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THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY<br />
PO BOX 106 954, AUCKLAND CITY 1143<br />
Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz<br />
FEBRUARY <strong>2018</strong><br />
You can grow your<br />
business with Optomism ® .<br />
That’s our promise.<br />
Live Brightly.
The future of digital<br />
customer engagement<br />
is now<br />
Do you want a cost-effective<br />
technology that helps you compete<br />
with corporate optometry?<br />
Would you like to maximise your<br />
availability with new customers?<br />
Does reducing the daily call load<br />
for your receptionists sound good?<br />
How about improving practice<br />
efficiency with a fully integrated<br />
recall and reminder system?<br />
Welcome to<br />
2 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
MyHealth1st, the 1st online healthcare<br />
platform exclusively designed to<br />
support independent optometrists,<br />
is officially coming to New Zealand<br />
These days you can do most things online,<br />
like organising a holiday or searching for a<br />
new job, so why should booking an optometry<br />
appointment be any different? Thanks to<br />
MyHealth1st, that’s possible 24 hours a day,<br />
7 days a week from any digital device.<br />
We’re focused on revolutionising your<br />
customer engagement<br />
MyHealth1st’s smart technology provides an<br />
effective and economical way for independent<br />
practices to compete with corporate optometry<br />
by attracting new customers while still<br />
retaining the existing.<br />
We’re now the leading directory<br />
1 st for independent optometrists!<br />
The platform facilitates the connection,<br />
engagement and management of the entire<br />
booking journey so you and your staff can<br />
spend less time fielding phone calls and<br />
chasing up recalls, and more valuable time<br />
focusing on customer care.<br />
With more than six million online appointments<br />
made via MyHealth1st across NZ, Australia<br />
and beyond, it’s obvious the future is digital.<br />
What are you waiting for? Find out more at<br />
myhealth1st.co.nz/optometry<br />
An event to see your practice grow<br />
Join us at your nearest launch event to see how MyHealth1st’s comprehensive digital customer<br />
engagement platform can help your practice compete with corporate optometry.<br />
RSVP now for our March events at:<br />
myhealth1st.co.nz/optometryevents<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
3
OPEN TO ALL<br />
OPTICAL<br />
PROFESSIONALS!<br />
THE ULTIMATE PATHWAY TO<br />
ACHIEVING YOUR AMBITION<br />
CALLING ALL EXPERIENCED OPTOMETRISTS, OPTICAL<br />
DISPENSERS AND RETAIL MANAGERS<br />
In the last ten years, we have opened more than 375 current stores across Australia and New Zealand,<br />
creating business ownership opportunities in every store – with at least one optometry partner and one<br />
dispensing partner in every location being the standard Specsavers recipe for success.<br />
Now, as our network of locations grows and as individual stores continue to<br />
expand, a greater number of partnership roles are being created, while some of<br />
our longer-term partners are in succession-planning mode. And that all adds up<br />
to one thing: opportunity.<br />
So, if you are an experienced and ambitious optometrist, dispenser or store<br />
manager and you are thinking of taking the next step – towards business<br />
ownership – we would like to talk to you about how we can help you turn that<br />
opportunity into a partnership role with Specsavers.<br />
Our Pathway program has established a well-travelled route that, partner by<br />
partner, delivers exactly that. It’s an intensive six-month development program<br />
that adds much-needed business management and development skills to<br />
participants’ clinical, dispensing or retail skills. In short, Pathway’s job is to set up<br />
future store-owners for success.<br />
So, whether you currently work for Specsavers or have built an impressive<br />
career elsewhere, we’d love to talk to you about the Pathway to your future.<br />
Please contact Kimberley Hannan on +61 429 566 846 or at kimberley.hannan@specsavers.com for a confidential discussion.<br />
Voted by New Zealanders<br />
Reader’s Digest<br />
Quality Service<br />
Award<br />
2017<br />
Best Talent<br />
Development<br />
Program<br />
2017<br />
Best Customer<br />
Service in NZ<br />
Optometry<br />
2017<br />
Millward Brown<br />
Research<br />
No.1 for eye tests<br />
2016<br />
Excellence in<br />
Marketing<br />
Award<br />
2016<br />
Retail<br />
Store Design<br />
Award<br />
2016<br />
Retail<br />
Employer<br />
of the Year<br />
2015<br />
Overall<br />
National<br />
Supreme Winner<br />
2015<br />
Franchise<br />
Innovation<br />
Award<br />
2015<br />
NZ Franchise<br />
System of<br />
the Year<br />
2014<br />
Retail<br />
Innovator<br />
of the Year<br />
2014<br />
4 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
Visique evolves for independence<br />
BY LESLEY SPRINGALL<br />
Visique has evolved into the Independent<br />
Optometry Group, a “fiercely independent<br />
group” designed to support and grow the<br />
wealth of its independent members in these<br />
changing times, says Neil Human, formerly<br />
Visique, now the Independent Optometry Group<br />
chief executive.<br />
Formed in 2009, Visique as a group has always<br />
been hampered by its member requirement to<br />
use the Visique name, says Human, but that’s<br />
now gone. The newly launched Independent<br />
Optometry Group (IOG) is a true 100%-owned<br />
and run cooperative, he says. “Any independent<br />
practice can join and become a shareholder and<br />
continue to trade under their existing name.<br />
The cooperative company is wholly-owned by its<br />
shareholder members, so they have a vote and<br />
say in determining the company’s direction.”<br />
The new group is about keeping independent<br />
optometry practices, independent, while<br />
helping them grow by providing them with<br />
business support and greater buying power, says<br />
Human pointing out how the group’s new logo<br />
embraces the idea of an individual, supported<br />
within a group. “Autonomy in decision-making<br />
for practices is paramount. Members drive their<br />
businesses as they determine, but can leverage<br />
the collective strength and knowledge that<br />
comes with our group.”<br />
The most exciting part of this evolutionary<br />
journey is that this is not change for change’s<br />
sake, he adds. “This is change to have a thriving,<br />
independent sector. We want to be part and<br />
parcel of a thriving independent optometry<br />
sector. For a long time, independents have<br />
thought they didn’t have the muscle to operate<br />
against the corporates, but they do, they<br />
absolutely do. The actual revenue growth of<br />
our members over the past couple of years<br />
shows you can run your own business, pool your<br />
strengths and succeed very strongly against the<br />
corporate muscle.”<br />
The decision to actually change to the<br />
Independent Optometry Group (IOG) was made<br />
last year and was primarily driven by the growing<br />
consolidation and corporatisation in the market,<br />
says Human. “At a global<br />
level, there are a number<br />
of strategic shifts taking<br />
place. To maintain and grow,<br />
independents need to work<br />
together.”<br />
The proposed changes<br />
were put forward to Visique’s<br />
current membership,<br />
encompassing 49 practices,<br />
at its AGM last November<br />
and were fully supported,<br />
he says, with no one leaving<br />
the new group. Current<br />
Visique members can choose<br />
whether to keep or lose the<br />
Visique name, he says. “It’s<br />
completely up to them.”<br />
The IOG will continue to<br />
be supported by a small<br />
central team, based in<br />
Auckland, comprising Human, marketing and<br />
customer experience strategist, Melissa Green,<br />
and finance and insurance administrator, Bala<br />
Prasad. They will be guided by members through<br />
the company’s board, currently comprising<br />
independent chair, Brian Rosenberg, and two<br />
member directors, Vanessa Cumming and Jagrut<br />
Lallu.<br />
In return for an annual fee, IOG members will<br />
receive:<br />
• Supply chain benefits for frames, lenses,<br />
contact lenses and accessories etc.<br />
• Business services, such as marketing and<br />
practice management tools, data analytics, SaaS<br />
benchmarking systems and mentoring/training<br />
• Corporate contracts for insurance, Ministry of<br />
Social Development (MSD) and the cooperative<br />
sector<br />
• Plus, other projects, still in the planning stage<br />
Currently the group has supply contracts with<br />
nine frame suppliers, one lens company, though<br />
it’s in discussions with others, plus a number<br />
of other suppliers, all of whom will be assessed<br />
on a regular basis. “There will be choice for<br />
members and we will only select suppliers our<br />
members want to work with,” says Human.<br />
Members will be expected to support the<br />
Melissa Green and Neil Human supporting the newly launched Independent Optometry Group<br />
group’s strategic suppliers, not exclusively, but<br />
significantly as that is where the greatest value<br />
lies for them from a cost perspective, he says.<br />
Another membership benefit, often<br />
underestimated, is the business services the<br />
group can offer, says Human. “Most of us are<br />
time poor. Our business advisory services are<br />
directed at giving members dedicated time and<br />
a structure to work on their business as many<br />
can get stuck just working in their business.”<br />
Human and his team hope to build awareness<br />
about the membership benefits of the new<br />
group over the next several months with the<br />
aim of doubling the group’s member base<br />
within two years.<br />
“It is very exciting,” he says. “It’s about<br />
independents working more closely with each<br />
other to secure their future. That’s why, in<br />
Australia, ProVision and Eyecare Plus are doing<br />
very well. Independents can succeed, but they<br />
will do that best by working collectively and<br />
cooperatively.” ▀<br />
New<br />
beginnings<br />
EDITORIAL<br />
Our first issue of the New Year is straining at<br />
the seams, packed with news, views and<br />
experiences from our exciting optometry and<br />
ophthalmology world.<br />
There’s exciting news about Visique’s evolution, or<br />
should that be revolution (this page), and 1stGroup’s<br />
launch in New Zealand after taking Australia’s<br />
independent optometry market by storm. All<br />
independent optometry practice owners and managers,<br />
and anyone who aspires to run their own practice,<br />
should have received an invitation to attend one of<br />
1stGroup’s presentations in either Auckland, Wellington<br />
or Christchurch by now. But, if you haven’t, check out<br />
the story on p6 and ad on p2-3 to find out more.<br />
In this issue, we’re also lucky to be able to share the<br />
incredible experiences of one patient with Charles<br />
Bonnet Syndrome (p8), which has lessons for us all;<br />
a new New Zealand eco-frames designer (p10); and<br />
the Irlen Institute, about this oft maligned syndrome,<br />
which is now gaining in acceptance and understanding<br />
(Chalkeyes, p25).<br />
There’s a special thanks to all the Special Olympics’<br />
volunteers who gave up their time to test the eye health<br />
of some of New Zealand’s most important, but often<br />
forgotten citizens (p14); we provide impetus for a New<br />
Year resolution with our first feature on nutrition and<br />
its importance to eye health (p16-18); we share our<br />
reader’s volunteering experiences with Eyes for Everest<br />
(p12), Orbis (p20) and VOSO (p26). Plus, Dr Jina Han<br />
tells us why the new Review of Ophthalmology is one<br />
of her favourite textbooks (p20), Dr Philip Polkinghorne<br />
shares his time at the Asia Pacific Vitreo-retina Society<br />
Congress (p21) and US writer Courtney Elder looks at<br />
why metal is back (p24).<br />
Then there’s mysterious teaser ad below – what could<br />
that be? We’re sworn to secrecy, but all will be revealed<br />
in subsequent<br />
issues of NZ<br />
Optics. Happy<br />
New Year!<br />
Lesley Springall, editor, NZ Optics<br />
Professor Dipika Patel<br />
The University of Auckland has promoted Dipika<br />
Patel from associate professor to full professor in<br />
the Department of Ophthalmology, effective from<br />
1 <strong>Feb</strong>ruary, this year. Promotion to professor is a mark of<br />
distinction, recognising an individual’s professional and<br />
academic achievements at an international level.<br />
“I am thrilled to join the eminent team of professors<br />
at the Department of Ophthalmology,” said Prof<br />
Patel. “This is a great accolade for both myself and the<br />
department. I am fortunate to have worked with a<br />
fantastic team of talented people along the way and,<br />
in particular, I would like to thank Professor Charles<br />
McGhee for his mentorship and unwavering support.”<br />
Prof Patel’s research interests centre on a series<br />
of inter-related themes including ocular imaging,<br />
keratoconus and corneal dystrophies, microbial keratitis,<br />
