*, anterior chamber inflammation*, visual acuity reduced, endophthalmitis, hypotony of eye, retinal detachment, complication of device insertion, device dislocation, conjunctival hyperaemia*, visual disturbance, photopsia*, headache, 

myodesopsia, blepharitis, abnormal sensation in the eye*, eyelid pruritus, scleral hyperaemia*, visual impairment, migraine, anterior chamber cell*. Note: “*” indicates adverse drug reactions considered to be related to the intravitreal injection procedure. 

REFERENCES: 1. PHARMAC Pharmaceutical Management Agency (2017). Decision to fund dexamethasone implants (Ozurdex). Viewed 9 Nov 2017. Available from: https://www.pharmac.govt.nz/news/notification-2017-10-13-dexamethasoneocular-implants. 

2. OZURDEX ® Data Sheet. 3. Boyer DS et al. Ophthalmology. 2014; 121: 1904–14. 4. Eylea ® Data Sheet. 5. Lucentis ® Data Sheet. 

6. Nehme A & Edelman J. lnvest Ophthalmol Vis Sci 2008; 49: 2030–8. 

Allergan New Zealand Limited, Auckland. ® Trademark(s) and registered trademark(s) of Allergan, Inc. © Allergan, Inc. 2017. 

All rights reserved. Date of preparation: November 2017. NZ/0016/2017. DA1731CB. AM7187. 



15


CONTINUED FROM PAGE 15 

holding force. It’s a massive improvement. It’s 

brand new here, but the feedback we’ve had from 

Europe is that this is fantastic.” 

DORC also launched a new SF6 gas, used in 

retinal surgery, at RANZCO 2017. 

Designs for Vision – Oculus Corvis ST 

New on DFV’s stand was the updated Oculus 

Corvis ST, the first instrument to enable 

ophthalmologists to perform fast and 

comprehensive screenings for biomechanically 

weak corneas, said the company, recording the 

cornea’s reaction to a defined air pulse with a 

high-speed Scheimpflug-camera that takes over 

300 images a second, to measure IOP and corneal 

thickness with far greater precision. 

The Corvis ST is particularly useful for 

comprehensive biomechanical screening and 

keratoconus detection, said Ignatios Koukouras, 

DFV’s national product manager, diagnostic, at 

RANZCO 2017. “Nothing else in the world can 

measure corneal biomechanics like the Corvis. It is 

the only instrument that can actually determine 

the stiffening effect of corneal cross-linking.” 

The Corvis also integrates with the Oculus 

Pentacam to provide an even more detailed 

corneal analysis, he added. 

Battling DHB 

bureaucracy 

“An ophthalmologist 

without 

images is like 

a radiologist 

without x-rays.” 

Read how a Kiwi 

doctor is trying 

to change one 

backward 

practice in 

our DHBs. See 

‘Chalkeyes 

presents…’ 

on p26 

360˚ 

Pachymetry 

Tonometry 

Refraction 

Keratometry 

From little things, big things grow 

BY HEATHER MACHIN* 

Versatility and collegiality were celebrated 

at this year’s Australian Ophthalmic Nurses 

Association – Western Australia (AONAWA) 

meeting, held adjunct and just prior to the main 

RANZCO meeting in Perth. 

With more than 100 delegates from across 

Australia and further afield, the programme, 

led by AONAWA president Gina Storey, focused 

on the connectivity between service providers, 

ophthalmologist and nurse sub-specialty experts, 

and independent nurse-led project and research 

presentations. 

Perth-based ophthalmologist, Associate 

Professor Geoffrey Lam, presented alongside 

neonatal clinical nurse specialist, Karen Shearer, an 

early career nurse responsible for implementing 

a dynamic nurse-led digital imaging programme 

for the screening of retinopathy of prematurity. 

Associate Professor Angus Turner and nurseparamedic 

Sharon Brown, both from Lions Outback 

Vision, further demonstrated the unique nature 

of their collaboration while managing eye care for 

rural and remote communities where teamwork is 

essential and demand on services remains high. 

The collaborative approach continued, with 

Professor Steven Wiffen, from Lions Eye Bank of 

Western Australia, and myself exploring the many 

facets of eye tissue bioethics, corneal recipient 

needs and surgical techniques, challenging 

delegates to consider the possibilities and 

limitations we would go to, as a society, to 

provide human tissue to those waiting for ocular 

transplant surgery. 

An impressive line-up of nurse-led initiatives 

continued, with key note international nurse 

speaker, Dr Elissa McDonald, a microbial keratitis 

researcher from the University of Auckland, 

setting the pace. Elissa was joined on the 

platform by Associate Professor Vicki Drury 

from the Singapore Eye Institute; clinical nurse 

specialist Joanna McCulloch from the Sydney Eye 

Hospital; outgoing AONA-National Council chair 

and educator Amanda Wylie from Queensland 

University of Technology; and nurse practitioner 

TRK-2P 

Four in one 

Save Time, Save Space 

One-touch operation 

Operate from any position 

Your complete automated refraction solution 

For further information regarding these leading-edge 

products please contact Device Technologies Sales: 

P: 0508 338 423 

sales@device.co.nz | www.device.co.nz 

EMR 

patient 

record 

Anne Lentakis from Kingswood Eye Centre in 

Adelaide. Their collective take home message was 

loud and clear: ophthalmic nurses are in a unique 

position to contribute further to the needs of the 

vision impaired, be that through self-reflection 

and improvement of their own practice; by 

supporting other eye care providers; or through 

nurse-led research initiatives, all creating a lot of 

enthusiastic discussion among delegates. 

On the eve of the conference, during an exclusive 

cocktail hour and tour of the Perth Eye Hospital, 

AONAWA launched their new logo – a crisp 

inspirational design that retains its symbolic, yet 

reimagined, WA Swan. 

The lasting appeal of the ophthalmic nurse 

programme was the positive anticipation built 

up amongst delegates and the expectation and 

opportunities to rejuvenation and reimagine 

ophthalmic nursing in Australia, with hopeful 

symbiotic opportunities with the ophthalmic 

nursing community in New Zealand and beyond. 

With a successful close to the 2017 nursing 

calendar, and a commendable event for AONAWA, 

the ophthalmic nursing community turn their 

attention to RANZCO Adelaide 2018, hosted by 

AONAVIC and their South Australian sub-branch. 

International key note speaker, Dr Elethia Dean 

MBA PhD from Chicago will lead the event, with 

promise of further names to be announced in the 

coming months. 

The 2018 hosts warmly welcome participation 

from ophthalmic nurses in New Zealand and 

beyond and will be calling for abstracts shortly. 

* Heather Machin RN MBA, is an ophthalmic operating theatreregistered 

nurse, project officer to the Lions Eye Donation Service 

and to the Eye Bank Association of Australia and New Zealand, a 

consultant to the Fred Hollows Foundation NZ and the incoming 

AONA-National Council chair. 

Ozurdex approved 

Ozurdex, a long-acting 

intravitreal steroid, 

delivered via a sustainedrelease 

ocular implant is now 

available and funded for New 

Zealand adult diabetic macular 

oedema (DMO) patients, which 

is welcome news, say Kiwi retina 

specialists. 

“It’s great news because Pharmac 

has been very reticent to fund new 

medications for use in the eye, 

and we’ve found ourselves behind 

our international colleagues a lot 

of the time in what we can use 

to treat our patients, without 

them getting a big out-of-pocket 

expense. So, we’re really very 

excited about this,” said Retina 

Specialists’ Dr Rachel Barnes at 

RANZCO 2017. 

Eye Doctors’ Andrew Riley was 

involved with the clinical studies 

on Ozurdex (previously Posurdex) 

with his colleague, principal 

investigator, Dr Mark Donaldson, 

so he knows first-hand the benefits 

the Ozurdex slow-release system 

can bring to patients, he said. “It gives you 

another option, a good option. We haven’t had a 

second or third line (treatment) as good as this. 

The treatment load won’t be as bad for patients, 

and we now have something to better maintain 

their vision.” 

Ozurdex is a biodegradable, intravitreal, 

rod-shaped implant containing 700mcg 

dexamethasone, which targets inflammatory 

mediators involved in the generation and 

regulation of the inflammatory response in 

DMO. Specially-designed to provide sustained 

delivery, the implant results in less frequent 

injections compared to anti-VEGFs. 

“Diabetes is an ever-increasing problem in 

New Zealand, and is particularly prevalent in 

the Maori and Pacific Islander populations. 

Many of these patients already inject insulin, 

so the additional burden of frequent injections 

for DMO can severely affect independence and 

quality of life,” said Auckland Eye’s Dr Philip 

Polkinghorne. “For some patients, anti-VEGF 

treatments are less effective than we would 

like, so it is important that New Zealanders with 

diabetes and DMO have access to alternative 

treatments in order to avoid preventable sight 

loss.” 

A recent study showed that more than 35% 

of patients with DMO fail to achieve ≥10-letter 

improvement in best-corrected visual acuity 

(BCVA) after two years of first-line anti-VEGFs. 

While in clinical trials, Ozurdex delivered a rapid 

and significant vision improvement of 15 or 

AONA keynote, Dr Elissa McDonald from the University of Auckland 

Dr Rachel Barnes and Allergan’s Mellissa Isa 

more letters compared with sham treatment 

in the whole population of DMO patients; 

provided sustained, long-term improvements 

in vision in DMO patients with a mean of four 

injections over three years, compared with 

sham treatment: and was found to promote 

rapid central retinal thickness reduction, with 

significant and sustained visual gains. 

The efficacy and tolerability profile of 

Ozurdex is supported by two, three-year, 

multicentre, double-masked, randomised, 

sham-controlled phase III studies involving 

more than 1,000 patients as part of the MEAD 

(macular (o)edema: assessment of implantable 

dexamethasone in diabetes) trials. Only a small 

percentage of patients in the trial are reported 

to have experienced adverse ocular events, 

including: 1.4% with retinal tears and 0.6% for 

each of retinal detachment, endophthalmitis 

and hypotony of the eye. Less than one in three 

patients experienced an IOP increase from 

baseline of ≥10 mmHg. Elevations in IOP did not 

have a cumulative effect and were manageable 

with topical IOP-lowering treatment, reported 

Allergan. 

Ozurdex has been approved for the treatment 

of macular oedema due to retinal vein occlusion; 

adult patients with visual impairment due 

to DMO who are pseudophakic or who are 

considered insufficiently responsive to, or 

unsuitable for non-corticosteroid therapy; and 

non-infectious uveitis affecting the posterior 

segment of the eye. 


Is multicolour imaging 

better for AMD? 

A 

new study¹ by the Centre for Public Health at 

the Queen’s University in Belfast, Northern 

Ireland, has shown that multicolour imaging 

has a higher sensitivity for detecting early agerelated 

macular degeneration (AMD) compared to 

colour fundus photography (CFP). 

The study which used a sample of 105 eyes 

and the Spectralis Diagnostic Imaging Platform 

muliticolour option, was led by Professor Usha 

Chakravarthy. 

“This systematic analysis of colour fundus 

photography versus multicolour demonstrated the 

robustness of multicolour imaging in the detection 

of early AMD features,” she said. “The ability to 

delineate atrophy and fibrosis in late stage AMD 

gives added value in the clinical setting, as these 

components of the wet AMD lesion have an 

important impact on visual function.” 

In cases with discrepancies, an analysis of OCT 

also showed better agreement with multicolour for 

all AMD lesions, with the exception of haemorrhage 

and non-geographic atrophy hypopigmentation. For 

The Spectralis MultiColor Module is an imaging modality which uses 

confocal scanning laser technology instead of white light to visualize 

the retina 

pigment clumping, 

CFP and multicolour 

were in equal 

agreement to OCT, 

the study found. 