corneal transplantation, and corneal stem cells. She is<br />
also joint series editor with Prof McGhee for the popular<br />
Eye on Ophthalmology series in NZ Optics. ▀<br />
Professor Dipika Patel<br />
OTC update<br />
Registration is open for the <strong>2018</strong> Ocular<br />
Therapeutics Conference. The conference<br />
will be held on Sunday 11 March at the<br />
Waipuna Conference Centre in Auckland and<br />
promises to be even bigger and better than last<br />
year’s successful inaugural conference.<br />
This year’s conference includes a special session<br />
on dry eye and<br />
the outcomes of<br />
the TFOS’ second<br />
dry eye workshop<br />
(DEWS II) from the<br />
workshop’s vice<br />
chair, Associate<br />
Professor Jennifer<br />
Craig, plus<br />
presentations<br />
on prescribing,<br />
drug interactions<br />
and side effects,<br />
therapeutics for<br />
Dr Ilva Rupenthal<br />
posterior segment<br />
diseases and anterior segment therapeutics.<br />
A wide range of exciting topics will be covered<br />
in several 12-minute, rapid-fire sessions and<br />
interactive panel discussions, says Dr Ilva<br />
Rupenthal, head of the Buchanan Ocular<br />
Therapeutics Unit (BOTU) at the Unversity of<br />
Auckland, which is organising the conference.<br />
“All of these topics will not only enhance<br />
your everyday practice but will also offer an<br />
opportunity to apply for a full day of clinical<br />
diagnosis and enhancement points.”<br />
For more information or to register, keep an eye<br />
on your in-boxes or visit: https://www.regonline.<br />
com/builder/site/Default.aspx?EventID=1969349<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
5
News<br />
in brief<br />
NZ STUDENT DEVELOPS CLS FOR EPILEPSY<br />
Inspired by a close friend, University<br />
of Canterbury student Logan<br />
Williams has invented 3D-printed<br />
polarised contact lenses (CLs) to<br />
address photosensitive epilepsy.<br />
William’s CLs, called Polar Optics,<br />
work by refracting the light entering<br />
the sufferer’s vision and dampening Logan Williams<br />
its intensity, giving wearers vital<br />
seconds to close their eyes, he said. Williams is working on a wearable<br />
prototype, which he hopes to commercialise.<br />
OPTOMETRY AUSTRALIA PARTNERS SILMO SYDNEY<br />
Optometry Australia, which celebrates its 100th anniversary in <strong>2018</strong>,<br />
has agreed to partner with and hold workshops at Silmo Sydney<br />
due to its strong focus on innovation and future planning, said CEO<br />
Lyn Brodie. “Silmo Sydney <strong>2018</strong> will feature a full-scale, interactive<br />
practice of the future… which supports Optometry Australia’s goal to<br />
gain deeper insights into emerging trends.” Silmo Sydney <strong>2018</strong> will be<br />
held in Sydney from 20-22 July this year.<br />
PILL TRACKS COMPLIANCE?<br />
The FDA has approved a pill with a sensor that digitally tracks if<br />
patients have ingested their medication. Abilify MyCite (aripiprazole<br />
tablets with sensor) have an ingestible sensor embedded that records<br />
that the medication was taken, sending a message to a wearable<br />
patch linked to mobile devices so patients, and their caregivers,<br />
can track ingestion. The product is approved for the treatment of<br />
schizophrenia and other mental disorders, but paves the way for other<br />
medications to include digital sensors.<br />
BLIND FOOTY GOES GLOBAL<br />
The International Blind Sports<br />
Federation (IBSA) has announced<br />
the first ever Blind Football<br />
World Grand Prix. The brainchild<br />
of the Japanese Blind Football<br />
Association, the first event will<br />
take place in Tokyo from 18-25<br />
March <strong>2018</strong>, which organisers<br />
Blind football, growing in popularity<br />
hope will build interest among<br />
sponsors and spectators in the sport for the 2020 Paralympic Games.<br />
In response, Blind Sports Australia (BSA) has established the Australian<br />
Blind Football (ABF) programme, naming inaugural squads (blind and<br />
partially sighted) at the end of last year.<br />
FLINDERS TACKLES GENETICS FOR GLAUCOMA<br />
The Australian National Health<br />
and Medical Research Council<br />
(NHMRC) has awarded an A$9.46<br />
million grant to Flinders University’s<br />
Ophthalmology Eye and Vision<br />
Clinic team to help convert genetic<br />
discoveries in primary open angle<br />
glaucoma into new clinical practices.<br />
The five-year programme, led by<br />
Flinders’ Professor Jamie Craig<br />
Flinders Professor of Ophthalmology<br />
Jamie Craig, will use CRISPR/Cas editing and next-generation gene<br />
sequencing approaches and run the world’s only DNA bank of patients<br />
to understand advanced glaucoma genetics.<br />
DRUG IMPLANT TREATS GLAUCOMA<br />
Recognising the need for a drug<br />
delivery method that reduces patient<br />
inconsistency, researchers at the<br />
University of California San Francisco<br />
(UCSF) have engineered a drug delivery<br />
device that slowly releases glaucoma<br />
medication, inside the eye for over six<br />
months before dissolving away. The<br />
implant, described as a “sandwich” of<br />
biodegradable films surrounding an antiglaucoma<br />
drug, successfully reduced eye<br />
The new biodegradable inplant<br />
pressure in animals over 24 weeks, reported team leader Dr Tejal Desai.<br />
PORTABLE GLUE FOR EYE EMERGENCIES<br />
University of Southern California (USC) scientists have developed a<br />
hydrogel and special syringe that can quickly seal eye injuries on the<br />
battlefield or in emergency situations. The reversible, temperaturesensitive,<br />
temporary gel seal changes from a fluid to a super-strong<br />
semi-solid when applied to the eye and can be removed by adding<br />
cool water once the patient reaches hospital. It’s very simple to use —<br />
almost like caulking a bathroom seal,” said study co-author Assistant<br />
Professor John Whalen. Human trials are scheduled for 2019.<br />
KIWI DRIVERS’ VISION PROBLEMS<br />
Research reveals almost half (42%) of all Kiwi drivers over 18<br />
experience vision difficulties on the road. Vision difficulties<br />
highlighted include reading road signs, blurred vision, strain,<br />
headaches or dizziness and squinting. The research, conducted by<br />
Specsavers as part of its promotion for AA members, also revealed<br />
people don’t realise how their vision changes over time and,<br />
worryingly, that 27.5% think travelling a short distance without<br />
wearing their glasses is ok, said Roger Venn, AA Driving School GM.<br />
1stGroup launches in NZ<br />
BY ELLA EWENS<br />
1stGroup, an ASX-listed<br />
software provider, has<br />
taken Australia by storm,<br />
capturing 60% of the independent<br />
optometry market in a couple of<br />
years. Now it’s planning to roll<br />
out its unique, socially-integrated<br />
practice support platform in New<br />
Zealand.<br />
Independent optometrists<br />
across the country are being<br />
invited to attend presentations<br />
in March in Auckland, Wellington<br />
and Christchurch* so 1stGroup<br />
can explain its point-of-difference<br />
and why it managed to expand so<br />
1stGroup managing director, Klaus Bartosch<br />
quickly in Australia.<br />
Managing director Klaus Bartosch says he’s excited to bring this<br />
technology to New Zealand as it significantly reduces administrative<br />
work for optometry practice staff, makes it simpler and easier for the<br />
patient to interact with the practice, improves the patient experience<br />
and drives new patients into optometry businesses.<br />
According to 1stGroup’s research, patients are increasingly<br />
engaging with healthcare services online and it is estimated that<br />
50% of patients now book their appointments online, including new<br />
patients. The company’s software platform, MyHealth1st includes<br />
an online appointment booking system, designed to make it simpler<br />
and easier for patients to interact with practices; EasyRecall, to<br />
maintain the connection to patients; and EasyFeeback for tailored<br />
patient surveys. Using the MyHealth1st platform, patients can book<br />
appointments 24/7, in real time via the practice’s own website,<br />
Facebook or blog page. The software is also fully-integrated with<br />
many practice management systems, including Sunnix Vision and<br />
Optimate, says Bartosch.<br />
“There are huge opportunities for optometry practices to broaden their<br />
business using 1stGroups’s suite of digital patient engagement products<br />
such as EasyRecall and EasyFeeback. 80% of patients don’t come back to<br />
the same practice, but EasyRecall encourages loyalty and helps improve<br />
the customer experience so they do come back. This automated and<br />
integrated system simplifies and tracks recalls. It also sends patients a<br />
first notice and further notices to those that did not attend.”<br />
1stGroup is all about independent optometry, says Bartosch,<br />
providing independents with the software tools they need to better<br />
compete. “We love working with independent optometry. We want<br />
to level the playing field by providing independents with simpler<br />
and better tools, allowing them to be more efficient and effectively<br />
compete with the corporate market. Independent optometrists<br />
in New Zealand are savvy business people and will embrace this<br />
software. We have had tremendous customer feedback so far.”<br />
The MyHealth1st booking system has already been rolled out<br />
across 20 practices in New Zealand and the aim is to extend this to a<br />
further 100 practices by the end of the year, says Bartosch.<br />
Visualeyez boutique optometrists in Whangarei is one of the first<br />
New Zealand practices to use 1stGroup’s software and director<br />
Younger’s new<br />
chameleon effect<br />
Younger Optics has launched<br />
NuPolar Infinite, a prescription, grey,<br />
polarised, photochromic sun lens<br />
that automatically reacts to changing light<br />
conditions, varying between a light grey 60%<br />
tint to dark grey 91% tint.<br />
Younger is promoting the launch with a<br />
new campaign featuring a chameleon, which<br />
has two layers of cells under its skin loaded<br />
with tiny nanocrystals. Chameleons can<br />
instinctively expand and reduce the distance<br />
between these nanocrystals to reflect different<br />
coloured light, lightening or darkening their<br />
skin colour in just a few seconds allowing them<br />
to adapt to their environment.<br />
Like the chameleon, NuPolar Infinite is<br />
the master of adaptability and versatility<br />
by naturally responding to changes in light<br />
conditions, said Craig Johnston, Younger<br />
Optics ANZ sales and marketing manager.<br />
www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand<br />
“This is a very exciting product release for us<br />
because it’s the lens customers have been<br />
asking us to create for years. Finally, we have<br />
a photochromic sun lens utilising NuPolar<br />
polarisation technology in the most popular<br />
lens colour, grey.”<br />
The NuPolar Infinite campaign builds on<br />
the successful branding refresh for NuPolar<br />
in 2017, which demonstrated the power of<br />
polarised vision using the dragonfly.<br />
To support practices in-store, free NuPolar<br />
Infinite point-of-sale (POS) is available<br />
including a window poster, window decal<br />
to add depth and interest to the window<br />
poster and a counter card. The NuPolar<br />
patient brochure has been updated to include<br />
NuPolar Infinite. Practices can also order<br />
social media content and digital advertising.<br />
NuPolar Infinite is available in hard resin 1.50<br />
initially, in a prescription range of -8.50 to<br />
and dispensing optician, Craig Robertson, admits he’s a fan. “I find<br />
the software excellent (and) user-friendly. Once you’ve set it up, it<br />
maintains itself. It links live and directly to the Optimate software,<br />
which is great. You can see the appointment roster and when it’s free.<br />
It’s just effortless. Especially for the younger generation who want to<br />
book online. It’s really working well.”<br />
Robertson says he’s noticed an increase in new patients recently<br />
and believes that’s also partly due to his new booking system as it<br />
makes it so easy for new patients to go from Googling for a practice<br />
to reaching out and contacting you.<br />
1stGroup is also partnering with contact lens company Alcon on<br />
a campaign to encourage more contact lens (CL) wearers by using<br />
marketing touch points to educate patients about the benefits of<br />
lenses to initiate discussion with their optometrist.<br />
*For more about 1stGroup and the March presentations, see the ad<br />
on p2-3 and keep an eye on your inbox.<br />
About 1stGroup<br />
1stGroup, formerly known as 1stAvailable, listed on the Australian<br />
Securities Exchange (ASX) on 9 June 2015. Its aim is to build a<br />
health-based digital community, “where health providers and<br />
patients connect 1st.”<br />
The company completed the acquisition of GObookings, Clinic<br />
Connect and DocAppointments in 2015; launched a new brand,<br />
PetYeti in 2016 to support the pet services space; and in 2017<br />
rebranded and renamed its original 1stAvailable healthcare portal<br />
as MyHealth1st<br />
By June 2017, 1stGroup had grown to 5,500 installed sites<br />
on its platform’s and had booked more than six million online<br />
appointments since 2012. In Australia its customers include<br />
pharmacies, doctors, dentists, optometrists, allied services,<br />
specialists, natural therapists, radiology, vets, corporates and<br />
government agencies. In its marketing material, the company says<br />
it is the market leader in pharmacy and optometry in Australia.<br />
1stGroup’s software enables appointment bookings, recalls,<br />
continued patient contact and surveys. In late 2016, the company<br />
also launched a range of additional products including self-checkin<br />
kiosks and apps, patient clipboard apps, advertising and a call<br />
centre app to help practices grow their revenue from their existing<br />
customer base. More products are in the pipeline.<br />
“We improve lives by connecting consumers to a variety of<br />
healthcare services and information anytime, anywhere, so they<br />
can get well sooner and stay well longer,” says the company.<br />
Like the chameleon, NuPolar Infinite adapts to changes in light<br />
conditions<br />
+6.00. A polycarbonate release will follow<br />
shortly. The free POS materials can be ordered<br />
online at: www.youngeroptics.co.nz/orderpos<br />
▀<br />
For general enquiries or classifieds please email info@nzoptics.co.nz<br />
For editorial, please contact Lesley Springall at lesley@nzoptics.co.nz or +64 27 445 3543<br />
For all advertising/marketing enquiries, please contact Susanne Bradley at susanne@nzoptics.co.nz or +64 27 545 4357 in the first instance, or Lesley Springall at lesley@nzoptics.co.nz<br />
To submit artwork, or to query a graphic, please email susanne@nzoptics.co.nz<br />
NZ Optics magazine is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times a year, by New Zealand Optics 2015 Ltd. Copyright is held by<br />
NZ Optics 2015 Ltd. As well as the magazine and the website, NZ Optics publishes the annual New Zealand Optical Information Guide (OIG), a comprehensive listing guide that profiles the<br />
products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The views expressed in this publication are not necessarily<br />
those of NZ Optics 2015 Ltd or the editorial team.<br />
6 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
Independent spirit, collective strength<br />
The Independent Optometry Group is a 100% member-owned cooperative of independent optometry practices<br />
with a clear mandate: to leverage the collective strength to drive growth, while maintaining individual practice<br />
autonomy. Our goal is to help all our members enjoy prospering practices.<br />
With rapidly changing social landscape dynamics, strategic shifts in the optometry market and the impact of<br />
technology, keeping pace and recognising which ideas hold merit against those which don’t, is challenging<br />
within the time-poor environment that independents face.<br />
Standing still is effectively going backwards. The IO Group seeks to keep members up to speed with advances<br />
to give them a competitive edge in a rapidly changing landscape. We aim to facilitate well-informed decisionmaking,<br />
growth and resilience for independents through the delivery of a spectrum of tools and services to<br />
create value. These cover the following aspects:<br />
Supply chain: creating value and improved profitability through well negotiated and structured product and<br />
software costs including frames, lenses, CLs and accessories. Business services: the group has a suite of<br />
business planning and management, data analytics and marketing tools available which allow for improved<br />
decision-making within the practice. Corporate contracts: we have established relationships with key<br />
figures in insurance, the MSD and the cooperative sector which facilitate and lower the cost of<br />
customer acquisition and retention.<br />
TO FIND OUT MORE CALL NEIL HUMAN ON +64 210 292 8683 OR NEIL.HUMAN@IOGROUP.CO.NZ<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
7
Living with Charles Bonnet Syndrome<br />
BY ELLA EWENS<br />
Not one, but a whole herd of elephants,<br />
blocking the main street of Taupo. Their tails<br />
were swishing, their ears flapping and their<br />
huge rumps wriggling. I stood there and I thought<br />
to myself, ‘there is not a herd of elephants in the<br />
main street of Taupo today or any day’,” says Gael<br />
Spence, recalling just one of the strange, weird, but<br />
utterly realistic, visual hallucinations she began to<br />
contend with soon after receiving the devastating<br />
news she had gross, atrophic dry macular<br />
degeneration.<br />
That was 2008, Gael was 74 years old, and life<br />
had suddenly got a lot harder. Not only was she<br />
coping with the mental stress of having lost most<br />
of her central vision, her driver’s licence and her<br />
independence, a GP (not her usual one) then told<br />
her she probably had early dementia after she<br />
shared her visions of large blobs on the shower<br />
curtain, bugs on the carpet, faces on the wall and<br />
that herd of elephants in Taupo.<br />
Her problems were compounded by the eye<br />
health world’s lack of consideration to her plight,<br />
she explains, recalling her stress and struggle to<br />
make the 70-kilometre trip from Mangakino, where<br />
she lives, to Rotorua to attend her ophthalmology<br />
appointments.<br />
“I tried everything to get to there. I spoke<br />
with various support groups – Age concern,<br />
the Blind Foundation, Lions, Red Cross, Macular<br />
Degeneration New Zealand (MDNZ) – but to no<br />
avail. I don’t know anyone who can drive me; I<br />
cannot see a phone book; I cannot look up buses.<br />
How could I ring a bus? I just could not get to<br />
Rotorua. I even thought if I started walking at 4<br />
am, maybe I could I make it...”<br />
Feeling desperate and isolated, plagued by weird<br />
visions and trapped in a fading world, Gael admits<br />
she considered suicide. “Should I walk into the lake<br />
and end it all?” she thought.<br />
Not dementia?<br />
Gael Spence with her grandaughter Melanie, now coping well with macular degeneration and CBS<br />
www.littlepeach.co.nz<br />
office@littlepeach.co.nz<br />
0800 573 224<br />
NEW INNOVATION<br />
FROM LITTLE PEACH<br />
Then one day a friend of Gael’s was reading an<br />
article about Charles Bonnet Syndrome (CBS) in<br />
the MDNZ magazine Viewpoint, and asked her,<br />
“Gael have you seen this article? It’s all about you.<br />
The article said the hallucinations could easily be<br />
mistaken for early dementia.”<br />
Armed with this first piece of positive knowledge,<br />
Gael went back to her usual GP and cautiously<br />
asked if he thought she could have CBS. The GP ran<br />
her through some dementia screening tests – she<br />
passed – and said, yes, he thought she was suffering<br />
from CBS. Fortunately, her GP was familiar with the<br />
condition and so was able to reassure her she was<br />
mentally as able as she’d always been.<br />
Charles Bonnet Syndrome, sometimes known as<br />
visual release hallucinations, is a<br />
common condition among people<br />
with partial or severe blindness<br />
(see box). The main cause of CBS,<br />
according to psychiatrists, is the<br />
loss of vision and how your brain<br />
reacts to this loss. “When you<br />
lose your sight, your brain doesn’t<br />
receive as much information and<br />
fills in these gaps by releasing<br />
new fantasy pictures, patterns or<br />
old pictures that it has stored,”<br />
explains the Royal National<br />
Institute of the Blind in the UK.<br />
Gael was simply relieved she<br />
wasn’t losing her mind and could<br />
now rationalise the strange<br />
visions she kept having, but she<br />
was concerned how few people<br />
appeared to be aware of CBS and other problems<br />
visually-impaired people have to contend with, so<br />
she shared her story with MDNZ.<br />
She’s so glad she returned to her GP and asked<br />
about CBS, she says, as that’s when she started<br />
to cope. Though she knew the images and<br />
hallucinations were not real, the fear of losing her<br />
mind was great, so telling people you’re having<br />
hallucinations is not an easy thing to do.<br />
She hopes her story will bring awareness to the<br />
condition and urges all professionals, especially<br />
GPs, to acknowledge and learn more about CBS.<br />
“Don’t be afraid to commit to this phenomenon just<br />
because it’s not easily explained,” she says. “As a<br />
visually-impaired person, life can be tough enough<br />
Understanding CBS<br />
NZ Optics’ asked Tauranga-based ophthalmologist and MDNZ<br />
trustee, Dr Andrew Thompson, to talk about Charles Bonnet<br />
Syndrome (CBS).<br />
Charles Bonnet Syndrome (CBS) is a common<br />
condition characterised by the occurrence of<br />
phantom images or hallucinations in a person<br />
living with acquired vision loss. The condition<br />
can affect people of any age with partial sight or<br />
severe blindness and generally begins weeks to<br />
months after sight loss has occurred.<br />
The condition is experienced by those who are<br />
psychological or cognitively sound, however,<br />
patients may often think they are going mad.<br />
The condition was initially described by Swiss<br />
scientist Charles Bonnet in 1760, but was not<br />
evident in medical literature until the 1980s.<br />
Hallucinations vary from abstract shapes and<br />
colours to detailed images of people, animals and<br />
landscapes. In contrast to the images a partialsighted<br />
person may see, the hallucinations of<br />
CBS’ sufferers can be very clear and detailed, and<br />
are usually of nice things. Occasionally, people<br />
may experience frightening images but this is<br />
uncommon. Most people find the hallucinations<br />
become less frequent over 18 months to two<br />
years, though<br />
many will still<br />
have occasional<br />
hallucinations up<br />
to five years later.<br />
Swiss lawyer, philosopher and scientist<br />
Charles Bonnet who first described<br />
visual release hallucinations in 1760<br />
What causes<br />
CBS?<br />
CBS appears to be<br />
poorly understood,<br />
though it is<br />
quite a common<br />
condition in<br />
people who have<br />
lost their vision.<br />
The exact cause<br />
when you cannot even go to the bank by yourself,<br />
let alone sign a withdrawal slip.”<br />
Gael says she’s thankful to groups like Age<br />
Concern and MDNZ for their support and hopes,<br />
in the future, carers will have more insight into<br />
the everyday difficulties someone who is vision<br />
impaired experiences.<br />
As for finding her place in this new life of hers,<br />
she’s giving it her all despite her disabilities and,<br />
after some encouragement by her GP, has even<br />
written a children’s book entitled, ‘Who do these<br />
shoes belong to?’. Illustrated by her grand-daughter,<br />
Melanie, the book takes the reader on a search for<br />
the owner of some mysterious shoes, providing a<br />
peek into the life of someone with central scotoma.<br />
is not known. For<br />
a normal sighted<br />
person, the brain<br />
receives visual<br />
input and this stops<br />
the brain from<br />
generating its own Dr Andrew Thompson<br />
images. When sight<br />
is lost, it is thought the brain starts to fill in gaps<br />
by generating hallucinatory images, patterns or<br />
previously stored images as it is not receiving<br />
visual input in the usual manner. It is not a sign<br />
of psychiatric illness or madness, even if patients<br />
consider it may be.<br />
How common is CBS?<br />
The reported prevalence rates for CBS vary widely.<br />
An Australian study reported the prevalence to be<br />
17.5% in 2008.<br />
Approximately 40% to 65% of CBS-affected<br />
people tend not mention their symptoms to<br />
anyone, reluctant for fear of being labelled mad.<br />
So, it is sensible to enquire about CBS when<br />
seeing patients with partial or severe vision loss.<br />
CBS only affects vision and does not cause<br />
hallucinations involving other senses. Patients with<br />
CBS are aware that what they are seeing isn’t real,<br />
although the hallucinations can seem very real.<br />
What can be done about CBS?<br />
There is no cure for CBS and drug therapy is not<br />
usually indicated to treat the hallucinations. For<br />
most people with CBS, a simple explanation of<br />
what is happening is all that is required to put<br />
their mind at rest.<br />
For more information contact: www.<br />
charlesbonnetsyndrome.org<br />
Fleye firms up NZ presence<br />
Danish designer eyewear Fleye,<br />
as worn by Kiwi celebrity<br />
chef Al Brown, has appointed<br />
its first on the ground rep in New<br />
Zealand, Tracey Dobson, who’s set<br />
up her own company, Lotus Star, to<br />
accommodate the new move.<br />
Dobson used to work for the<br />
jewellery side of Australian-based<br />
distributor, House of Brands KJ,<br />
which previously looked after Fleye<br />
in this part of the world. Though<br />
responsible for jewellery in New<br />
Zealand, Dobson was often called<br />
upon to help with Fleye. So, she’s<br />
familiar with Fleye and many of<br />
Fleye’s Kiwi customers and a big fan<br />
of the brand, she says, and was delighted when she<br />
was asked to directly represent Fleye here. “Working<br />