Multicolour imaging 

was able to identify 

soft drusen in 85% 

of the eyes studied, 

Dr Jim Borthwick 

reticular drusen in 83% and atrophy and fibrosis 

in 100% of cases where these abnormalities were 

seen on CFP. When using multicolour as the basis 

for analysis, however, CFP was less sensitive. In 

this study, soft drusen were identified in only 58%, 

reticular drusen in 28%, atrophy in 83%, and fibrosis 

in 68% of the cases where such changes were seen 

on multicolour images. 

Dr Jim Borthwick of Southern Eye said he’s been 

using the Spectralis multicolour module for nearly 

three years and is impressed with its capabilities 

for macular degeneration. “It is great. I’ve found 

it very useful for macular degeneration because it 

shows up the deeper layers.” 

Compared with CFP, the multicolour platform 

is proving to be particularly useful for spotting 

reticular pseudodrusen, which have been 

recognised as important for both identifying 

MD and assessing its severity, he said, and for 

better visualisation of epiretinal membranes for 

preoperative evaluation. 

But you do have to get used to using it, said 

Dr Borthwick, and it too has its limitations. “For 

example, it’s not as good at showing up naevi as a 

colour photograph. So, they both have a role. But 

it’s certainly a very useful extra tool for macular 

degeneration.” 

The Spectralis MultiColor Module, is a newer 

imaging modality which uses confocal scanning 

laser technology with light of discrete wavelengths 

instead of standard optics and white light to 

visualize the retina. It uses three laser wavelengths 

– blue, green and infrared – simultaneously to 

provide diagnostic images that show distinct 

structures at different depths within the retina. 

Each offers unique details, said the company, 

New J&J surgical rep 

J&J Vision (formerly AMO) has appointed 

Camille Furnandiz as a specialist sales 

representative for New Zealand, effectively 

doubling New Zealand’s on the ground surgical 

sales team. 

The New Zealand market for J&J Vision has 

grown significantly in the last 12 months, says 

Helen Cameron, J&J Vision’s surgical sales manager 

ANZ, so the country needed additional support, 

especially in Wellington and the South Island. 

Appointing Furnandiz is an exciting step for the 

company as it demonstrates J&J’s commitment 

to New Zealand and especially, given Furnandiz’s 

background in general surgical, to New Zealand’s 

ophthalmologists and registrars, she says. 

Furnandiz says she’s thrilled to be on the team 

and is loving learning about ophthalmology 

and especially cataract surgery. “I’m very 

excited about this role. Eyes is the most civilised 

speciality and cataracts just have such finesse.” 

She’s particular excited to be working with 

the ophthalmology registrars, she says, which 

is something she also enjoyed in her past roles 

in general surgery. “I’m very passionate about 

educating the registrars, because they are the 

future, so anything we can do to help upskill and 

partner with them benefits all of us in the future.” 

As well as sponsoring the annual NZORC 

(ophthalmic registrars conference), Furnandiz 

has put together a registrar training programme, 

which she’s run in Wellington and is planning 

due to the penetration depth and reflectance 

properties of each individual wavelength used: 

the infrared reflectance image shows deeper 

structures in the choroid and the retinal pigment 

epithelium; the green reflectance image is 

useful for examining blood, blood vessels, and 

exudates; while the blue reflectance image is 

best for identifying changes in superficial retinal 

structures, like epiretinal membranes or retinal 

nerve fibre layer defects. 

“It is encouraging to see the clinical significance 

of the multicolour module proven in a large study 

related to a prevalent pathology such as AMD. 

Beyond the clinical value, clinicians also appreciate 

the fact that multicolour images can be acquired 

Camille Furnandiz, joins the J&J surgical sales team in NZ 

on running in Christchurch and Dunedin next 

year. The programme covers wet labs, phaco and 

IOL education. J&J also runs a free toric training 

programme for registrars, towards the end of 

their training, which is popular in Australia, but 

is not well-known in New Zealand; something 

Furnandiz plans to change. 

Prior to joining J&J, Furnandiz was surgical 

business development manager for Medtronic’s 

minimally invasive therapies group, a senior 

technical consultant with Coviden and a key 

account manager with EBOS Healthcare. 

Furnandiz will be based in the capital, with 

responsibility for Wellington, the Hawke’s Bay, 

Palmerston North and the South Island, while 

Matthew Northage will continue to be based in 

Auckland, covering the rest of the North Island. 

through undilated pupils and in patients with 

media opacity or even nystagmus. While we don’t 

see multicolour as a substitute for colour fundus 

photography... it is a particularly useful diagnostic 

tool that can be combined with other imaging 

modalities,” said Dr Kester Nahen, managing director 

of Heidelberg Engineering, maker of the Spectralis. 

References 

1. Identifying features of early and late AMD: A 

comparison of multicolour versus traditional colour 

fundus photography by Katie W. Graham, Usha 

Chakravarthy, Ruth E. Hogg, K. Alyson Muldrew, Ian S. 

Young and Frank Kee, was published digitally in August 

and will appear in the November issue of Retina 

CLINICAL OUTCOMES 

the ONLY 200° single-capture choroidal layer 

optomap ultra-widefield imaging is a proven tool 

for effective clinical decision making. 

More than 400 peer reviewed studies show the value 

of optomap imaging in diagnosis, treatment planning, 

and patient engagement. 

To find out more please contact us at 08 8444 6500 

or auinfo@optos.com 

www.optos.com 

Building The Retina Company 

©2017 Optos. All rights reserved. Optos ® , optos ® and optomap ® are registered trademarks of Optos plc. 



17

Focus on 

Eye Research 

IPE cysts, VFs and lamina cribrosa 

CYSTS OF THE IRIS PIGMENT EPITHELIUM – WHAT 

IS NEW AND INTERESTING? Jerry A. Shields, MD 

and Carol L. Shields, MD 

Asia-Pacific Journal of Ophthalmology, Jan/Feb 2017; 

Vol 6, No. 1 

This is a very interesting article with attractive 

images by the Shields group in the USA, in which 

they described the cysts of the iris pigment 

epithelium (IPE), not stromal ones. Lesions in 672 

eyes were classified by the pupillary margin (7%), 

midzone (28%), peripheral (63%) or dislodged/freefloating 

(2%). Cysts of the IPE occurred most often 

in young adults (21-40 years), 34% manifesting 

with peripheral or mid-zonal cysts. The article also 

summarises the classification of IPE cysts, with 

descriptions of the shape of the cysts in different 

regions. Furthermore, the authors discuss the role of 

diagnostic imaging modalities, including ultrasound 

biomicroscopy and anterior segment optical 

coherence tomography (OCT), to rule out solid 

tumours like iris melanoma or nevi. 

The most interesting part of the article is the 

importance of recognising iris flocculi, a bilateral 

multifocal variant of pupillary margin IPE cysts 

characterised by variable-sized dark-brown lesions that 

can encircle the pupil and overlie the pupillary margin. 

These often spontaneously collapse and then re-form, 

producing irregular wrinkled lesions, which can be 

found with dissecting thoracic aortic aneurysms, 

related to genetic mutation in smooth muscle of the 

iris and aorta. Most IPE cysts require no treatment, but 

those in the pupillary margin (iris flocculi) should have 

lifelong annual examinations for thoracic aneurysm as 

this could be a life-threatening condition. 

EVIDENCE-BASED CRITERIA FOR ASSESSMENT 

OF VISUAL FIELD RELIABILITY Jithin Yohannan, 

Jiangxia Wang, Jamie Brown, et al 

Ophthalmology 2017;124: 1612-1620 

This is a retrospective study of a total of 10,262 

visual fields from 1,538 eyes of 909 subjects with 

suspect or manifest glaucoma and ≥ 5 visual field 

(VF) examinations. The authors reported the impact 

of false-positives (FP), false-negatives (FN), fixation 

losses (FL), and test duration (TD) on VF reliability at 

different stages of glaucoma severity. 

The results showed that FL had little impact on 

changes of MD, 20% of catch trials. 

3. FN has less of an impact than FP. FN does not 

significantly affect reliability in advanced disease 

BY DR RASHA ALTAIE* 

unless they are high – at least 35%, but often more 

than this value. In early disease, FNs are more 

impactful, where as few as 25% FNs can have a 

significant impact. 

4. Large increases in TD, >2-3 minutes beyond what 

is typical, are an indicator of poor reliability and 

should be taken into consideration. 

In summary, this study showed that in established 

VF test takers, FP, FN, and TD are all clinically 

significant predictors of VF reliability (defined as 

∆MD), with FP producing the largest impact on ∆MD 

and FL producing almost no impact on ∆MD. 

MULTIPLE TEMPORAL LAMINA CRIBROSA 

DEFECTS IN MYOPIC EYES WITH GLAUCOMA AND 

THEIR ASSOCIATION WITH VISUAL FIELD DEFECTS 

Yu Sawada, Makoto Araie, Makoto Ishikawa, 

Takeshi Yoshitomi 

Ophthalmology 2017;124:1600-1611 

This is cross-sectional study investigating the 

characteristics of lamina cribrosa (LC) defects in 

myopic eyes. It highlights the reasons for glaucoma 

in myopic eyes, in particular the characteristic 

deformations of the parapapillary region, including 

optic disc tilt and torsion and parapapillary atrophy. 

LC is a deep component of the optic nerve and could 

be deformed in myopia. 

In this study, Serial enhanced depth imaging OCT 

B-scans of the optic disc were acquired and reviewed 

for LC defects. The numbers and locations of LC 

defects and large pores in each eye were assessed, as 

well as the association between the locations of LC 

defects and VF defects. 133 eyes were assessed with 

open angle glaucoma OAG) and 83 eyes without OAG, 

with axial length of 24mm or more. 

The authors found myopic eyes with OAG exhibited LC 

defects and large pores at similar locations as those 

without OAG, but in greater numbers, suggesting 

that these focal alternations of the LC in myopic 

eyes may evolve into larger defects when glaucoma 

develops in the eye. The number of LC defects, which 

was related to the optic disc tilt angle, was associated 

significantly with glaucomatous VF defects in both 

severity and location. 

This suggests that myopia may influence 

glaucomatous VF defects through optic disc tilt by 

way of an increased number of LC defects at the 

temporal periphery. ▀ 

ABOUT THE AUTHOR: 

*Dr Rasha Altaie is an 

ophthalmologist with particular 

interest in pterygium surgery, 

paediatrics, cornea and cataracts. 

After training in Ireland, she 

received advanced clinical 

fellowship and sub-specialty 

training in cornea and anterior 

segment reconstruction and 

paediatric ophthalmology at 

Auckland University. She is 

currently working as a specialist 

with Counties Manukau District Health Board and at Milford 

Eye Clinic. 

ONZ gets commercial 

Ophthalmology New 

Zealand (ONZ) has 

launched a new website 

as part of its transformation to 

a more commercial and thus 

professional umbrella body to 

better service New Zealand’s 

ophthalmologists. 

Driving these changes, 

with the support of the ONZ 

board, is former Auckland Eye 

chief executive and health 

management consultant, Moira 

McInerney, who was appointed 

towards the beginning of the year. 

The ONZ was established in 

2012 to provide a uniquely New Zealand service to 

Kiwi ophthalmologists, especially when it comes 

to more commercial and medico-political interests 

which fall outside RANZCO’s, primarily training 

and education, remit. But ONZ has been unable 

to really fulfil its remit, until now, says McInerney 

who has been busy surveying members and, with 

their and the ONZ Board’s support, putting in place 

the processes and systems required to provide a 

more professional and thus effective service. 

As part of this service, McInerney has helped run 

two forums this year: a new ONZ Business Forum 

and the annual Clinical Leaders Forum, which 

includes updates with all the DHBs on regulatory 

changes and issues. 