with Fleye, I came to really enjoy the industry, so<br />
when the offer was made, I jumped at it. Annette<br />
Estø, creator and one of the founders of Fleye, is the<br />
Fleye’s new NZ rep, Tracey Dobson<br />
Correction – Ozurdex<br />
Ozurdex (dexamethasone 700mcg) a long-acting<br />
intravitreal steroid, delivered via a sustainedrelease<br />
ocular implant is funded in New Zealand<br />
for diabetic macula oedema (DMO). It is also<br />
Medsafe approved, but not funded (as was<br />
wrongly stated on p14 of December’s issue of<br />
most inspiring and motivational<br />
person I have met and I’m very<br />
happy to be working alongside<br />
her on this venture.”<br />
Estø is equally pleased to have<br />
Dobson on the ground to help<br />
and support Fleye’s customers<br />
directly, after building up a loyal<br />
customer base over the past<br />
four years.<br />
“We are pleased to have<br />
Tracey as our distributor in New<br />
Zealand and are very much<br />
looking forward to a stable<br />
long-term collaboration. There<br />
is a great potential for Fleye in<br />
New Zealand as Danish design is<br />
much appreciated here.”<br />
As well as Fleye, Dobson will also be representing<br />
Australian frames distributor Eye Candy Optics’<br />
Iyoko Inyaké brand, designed in Belgium and<br />
handcrafted in Japan. ▀<br />
NZ Optics), for the treatment of macular oedema<br />
due to retinal vein occlusion (RVO) and noninfectious<br />
uveitis affecting the posterior segment<br />
of the eye.<br />
For more, see full story on p16 of December’s<br />
issue.<br />
8 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
INTRODUCING<br />
NEW<br />
NUPOLAR ® INFINITE <br />
FOR SOME,<br />
CHANGE COMES<br />
NATURALLY.<br />
The chameleon has two layers of cells<br />
loaded with tiny nanocrystals under its<br />
skin. By expanding and reducing the<br />
distance between these nanocrystals, the<br />
chameleon is able to lighten or darken its<br />
skin colour to adapt to its environment.<br />
INFINITE CONTRAST, COMFORT<br />
AND VISUAL CLARITY.<br />
Like the chameleon, NuPolar ® Infinite<br />
is the master of adaptability, naturally<br />
responding to changes in light<br />
conditions. Combining photochromic<br />
and polarization technology, NuPolar<br />
Infinite is a grey variable tint polarized<br />
sun lens that responds naturally to light.<br />
• Available in grey, the most<br />
popular lens colour.<br />
• Lightest state – 60% tint.<br />
• Darkest state – 91% tint.<br />
• Reacts quickly to both UV and visible light.<br />
• Blocks blinding glare.<br />
• Polarization efficiency – 99%.<br />
• Activates moderately behind the windscreen.*<br />
• Affordable photochromic polarization.<br />
ORDER FREE<br />
MARKETING MATERIALS<br />
Our bold new point-of-sale materials<br />
complement the existing NuPolar dragonfly<br />
point-of-sale materials to synergistically<br />
co-exist within your practice. Social media<br />
content and digital advertising artwork is<br />
also available. Order yours today at:<br />
youngeroptics.com.au/order-pos<br />
• Window posters (1000mm x 692mm)<br />
• Counter cards (A4)<br />
• Patient brochures (DL - 8 pages)<br />
• Window decals (400mm x 400mm)<br />
UPDATED<br />
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back multi-coats.<br />
• Available in 1.50 hard resin.<br />
• Coming soon in polycarbonate.<br />
Low light Overcast Partly sunny Bright sunlight<br />
Lightest state<br />
Darkest state<br />
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NuPolar Infinite. Naturally Responsive.<br />
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INTEGRATED<br />
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youngeroptics.co.nz<br />
*Degree of photochromic activation dependent on windscreen’s total light transmission and UV light absorption characteristics. NuPolar is a registered trademark and Infinite is a trademark of Younger Mfg. Co. www.youngeroptics.com ©<strong>2018</strong> Younger Mfg. Co.<br />
YNG0028<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
9
Duskies: a passion for wood<br />
Driven by the desire to create a sustainable business, Andrew “Macca” McKenzie, co-creator<br />
and owner of Duskies Eco Eyewear, started up his own handcrafted wooden eyewear business<br />
in Hawkes Bay. Susanne Bradley caught up with him to find out more.<br />
Andrew Mckenzie “Macca” and Jessica Whyte, the Duskies eyewear team<br />
How did Duskies come about?<br />
After many years of timber-house building in<br />
New Zealand, including a major renovation of my<br />
family’s art deco home in Havelock North, I decided<br />
to head over to the UK for a two-year working<br />
holiday as many kiwis do.<br />
After six months in London, I left the rat race<br />
behind and moved to Aberdeen to do some<br />
carpentry work. The initial two years extended into<br />
an amazing seven years in Scotland and Ireland<br />
working in construction. I also travelled extensively<br />
throughout Western and Eastern<br />
Europe, which is where I first came<br />
across the wooden frame concept. After<br />
returning to New Zealand, I decided I<br />
wanted a drastic change in career. This<br />
is when Duskies started to evolve.<br />
Why wooden frames?<br />
Back in the UK, I attended many music<br />
festivals and couldn’t help noticing<br />
all the waste left behind by festival<br />
goers. Copious amounts of bottles, cups<br />
and plastic food utensils along with<br />
paddocks full of tents and clothing, all<br />
left behind. At one event, there was a<br />
company handing out complimentary<br />
bright green, plastic sunglasses at the<br />
gates and of course, the fluorescent<br />
green memorabilia were over-powering<br />
the pile of trash left behind.<br />
It was at that very moment I thought<br />
there must be an alternative; an<br />
environmentally-friendly material<br />
sunglasses can be made from. I was<br />
very proud of my festival Trilby-style hat<br />
made from bamboo fibre and being a<br />
carpenter, frames produced from wood<br />
seemed an obvious choice.<br />
Following my green light moment and<br />
after some research, I found the concept<br />
of wooden sunglasses was out there.<br />
But only a handful of small companies<br />
in Europe and USA were producing wooden<br />
eyewear, and no companies in New Zealand, so I<br />
made it my mission to create something uniquely<br />
awesome from wood, from here.<br />
What’s Duskies’ difference?<br />
Duskies wooden frames are very light and<br />
comfortable to wear. Our customers and stockists<br />
are often surprised at how light they are when<br />
they first try them on. The frames are robust and<br />
hardy and our German spring-loaded hinges offer<br />
extra comfort.<br />
How important is the ‘eco’ part<br />
of the business?<br />
So many people, especially the<br />
younger generations, are becoming<br />
more aware of using sustainable<br />
materials and what impact their<br />
(buying) decisions have on our<br />
environment. I saw a niche in the<br />
market for a sustainable fashion<br />
accessory and I’m very proud of the<br />
eco aspect of Duskies. We have some<br />
extremely loyal supporters in this domain, but<br />
it’s the fashion-forward, unique designs we are<br />
creating that seem to be really pushing Duskies<br />
ahead as the pioneers of wooden eyewear in New<br />
Zealand.<br />
Who else is involved with Duskies?<br />
We are a small boutique company operating from<br />
the hills of Havelock North in Hawkes Bay.<br />
It’s myself and my partner Jessica (Whyte) driving<br />
this ship. We have a small team in China helping<br />
us with production and we work very closely<br />
with them. I am very hands on in the production<br />
process and the face-to-face sales of the Duskies’<br />
brand. Jessica is amazing support and does a lot of<br />
the behind the scenes work whilst keeping me in<br />
check.<br />
What’s been the hardest thing about<br />
setting up the business?<br />
We have been producing and distributing wooden<br />
frames for just over three years now and have<br />
some amazing support throughout the country.<br />
Manufacturing is the biggest challenge as it’s very<br />
labour intensive with a huge amount of handsanding<br />
to get that top-quality finish Duskies’<br />
requires. Keeping up with new designs and<br />
implementing ideas to make the frames stronger<br />
and more durable is also crucial with wooden<br />
eyewear. There was a lot of trial and error with<br />
Duskies and Mt Difficulty limited edition sunglasses<br />
processes and materials at the start which, at<br />
times, was very frustrating but we now have the<br />
knack for it and produce what we consider to be<br />
a beautiful, fashionable range of unique wooden<br />
eyewear.<br />
Manufacturing in China also has its challenges.<br />
There is a lot to learn when it comes to Chinese<br />
culture and work ethics. We now have a great<br />
team in place and have become very close with<br />
the family-owned wood workshop we work with.<br />
On our last trip, we actually took my parents and<br />
Jess’ mother with us, and meeting our China team<br />
was a total highlight for them. The two families,<br />
spending time together has helped confirm our<br />
loyal relationship with our Chinese connections as<br />
we later found out it was a massive sign of respect<br />
for us to introduce our ‘Xinxilan’ (New Zealand<br />
family) to them.<br />
Any other news you’d like to share?<br />
We’ve just launched a collaboration with Central<br />
Otago winery Mt Difficulty, which I am super<br />
excited about. We have recycled Mt Difficulty’s<br />
pinot noir soaked wine barrels into oak wood<br />
sunglasses. It’s been a long process but well worth<br />
the wait as the barrels initially came from Europe,<br />
then held their award-winning vintage for three<br />
years. The production process has taken a further<br />
eight months but, this summer, Mt Difficulty<br />
will be selling these limited-edition wine barrel<br />
sunglasses through their cellar door. ▀<br />
Constant Progress<br />
ZEISS Precision Lenses<br />
1912<br />
Punktal ®<br />
The first axially symmetric spectacle lenses with point-focal<br />
Imagery, a concept that still plays a significant role in today’s<br />
lens designs. This invention was enabled by a close collaboration<br />
with Moritz von Rohr and Alvar Gullstrand.<br />
1935<br />
Patent for AR coatings<br />
ZEISS invents a process to create durable coatings<br />
to reduce reflections on optical lens surfaces.<br />
1969<br />
The photos of the first moon landing<br />
were taken with ZEISS camera lenses.<br />
1970<br />
First photochromic spectacle lenses<br />
A partnership with SCHOTT helps ZEISS launch<br />
the world’s first brown glass photochromic spectacle,<br />
known as Umbramatic.<br />
1980<br />
Gradal ® HS<br />
ZEISS unveils the world’s first progressive lens design<br />
based on splines. It is the predecessor of freeform lenses.<br />
1992<br />
Video Infral ®<br />
The world’s first computer-based centration device is introduced<br />
by ZEISS to set new standards in individualised lens fitting.<br />
1997<br />
Patent for a new manufacturing process<br />
With the Hof / Hanssen patent ZEISS sets a new standard in<br />
progressive lens production. To date, this manufacturing process<br />
has been licenced to the entire ophthalmic market by ZEISS.<br />
2000<br />
Gradal Individual ® Progressive Lenses<br />
For the first time in history, ZEISS offers personalised<br />
parameters in the computation of progressive<br />
lens surfaces.<br />
2007<br />
i.Scription ®<br />
ZEISS launches the first lens technology that<br />
incorporates higher-order aberrations and combines<br />
subjective refraction and wavefront analysis.<br />
2010<br />
MyoVision ®<br />
The world’s first lens that enables a reduction in myopia<br />
progression by an average of 30% in Asian children.<br />
2014<br />
Digital Lenses<br />
ZEISS introduces a new first-pair lens product category<br />
that is an eye care solution for mobile devices.<br />
2015<br />
DriveSafe Lenses<br />
ZEISS develops an everyday lens solution consisting of three<br />
elements to make driving safer and more comfortable.<br />
<strong>2018</strong><br />
Watch this Space!<br />
Our breakthrough innovations are the result of every decision we have made, every idea we have had and every contribution that everyone<br />
at ZEISS has made. We are proud of our long history and tradition in shaping the future of optics. We even made it to the moon, and we are<br />
aiming for even greater heights. Be part of this never-ending story.<br />
Find out which ZEISS lens solutions are most suitable for you and your business at www.zeiss.com.au/vision or 1800 882 041.<br />
10 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
UNIQUE WATER GRADIENT<br />
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CORE<br />
THIS IS WHY patients<br />
can experience a surface<br />
so soft, it feels like nothing. ** 1<br />
DAILIES TOTAL1 ® contact lenses have an ultrasoft surface,<br />
almost as soft as the corneal epithelial cells. 2–5<br />
The First and Only Water Gradient Contact Lens<br />
>80% 33%<br />
>80%<br />
~0.01<br />
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UNIQUE WATER GRADIENT<br />
Features different surface<br />
and core water contents 6 LASTING LUBRICITY<br />
Hydrophilic surface gel<br />
approaches 100% water<br />
LOW SURFACE MODULUS<br />
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the outermost surface 2,4<br />
at the outermost surface †2<br />
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PERFORMANCE DRIVEN BY SCIENCE <br />
*Dk/t = 156 @ -3.00D. **Based on wearers agreeing with the statement, “while wearing my lenses, I sometimes forget I have them on”. †In vitro measurement of unworn lenses.<br />
References: 1. Perez-Gomez I, Giles T. Clin Optom 2014;6:17–23. 2. Angelini TE et al. Invest Oph & Vis Sci 2013;54:E-Abstract 500. 3. Angelini T. Hydrogel surface viscoelasticity<br />
and mesh-size characterized with microrheology. ARVO, 2013:E-abstract 1614872. 4. Dunn AC et al. Tribol Lett 2013;49(2):371–378. 5. Straehla JP et al. Tribol Lett 2010;38:107–113.<br />
6. Thekveli S et al. Cont Lens Anterior Eye 2012;35(Supp1):e14.<br />
© 2017 Novartis. Alcon Laboratories (Australia) Pty Ltd. ABN 88 000 740 830. Phone: 1800 224 153; NZ Phone: 0800 101 106. 04/17 ALC0715 NP4:A21611561214.<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
11
International updates to home-grown problems<br />
The Eye Doctors’ last Grand Round of the year<br />
was a good-natured and warm affair. Guests<br />
were welcomed by the full Eye Doctors’ team<br />
and a choice of refreshments. Zeiss’ Chris Money<br />
kicked off proceedings by introducing Zeiss’ new<br />
ultra-widefield imaging system, the Clarus 500, said<br />
to be the first fundus camera to combine true colour<br />
and high clarity with an ultra-wide view of the retina.<br />
Money also discussed SITA Faster, Zeiss’ newest<br />
addition to the SITA family of testing strategies for<br />
the Humphrey Field Analyzer 3 (HFA3) perimeter.<br />
SITA Faster testing takes about two-thirds of the<br />
time required by SITA Fast and about half the time<br />
required by SITA Standard, he said, with no blind<br />
spot or false negatives.<br />
Xen and the art of trabeculectomy<br />
The evening proper got underway with Dr Mark<br />
Donaldson sharing his journey with trabeculectomy<br />
surgery and the reticence surgeons have towards<br />
applying it given the risks and recovery time, despite<br />
its positive effect for many glaucoma patients,<br />
especially when micro-invasive glaucoma surgery<br />
(MIGS) is not suitable. All eye health practitioners<br />
should be mindful of the recovery time and the<br />
assistance patients require after surgery given the<br />
resultant temporary vision loss, he said, citing one<br />
patient who had arranged to stay with relatives for<br />
five weeks following surgery, but found it actually<br />
took three months before he could manage without<br />
outside care.<br />
Thus, Dr Donaldson said he was pleased to<br />
discuss a new way of doing trabeculectomy<br />
that’s much faster, less-invasive and enables a<br />
far quicker recovery, and is now available in New<br />
Zealand. The new Xen Implant from Allergan will,<br />
he said, become a common option for glaucoma<br />
patients, whose condition is not being well<br />
managed with drops. However, he warned, Xen<br />
trabeculectomies have a similar complication profile<br />
to trabeculectomy and great care is still required.<br />
According to Allergan’s studies, approximately three<br />
Xen procedures can be done in the time required for<br />
one trabeculectomy, with less intensive and timeconsuming<br />
follow-up required.<br />
For more on Xen and the new Clarus 500 see<br />
December’s NZ Optics.<br />
Retinal cotton wool to RANZCO’s best bits<br />
12 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong><br />
Dr Andrew Riley took the audience on a rapid tour<br />
of retinal cotton wool spots: what causes them,<br />
how long they last, what to worry about and what<br />
not to worry about.<br />
Cotton-wool spots are small white areas on<br />
the retina and are caused by a lack of blood flow<br />
to the nerve fibre layer. They usually disappear<br />
within several weeks and don’t threaten vision,<br />
however, they can be an early sign of diabetic or<br />
hypertensive retinopathy and, less commonly,<br />
vasculitis, such as the presented case of syphilis.<br />
He also discussed the commonest cause of retinal<br />
cotton wool spots and reiterated the benefits of<br />
Eylea, especially for diabetic retinopathy, which,<br />
frustratingly, he said, is still not funded in New<br />
Zealand though it is currently being reviewed,<br />
again. “90% of patients respond to Avastin,<br />
but some patients don’t, so Eylea would be an<br />
excellent second line agent.”<br />
One product that is now funded in New Zealand<br />
for diabetic macular oedema (DMO), and was<br />
proudly on display at RANZCO’s Scientific Congress<br />
in Perth at the end of last year, is Ozurdex – a<br />
long-acting intravitral steroid, delivered via a<br />
sustained-release ocular implant. Eye Doctors’ Dr<br />
Donaldson and Dr Riley were part of the Phase III<br />
trial of Ozurdex in DMO and vein occlusions (see<br />
December’s NZ Optics).<br />
Another RANZCO highlight was Alcon’s Ngenuity<br />
3D Visualization System, a platform for digitallyassisted<br />
vitreoretinal surgery (DAVS), designed to<br />
enhance visualization of the back of the eye, with a<br />
variety of colour-enhanced filters. One of the main<br />
benefits of this system, however, is the reduction of<br />
neck strain for eye care professionals, 50% of which<br />
report neck pain due to their posture in surgery and<br />
on the slit lamp. “The ‘ophthalmic surgeon stoop’<br />
may become a thing of the past if this could also be<br />
included in the slit lamp,” said Dr Riley.<br />
He then closed with some other RANZCO highlights<br />
and a comment on defining macular degeneration.<br />
“Hard drusen is aging; soft drusen is ARMD.”<br />
Thyroid disease<br />
Dr Shuan Dai gave a memorable, case-based<br />
presentation on thyroid eye disease’s diagnosis<br />
and management. It can be sight-threatening and<br />
debilitating due to its effect on the optic nerve,<br />
ocular surface and ocular motility. Non-surgical<br />
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Vaishna Singavarothayan, Trevor Skinner and Shookria Rajaiy<br />
management includes normalising the endocrine<br />
imbalance, stopping smoking, prismatic correction<br />
of vertical or horizontal deviation and observation<br />
for stability.<br />
It’s important to set appropriate expectations,<br />
said Dr Dai, as 20% of cases require more than one<br />
surgery; patients may require lid surgery and optic<br />
prisms to achieve binocular single vision (BSV); and<br />
patients are likely to still have some diplopia in<br />
some directions of gaze. The cessation of smoking<br />
is very important to maintain long-term stability<br />
after successful eye muscle surgery, he stressed.<br />
OSA and floppy eyelids<br />
Dr Penny McAllum then discussed her typical corneal<br />
transplant patient from South Auckland: a 30-yearold<br />
male, usually of Polynesian or Indian descent,<br />
with advanced keratoconus, allergic eye disease,<br />
floppy eyelids, obesity, obstructive sleep apnoea<br />
and, sometimes, diabetes. Using case studies, she<br />
discussed the dangers of obstructive sleep apnoea<br />
(OSA) and its relation to eye disease, especially<br />
keratoconus. OSA patients tend to have red, irritable<br />
eyes, and there’s a clear link to allergic conjunctivitis<br />
and/or eyelid eczema. 10-20% of patients with<br />
OSA have floppy eyelid syndrome (FES) but 96%<br />
of patients with FES have OSA. The best ways to<br />
Gary Filer, Dr Andrew Riley and Rob Allen<br />
Stephen Hill and Carolyn Campbell<br />
manage FES is lubrication at night, tape or shielding<br />
eyes at night, treating other eye diseases, such as<br />
allergic conjunctivitis, and, when necessary, surgery<br />
to reduce horizontal lid laxity, but this has a 25% to<br />
50% failure rate at two years, she said.<br />
OSA is also associated with normal tension<br />
glaucoma (NTG), with 5-10% of patients with OSA<br />
having NTG, while up to 50% patients with NTG<br />
have OSA; more if they also have FES. So treating<br />
OSA may stop the progression of NTG, said Dr<br />
McAllum.<br />
If your patient has symptoms of OSA, encourage<br />
them to talk to their GP about having a sleep<br />
assessment, and encourage them to lose weight as<br />
this could help save their lives, she added. ▀<br />
An Everest experience<br />
BY COURTNEY JELLEY*<br />
I<br />
grew up in Rural Zimbabwe, where my dad built<br />
a small clinical practice to provide medical care<br />
in the community, so I’ve always been inspired to<br />
volunteer and help those in need. Having recently<br />
qualified as a dispensing optician, I was looking for<br />
a volunteer opportunity and, given my current focus<br />
on meditation and wellbeing, I thought Eyes4Everest<br />
would be perfect, and it was.<br />
In fact, it was absolutely phenomenal; a real life<br />
changing experience. Nothing can really prepare you<br />
for the literally breathtaking views of the towering<br />
peaks, Everest itself and the endless amounts of<br />
stairs. Although strenuous, people of average fitness<br />
can trek through Nepal – slow and steady is the key!<br />
We started out as a group of nine optometrists<br />
from Australia, plus myself from New Zealand, all<br />
brought together by a common desire to make a<br />
difference to people who don’t have access to the<br />
same eye care we do. Most of us were first time<br />
trekkers. The support of our Sherpa guides and yaks,<br />
who carried the majority of our gear, made the trip<br />
a lot more pleasant. We also met up with a young<br />
Nepalese optometrist, Tashy, who had just finished<br />
her qualification in India and is the first Sherpa<br />
optometrist as far as we know! It was so amazing<br />
seeing how proud her community was of her.<br />
We spent the majority of our time on this<br />
Eyes4Everest trip helping in a village named<br />
Khumjung (3970m) where we saw around 100<br />
Nepalese people over two days. I was lucky enough<br />
to have my work station outside with a memorial<br />
statue of Sir Edmond Hillary and a stunning<br />
mountain overlooking me. I was also fortunate to<br />
be the last person our patients saw, so it was a bit<br />
emotional having Sherpa elders hold my hand to<br />
their cheeks in thanks! It all becomes that much<br />
more rewarding when you realise a couple of<br />
80-year-old ladies have walked for four hours just<br />
to see you before walking home again. We all spent<br />
time trying to learn as much Nepalese as we could<br />
to try to communicate more effectively, though our<br />
Sherpa guides were on hand to help us out!<br />
One of my favourite moments was watching two<br />
young boys freeze, their eyes go incredibly wide and<br />
then run away as one of our optometrists, Rose,<br />
stepped outside while wearing her BIO!<br />
While we were primarily there to provide eye care<br />
services, the trip also let us explore one of the most<br />
remarkable places on Earth. Our trek took us along<br />
the Gokyo track, culminating in an ascent of Gokyo<br />
Ri (5357m). This was by far our toughest day and<br />
we could barely sleep with the anticipation of being<br />
among the few people in the world to summit the<br />
peak. We got up at 3am. It was minus 20 degrees<br />
Courtney Jelley hard at work and play with Eyes4Everest<br />
and we only had the light of our headlamps to lead<br />
the way. The stars were unbelievably clear and the<br />
sheer beauty of the sun slowly rising over the four<br />
highest peaks in the world can’t be put into words.<br />
The achievement of reaching the top, especially<br />
with people you have become so close with, was<br />
undoubtedly the main highlight of the trip.<br />
Another highlight for me, however, was spending<br />
time with a local Nepalese woman learning how to<br />
cook traditional Dal Bhat (lentil soup and vegetable/<br />
chicken curry). As I’m an avid cook, this was a skill I<br />
am happy to have brought home with me so I will<br />
always have a bit of Nepal to remember!<br />
Being from New Zealand and knowing enough<br />
Nepalese to be able to explain that, I felt a<br />
huge connection to the mountains and Sherpa<br />
people through their fondness of Sir Ed and his<br />
achievements. This connection and the Sherpa<br />
culture has inspired me to return and explore,<br />
as well as continue to help, in different areas of<br />
the Himalayas with Eyes4Everest. I also hope by<br />
sharing my experiences I can encourage fellow<br />
dispensers and other optical professionals to jump<br />
at opportunities to use their skills overseas.<br />
Eyes4Everest will be hosting four trips next year<br />
and are always on the lookout for people who<br />
want to get involved and maybe push themselves<br />
outside their comfort zones! If you would like more<br />
information, please don’t hesitate to get in touch<br />
through http://eyes4everest.org.au/<br />
*Courtney Jelley is a dispensing optician with Visique Eye Spy<br />
Optometrists in Palmerston North. She made the change to<br />
optics after leaving the military, where she was training to<br />
become a medic, and finished second in her year of dispensing<br />
students last year.