The ONZ Business Forum, held in May following 

the RANZCO NZ Branch Meeting in Pahia, tackled a 

wealth of commercial issues, including accounting, 

the Commerce Act, career risk management, 

quality accreditation and Southern Cross. This 

Forum is a good example of how ONZ can help its 

members, says McInerney. 

Another change, already in place, is the ONZ’s 

approach to the country’s increasingly bureaucratic 

and demanding health insurer, Southern Cross. The 

ONZ is now far more proactive with Southern Cross, 

Moira McInerney, ONZ’s executive officer 

says McInerney. It arranges regular 

meetings to discuss changes in 

ophthalmic healthcare, such as 

MIGS, and how these can be best 

managed, and lobbies on behalf 

of members to clarify intentions 

regarding reimbursement model 

changes to ensure doctors can 

continue to do their best for their 

Southern Cross patients. 

ONZ’s direction is similar to 

that of the Australia Society of 

Ophthalmologists (ASO), but 

it is only part way through its 

transformation, says McInerney, 

as it seeks to gain more members, 

and membership funds, by proving it’s worth as a 

society. To bridge the current funding gap, McInerney 

has enticed some general sponsors on board to also 

provide knowledge useful to ONZ members. These 

include ANZ Bank, accountants Crowe Howarth and 

life insurance company Legacy Benefits. 

“It is quite an exciting time for ONZ,” says 

McInerney, because it hasn’t reached anywhere near 

it’s potential, but now it has the systems in place to 

do what it’s members would like it to do. “But we 

do need all the country’s ophthalmologists to be 

members, so we can really achieve those goals.” 

According to its constitution, now proudly 

displayed on its new website, ONZ’s goals are to: 

• Build relationships and lobbying at a national, 

local and DHB level with government 

• Work with health insurance providers 

and other third-parties to raise the profile of 

ophthalmologists and their concerns, and 

• Add value through resources and education on 

uniquely New Zealand commercial matters. 

ONZ’s board comprises: chair, Dr Michael 

Merriman; treasurer, Dr Kevin Taylor; and board 

members, Drs Peter Hadden, Rebecca Stack, Dean 

Corbett and Shenton Chew. 

For more, visit www.ophthalmologynz.co.nz 

Eylea reassessed for NZ 

Following a bit of a backlash from some Kiwi 

ophthalmologists, aflibercept is back on the 

government’s Pharmaceutical Management 

Agency’s (Pharmac’s) funding agenda and has 

been recommended as the second line anti-VEGF 

treatment, replacing ranibizumab. 

Pharmac consulted on a proposal to list 

ranibizumab (Lucentis) and aflibercept (Eylea) in 

Section H of the Pharmaceutical Schedule for the 

second and third line treatment (respectively) of 

wet age-related macular degeneration (wAMD) 

in the second half of last year, following a request 

for proposals for the supply of anti-endothelial 

growth factor (anti-VEGF) agents in May 2016. But 

aflibercept was dismissed as an additional listed 

treatment in December, despite Pharmac at the 

time noting a strong preference for it from some 

clinicians over and above the fully-funded (and said 

to be more expensive) alternative ranibizumab. 

But following further feedback from some 

ophthalmologists, Pharmac’s primary clinical 

advisory committee, the Pharmacology and 

Therapeutics Advisory Committee (PTAC), in May 

recommended aflibercept be funded as second line 

anti-VEGF treatment for wAMD after bevacizumab 

(Avastin), bumping it above ranibizumab, and a 

third line anti-VEGF 

agent be declined. The 

published minutes of 

the committee, stated 

that: 

“The Committee 

considered that whilst 

the quality of evidence 

for second line use for 

both ranibizumab and 

aflibercept is moderate 

to poor, both the 

quantity and quality of 

evidence is higher for 

studies using aflibercept than ranibizumab in the 

second line setting… The Committee considered 

that if only one anti-VEGF agent were to be funded 

for second line treatment, that aflibercept would be 

the preferred agent.” 

The Committee recommended aflibercept be 

funded with a medium priority and then referred 

the recommendation to Pharmac’s ophthalmology 

subcommittee for further consideration. A further 

meeting on aflibercept was held in November, but 

no final decision had been released at the time of 

going to press. ▀ 

BOOK REVIEW 

The Ophthalmic 

Assistant, tenth edition 

by Harold A. Stein, Raymond M. Stein and Melvin 

I. Freeman. Published by Elsevier, 2017 

REVIEWED BY DR STUTI MISRA* 

Much has changed in 

ophthalmology since 

the publication of the 

first edition of ‘The 

Ophthalmic Assistant’ 

almost 50 years ago. In 

an era before the internet 

and Wikipedia, resources 

for a quick reference 

were scarce. The first 

edition was published 

in 1968 to fill the gap and act as a ‘go-to guide’ 

for technicians, allied health professionals and 

physician assistants, or PAs as they are addressed 

in the US. Subsequent editions have expanded 

into different areas of eye care delivery with 

expansive colour illustrations for a quick grasp 

of content. The 10th edition by Harold Stein, 

Raymond Stein and Melvin Freeman promises to 

continue that five-decade tradition with a few 

added chapters and some interesting surprises. 

The 900-page book has 10 sections, covering 

the basics of clinical practice, common clinical eye 

problems and refractive error to ocular imaging and 

a brief atlas of clinical ophthalmic disorders. The 

order of sections and chapters is logical and clear. 

The first couple of sections briefly introduce 

readers to ocular anatomy and physiology. This is 

followed by a more in-depth look at history taking, 

refractive error, spectacles and, importantly, 

contact lenses. Four chapters in total have been 

aptly dedicated to contact lenses, covering 

fitting, management and its complications. 

However, these four chapters are still just a mere 

introduction to contact lenses if one wishes to 

master the topic. 

The addition of a separate chapter on dry eye 

is timely since the Dry Eye Workshop II (DEWS II) 

report was released earlier this year. The chapter 

briefly discusses novel diagnostic techniques which 

have emerged over the past few years. This is 

crucial since dry eye disease is now recognised as a 

chronic problem with a wide range of complications 

by an increasing number of eye care professionals. 

Another important chapter covers refractive 

surgery, given its growing popularity over the past 

decade. LASIK, LASEK, PRK, plus bifocal implants 

and other surgical techniques to correct presbyopia, 

are discussed. Notably, there is also a chapter on 

recent technological advances including ocular 

coherence tomography (OCT), computerised corneal 

topography and specular microscopy. 

Another important aspect of ophthalmology 

today is paediatric vision. Examination of the 

newborn, infant and toddler all find a place in this 

book, along with crucial tests for ocular motility 

and binocular vision. Low vision aids are also 

briefly mentioned in another chapter. 

Photographs and illustrations are always 

required in a good text book to speed and help 

understanding and in The Ophthalmic Assistant 

these are exceptional, making it an easy read. 

Catching the eye particularly, is a chapter called 

‘Art and the eye’. This fascinating chapter 

analyses a few famous historical art pieces and 

argues whether a particular stroke or colour was 

deliberate or merely due to cataract or presbyopia 

of the respective painters. 

An interesting inclusion is the chapter on ethics, 

which could prove crucial for this book’s target 

audience – ophthalmic technicians. A basic 

understanding of ethics is required for everyone 

who works with patients, particularly patients with 

limited ability. A deeper understanding of a blind 

patient might prove useful in recognising the role 

of allied health professionals in the prevention of 

blindness worldwide. While the information on 

ocular emergencies, common pharmaceuticals and 

conversion tables in the quick-reference appendices 

is useful and adds further depth to the book. 

This book is only the tip of the iceberg, however. 

It is, essentially, an all-in-one book covering a 

multitude of areas to help guide anyone working 

in an allied role in eye health, so is particularly 

useful for anyone starting out requiring basic 

information. If you are looking for in-depth detail 

on any ocular disease though, then this is not the 

book for you. ▀ 

*Dr Stuti Misra is an overseas-trained optometrist, holds a 

doctorate in ophthalmology and is currently a Stevenson research 

fellow in the ophthalmology department at the University of 

Auckland, New Zealand. 


for optometrists and eye care professionals 

with 

Prof Charles McGhee 

& A/Prof Dipika Patel 

Series Editors 

Update on scleritis 

BY DR RACHAEL NIEDERER* 

Scleritis is inflammation of the sclera and deep 

episcleral vessels. It typically presents with a 

deep aching pain, not responding to simple 

analgesia and sometimes waking the patient from 

sleep. Scleritis is an uncommon cause of red eye, 

but vital to diagnose, as untreated it may be vision 

(or globe) threatening, and a diagnosis of scleritis 

may point the clinician towards the diagnosis 

of an underlying systemic disease. Scleritis may 

be classified by location (anterior/posterior), 

appearance (nodular/diffuse/sectoral), presence of 

occlusive vasculitis (necrotising/non- necrotising) 

and aetiology (infectious/non-infectious/surgically 

induced) 1 . 

Anterior scleritis typically presents as a painful 

red eye. The affected vessels are large calibre from 

the deep episcleral plexus and don’t blanch with 

phenylephrine. There may be a violaceous hue – 

the best way to see this is to look at the patient 

under natural light. Inflammation in scleritis may 

be sectoral, diffuse or nodular. 

Fig 1. Anterior non-necrotising scleritis 

Always check carefully for necrotising scleritis as 

this can be subtle in the early stages. If in doubt, it 

can be useful to look with a green light and also to 

check for fluorescein staining over the conjunctiva. 

Posterior scleritis usually presents with 

periocular pain and headache or with symptoms of 

associated anterior scleritis. Vision loss is present 

in one third of patients 2 . The clinical presentation 

is more varied than anterior scleritis and may 

include serous retinal detachment, swollen optic 

disc, subretinal localised granuloma, choroidal 

folds and scleral thickening on transverse section 

B-mode ultrasound scan (B-scan). 

and scleral buckling 3 . A similar presentation may 

also occur following ocular trauma. Patients 

typically present with necrotising anterior scleritis, 

with the site of inflammation usually situated 

around the surgical wound. Presentation may 

be significantly delayed, ranging from day one 

to many years following surgery, with the mean 

around six months 3 . 

Whilst most scleritis is immune mediated, 

around 5-18% of scleritis may be infectious. It 

is important to identify these cases to allow 

treatment of the underlying infection and to 

avoid clinical worsening from inappropriate 

use of immunosuppression. Pseudomonas 

aeruginosa is the most common organism, 

particularly following trauma, however multiple 

other organisms may be implicated, including 

fungi, mycobacterium species and also viruses 

such as herpes zoster and simplex. Red flags 

that should alert the clinician to the possibility 

of infection include: history of prior trauma or 

surgery, although there may be a long delay to 

presentation; use of topical corticosteroid prior 

to presentation with scleritis; other immune 

compromising conditions such as diabetes, 

necrotising scleritis and scleral abscess formation; 

and pronounced anterior chamber inflammation 

and hypopyon 4 . Diagnosis is often delayed in 

infectious scleritis and organisms may be difficult 

to culture, frequently requiring scleral biopsy. 

In rare cases, malignancy may mimic scleritis 

and this should always be considered in atypical 

presentations and in treatment-resistant cases. 

The most common masquerades are choroidal 

melanoma, conjunctival tumours and extranodal 

lymphoma 1 . 

Fig 3. Surgically induced necrotising scleritis following diabetic 

vitrectomy 

Fig 4. Fungal scleritis with hypopyon 

What is new in scleritis 

Biologic drugs are a powerful new treatment 

modality in scleritis and increasing reports 

show effectiveness in treatment-resistant cases. 

Tumour necrosis factor (TNF) α is a cytokine 

and inflammatory mediator that plays a role 

in uveitis and scleritis. Specific blockade of 

TNF with infliximab (intravenous infusion 

approximately every six weeks) or adalimumab 

(subcutaneous every two weeks) can markedly 

reduce inflammation and allow tapering of oral 

prednisone. Another biologic agent, rituximab, 

has also shown great promise in the treatment 

of refractory cases. Rituximab is a monoclonal 

antibody directed against CD20 B-lymphocytes. 

Treatment consists of two 1g infusions at day one 

and day 15 and results in a drop in B-lymphocyte 

population for around six months, frequently 

BANNER | Size : A5 | 148 x 210 mm 

with considerable improvement in inflammation, 

Dr Rachael Niederer 

and is particularly effective in patients 

with GPA/ANCA-associated vasculitis 5 . 

Current results from retrospective 

case series have been promising, but 

further randomised, controlled trials are 

needed. ▀ 

References 

1. Daniel Diaz J, Sobol EK, Gritz DC. Treatment 

and management of scleral disorders. Survey 

Ophthalmol 2016;61:702-717. 

2. McCluskey PJ, Watson PG, Lightman S, 

Haybittle J, Restori M, Branley M. Posterior 

scleritis: clinical features, systemic associations, 

and outcome in a large series of patients. 

Ophthalmol 1999;106(12):2380-6. 

3. O’Donaghue E, Lightman S, Tuft S, Watson 

P. Surgically induced necrotising sclerokeratitis 

(SINS) – precipitating factors and response to 

treatment. Brit J Ophthalmol 1992;76(1):17-21. 

4. Murthy SI, Reddy JC, Sharma S, Sangwan VS. Infectious 

scleritis. Curr Ophthalmol Rep 2015;3:147-157. 

5. Cao JH, Oray M, Foster CS. Rituximab in the treatment 

of refractory non-infectious scleritis. Am J Ophthalmol 

2016;166:207-208. 

About the author 

*Dr Rachael Niederer trained in 

ophthalmology in New Zealand, 

receiving the Howsam Medal for 

Excellence, the Vice-Chancellor 

Best Doctoral Thesis Award 

and the Sir William McKenzie 

prize in ophthalmology. She 

subsequently completed her 

fellowship training in uveitis 

at Moorfields Eye Hospital 

in London. She now works at 

Greenlane Hospital, Auckland, 

as a uveitis specialist. 

ODOCS EYE CARE 

Limited 

A New Zealand Social Enterprise. 

Proud supporter of the New Zealand 

Blind Foundation. 

Fig 2. Posterior scleritis showing choroidal folds and exudative retinal 

detachment 

Aetiology 

In up to 50% of cases, scleritis is associated with 

a systemic autoimmune disease. The differential 

diagnosis for this is wide, but most common 

are rheumatoid arthritis, granulomatosis with 

polyangiitis (GPA, previously known as Wegener’s 

granulomatosis) and other ANCA-associated 

vasculitis, seronegative arthritis (including 

ankylosing spondylitis, reactive arthritis, psoriatic 

arthritis), inflammatory bowel disease, systemic 

lupus erythematosus (SLE) and relapsing 

polychondritis 1 . The clinician first seeing a patient 

presenting with scleritis is able to play a vital role 

in screening for associated autoimmune disease, 

arranging appropriate tests and, where necessary, 

referring to appropriate subspecialists for further 

evaluation. History should include previous 

ocular history including trauma or surgery, topical 

corticosteroid use, known medical conditions 

and also a thorough systems review. Medication 

history should also be taken, as scleritis may be 

associated with bisphosphonate use 1 . 

Surgically-induced necrotising scleritis is a rare 

complication of surgery to the eye, particularly 

following pterygium excision, cataract surgery 

Management 

Early scleritis may respond to topical 

corticosteroid treatment, however, most cases 

will require additional systemic therapy, either 

oral non-steroidal (NSAID) treatment or oral 

corticosteroid. NSAIDs are reported to be 

effective at resolving around 80% of anterior 

non-necrotising scleritis. Corticosteroids are used 

for subjects with posterior scleritis, necrotising 

scleritis and those who have failed oral NSAIDs. 

A typical oral dose would start at 1mg/kg, 

tapering over around six weeks. Those with 

vision threatening disease require admission 

for intravenous methylprednisolone 1g/day for 

three days followed by high-dose oral steroid 1 . 

Similar to other necrotising scleritis, SINS requires 

high-dose oral or intravenous corticosteroids 

and almost half will require second line 

immunosuppression 3 . 

Indications for second-line immunosuppression 

in scleritis include: 1) unable to taper prednisone 

to ≤ 7.5mg/day; 2) intolerable side effects from 

oral prednisone; 3) anticipated long course of oral 

prednisone; 4) specific disease known to have a 

poor outcome with steroid treatment alone (such 

as GPA, rheumatoid arthritis, necrotising scleritis). 

Infectious scleritis usually requires combined 

medical and surgical management, with only 

1/5 responding to medical treatment alone. Both 

topical and oral antimicrobials directed towards 

the causative organism are needed and drug 

penetration is poor through the avascular sclera. 

Surgical management is important in providing a 

microbial diagnosis, debulking a scleral abscess, 

debriding necrotic tissue and removing any 

foreign bodies that may serve as a nidus for 

infection, such as a scleral buckle or glaucoma 

drainage device 4 . 

VisoScope 

Smartphone retinal imaging 

adapter. 

Capable of up to 50-degree 

field of view with mydriasis. 

w w w . o d o c s - t e c h . c o m 

oDocs Slit Lamp 

Slit-lamp microscope and operating 

microscope smartphone adapter. 

Record your slit-lamp findings or 

your surgeries. 



19

Focus 

on Business 

Take your business into the 

future 

BY DAVID PEARSON AND JESS RADICH* 

MDNZ’s vision for 2020 

As we head into the busy summer 

months, using your time and 

resources efficiently is a must 

to ensure your business is running 

smoothly and your patients are feeling 

valued and coming back for more. 

The rise of cloud-based accounting 

software and other business applications 

has been a game changer for business 

owners. Being able to access real-time 

information enables informed and timely 

decision making and having transactions 

flow directly from your bank removes 

the need for time consuming data entry, 

allowing you to spend more hands-on 

time in your business. 

As business advisors, we are more 

than aware of the time pressures put on 

small business owners. Planning staff 

rosters, processing payroll, inventory and 

planning purchases leaves little time 

for other important areas like engaging 

with your patients or keeping your team 

motivated and productive. 

Real time accounting software and 

other business applications can help 

streamline your business while making 

your life a whole lot easier. Here are 

some key apps to consider, streamlining 

your entire operation, giving you time to 

focus on the things you love about your 

business. 

Reporting 

Reporting add-on software provides 

core KPIs and enables benchmarking for 

your optometry practice in a way that 

can be easily visualised and understood. 

Financial information is pulled from your 

accounting software in real time and 

presented in a way most meaningful to 

your practice, customised by you. 

Futrli and Spotlight Reporting 

applications are amongst the favourites. 

Both apps deliver crucial, need-to-know 

metrics required to help your practice 

thrive. Seamlessly integrated with a raft 

of accounting software, the app allows 

you to view your business’ financial 

information in easy to understand 

reports or dashboards, which can be 

customised. If you wanted to track how 

a new product or brand is performing 

during a ‘trial basis’, done! Want to 

ensure your stock levels are at the correct 

level for different stages throughout the 

year? Easy! Alerts can also be set to notify 

key people of changes in performance 

or trends. Recognising each business 

is different, both Spotlight and Futrli 

allow you to create your own KPIs and 

benchmarks. Plus you can break down 

revenue streams, forecast, budget, 

calculate gross profit percentages and 

wages to sales ratios among many other 

things. 

This can help you plan and reduce risk 

to grow your practice. Giving key staff 

members access to certain reports can 

also incentivise them to set and achieve 

targets for themselves and the company, 

while also increasing accountability and 

understanding. 

Data Entry 

Even though we live in a tech savvy 

world, there still seems to be a lot of 

paper. Invoices can quickly pile up, while 

disgruntled suppliers wait in the wings. 

A lot of business owners take care of this 

themselves, when in actual fact it is far 

more efficient and cost effective to pay 

someone else to do it. Being the face of 

your business will pay off far more than 

sitting in the back-office mulling over 

accounts payable data entry, especially if 

this is not your strong suit. 

20 NEW ZEALAND OPTICS December 2017 

An easy to way to get all your 

invoices processed quickly is to use a 

document collection and management 

software tool, such as Receipt Bank or 

Hubdoc. Email, take a photo or scan 

an invoice or receipt into the software 

and it will do the rest. The technology 

extracts all relevant data from the 

document and automatically enters 

the key components into your chosen 

accounting software along with the 

source document electronically attached. 

Payroll and staff management 

In a busy practice, staff rostering can 

be a nightmare and dealing with casual 

employees hired to help over the busy 

period adds to its complexity. One of 

the most popular cloud based payroll 

apps is FlexiTime. Multiple customised 

templates can be created as a starting 

point each week and FlexiTime provides 

you with the option of viewing your 

rosters in hours as well as dollars which 

is great for forecasting. The software 

also has clock-in, clock-out functionality 

ensuring labour costs are accurate as 

staff are only paid for the hours they 

work. And once a payrun has been 

processed, the information is sent 

directly to your accounting software to 

be reconciled – no need for manual data 

entry. It’s great for employees too as 

they can apply for leave and view their 

payslips through the employee portal all 

from a smartphone. 

Point of sale 

A reliable point-of-sale (POS) system is 

vital for the retail side of your practice. 

A good system can do more than just 

process transactions, it can track sales, 

manage inventory, automate ordering 

and help with pricing and again is 

all integrated with your accounting 

software so you can identify where 

profits are and aren’t being made. 

The Vend app is a powerful backoffice 

tool, allowing you to streamline 

processes and align staff and product 

supplies with demand. The front end is 

easy to use and works on any device and, 

if your business ever needs to operate off 

site, you can process sales from a tablet 

offline, which then automatically syncs 

when you are back online. 

All businesses today should be utilising 

the wide range of information systems 

business solutions available to them. 

Using apps such as these outlined above 

will help you work smarter, not harder in 

your business. You will thank yourself for 

them, when you’re finally spending all 

your Sundays at the beach!. ▀ 

ABOUT THE AUTHORS: 

*David Pearson is 

managing partner 

and Jess Radich is 

information systems 

business manager with 

chartered accountants 

and business advisors 

BDO Central (NI). 

Jess is passionate 

about ensuring her 

clients have the right 

accounting software for 

their business and the 

knowledge and skills 

to maximise their use. 

For more information, 

contact Jess at Jessica. 

radich@bdo.co.nz 

or David at David. 

Pearson@bdo.co.nz or 

visit www.bdo.nz 

Chris and Annie Bradley, Phillippa Pitcher, Dr Andrew Thompson, Di Goldsworthy and Henry Ford. In the background: Allan and Viv Jones 

BY PHILLIPPA PITCHER, MDNZ GENERAL MANAGER 

Macular Degeneration New Zealand (MDNZ) 

unveiled its vision for 2020 at a cocktail party 

in October, generously hosted by The Kelliher 

Charitable Trust in Parnell, Auckland. 

MDNZ gathered key supporters and donors together 

to remind those present about the devastating effects of 

macular degeneration and how sight can be saved, and to 

hear how MDNZ’s Vision for 2020 campaign will help fight 

this terrible disease. Vision for 2020 aims to raise $150,000 

a year, over three years to raise awareness about MD among 

the 41% of people over 50 years of age in New Zealand who 

remain unaware of it, yet are at risk of developing it. 

Using the Kelliher Trust art gallery to highlight our 

work, MDNZ distributed glasses, kindly donated by MSO 

(previously Mike Sladen Optical), that simulated vision loss 

from macular degeneration. We encouraged guests to look 

at the art wearing the glasses so they could understand 

the devastating effect of the disease. We also took the 

opportunity to auction artworks by emerging artists that 

raised $3,000 for MDNZ’s work, which is still unsupported 

by the government. 