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travel 07/07/<strong>2018</strong> - 14/07/<strong>2018</strong>. Total prize pool is up to $10,000 (inc GST). Prize draw 10:00 AM AEST 5/4/<strong>2018</strong> at Level 2, 11 York Street Sydney NSW 2000. Winners notified via<br />
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<strong>Feb</strong>ruary<br />
transitions.com<br />
<strong>2018</strong> NEW ZEALAND OPTICS<br />
TRA0003<br />
13
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M<br />
Y<br />
CM<br />
MY<br />
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Special Olympics: a big thank you<br />
Evan Brown triaging Max Nyenkamp who went on to win a gold medal in basketball<br />
1200 Special Olympic athletes assembled in Wellington from 26<br />
November to 1 December 2017 to compete in their respective sports<br />
at the National Summer Games (NSG). Since 2001, the New Zealand<br />
Opening Eyes programme has screened athletes to assess vision<br />
problems. Local wholesalers OptiMed, OIC and Designs for Vision<br />
generously donated equipment and expertise to enable a volunteer<br />
team of 22 optometrists, 17 student optometrists, one dispensing<br />
optician and two Essilor staffers to screen and support more than<br />
800 athletes CooperVision at the Half ASB Page Sports NZ Optics Centre <strong>Feb</strong> <strong>2018</strong>.pdf in Kilbirnie, 1 8/01/<strong>2018</strong> Wellington.<br />
2:18:09 PM<br />
Live Brightly.<br />
BY EVAN BROWN, CLINICAL CO-DIRECTOR OF SOLCIOENZ<br />
Great<br />
technology<br />
alone is<br />
not enough<br />
Greg Sampson<br />
General Manager, CooperVision ANZ<br />
AGENT OF OPTOMISM<br />
Despite the impressive range of excellent contact lenses<br />
available, we understand it can be hard to retain patients<br />
and maintain profits.<br />
That’s why at CooperVision we’re doing everything we<br />
can to make you more optimistic about the future of your<br />
contact lens business with our new Optomism mission.<br />
To find out more, contact your CooperVision<br />
Agent of Optomism.<br />
Our Optomism promise<br />
We promise to give you the tools, techniques and<br />
products you need to transform your contact lens<br />
business and generate measurable growth.<br />
Keratoconus is significantly more common in individuals living with<br />
Down syndrome and can be more complicated to treat and manage.<br />
This year also saw the introduction of a specialist team from the<br />
University of Auckland, comprising Akilesh Gokul, Samantha Simkin<br />
and Joyce Mathan, who using a corneal topographer, auto-refractor<br />
and biomicrosope screened all Down syndrome athletes, detecting<br />
keratoconus or sub-clinical keratoconus in 45 athletes. Many athletes<br />
with keratoconus presented with asymmetry of disease, having<br />
quite advanced progression in one eye and mild or sub-clinical status<br />
in the other eye. We are hopeful corneal cross linking will be very<br />
helpful for future management of these athletes.<br />
Cataract, pterygium and blepharitis are other conditions seen with<br />
high frequency in Special Olympic athletes and this year, another 30<br />
athletes were referred to ophthalmology, their GP or optometry for<br />
further investigation.<br />
The Special Olympics Lions Club International Opening Eyes<br />
(SOLCIOE) programme is designed to provide quality eye care for<br />
people with intellectual disabilities, increasing the athlete’s access<br />
to care by providing vision screening, refraction and dispensing of<br />
appropriate eyewear during Special Olympics events. From previous<br />
SOLCIOE screenings it’s known that about one third of Special<br />
Olympic athletes present wearing clinically incorrect eyewear or<br />
not wearing eyewear at all. This statistic was born out yet again at<br />
the NZ National Games, with the programme dispensing 360 pairs<br />
of prescription eyewear, confirming how this vision programme<br />
continues to fill an unmet healthcare need for those individuals<br />
with intellectual disabilities in our community. The programme also<br />
educates athletes, their guardians, coaches and administrators about<br />
Akilesh Gokul with Max at the topographer<br />
the importance of vision to the athletes’ performance in sports,<br />
school, craft and work and provides continuing education for our<br />
volunteer optometrists to familiarise them with the best techniques<br />
for testing this patient population.<br />
We would like to thank all the sponsors and volunteers who helped<br />
support this year’s programme and also recognise SOLCIOE’s global<br />
sponsors: the Essilor Vision Foundation, which provided the athletes’<br />
lenses; Safilo Group which provided the frames and free plano<br />
sunglasses for those who passed the screening; and Liberty Optical<br />
which supplied the sports frames and protective eyewear.<br />
The Special Olympics brings out the best people and the best<br />
in people! We had a great time and everyone was positive and<br />
enthusiastic. The team worked hard, but received the emotional<br />
reward of a job well done.<br />
We hope to see you all again at the next SOLCIOE NZ event in 2021.<br />
Gates move<br />
Gates Optometrists celebrated its move to a new central location<br />
in Hamilton’s CBD by toasting the new premises with a soiree<br />
for local business people, customers and guests at the end of<br />
last year.<br />
Now based in Wiseman Central, an iconic building situated on the<br />
corner of Ward and Victoria Streets, the relocation means the business<br />
has come full circle, says Darren Savage, chief executive of Gates. The<br />
business began in 1991 as “Eyewear Collection” which was originally<br />
based on Ward Street. In 2004, the practice was renamed “Gates<br />
Opticians” and moved to Barton Street. Another name change to Gates<br />
Optometrists occurred after the business was purchased by Paterson<br />
Burn Optometrists in 2010.<br />
Savage says he’s excited about this new chapter in the business’<br />
history and the relocation within Hamilton central. “We were<br />
committed to staying in the CBD and our new location provides both<br />
high-foot traffic and excellent visibility from passing vehicles.”<br />
In recent years, Hamilton CBD buildings have been refurbished<br />
providing opportunities for businesses like Gates to relocate into<br />
purpose-friendly premises. Waikato Chamber of Commerce CEO<br />
William Durning says he’s thrilled Gates is remaining in the centre of<br />
town. “Businesses like Gates are reinvigorating Hamilton’s CBD.”<br />
Gates’ new premises has floor to ceiling glass windows with brass<br />
trimmings, accommodating new display screens, replacing traditional<br />
poster advertising. The interior design, influenced by the Art Deco<br />
period of the Wiseman building, was designed by local architects<br />
Edwards White.<br />
“As a large portion of our patients are professional males, we wanted<br />
the practice to appeal to them as much as it would to the professional<br />
female,” explains Savage adding how the masculine designs,<br />
influenced by the industrial look, were softened with lighting, both<br />
natural and artificial.<br />
The sensory experience for Gates customers is also very important,<br />
he says. “The main door remains open and with the air curtain, we are<br />
able to maintain a comfortable temperature indoors all year round<br />
and block out some of the noise from passing traffic.” This is helped<br />
by surround-sound music, which also adds ambience. While mirrors<br />
are cleverly placed near the large windows to take advantage of the<br />
natural light for customers trying on glasses, says Savage, and shelves<br />
are lit up so frame colours pop. “The dispensing room is private yet<br />
our staff can still look<br />
out to the practice<br />
retail area and we use<br />
tablets to dispense if<br />
required throughout<br />
the practice to enable<br />
staff and patients’<br />
mobility.” ▀<br />
© <strong>2018</strong> CooperVision.<br />
above: Dale Thomas, Darren Savage and Essilor’s Chris Aldous<br />
14 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
6<br />
months<br />
shelf life after<br />
opening<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
15
SPECIAL FEATURE: NUTRITION<br />
Diet defence against eye disease<br />
BY ELLA EWENS*<br />
Nutrition for optimal eye health is an<br />
exciting area that has gained a huge<br />
amount of interest recently, and for good<br />
reason. Our ageing population, coupled with a<br />
decreasing death rate means eye care practitioners<br />
will be faced with an increasing number of<br />
patients suffering from age-related eye diseases<br />
in the future. The projected number of patients<br />
with age-related macular degeneration (AMD) is<br />
predicted to be 196 million in 2020, increasing to a<br />
whopping 288 million in 2040 1 .<br />
While new treatment options for conditions<br />
for AMD, dry eye and glaucoma are entering the<br />
market each year, prolonging eye health and<br />
prevention should be a primary focus. We need to<br />
be eye health practitioners in the fullest sense and<br />
key to this is encouraging our patients to adopt a<br />
healthy diet to prolong the health of their eyes and<br />
their sight.<br />
The evidence for diet<br />
Epidemiological studies from the last two decades<br />
have shone some light on some of the risk factors<br />
associated with AMD, including smoking, ethnicity,<br />
age, diet, nutritional status, hypertension and also<br />
genetic markers 2 . The ground-breaking, landmark<br />
Age-Related Eye Disease Study (AREDS), which<br />
began in 1992, closely followed 3640 patients<br />
over 6.3 years and found that taking high levels<br />
of antioxidants (vitamin A, C and E) and zinc can<br />
reduce the risk of developing advanced AMD by<br />
approximately 25% and can also reduce associated<br />
vision loss 3 . When considering the huge public<br />
health burden of AMD (including everything from<br />
treatment costs to falls in the elderly), this 25%<br />
reduction is significant. The success of AREDS<br />
began a cascade of new investigations into other<br />
potential supplements such as zeaxanthin, lutein,<br />
docosahexaenoic acid (DHA), eicosapentaenoic<br />
acid (EPA), resveratrol and vitamin D in the<br />
prevention of AMD. One study showed progression<br />
of both dry and wet AMD is 25% less likely among<br />
those eating a diet rich in omega-3s, EPA and<br />
DHA. Plus, a high omega-3 diet combined with a<br />
low glycaemic index (GI) intake reduced the risk<br />
of progression to advanced disease even further,<br />
cutting it by 50%, while a high meat intake is<br />
associated with early onset AMD 4,5 .<br />
The Blue Mountains Study, a large 15-year<br />
population-based study in Australia, showed<br />
smoking is linked to both AMD and cataract. In<br />
fact, there is a four-fold increased risk of latestage<br />
AMD among smokers compared with past<br />
or non-smokers and 10-year earlier onset 6 . The<br />
well-known Beaver Dam Eye Study also found an<br />
association of cigarette smoking with cataract and<br />
AMD 7 .<br />
More recently, studies investigating vitamin D<br />
indicate it may play an important role in agerelated<br />
disease. Vitamin D could have a function in<br />
immune regulation and barrier function in ocular<br />
barrier epithelial cells 8 . Macular thickness may<br />
also change in accordance with serum vitamin<br />
D concentration in older patients 9 . Furthermore,<br />
vitamin D is a powerful inhibitor of vascular<br />
neovascularisation 10 . With more than 50% of the<br />
world’s population at risk of vitamin D deficiency<br />
and decreased skin production of vitamin D as we<br />
age, it makes sense that vitamin D, with its role in<br />
combating inflammation, neovascularisation and<br />
fibrosis, might be the next contender to add to our<br />
list of supplements.<br />
As well as AMD, there is also an abundance of<br />
nutrition and lifestyle research relating to other<br />
common age-related diseases, such as glaucoma<br />
and dry eye disease (DED). While there are no<br />
environmental factors clearly associated with<br />
primary open angle glaucoma 11 , several studies<br />
have found risk factors relating to DED, such as<br />
age, sex, systemic disease (arthritis, diabetes<br />
and thyroid disease) smoking and medications<br />
(aspirin and antidepressants) 12 . Higher intake of<br />
omega-3 fatty acids is associated with decreased<br />
DED incidence in women 13 . While both systemic<br />
and topical omega-3 and omega-6 fatty acids have<br />
showed promise as treatments in dry eye, omega-3<br />
supplements remain the mainstay for nutritional<br />
management of DED today.<br />
Taking an educator role<br />
As eye health practitioners, we need to keep<br />
abreast of nutritional research developments<br />
and be proactive in educating patients on how to<br />
maintain their own eye health. Asking patients<br />
whether they smoke for instance and giving<br />
appropriate nutritional advice could have a major<br />
impact years down the line. So, it’s important<br />
patients understand the association between diet<br />
and lifestyle and the health of these incredible<br />
ocular organs so they can keep an eye on their diet<br />
and go for regular eye check-ups.<br />
To this end, NZ Optics’ brings you our first<br />
feature dedicated to nutrition. With the help of<br />
Grant Watters, we look at some potential new<br />
nutraceuticals in the wings, which may help<br />
slow eye ageing and better protect our eyes<br />
against dry eye, presbyopia, cataract and macular<br />
degeneration; celebrity nutritionist Dr Libby<br />
Growing evidence shows a healthy diet improves and protects eye health<br />
Weaver discusses what to eat for eye health; and<br />
we take a peep inside the world of one of our<br />
own ocular nutrition scientists, Andrea Braakhuis,<br />
whose fascinating research on oxidative stress<br />
disease demonstrates the correlation between<br />
high meat consumption and eye disease. For the<br />
cooks among you, we even have a delicious recipe<br />
for you to try from the Feast your Eyes cook book.<br />
Hopefully it will inspire us all to do a little more for<br />
ourselves and for our patients.<br />
References<br />
1. Wong, Wan Ling et al, Global prevalence of age-related<br />
macular degeneration and disease burden projection for<br />
2020 and 2040L a systematic review and meta-analysis.<br />
The Lancet Global Health, Vol. 2, Issue 2, e106-e116.<br />
2. Fletcher AE (2009). Healthy Ageing: The Eye. In: Stanner<br />
et al (eds). Healthy ageing: the role of nutrition and<br />
lifestyle. Wiley-Blackwell, Oxford, 2009.143- 158.<br />
3. The Age-Related Eye Disease Study Research Group.<br />
A randomized, placebo-controlled, clinical trial of<br />
highdose supplementation with vitamins C and E, beta<br />
carotene, and zinc for age-related macular degeneration<br />
and vision loss. AREDS report no. 8. Arch Ophthalmol<br />
2001;119:1417–36.<br />
4. Chiu C-J, Klein R, Milton RC et al. Does eating particular<br />
diets alter risk of age- related macular degeneration in<br />
users of the age-related eye disease study supplements?<br />
Br J Ophthalmol 2009;93:1241-1246.<br />
5. Chong EW, Simpson JA, Robman LD et al. Red meat and<br />
chicken consumption and its association with age-related<br />
macular degeneration. Am J Epidemiol 2009;169:7 867-76.<br />
6. Multiple papers from the Blue Mountains Eye Study,<br />
including Cumming RG, Mitchell P, Smith W. Diet and<br />
cataract: the Blue Mountains Eye Study. Ophthalmology<br />
2000 Mar; 107(3): 450-6; and Moshtaghiam H et al. Trends<br />
in added sugar intake and food sources etc. J. Hum Nutr<br />
Diet 2017 Jun: 30(3):339-348<br />
7. Klein, R et al. Am J Epidemiol. 1993 Jan 15;137(2):190-200.<br />
The Beaver Dam Eye Study: the relation of age-related<br />
maculopathy to smoking.<br />
8. Alsalem, JA. Characterization of vitamin D production by<br />
human ocular barrier cells. Invest Ophthalmol Vis Sci.<br />
2014 Apr 7;55(4):2140-7.<br />
9. Alsalem, JA. Characterization of vitamin D production by<br />
human ocular barrier cells. Invest Ophthalmol Vis Sci.<br />
2014 Apr 7;55(4):2140-7.<br />
10. Albert, D. et al. Calcitriol is a potent inhibitor of retinal<br />
neovascularization. Invest Ophthalmol Vis Sci. 2007<br />
May;48(5):2327-34.<br />
11. Pasquale LR and Kang JH. Lifestyle, nutrition and<br />
glaucoma. J Glaucoma 2009;18:6 423-8.<br />
12. Scot E Moss et al. Arch Ophthalmol. 2000;118(9):1264-<br />
1268. doi:10.1001/archopht.118.9.1264 Prevalence of and<br />
Risk Factors for Dry Eye Syndrome<br />
13. Miljanović B, Trivedi KA, Dana MR et al. Relation between<br />
dietary n-3 and n-6 fatty acids and clinically diagnosed<br />
dry eye syndrome in women. Am J Clin Nutr 2005; 82:4<br />
887-93.<br />
*As well as being a reporter for NZ Optics, Ella Ewens is<br />
an optometrist at the Greenlane Clinical Centre who has a<br />
particular interest in nutrition for eye health, having lectured<br />
in the UK and Europe about this as part of her previous role as<br />
medical affairs manager with J&J.<br />
Nutraceutical supplements for eye health?<br />
BY GRANT WATTERS*<br />
Intense exposure to light, intense metabolic<br />
activity and high oxygen tension render the<br />
human eye particularly vulnerable to oxidative<br />
damage at all levels from the ocular surface and<br />
dry eye, cornea, anterior chamber, crystalline<br />
lens and back to the retina, macula and optic<br />
nerve. Hence compounds with strong antioxidant<br />
capabilities are under the spotlight as potential<br />
treatments to slow eye damage and ageing by<br />
reducing the production of reactive oxygen and<br />
nitrogen species (ROS and RNS) in the eye.<br />
Similarly, naturally found “alternative”<br />
antibiotics, such as New Zealand manuka honey<br />
extract, are being studied for ocular applications,<br />
particularly now with the potential of antibiotic<br />
resistance becoming worrisome.<br />
There is also a growing trend towards people<br />
turning towards “natural health” alternatives for<br />
treating their ailments but, of course, the issue<br />
with this is often the lack of evidence-based<br />
research to support the manufacturer’s claims.<br />
But now, some more enlightened nutraceutical<br />
manufacturers, are approaching researchers and<br />
funding their studies to legitimise their product<br />
claims. Our recent work with Manuka Health has<br />
already led to the development of an exciting<br />
eyelid night cream treatment for blepharitis. Here<br />
are some of the more promising natural products<br />
also on our radar that could also become effective<br />
and respected supporters of eye health with<br />
appropriate funding support and well-designed<br />
studies.<br />
Krill oil: a recent paper by Deinema et al 1<br />
compared oral krill oil, fish oil and a placebo (olive<br />
oil) for treating dry eye disease (DED). Krill oil came<br />
out on top and the researchers hypothesised that<br />
was because krill oil is a phospholipid which makes<br />
it more bioavailable than the triacylglyceride<br />
of fish oil. They also noted that krill oil contains<br />
astaxanthin (AXT) which is a powerful natural<br />
antioxidant and anti-inflammatory. Of course, krill<br />
is a very important part of the marine food chain<br />
so it would need to be ethically farmed to avoid<br />
hungry whales!<br />
Astaxanthin (AXT): a Kiwi company called Supreme<br />
Health (formerly Supreme Biotechnology) farms<br />
the green algae Haematococcus pluviallis, which<br />
produces AXT to protect itself from environmental<br />
stresses such as excessive sunlight and dryness.<br />
AXT is a marine carotenoid closely related to lutein<br />
16 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
Eating for eye health<br />
BY DR LIBBY WEAVER*<br />
Investing in your eye health is potentially one of<br />
the most important investments you can make.<br />
From having regular eye checks and monitoring<br />
any degeneration through to supporting the<br />
health of your eyes with a diet full of fresh whole<br />
foods, there are many different ways you can<br />
support these amazing organs. We don’t get<br />
another shot at taking excellent care of our eyes!<br />
Though a good, healthy diet is good for our<br />
whole bodies, including our eyes and our eye<br />
sight, there are certain vitamins and minerals that<br />
are particular good for eye health and, in part,<br />
can protect against and in some cases even help<br />
prevent diseases such as cataracts, glaucoma and<br />
age-related macular degeneration. Here’s just a<br />
few examples of the most important nutrients and<br />
foods that support optimal eye health.<br />
Vitamin A and beta-carotene<br />
Vitamin A has many functions, but when it comes<br />
to our eyes, it is critical for keeping the retina<br />
healthy. In many third-world countries, vitamin A<br />
deficiency is the leading cause of night-blindness<br />
– an inability to see at night or in dim light.<br />
Vitamin A is also sometimes used in the treatment<br />
of hereditary retina deformities and has been<br />
shown in some studies to slow the progression of<br />
retinal disorders. Sufferers can take supplements,<br />
but we can all keep up our vitamin A intake by<br />
eating lots of coloured vegetables and fruit, high<br />
in carotenoids, such as beta-carotene and alphacarotene,<br />
which our bodies convert into vitamin A.<br />
Hence, why carrots are often cited for being good<br />
at helping us see at night.<br />
Carotenoids are also good antioxidants,<br />
considered by many eye care professionals to be<br />
extremely important for eye health. Research<br />
indicates beta-carotene may also play a role in<br />
cataract prevention. Foods rich in beta-carotene<br />
include carrot, sweet potato, kale, spinach, papaya,<br />
capsicum and pumpkin to name a few, and these<br />
foods are a wonderful inclusion in your diet for a<br />
number of other health benefits as well.<br />
Zinc<br />
Zinc deficiency is associated with functional<br />
impairments in various parts of the eye. Zinc is<br />
needed for the conversion of retinol (a form of<br />
vitamin A) into retinal, which is required for night<br />
vision. Zinc is also needed to deliver vitamin A to<br />
the eyes and it works with vitamin C to protect<br />
the eyes against oxidative damage. Zinc is found<br />
in oysters from clean waters, red meat, eggs,<br />
Australian nutritionist, Dr Libby Weaver<br />
sunflower seeds and pumpkin seeds, however too<br />
many people these days aren’t obtaining enough<br />
from their food. Supplementation of this mineral is<br />
therefore, sometimes beneficial.<br />
Top foods for eye health<br />
Kale, eggs – Leafy green vegetables like kale are<br />
superstars for eye health as they’re a good source of<br />
lutein and zeaxanthin, two antioxidants known to<br />
support healthy eye function. Evidence suggests that<br />
people with diets high in lutein are up to 23% less<br />
likely to develop cataracts than those whose diets<br />
are low in this nutrient. If kale isn’t your thing, simply<br />
choose other dark leafy green vegetables, like spinach<br />
or silverbeet as they’re also good sources of lutein<br />
and zeaxanthin. Eggs are another great source.<br />
Salmon, sardines – Evidence shows diets rich in<br />
omega-3 fatty acids from fresh, cold-water fish like<br />
salmon and sardines, reduce the risk of developing<br />
eye disease later in life. If your diet is vegetarian or<br />
vegan be sure to include plant sources of omega-3<br />
fatty acids such as linseeds, walnuts, pecans or<br />
chia seeds.<br />
Citrus fruits – Citrus fruits are a wonderful source<br />
of vitamin C, an antioxidant that is critical to eye<br />
health. Oranges, lemons, grapefruit and mandarins<br />
are all delicious additions to the diet with many<br />
other benefits to your health.<br />
*Libby Weaver (PhD) is one of Australia’s leading nutritional<br />
biochemists, an international speaker, media personality,<br />
founder of the plant-based supplement range, Bio Blends, and<br />
a well-known author, having sold more than 300,000 books in<br />
New Zealand and Australia.<br />
Feast your eyes<br />
Taking the nutritional health of our eyes<br />
seriously in a truly inspiring way, is the<br />
Look for Life Foundation’s beautifully puttogether<br />
Feast Your Eyes cook book.<br />
Look for Life (formerly the Genetic Eye<br />
Foundation) is an Australian-based, not-forprofit<br />
dedicated to promoting awareness,<br />
diagnosis and support for patients with<br />
genetic eye conditions. Lifestyle factors are<br />
a significant contributor to the severity of<br />
genetic eye conditions and in an effort to raise<br />
awareness, the foundation has long supported<br />
the Mediterranean diet as a leading method of<br />
genetic eye condition prevention.<br />
The Foundation’s Feast your Eyes cook book<br />
includes contributions from some of Australia’s<br />
leading chefs to both promote eye health<br />
through healthy eating and raise funds to<br />
support research<br />
into genetic<br />
eye conditions.<br />
The book was<br />
compiled by<br />
Foundation<br />
directors, Professor<br />
Minas Coroneo,<br />
chair of the<br />
ophthalmology<br />
Baked asparagus with oregano, feta and lemon zest<br />
By Maria Benardis<br />
2 bunches of asparagus<br />
Sea salt and cracked pepper<br />
100g feta, crumbled<br />
4 tablespoons extra virgin olive oil<br />
2 cloves of garlic, crushed<br />
2 tablespoons lemon zest, grated<br />
1 teaspoon wild oregano, dried<br />
Juice of 1 lemon<br />
1 tablespoon dill, chopped (optional)<br />
Pre-heat the oven to 180°C.<br />
Wash the asparagus and place in a baking dish.<br />
Season with salt and pepper, then scatter the<br />
crumbled feta over the top.<br />
Heat the olive oil in a frying pan or skillet over<br />
a low heat. Add the garlic, lemon zest and<br />
oregano and cook, stirring, until the garlic<br />
is lightly golden. Remove the pan from the<br />
heat, stir in the lemon juice and pour over the<br />
asparagus and feta. Bake for 15 minutes or<br />
until the asparagus is tender.<br />
Garnish with dill (if using) and serve either as<br />
Hellene and Prof Minas Coroneo from the<br />
Look for Life Foundation<br />
department at the University of New South<br />
Wales, and his wife and practice manager Hellene<br />
Coroneo. A second digital edition of the cook<br />
book, featuring recipes from international as well<br />
as Australian chefs if due out later this year.<br />
As a taster, here is Sydney-based Greekalicious’<br />
chef Maria Bernardis’ contribution to the Feast<br />
Your Eyes cook book.<br />
Maria Benardis from Greekalicious’ baked asparagus<br />
a main meal or as an accompaniment to meat<br />
or poultry.<br />
To purchase a copy of Feast Your Eyes or to<br />
learn more about the Foundation, go to www.<br />
lookforlife.com.au<br />
and zeaxanthin and it has<br />
the strongest antioxidant<br />
(AO) activity of all of the<br />
carotenoids 2 , as well as<br />
having immunomodulatory<br />
characteristics. Funding is<br />
currently being sought to<br />
investigate whether various<br />
AXT-containing nutraceutical<br />
“recipes” could be effective in<br />
treating dry eye disease (DED),<br />
presbyopia, cataract, and agerelated<br />
macular changes.<br />
Saffron: Saffron is a culinary<br />
spice derived from parts of<br />
the Crocus sativus flower.<br />
It contains the compounds crocin and crocetin,<br />
which are derivatives of carotenoids and, again,<br />
are powerful antioxidants with antiapoptotic<br />
characteristics. A 2010 study by Falsini et al 3<br />
found that saffron supplementation for three<br />
months improved retinal flicker sensitivity and<br />
best-corrected visual acuity (BCVA) in 25 subjects<br />
with early age-related macular degeneration<br />
(AMD) compared to a placebo.<br />
Turmeric: another spice from the herbal plant,<br />
Curcuma longa, with multifunctional medicinal<br />
properties, turmeric contains curcumen which<br />
when concentrated has antioxidant, antifungal,<br />
antimicrobial and Cox-2 inhibiting antiinflammatory<br />
properties. A review paper by<br />
Nasri et al 4 noted that curcumen already has a<br />
good reputation in China and India for treating<br />
diabetes, kidney disease, cancer and arthritis.<br />
Ocular applications just started to be studied.<br />
Castor oil: is derived from the seeds of the castor<br />
bean plant (Ricinus communis). The use of castor<br />
oil goes back as far as the ancient Egyptians, who<br />
used it to treat eye irritations and as a natural skin<br />