Goodbye from NZOSS 2017 

As 2017 draws to a close, students are drowning 

their exam sorrows in copious amounts of caffeine, 

consolidated by thoughts of summer, BBQs and 

quality beach time around the corner. This marks the 5th 

year that NZOSS has been in operation, a progressive year 

filled with milestones, challenges and rewards. 

Right from the beginning, we were thrown into sign-ups 

and Round the Bays. For the first time we worked with the 

School of Optometry to run separate orientations for Part 2 

students, as well for Part 4s and 5s. We introduced the first 

ever NZOSS newsletter, ‘The Lookout’, while the biennial 

NZOSS BBQ, pub crawl and camp were all well-received, 

and our new buddy system was deemed effective in further 

bridging the gap between year levels. 

We also ran two seminars this year: ‘2017 and Beyond’ 

was targeted towards senior students with invited speakers 

providing some insight regarding the industry and our 

future careers; while ‘How 

to BOptom’, involved older 

students talking about their 

experiences of surviving tests 

and other shenanigans at 

optometry school. 

We kicked off the second 

half of the year with the 

annual quiz night, attracting 

the largest turnout to date. 

The winning team scored free 

tickets to the hugely anticipated 

annual EyeBall – a magical 

night enjoyed by all! We also 

introduced the inaugural, 

sponsored NZOSS Cocktail 

Party, which allowed students 

to socialise with lecturers and 

network with professionals in 

the industry. 

We are getting more and 

more well-known throughout 

the optometry community and 

the overwhelming support and 

BY ALICIA HAN, OUTGOING NZOSS PRESIDENT 

Our ambassador and founding trustee, Viv Jones 

spoke about her experience of vision loss from macular 

degeneration and how being aware and proactive not only 

saved her sight, but improved it. Board chairman, Henry 

Ford introduced the Vision for 2020 campaign and inspired 

attendees to consider how they could contribute. 

To kick start the campaign and to encourage others to 

contribute, a generous donor granted MDNZ $25,000 a year 

for the next three years. MDNZ’s event at the Kelliher Trust 

helped secure the donation as the donor could see we are 

engaging with our major donors and supporters and this 

would amplify their contribution. 

The evening had a lovely atmosphere in the delightful 

surroundings of quality artworks. Attendees all said they 

really enjoyed the evening and are keen to learn more about 

Vision for 2020 and our work. If you would like to know 

more, please visit http://mdnz.org.nz/ 

connections from all of you who are reading this column is 

what keeps us running. Of course, none of this would have 

been possible without our generous sponsors, the student 

body and the School of Optometry. 

On behalf of the graduating class of 2017, I would like 

to say a huge thank you to everybody who has supported 

us, especially the supervisors, lecturers and staff for your 

endless dedication and patience to teach us and help us 

grow as clinicians. 

Finally, a big thank you to my colleagues on the 2017 

executive team for all your hard work. It has been so much 

fun working with you and getting to know you all. I am 

so proud of what we have achieved. Best of luck to Nick 

Lee, NZOSS new president for 2018, and the newly elected 

committee. The students can’t wait to see what 2018 will 

bring. 

With warmest regards, Alicia ▀ 

Goodbye from the 2017 NZOSS Executive: Alice Jackson, Andrew Kim, Darina Khun, Katarina Marcijasz, Nick Stuhlmann, 

Alicia Han, Menaga Manokaran, George Stewart, Gemma Ji, Marna Claassen and (2018 president) Nick Lee

NZ Optics.half page adNov2017.indd 1 

31/10/2017 11:48:07 AM 

Celebrating 12 years of Insight 

BY NAOMI MELTZER 

Auckland Eye celebrated 12 years of offering 

continuing education with the last of 

its Insight seminars for the year at the 

beautiful Orakei Bay venue in Auckland. 

As the formal part of the evening got underway, 

we were treated to a moment of levity as 

optometrist Nigel Somerville was called to the 

podium to present his World Masters football team 

mate and Auckland Eye partner, Dr Paul Rosser, with 

his well-earned trophy shirt, celebrating their team’s 

silver medal win in the over 50s division. 

Back to the education and Auckland Eye’s newest 

recruit, Dr Shenton Chew, opened proceedings 

with a presentation on the art and science of 

gonioscopy to aid understanding of when a narrow 

drainage angle needs referral and when the best 

management may involve surgery, particularly nonroutine 

cataract surgery. 

His opening statement that primary angle closure 

glaucoma (PACG) is three times more likely to lead 

to blindness than primary open angle glaucoma 

(POAG) and only gonioscopy can tell you if what 

you have in front of you is POAG or a PACG suspect, 

was an eye opener for many of us. Though every 

gonioscopist will have their personal favourite 

instrument, Dr Chew’s recommendation is the 

Goldman-style high-magnification lens which gives 

a high quality detailed image. He recommended 

having the room 

illumination as 

low as possible, 

as those most at 

risk of PACG can 

best be identified 

when the 

pupil is dilated 

in darkened 

conditions. Build 

up experience 

using it on 

everyone until 

the once difficult 

“squeezy” patient 

becomes easier 

and orientation 

in what was 

Carolyn Campbell and Cliff Harrison 

previously foreign 

territory becomes 

routine, he said. 

The main course 

was served up by 

Associate Professor 

Phillip Polkinghorne, 

who said that 50% 

of us will experience 

a posterior vitreous 

detachment (PVD) 

once we are over 60. 

PVD is preceded by the 

development of large, 

optically-vacant spaces 

in the vitreous and an 

increase in floaters. 

Myopes and those 

who have had cataract 

surgery at an early age 

will experience PVD, and the consequent potential 

for retinal detachment and macular holes, earlier, 

with approximately 50% having a PVD within a year 

of surgery. He said a study is currently underway to 

determine whether oxidative damage caused by 

cataract surgery leads to vitreous detachment. 

A/Prof Polkinghorne took us through the unique 

features of optic nerve head haemorrhages 

resulting from PVD. These are relatively common, 

Dr Phillip Polkinghorne, Roger Apperley and Alice Ku 

Drs Sarah Welch, Shenton Chew and Dean Corbett 

Sonia Swan, Frank Snell and Dr Justin Mora 

occurring in 6% of PVDs and often confused with 

haemorrhages due to glaucoma. The location of the 

haemorrhage within the optic nerve head is related 

to the traction and can be preretinal, in the line of 

the retina or subretinal. Large population studies 

have shown more than 80% of people with optic 

disc haemorrhages did not have glaucoma. Further 

studies are pending. 

The final course focused on staphylococcal marginal 

keratitis versus peripheral ulcerative keratitis, 

delicately served by Dr David Pendergrast. Differential 

diagnosis is complex as they may have similar signs 

and symptoms particularly on first presentation, 

but may come down to the responsiveness or not to 

topical therapy. Prevention via blepharitis treatment 

is always preferable, he said. 

I, for one, am looking forward to more delectable 

offerings next year. ▀ 

Nigel Somerville (left) presenting Dr Paul Rosser (right) with his World Masters football shirt, with Dr 

Stephen Best (centre) 

Easy Online 

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21

ADONZ: an educational, friendly affair 

BY SUSANNE BRADLEY AND LESLEY SPRINGALL 

A 

regenerating Christchurch, full of optimism Why trained DOs matter 

for the possibilities that lie ahead was a Gibbins opened by providing an amusing but 

suitable setting for this year’s Association thoughtful take on why optometrists and practices 

of Dispensing Opticians of New Zealand (ADONZ) need a trained DO, pulling analogies from the 

annual conference. 

popular Dreamworks’ movie ‘How to train your 

Nearly 100 delegates, sporting a colourful array dragon’, stressing how working together well, can 

of eyewear, plus a handful of selected exhibitors, create a powerful business force. “It’s a critical role 

congregated at the Rydges Latimer, for a little over that needs to be handled well.” 

two days of education, networking and fun. 

Finding this business soul mate starts from 

President Peggy Savage kicked off proceedings with knowing where and how to recruit the right person, 

a bit of housekeeping, before warmly welcoming he said, ensuring they are introduced correctly 

the audience to Christchurch and celebrating the into the practice and given the skills, training and 

growing number of trained and registered dispensing support they need to become a valuable member of 

opticians in New Zealand. This led nicely into an the team. “Experience can be given, can be trained, 

introduction to James Gibbins who, together with his but a good personality can’t,” he summarised. 

business partner Chedy Kalach, run the Australasian Once a practice has found and employed the right 

College of Optical Dispensing (ACOD), the new 

potential DO don’t, however, shove them straight 

provider of DO education in New Zealand (see NZ out the door on to ACOD’s course, said Gibbins. 

Optics’ July 2017 issue). 

“The learning curve at the workplace is already 

very steep. Let them settle in a little bit first before 

pushing them into another steep learning curve.” 

He also stressed how a practice owner’s support 

is vital to the success of a training DO, both from 

a time management and emotional perspective. 

Consider a course completion celebration and 

perhaps even a financial incentive to keep them 

going, he said, as it’s not easy to become a trained 

DO in New Zealand, which is what makes them so 

valuable. 

In his second talk, Gibbins tackled the tricky 

subject of conflict resolution. As an unhappy 

customer shares their experience with others 

David Brenton-Rule, Lauren Hadfield and Anita Neill 

Hallie McCloy, Alastair Stewart and Genna Morrison 

Founding ADONZ member Morris Black with 2017 keynote speaker and 

his son, Nick Black, and his brother Brian Black from Eyeline Optical 

nine to 15 times, compared with a happy 

customer’s four to six times, there’s no excuse 

not to listen and express empathy. Just “zip 

it,” said Gibbins, and let the customer unload! 

Getting down to business 

Following ADONZ’s AGM, ACOD’s Chedy 

Kalach and fellow optics educator Steve 

Daras tackled some serious maths with 

prisms and the difference between 

occupational and progressive lenses. 

“Any lens that helps a person do a job is an 

occupational lens. But not everyone works in 

an office or indoors,” said Daras. Dispensing 

and recommending occupational lenses adds 

value to both your patient and your practice, 

“but it’s knowledge that creates these sales,” 

he said. 

Later in the conference, Daras also gave a 

quick quiz about why standard alignment is 

so important. The final frame fitting is crucial 

and a good DO should know how to do this 

well, he said. “Going the extra mile [when 

fitting] will give your practice a competitive 

edge.” 

Elaine Grisdale, the Association of British 

Dispensing Opticians (ABDO) head of 

professional services and international 

development, was a welcome return speaker 

to the ADONZ conference. This year her 

talk focused on our rapidly changing world. 

Although tools are only as good as the person 

using them, she said, embracing technology 

is essential to build trust in modern day 

society as well as to stay ahead in today’s 

competitive market. 

Rounding off the first day, Fiona Anderson, 

ABDO president, who had flown in the same 

day as her talk, had the whole audience 

laughing with some highly entertaining 

Scottish references to the impact of culture 

on your practice. It really is not about what 

you say, but how you say it, she stressed, 

adding it may sound simple but it’s a lot 

easier said than done. Anderson highlighted 

the importance of using inclusive and 

non-judgemental communication at the 

workplace, about considering your whole 

demeanour, respecting personal space, your 

appearance, understanding local ways and 

cross-cultural communication strategies. 

In a later talk, she tackled occupational 

dispensing and how important it was to ask 

the right questions to really understand a 

customer’s needs and so avoid trouble later. 

She highlighted ‘drivers’ as an example. They 

essentially do the same job, but have very 

different needs depending on what they 

drive, how they sit and when they work, she said. 

Tackling more specific problems 

Optometrist Iris Xu tackled the somewhat 

controversial topic of Irlen syndrome*, sparking lots 

of questions. Irlen often presents as pattern glare 

symptoms and this inefficient optical processing 

problem can cause quite severe reading difficulties 

and discomfort for patients, she said. Tinted Irlen 

lenses suppress the hyper-excitation of the cortex 

causing the overloading of the visual system and 

can, in Xu’s and other members of the audience’s 

experience, help enormously to reduce symptoms. 

Sometimes Irlen syndrome is mistaken for 

dyslexia, said Xu, but coloured lenses can still be 

of benefit to these patients if the child has visual 

dyslexia. In cases when a child presents with both 

visual and language-based dyslexia, the Irlen 

method allows the child to focus longer and with 

greater comfort, she said, before walking the 

audience through an Irlen diagnosis. 

A member of the Black optometry and dispensing 

optician dynasty, Nick Black a DO-practice owner, 

now based in the UK, discussed fitting children 

The OIC team, Chris Malicdem, Ian Bennett and Tim Way, with Kara Knight and 

Kelly Knight 

Sparkling DOs Jo Murray, Lynette Viviers, Samantha Davey and Sarah Bycroft 

ADONZ new committee: Lynette Hunter, Emmaleen Sherriff, Lucie Single, Donald 

Crichton (president) and Vineet Chauhan (vice-president) with outgoing president 

Peggy Savage 

Glenn Bolton, John Ruby and John Clemence compare checks 

with contact lenses and the myopia epidemic. It’s 

important to fit contact lenses early, when a child is 

still growing both for better myopia control and to 

ensure that good CL care becomes second nature to 

this new generation of visually-challenged beings, 

he said. Black has fitted children as young as six 

with lenses and said some quickly become adept at 

putting them in and taking them out themselves. 

Black also tackled a personal passion of his, low 

vision, and how DOs can make a big impact as a 

relationship builder with low vision patients. There’s 

a wealth of low vision tools out there today, but you 

need to ask simple questions to fully capture and 

really understand your patient’s daily needs, he said. 

Local ophthalmologist Dr David Kent from 

Fendalton Eye Clinic then walked the audience 

through some of the most common eye surgical 

procedures, such as cataract surgery, where he 

explained the different intraocular (IOL) lenses 

on the market, and patient care once they’ve had 

surgery. 

ANZ’s Stephen Caunter, a popular and regular 


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23

CONTINUEDFFROM PAGE 22 

ADONZ speaker, made sure everyone stayed 

awake with his highly entertaining talk ‘Scams, 

frauds, online love and the many other ways to 

lose money and feel dumb about it later’. His take 

home message: “if it seems too good to be true, it 

always is.” 

And last but not least, Independent Lens 

Specialists’ (ILS’) Glenn Bolton closed the conference 

with a talk on Rx sunglasses and specialised lenses 

and how it’s possible with today’s technologies 

to save someone from early retirement with 

occupational, specialised lenses. 

On the lighter side 

No ADONZ conference is complete without a 

fabulous fancy dress Saturday night event, and 

this conference was no exception. The muchanticipated, 

secret-venue gala dinner, themed in 

Canterbury’s red and black, was at the transitional 

Christchurch Cathedral. A spectacular venue! 

Pre-dinner drinks, generously sponsored by ILS, 

were followed by dinner, the awards ceremony 

(see below) and a heartfelt official handover of the 

presidency from Peggy Savage to Donald Crichton. 

Crichton said he would do his very best to honour 

Savage’s hard work, while thanking her for “putting 

her heart, body and soul into ADONZ.” 

Then, before you knew it, local band Puré was up 

on stage and there was no doubt the country’s DOs 

had brought their dancing shoes to Christchurch! 

ADONZ 2018 conference will be held in Auckland 

from 27 to 29 October, 2018. Don’t forget your 

dancing shoes! 

*For more about Irlen syndrome, make sure you read 

February’s NZ Optics. 

Awards celebrate new and old 

The 2017 ADONZ 

conference marked a 

significant milestone in 

DO’s New Zealand history, with 

the announcement that future 

conferences will now host the 

graduation ceremony for New 

Zealand’s home-grown, newlytrained 

dispensing opticians. 

The David Wilson student 

award 

To mark this milestone, 

outgoing ADONZ President 

Peggy Savage announced the 

creation of a new award, the 

David Wilson Medal. This will be 

awarded to a new graduate who 

not only excels at the academic 

part of the training, but also has the heart and 

passion for optics that David Wilson had, she 

said. “Previously students have had to travel to 

Australia for the graduation, but with the course 

now changing (to ACOD) the Association will now 

be holding the ceremony.” 

The award was named after David Wilson 

who was, among other things, head teacher 

of ophthalmic optics at the Open Training and 

Education Network for more than 20 years, an 

author of two text books on optical dispensing, 

an international lecturer, research manager at 

the Brien Holden Vision Institute and an honorary 

fellow of ADONZ. 

Given the changing nature of DO student 

training in New Zealand, it seemed fitting to 

introduce a new award for students and to name 

it for someone who was so dedicated helping 

students achieve their goals, said Savage. “David 

Wilson was instrumental in teaching all our New 

Zealand students and literally put thousands of 

hours into optics and helping us. He gave so much 

of himself, so when he passed away we wanted to 

honour his memory and the contribution he made 

to New Zealand.” 

New life member awards 

It is a rare occurrence when ADONZ awards a life 

member award, but this year’s conference marked 

the occasion for two stalwarts of the industry, 

Steve Stenersen and Mike Blackman. 

A life membership award is awarded to someone 

who has contributed to the association, often in 

the education of new dispensing opticians, and 

has been dedicated to our industry well and truly 

over the norm, said Savage. “These are people 

who, as time goes by, you forget how much they’ve 

actually sown into the Association, so we really 

wanted to honour them and say, ‘thank you’, to 

acknowledge their outstanding contribution.” 

Practising, Gisborne-based DO, Steve Stenersen 

was an Optiblocks course tutor, examiner and 

ADONZ board member for many, many years. He 

represented ADONZ on the Scopes of Practice 

Committee ensuring DO’s became a regulated 

Life member awardees Mike Firmston, Mike Blackman and Steve Stenersen with current and past 

ADONZ presidents Donald Crichton (second) and Peggy Savage (absent: David Sercombe) 

and recognised force in the industry under the 

Health Practitioners Competence Assurance 

Act and was subsequently part of ODOB’s CPD 

accreditation committee. He also co-authored 

the ‘Practical Optical Workshop’ with David 

Wilson and has worked closely with ACOD and 

Optiblocks to continue to ensure high training 

levels across the industry. 

Mike Blackman has also been active in the 

management of the industry and the development 

and recognition of the dispensing role both under 

law and in practice, previously serving as chair of 

the Scopes of Practice Committee. A member of 

ADONZ for more than 40 years, he kept people 

focused on the “relevant issues for ADONZ and 

optical dispensing in New Zealand” and has been 

a tireless worker for the cause, said Savage. He 

was one of those responsible for bringing over 

David Wilson to educate Kiwi DOs and was one 

of the country’s first training examiners. “He has 

dedicated his life to making optical dispensing a 

better profession; he was the ‘quiet achiever’ of 

dispensing optics in New Zealand and a constant 

supporter of training young people,” said Savage. 

Robert Maher Award – Vanessa Cumming 

Savage’s ADONZ presidential predecessor Vanessa 

Cumming was awarded the 2017 Robert Maher 

Award for her services to ADONZ and dispensing 

in New Zealand. Owner and practising DO at 

Cannon Street Optometrists in Timaru, Cumming 

was also president of the International Opticians 

Association from 2014 to 2016. On her company’s 

website, she says she loves the technology 

involved with lenses and lens design. “I have 

always considered myself incredibly blessed to 

have found a vocation I have continued to love but 

which constantly changes and challenges me. My 

love of unique, exquisite frames and finding the 

right personality to wear them is my favourite part 

of the day!” 

Look out for more news about another exciting 

DO-focused award and the IOA conference in the 

UK in April, in NZ Optics’ February issue. 

Fashion update 

Collage art by Xavier Garcia 

Xavier Garcia Barcelona has launched a new collection 

inspired by collage art, including new combinations of 

metal and acetates with XG characteristic boldness and 

colours. Dakota (top picture) is an oversized square design 

with a retro feel and a youthful look, says the company. The 

frame is made from a steel block with coloured laminate 

at the top of the eye wires. Available in several different 

metals and colour combinations. 

Contemporary Linus (below) is a unisex panto design also 

made from a steel block and combined with some vibrant 

coloured laminates at the top of the rims. Distributed by 

Cardinal Eyewear. 

Calvin Klein 

Belgian-born Raf Simons, the creative mind 

currently behind Calvin Klein, has released a new 

signature eyewear collection. Optical frames as well 

as sunglasses are available in a range of colours 

and classic shapes, with Calvin Klein’s trademark 

sophistication with an edge. CK 2158S 714 Gold 

Havana from the new range is featured here. 

Distributed by VSP Australia. 

Fleye’s winning streak 

Fleye is going from strength to strength, adding 

to its Silmo award with a first in men’s eyewear 

at the Japan Eyewear Awards with their frame 

‘Cole’ featured here. The award-winning Cole 

is a classic squared optical frame with an extra 

accentuated acetate layer on the top-line. See 

the latest OIG for contact details. 

Stars and their eyes… 

Michel Roux Jnr 

Two-star Michelin chef Michel Roux Jnr has 

experienced two sight-threatening retinal 

detachments. “It’s hard to describe, but it 

just didn’t feel right,” he told media about the 

experience. 

At first, he noticed his vision being blocked 

by a black line across the lower third of his eye. 

Everything below the line was black, he said. 

“Pretty soon it had risen to cover the entire 

bottom half of my eye.” 

The former British MasterChef presenter 

remembers how his optometrist’s face fell when 

she examined his eye, before ordering him to 

hospital, immediately. Later, at the infamous 

Moorfields Eye Hospital in London, when his 

macula was “hanging on by just a thread”, his 

consultant told him he had a very high chance of 

losing sight in his eye. Luckily Roux emerged from 

his surgery successfully and coped with sitting 

with his head in a face-down position for two 

weeks. “It wasn’t too bad. When you know your 

sight is at risk, you’ll do anything.” 

Since then, Roux has been heavily involved 

with children’s charity Visually Impaired Children 

Taking Action, running the London marathon 12 times to raise funds for its work. 

Christmas bling 

Looking for the ultimate season 

accessory? Or perhaps just something for 

the December window display? Italian 

manufacturer EBlock, is promoting 

Christmas frames with a touch of 

seasonal bling; glittery models available in 

red, gold and black. Available direct from 

EBlock Eyewear. 

back for 2018 

The Optical Distributors & Manufacturers 

Association of Australia’s (ODMA’s) 

boutique optical fair, O-Show, returns to 

Melbourne from 14-15 July 2018. 

The decision to repeat the fair, follows the 

success of the inaugural event, also in Melbourne, 

in 2016, said ODMA in a statement. “O-Show 

provides a great opportunity to have the latest 

industry trends in technology and frame fashion 

showcased in the southern part of Australia. (It) 

is owned by the Australian optical industry. It has 

been developed for the industry, by the industry.” 

The 2018 O-Show will once again be held again 

at Peninsula in Melbourne’s Docklands. “The 

latest offerings for the industry will be presented 

in a funky environment providing a relaxed 

opportunity to network and enjoy the unique 

ambience,” said ODMA, adding the event is timed 

for the latest frame and sunglass releases from 

MIDO and the US. 

“O-Show is a non CPD event with the 

emphasis on hands on demonstrations, and 

the opportunity to compare and contrast new 

products and equipment,” said Robert Sparkes, 

chairman of ODMA. 


Class of 2007 celebrates 

10 years 

The University of Auckland graduating optometry 

class of 2007 celebrated 10 years with a dinner at 

Meredith’s restaurant in Mount Eden, Auckland in 

November. Fourteen optometrists enjoyed a three-course 

meal with the bill for the food kindly donated by Meredith’s 

to Volunteer Ophthalmic Services Overseas (VOSO). The 

2007 year saw 44 optometrists (37 female and four male) 

graduate. It was the second group to graduate from the 

University with the additional therapeutic prescribing 

qualification. One member of the dinner group, Ella Ewens, 

who writes for NZ Optics, said it was a very enjoyable 

evening with lots to talk about, especially given the wide 

range of areas her former classmates were now involved 

in, including private 

practice, business 

ownership, volunteer 

work, hospital 

optometry, research, 

teaching, lecturing 

and, outside 

optometry, running 

a global online 

business. ▀ 

OPSM NZ appointments 

Erin Jackson and Jonathan Payne have joined 

the Auckland-based central support team 

at OPSM NZ as Human Resources (HR) and 

professional services manager, respectively. 

Payne replaces Hirdesh Nair who has moved to 

Sydney to take up another OPSM role. Like Nair, Payne 

will be responsible for all OPSM’s New Zealand-based 

optometrists. A former professional teaching fellow 

with the School of Optometry and Vision Science 

(SOVS) at the University of Auckland, he says he’s 

excited by the prospect of expanding OPSM NZ 

optometrists’ clinical understanding by providing 

both the latest tools and technology they need for 

their practice and by looking after their passions and 

clinical needs, and matching all of these as best he 

can. “For me, personally, I’m enjoying the challenge of 

stepping out of my comfort zone from a clinical role 

to a supporting role.” 

Prior to working with SOVS, Payne was an 

optometrist in a private practice in Manukau, where 

he also worked closely with Auckland DHB to deliver 

a diabetic photo-screening programme. 

Jackson meanwhile is new to the world of optics, 

having previously worked with building company 

Arrow International and advertising company OMD 

in HR roles. She says she fell into the people-side 

of business by chance after filling the role when 

OPSM NZ’s Erin Jackson and Jonathan Payne 

it needed doing, while working for a start-up firm 

in London. “I was paid next to nothing, but ended 

up loving it and have been working in HR roles 

ever since.” Jackson says her goal as OPSM NZ’s HR 

manager is ultimately to create a culture where 

staff love coming to work every day. “It’s a good 

time to join OPSM. We’ve now got a full support 

team and, with Australia’s backing, are fully geared 

up for success.” 

Payne and Jackson join OPSM NZ’s country 

manager Samantha Payne, who was appointed in 

January this year. ▀ 

Vision technology 

solutions 

BY ZEISS 

Some ‘Year of 2007’ Merediths’ 

dinner attendees (from top, 

clockwise) Ella Ewens, Amanda 

Snedden, Janice Yeoman, Rueben 

Gordon, Debra So, Sandyha 

Mathew, Renata Watene, Michelle 

O’Hanlon, Ming Wang, Jason Dhana 

and Surekha Parag 

SPONSORED FEATURE 

New Transitions POS 

Transitions Optical has 

launched a large suite of new 

point-of-sale (POS) materials 

available free to eyecare practices. 

The new suite includes window 

and wall posters, counter and 

reading cards, dispensing mats and 

consumer brochures. 

The material poses the question: 

“Which Transitions lens are you?” 

challenging consumers to ask 

which Transitions’ technologies 

is for them, from Transitions Signature, XTRActive 

or Vantage, and which colour they should go 

for. The aim of the new POS campaign is to help 

optometrists find the best solution for their 

patients’ unique needs, frame, 

life and personal style, said Stuart 

Cannon, Transitions optical 

general manager for Asia Pacific. 

“The choice… means eyecare 

professionals can better fulfil 

patient needs and personal 

preferences, ultimately leading to 

greater patient satisfaction.” 

Transitions has also appointed 

a new sales team in Australia and 

New Zealand to work more closely 

with practices and offer training on Transitions’ 

brand family, patient insights, dispensing tips and 

knowledge about how to increase profitability with 

Transitions lenses, said Cannon. ▀ 

Delivering the best possible vision to 

your patient involves more than just an 

accurate refraction. Lens choice, accurate 

lens dispensing measurements and precise fitting 

strongly influence the overall visual performance 

of a pair of spectacle lenses. 

Although many eye care professionals are 

highly adept at using a ruler to take PD and 

fitting height measurements, skill levels vary 

considerably. An internal ZEISS study indicated 

that PD measurements varied by up to 3.00mm 

between different eyecare professionals. While 

pupilometers delivered an improved accuracy, the 

variation between devices still ranged between 

1.20mm and 3.00mm. Additionally, pupilometers 

reference the nose bridge as the central vertical 

position, not taking into consideration that the 

nose may be off centre. 

Manual PD and fitting heights taken by 

qualified and experienced eyecare professionals 

mostly suffice when dispensing relatively 

unsophisticated, traditional lens designs. 

However, modern lens designs require highly 

accurate measurements to fully benefit from 

more sophisticated lens designs with complex 

surfaces. 

Determining the exact position of the lens 

during wear, also referred to as position of wear, 

optimises the lens performance, contributes 

to comfortable vision, reduces eye strain and 

maintains good body posture. i.Terminal 2, the 

digital centration device from ZEISS, captures 

all relevant facial and frame parameters to an 

accuracy of 1/10 mm, minimising lens fitting 

errors that can contribute to a loss of up to 40% 

in visual performance, particularly in progressive 

lenses. 

ZEISS i.Terminal 2 provides perfect position of 

wear measurements in a fast and pleasant digital 

manner for the wearer. The measurements are 

completed within 60 seconds. While wearing the 

selected frame, fitted with an ultra-light precision 

calibration jig, the wearer looks at an infrared 

cross within the device. Two photos are then 

taken – one from the front and one from the side. 

i.Terminal 2 combines a high-tech camera with 

intelligent ZEISS software to determine relevant 

centration data, which is saved to the associated 

iCom data box and can be uploaded to your 

practice management software or combined with 

the lens order provided to your lens processing 

laboratory – all with a simple click of a button. 

It’s all about precision and tailoring lenses for 

each individual wearer. Every face and frame 

combination is unique, with variation in the 

position of wear – pupil distance, fitting height, 

pantoscopic tilt, frame wrap and back vertex 

distance. 

You may also want to consider your customer’s 

perception and opinion of modern technology in 

your practice. It could be perceived that the young 

sales assistant employing the latest centration 

technology does a more accurate job than the 

well experienced eye care professional using a pen 

and ruler. 

More recently, ZEISS introduced i.Terminal 

mobile. An Apple iPad, loaded with dedicated 

ZEISS applications, accessing the Apple gyroscope 

and camera to calculate all relevant position 

of wear data without requiring cumbersome 

attachments. This is a convenient and cost 

efficient alternative to the floor mounted ZEISS 

i.Terminal 2. 

ENROL NOW… 

…and become a fully-accredited and trained 

Dispensing Optician in New Zealand 

HLT47815 – Certificate IV 

in Optical Dispensing is now 

open for 2018 enrolments. 

Workshop conveniently located 

in Glenfield, Auckland 

Enquiries and Enrolments www.acod.edu.au 



25

Chalkeyes presents… 

Tackling frustrations… 

by 

Dr Mike Mair* 

Ophthalmologists are not surprised at the 

ongoing difficulties the District Health 

Boards (DHBs) are having with timely 

ophthalmology follow-up appointments. ‘Fight 

the queue’ has always been a challenge for all 

eye clinic workers, made worse by the advent 

of anti-VEGF treatments, which have massively 

increased clinic work. Government directives 

that departments would be penalized if they 

did not see new patients within defined time 

intervals forced administrators to bounce followup 

appointments in favour of first specialist 

assessments, creating a now well-known 

backlog of unserviceable follow-up loads, and a 

forced ‘denial of care’ for many distressing eye 

conditions. 

This is now hopefully being addressed. But, 

in my view, the state of our medical records 

remains a serious impediment to improving care 

and efficiencies in our DHB clinics. Apart from 

‘contracting’ clinics, DHB clinics are still creating 

paper notes in manila folders. For some, the 

number of folders and paper within them has 

accumulated to such a degree that retrieving one 

nugget of relevant patient information is often 

not practicable given the time constraints of a 

typical clinical interview. To try and bring some 

order to this, some DHBs insert a piece of paper 

into the patient’s folder with different ‘boxes’ 

printed on it, to be filled in by hand each time a 

patient attends a clinic. This is truly expensive 

in paper space and doesn’t solve the underlying 

problem; in fact, it exacerbates it. 

A debilitating inability to access today’s 

screening tools 

In most DHBs, there are also no ‘on-screen’ 

electronic representations of images or reports 

from today’s all-important assessment devices 

which are now used routinely to help diagnose 

and monitor our patients. Often these can only 

be retrieved by going to the device directly and 

browsing manually, or sorting through paper in 

overloaded manila folders! 

This lamentable hybrid mix of paper and 

up to five ‘online’ programmes, which do not 

interoperate, is a great hindrance to the practice 

of efficient ophthalmology in DHB public clinics. 

Contracting clinics mostly use modern electronic 

health record (EHR) and practice management 

systems and, unsurprisingly, don’t have a 

floating population of un-dedicated follow-up 

appointments and the, well-publicized, morbidity 

which results. 

There are few complainers in New Zealand public 

clinics, however long the clinic gap has been and 

even when there has been a dramatic worsening 

of the patient’s condition as a result. The best 

expression of quiescent patient attitudes came 

from one person I met, who said: “I know it’s none 

of my business doctor, but am I going blind?” 

This Kiwi-way also causes a problem with the 

Clinical Priority Assessment Criteria (CPAC) cataract 

prioritisation system, where elderly people often 

underplay their difficulties and thus slow their path 

to surgery when there is clearly a need. 

But back to this lack of images in today’s DHB 

systems; it is an anachronism for professional 

guardians of the eye to be handicapped by only 

having paper images or, worse, no images at 

all. An ophthalmologist without images is like a 

radiologist without x-rays! In most DHBs, with the 

exception of onsite OCTs, there are no on-screen 

images accessible at all. My impression today is 

there are even less photos being taken in DHB 

clinics than we had in the ’70s, when patients 

with retinal problems always had a sleeve of 

filmstrips to view with high plus glasses, enabling 

a 3D view of discs and maculae. 

Concerto – an easy fix? 

Health software firm Orion supplies its system, 

Concerto, to nearly all the country’s DHBs. The 

company’s South Island manifestation is called 

Health Connect South (HCS) and it’s certainly a 

significant achievement to have one information 

portal to allow potential interoperability between 

DHBs, so there are many virtues to this product. 

But Concerto does not yet file images or reports 

from devices. 

I believe that modern ophthalmology, with 

today’s abundance of scanning and assessment 

technology, cannot be well managed except by 

a paperless practice. Frustratingly, this could be 

achieved with the Concerto software platform, if 

its ‘clinical document viewer’ was given the ability 

to file reports and images from different devices. 

And, as I understand it, this is an easy fix for Orion 

to make. So why hasn’t it been done? 

Claire Harman, the Ministry of Health’s (MOH’s) 

senior communications advisor, said it is up to the 

health provider which software it chooses and, in 

many cases, a health provider will use multiple 

products to meet its needs. Thus, she said, the 

problem should be referred to Orion. 

So I made a formal proposal to Orion to improve 

the functionality of HCS/Concerto by getting it to 

display images and reports. I was kindly supported 

in this by the executive committee of the New 

Zealand branch of the Royal Australian and New 

Zealand College of Ophthalmologists (RANZCO). 

But Orion said I should address my concerns to 

the South Island’s Clinical Informatics Leadership 

Team (the group’s acronym is CILT). Timaru’s chief 

medical officer Steve Earnshaw chairs this team, 

which is part of the MOH’s South Island Alliance 

(SIA), which looks after the HCS programme. 

The block of bureaucracy 

I have since been told that, yes, this proposal has 

been approved and it is “something that the HCS 

should do”, but it currently rests with the group’s 

‘Eyecare advisory group’. Apparently, there are 

many demands on Orion for Concerto at this time, 

particularly from Canterbury DHB, and it cannot 

take any action unless CILT tells it to! And so, we 

go round. 

As noted above, lying behind CILT is the South 

Island Alliance (www.siallance.health.nz). 

Procedurally, CILT decides what functionality will 

be included in a regional information system – at 

present HCS in the South Island, or Concerto by 

another name – so Orion cannot independently 

develop functionality like filing images and 

reports, however crucial it may be. So, it appears 

my proposal, even with RANZCO’s support, is stuck 

in a bureaucratic maze. 

Cost, politics and the lack of alternatives 

Further private enquiries to people within Orion 

about how much it would cost to include image 

and report functionality in Concerto revealed it 

would require hiring the services of a business 

analyst. However, they also admit Concerto 

already has the functionality to display images, 

but it has been turned off! Informal estimates, 

from three independent members of Orion’s 

team, have suggested the cost for turning it back 

on is little more than a few hours’ time. But, Orion 

cannot move on this, until told to by CILT. So, care 

of our patients’ sight continues to be handicapped 

because no one’s taking responsibility for pushing 

the button! 

From my understanding of this sad situation, 

this problem is compounded by the fact that the 

politics and cost of implementing an alternative 

image displaying software system across our 

DHBs appears to be prohibitive. Christchurch 

has the Synergy product from Topcon and, of the 

four private clinics contracting to the DHB, three 

run Best Practice’s ophthalmology system. The 

rest hold their images and reports on paper or 

in the camera, or in software that is not actually 

being used. Some DHBs also have software from 

Zeiss and Heidleberg Engineering, but appear 

to be using it ineffectively, and there’s seldom 

a designated photographer available to take, 

maintain and share patient image records in 

clinics. Confusingly, Christchurch also appears to 

have plans for another imaging access system 

called, ‘Weblogic’. But why, when there is no 

real technical reason why our DHB departments 

can’t have their cameras hooked up to Concerto 

to access, share and display images as and when 

needed? If we had this, we would then be able 

to teach and encourage more clinic personnel to 

take pictures and this would greatly facilitate the 

clinical process. In the meantime, however, this 

obvious enhancement is on the back burner and 

nothing is being done! 

Concerto also has the capabilities to function as 

an efficient EHR system, especially as a new and 

better version of its Winscribe dictation system 

has been released, which means medical staff 

could now just dictate their notes directly into 

Concerto. But again, this isn’t being rolled out 

yet nor is the basic system being used as it could 

as DHBs remain wedded to their paper filing 

systems. Perhaps everything is being deferred on 

the assumption that some sort of big technological 

bang is around the corner. Unfortunately, this is 

unlikely to produce anything new, so it is a dubious 

expectation without foundation. 

I think it undeniable there is a toxic hybrid of 

hard-copy and non-interoperable software in our 

DHBs, compounded by a lack of willingness to 

change. This fatal combination creates an iceberg 

that cannot be safely navigated around. As a 

first step we, collectively, have to acknowledge 

that there is a way forward, and it’s staring us in 

the face, literally looking out at us from our HCS 

screens. Concerto has the capability, we just have 

to authorise and embrace the changes needed. ▀ 

*Dr Mike Mair is a South Island locum ophthalmologist, having 

retired from private practice in 2015 after three decades as 

director of Timaru Eye Clinic. A progressive thinker, and an early 

adopter of EHR, he is a passionate believer in technology and 

improved processes to better serve the needs of both patients 

and the eye health community in New Zealand. He has no 

commercial interest in any companies mentioned in this article. 

MORE CLASSIFIEDS ON PAGE 28 

For all your optical and ophthalmic needs 

Ph: (09) 520 5208 

0800 555 546 

Fax: (09) 520 5515 

PO Box 28486 

Auckland 1541 

info@lowvisionservices.nz 

www.lowvisionservices.nz 

nzowa.org.nz 

Naomi Meltzer BSc, Dip Opt, PostGrad.Dip.Rehab. 

Low Vision Optometrist 

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An Optometrist dedicated to Low Vision support. 

EQUIPMENT FOR SALE 

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All offers considered. Email info@lowvisionservices.nz for more 

information and pictures 

OPTOMETRIST WANTED 

Specsavers require a full-time Optometrist 

at our Nelson store. 

Please contact Amanda on 03 5480168 or 

dir.nelson.nz@specsavers.com for further information. 

FULL-TIME OPTOMETRIST WANTED 

TE AWAMUTU 

We are looking for an experienced TPA qualified optometrist to 

join our team at Matthews Eyewear Eyecare Te Awamutu. 

This is a busy, well equipped practice with a great support team. 

If you are wanting to move away from the city life and work in a 

semi-rural setting, please contact John Grylls on 027 777 0480 or 

email john.grylls@seekapiti.co.nz 

ZEISS HUMPHREY MATRIX FOR SALE 

Matrix for sale. In good condition, approx 5 years old and in good 

working order. Only selling as we have upgraded. Asking price 

$7,000 or sensible offer. Please contact Tracy on 

0272 555 305 for more information. 

OPTOMETRIST REQUIRED 

ASHBURTON 

Our team at Ashburton Eyecare is looking for a TPA qualified 

optometrist with skills in all areas of the patient journey. 

We pride ourselves on the development of long-term patient 

relationships, so this may be ideal for a person who has had 

enough of the corporate world. 

Great inter-personal communication skills and an understanding 

of the importance of the patient experience are essential. 

Applicants must have a sound knowledge of both contact lens and 

spectacle lens options plus dispensing skills would be useful. 

This is a full time position with an option for partnership and/or 

ownership in the near future. 

Applications to eyeguy@xtra.co.nz 

OPTICAL RECEPTIONIST 

HAMILTON 

Bell Neuhauser & (Matthews) Optometrists is looking for 

an Optical Receptionist to join our great team. We are an 

independent, locally owned Optometry practice, providing 

the highest level of service and top quality products. We pride 

ourselves on customer service and going the extra mile. We are 

on the lookout for someone organised and motivated, who works 

well as part of a team and can also use their initiative to get the 

job done. Optical experience is preferred. 

This is a fixed term 12-month contract, with the possibility of a 

permanent position to follow. 

For more information, email anna@bellneuhauser.co.nz or follow 

the link to our full advertisement: 

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A number of roles are available in regional locations across both the North and South 

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Ask us about our market-leading salary packages and sign-on bonuses today. 

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27

MORE CLASSIFIEDS ON PAGE 26 

NEED TO REPLACE YOUR 

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SAVE THE DATE 

2018 2018 

SAVE THE DATE 

AcuityKit has a comprehensive range of digital eyecharts for 

eye-care professionals. Ideal for low vision and domiciliary work. 

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

LOCUM 

OPTOMETRIST 

Paterson Burn Optometrists is looking for an experienced 

Optometrist to join our team on a locum/contract basis. This 

position is flexible and requires you to provide cover at any of our 

Waikato branches during extremely busy periods and covering 

staff holidays. 

If you would like to be part of one of the largest independent 

optometry practice groups in New Zealand, please email your CV 

and cover letter to sandri@patersonburn.co.nz or call 07 9035424. 

SPECSAVERS SYLVIA PARK 

DISPENSING OPTICIAN 

We are looking for an experienced full-time Dispensing Optician 

to join our three room practice at Specsavers Sylvia Park. This 

is a great opportunity to work in a central Auckland location. 

Competetive salary and bonus package based on experience. Great 

training opportunities through Specsavers on managment and 

leadership. Specsavers experience not essential. Please email Ryan 

Mahmoud dir.sylviapark.nz@specsavers.com or call 021 166 5899 

for more information. 

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We are looking for a friendly, warm, full-time 

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The successful applicant will work with a great support team 

comprising of dispensing opticians and optical assistants and have 

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brand new slit lamp, NCT, Retinal Camera and Autorefractor. 

We are open to short-term and long-term contracts with flexible 

start dates. An attractive relocation package and rates will be 

offered, as well as accommodation and flight allowances. 

Email dir@optique.com.fj or call +679 999 0866 

OPTOMETRIST 

12 MONTH CONTRACT 

Grant & Douglas Optometry 

& Eyewear is looking for an Optometrist to join our team on a 

12-month fixed-term contract to cover maternity leave. 

We are an independent optometry practice providing excellent 

eye care with a personalised service. We have two locations; 

Hastings and Havelock North, within a 10-minute drive of each 

other. Our practices are busy, modern and well equipped enabling 

full scope clinical optometry. You will be supported by a friendly, 

experienced and professional team. 

Ideally starting in early December 2017, we operate Monday to 

Friday only. No weekends! 

If you would like the opportunity to enjoy the lovely climate and 

lifestyle of Hawkes Bay then please email your application to 

Anna Byers: abyers@grantanddouglas.co.nz 

DREAM OF 

TRAVELLING 

At OPSM, we are passionate about opening eyes to 

the unseen. Our advanced technology enables us to look 

deeper to ensure we give the best care to every customer. 

OPSM in New Zealand is looking to expand their Locum 

Optometrist network. 

LOCUM OPTOMETRISTS – NEW ZEALAND 

As a locum you will be your own boss, you will have 

the flexibility to set your own hours and will be exposed 

to lots of different patients and locations across New 

Zealand all while gaining lots of skills and experience. 

We are looking for Optometrists who share our passion, are 

willing to learn quickly and want to join our customer focussed 

teams in making a difference to how people see the world. 

WHAT’S ON OFFER: 

• Great working environment 

• Fantastic locum rates $$ 

• Accommodation and flights 

• Latest technology 

• Luxury brands 

• New friends and having fun 

JOIN OUR TEAM 

For a chance to be your own boss and part of an amazing 

team, contact us for a confidential, no obligation chat. 

CONTACT: 

Jonathan Payne 

Jonathan.Payne@opsm.co.nz 

OPSM.CO.NZ/CAREERS 

WE SEE YOUR 

FUTURE WITH US 

At OPSM, we are passionate about opening eyes to 

the unseen. Our advanced technology enables us to look 

deeper to ensure we give the best care to every customer. 

OPTOMETRISTS 

NORTH & SOUTH ISLAND, NEW ZEALAND 

Our New Zealand business is looking for passionate 

Optometrists to join the team. 

• Thames, Thames-Coromandel 

• Lower Hutt, Wellington 

• Mt Maunganui, Tauranga 

• Dunedin, Otago 

When you join OPSM, you work within a team who 

are committed to providing the best possible eyecare 

solution with exceptional customer service. You will work 

with world class technology including our exclusive 

Optos Daytona ultrawide digital retina scanner. You 

will have many opportunities for continuing professional 

development and can enjoy career flexibility through 

our extensive store network. You can also make a 

real difference in the way people see the world by 

participating in our OneSight outreach program. 

JOIN OUR TEAM 

Start your journey with us today! 

Recent graduates are very welcome to apply. 

CONTACT: 

NZ – Jonathan Payne 

Jonathan.Payne@opsm.co.nz 

OPSM.CO.NZ/CAREERS 

C 

M 

Y 

CM 

MY 

CY 

CMY 

K 

Thinking of selling your practice - we have buyers 

Considering buying - we’ll give you all the options 

OpticsNZ specialises in optometry practice sales, 

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

For more information contact Stuart Allan on: 03 546 6996 

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

• Locum Service 

• Recruitment Services 

• Practice Brokering 

• Business Consultants

Dec 2017

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