care remedy with antibiotic properties. On the<br />
advice of a colleague who already has a patient<br />
successfully using it around her eyes, we are<br />
embarking on a pilot study this year to see if highgrade,<br />
sterile castor oil might also be beneficial in<br />
treating anterior blepharitis.<br />
This is by no means an exhaustive list, as there<br />
are many vitamins and trace elements that also<br />
have the potential to benefit eye health. With<br />
increased understanding of the antioxidant and<br />
antibiotic properties of some of these “natural”<br />
compounds, there is a lot of potential for<br />
producing a new generation of novel and effective<br />
eye treatments.<br />
References<br />
1. Deinema LA et al. A randomised, double masked,<br />
placebo-controlled clinical trial of two forms of omega-3<br />
supplements for treating dry eye disease. Ophthalmol.<br />
2017;124(1): 43-52.<br />
2. Ambati RR et al. Astaxanthin: sources,<br />
extraction,stability,biological activities and its<br />
commercial applications- a review. Mar.Drugs. 2014; 12:<br />
128-152.<br />
3. Falsini B et al. Influence of saffron supplementation on<br />
retinal flicker sensitivity in early age-related macular<br />
degeneration. IOVS. 2010; 51(12): 6118-6124.<br />
4. Nasri H et al. Turmeric: a spice with multifunctional<br />
medicinal properties. J.HerbMed.Pharm. 2014; 3(1): 5-8.<br />
*Grant Watters (MScOptom) is an honorary teaching fellow<br />
in the Department of Optometry and Vision Science and an<br />
honorary research fellow in the Department of Ophthalmology<br />
at the University of Auckland<br />
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17
SPECIAL FEATURE: NUTRITION<br />
Meet the … Ocular nutritionist<br />
BY JAI BREITNAUER<br />
Andrea Braakhuis is a registered dietitian<br />
with a PhD from the University of Auckland.<br />
Her work with antioxidants triggered her<br />
interest and research into the impact of what we<br />
eat on eye health.<br />
We’re all busy, but Braakhuis takes the meaning<br />
of the word to a new level, not because she has<br />
more on her schedule than any other passionate<br />
scientist, but because of the level of energy and<br />
vigour she brings with her. A former senior sport<br />
dietitian for the United States Olympic Committee,<br />
as well as NZ’s own Olympic team, Braakhuis now<br />
lectures to nutrition and dietetic students at the<br />
University of Auckland while running her own<br />
research projects, including in the application of<br />
dietary antioxidants and phytochemicals.<br />
“I’ve got a particular interest in polyphenols. Those<br />
are the ones found in red wine, eggplant and berries,”<br />
she says. “The ones the media always write about.<br />
My PhD looked specifically at their use within diet.”<br />
From that research, Braakhuis noted that in studies<br />
involving rabbits, it appeared polyphenols had a<br />
positive impact on eye health. “Not a lot of research<br />
has been done in this area,” she says. “In fact, there<br />
isn’t a whole lot of research going into preventative<br />
medicine for eye health; it’s mostly reactive. I wanted<br />
to see what effect, if any, polyphenols might have on<br />
the outcome of ocular disease.”<br />
Braakhuis notes, that a large and growing<br />
number of New Zealanders, and people globally,<br />
are suffering from debilitating ocular diseases,<br />
such as glaucoma. Slower progression of these<br />
diseases could be linked to diet, she says.<br />
“I started with a meta-analysis of other studies.<br />
We looked at existing published literature to<br />
see whether the use of flavonoids, powerful<br />
antioxidants found in fruit and veg, correlated<br />
with an improvement to visual acuity.”<br />
Her team started with 16,840 articles dating back<br />
to 1980 and, by removing duplicates and applying<br />
specific criteria regarding the participants, whittled<br />
these down to six articles in the meta-analysis and a<br />
further two in the systematic review – a total of 286<br />
participants. This analysis demonstrated that visual<br />
acuity was recorded as improved in those who<br />
consumed flavonoid supplements for two months<br />
or more. The poorer the visual acuity to start with,<br />
the better the result.<br />
“Although there is some discussion about what<br />
increased visual acuity actually means, in my<br />
opinion these findings are clinically relevant. The<br />
improvement was high enough to be relevant to<br />
the patients, and this is very positive indeed.”<br />
Braakhuis then went on to conduct her own, New<br />
Zealand-based small<br />
survey, to try to obtain<br />
a picture of what is<br />
happening here. “I used<br />
participants from the<br />
university optometry<br />
clinic with oxidative<br />
stress disease, and a<br />
control group from<br />
audiology, weeding<br />
out any crossovers of<br />
course.”<br />
Dr Andrea Braakhuis<br />
Together with<br />
her co-researchers, Ryan Raman and Dr Ehsan<br />
Vaghefi, Braakhuis asked participants to complete<br />
a questionnaire about their diet over previous<br />
months. The team wanted the 78 participants<br />
from optometry and the control group of 149 to<br />
note the frequency of consumption of 31 specific<br />
food items. The questionnaire was based on a prior<br />
study from the University of Melbourne with a few<br />
local inclusions, such as kumara.<br />
“We found that those with a high meat intake<br />
were also those with progressive ocular disease,”<br />
says Andrea. “The fruit and vegetable intake was<br />
higher in the control group, as was the consumption<br />
of oils and lipids. These results, while from a small<br />
cohort, were similar to those of the much larger<br />
clinical study performed in Melbourne.”<br />
Braakhuis’ conclusions were simple<br />
and are seemingly common sense: that a<br />
healthy diet higher in fruit and veg is going<br />
to be better for eye health.<br />
“In fact, the benefits of such a diet for<br />
full body health have been confirmed by<br />
a number of papers,” she says. “But high<br />
meat consumption does seem to correlate<br />
specifically with eye disease.”<br />
Despite these clear findings, there is still<br />
very little work being done to push the<br />
importance of good diet on patients with<br />
ocular disease. Braakhuis would like to see<br />
a cross-departmental group of specialists<br />
working on this, but it’s been a tricky<br />
project to get off the ground, she says.<br />
“It would be great to get a collective of experts<br />
working together on this issue, but it is very<br />
complex because it involves deep research into<br />
areas like digestion and absorption and the impact<br />
of gut bacteria. I think that puts some people off<br />
even though the benefit for our ageing population<br />
of good (dietary) advice could be huge.”<br />
Despite this, Braakhuis’ interest in the link<br />
between diet and good eye health has not<br />
diminished. “I’m currently developing an idea<br />
around a link between diet and eye strain,<br />
especially in certain populations and ethnic<br />
groups. With the incredible increase in myopia, I<br />
think this will be of great interest.” ▀<br />
Dealing with brain injury<br />
Eight kiwis crossed the Tasman to be a part<br />
of the audience at the Neuro-Optometric<br />
Vision Rehabilitation Seminar in Sydney from<br />
2-3 December. Attendees from across Australasia<br />
and further afield gathered to hear Dr Charles<br />
Shidlofsky, a specialist neuro-developmental<br />
optometrist from Texas, USA, discuss the vision<br />
consequences, treatment and management of<br />
patients sustaining an acquired/traumatic brain<br />
injury (ABI), as a part of the Australasian College<br />
of Behavioural Optometrists’ annual continuing<br />
education series.<br />
Optometrists with specific interest in neurooptometric<br />
rehabilitation are being increasingly<br />
sought out as a part of multi-disciplinary medical<br />
<strong>2018</strong><br />
SAVE THE DATE<br />
BY EVAN BROWN*<br />
teams assisting patients rehabilitate from acquired<br />
brain injury. Visual dysfunction following ABI is<br />
common¹, with a wide variety of symptoms related<br />
to vision reported² , ³ including headaches, vertigo,<br />
diplopia, visual fatigue, focusing difficulty, movement<br />
of print on the page when reading, difficulty tracking,<br />
sensitivity to light, reduced field of vision, reduced<br />
depth perception, reduced colour vision perception,<br />
spatial disorientation, altered sense of midline,<br />
difficulty with posture and balance, delayed reaction<br />
time and impaired memory.<br />
This neuro-optometric weekend seminar covered<br />
the common vision deficits and sequelae secondary<br />
to brain injury, expanded upon the specialised<br />
neurological testing that assists diagnostic<br />
EDITION <strong>2018</strong><br />
28 TH SEPTEMBER-1 ST OCTOBER<br />
silmoparis.com<br />
evaluation and discussed<br />
the treatment options<br />
available for patients<br />
sustaining a brain injury,<br />
including specialist<br />
prescribing of lenses,<br />
prisms, tints and filters,<br />
sector patching options<br />
and the use of neurooptometric<br />
vision therapy.<br />
Injury to the striate<br />
cortex of the occipital<br />
cortex, cranial nerve palsy<br />
and orbital wall fractures<br />
are well recorded in<br />
the literature. But the<br />
bimodal process of vision,<br />
involving ambient and<br />
focal processing, and the role of the magnocellular<br />
projections in processing motion, extending spatial<br />
mapping to the visual process of orientation and<br />
anti-gravity, are now more clinically relevant in<br />
understanding how injury to the cortical and<br />
sub-cortical mechanisms (that organise vision<br />
and its integration with other sensory and<br />
motor processes) can result in subtle, but lifechanging<br />
symptoms seen in patients with ABI<br />
and concussion. Notably, 90% of individuals with<br />
concussion will have one or more visual symptoms,<br />
with 40% experiencing visual symptoms for<br />
longer than three months. Not addressed,<br />
these symptoms result in delayed recovery and<br />
significant difficulty in undertaking daily living<br />
activities, including returning to work.<br />
The weekend was a great success and all<br />
participants took home clinical pearls they were<br />
able to place into practice immediately. For those<br />
wanting further exposure to continuing education<br />
in neuro-optometric practice in brain injury,<br />
consider attending the annual conference of the<br />
Neuro-Optometric Rehabilitation Association<br />
(https://noravisionrehab.com/) or cross the<br />
Tasman next April to attend the ICBO conference<br />
‘Establishing the Future’. For more, visit: https://<br />
www.acbo.org.au/professionals/menu/events/91-<br />
icbo-<strong>2018</strong>-establishing-the-future ▀<br />
References:<br />
1. Risdall JE, Menon DK. Traumatic brain injury. Philos Trans<br />
R Soc Lond B Biol Sci. 2011;366(1562):241-250.<br />
2. Sabates NR, Gonce MA, Farris BK. Neuro-Ophthalmological<br />
findings in closed head injury. J Clin Neuroophthalmol.<br />
1991;11(4):273-277.<br />
3. Cockerman GC, Goodrich JL, Weichel ED, et al. Eye and<br />
visual function in traumatic brain injury. J Rehabil Res Dev.<br />
2009;46(6):811-818<br />
*Evan Brown is a certified behavioural optometrist with specific<br />
interest in visual dysfunctions related to learning and paediatric<br />
optometry. He is co-lecturer for the ACBO Practical Vision<br />
Therapy Programme and clinical co-director for the NZ Special<br />
Olympics Healthy Athletes Opening Eyes Programme (see<br />
associated story p14.)<br />
HVO and Face & Cie<br />
Howick Village Optometrists (HVO) held<br />
a promotional evening event on the 21<br />
November 2017 to showcase the new Face<br />
& Cie range of frames. Clients were invited to<br />
the practice, which has been providing eye wear<br />
products to the Howick community since the<br />
1960s, to view the largest collection of Face & Cie<br />
frames and faceplates in Australasia.<br />
“We invited some patients who already have the<br />
product and couldn’t wait to see the entire range,”<br />
said HVO co-owner Frith Jenkins. “Other attendees,<br />
who were new to the product, had a ball talking<br />
to those already converted and swapping and<br />
trying on each other’s clip-ons. It was a fabulous<br />
opportunity for our clients to interact with the<br />
supplier, giving tremendous feedback.”<br />
The event was a resounding success with 90% of all<br />
invitees attending, and many frames and more than<br />
60 clip-on fronts sold, all in just three hours. “Having<br />
so many clients in the shop, laughing and chatting<br />
to each other was fun; great for Howick Village<br />
Optometrists client relationships!” said Jenkins.<br />
Kiwis at the ACBO neuro conference: Niall McCormack, Renee Edgar, Paul Dickson, Nicola Boyce, Evan Brown,<br />
Sita Thakersi, Ricky Lee and Richard Shanks (front)<br />
Howick Village clients trying on Face & Cie<br />
“Face & Cie continues to grow in this market as<br />
more and more people wear them, get enthusiastic<br />
about them and share their enthusiasm with<br />
the people they mix with. It’s the best form of<br />
marketing,” said David Bearpark from Little Peach,<br />
the exclusive distributor for Face & Cie in New<br />
Zealand. ▀<br />
For more news from Little Peach see p24.<br />
18 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
Help your patients<br />
their pristine clean lenses<br />
For both<br />
HARD and<br />
soft contact<br />
lenses<br />
Acquaint your patients<br />
with the next level<br />
of lens care<br />
• Recommended for HARD<br />
lenses (e.g. OrthoK, RGP)<br />
and soft lenses<br />
• Preservative and irritant-free 1<br />
• Excellent disinfection 2<br />
• Exclusive HydraGlyde ®<br />
technology gives soft lenses<br />
long lasting moisture from<br />
morning till night 3-5<br />
PERFORMANCE DRIVEN BY SCIENCE <br />
ALWAYS READ THE LABEL. USE ONLY AS DIRECTED.<br />
References: 1. Alcon data on file. Preservative-free position paper. 2. Gabriel M et al. Invest Opthalmol Vis Sci 2015;56(7):272. 3. Muya L et al. Wetting<br />
substantivity of a new hydrogen peroxide disinfecting solution on silicone hydrogel contact lenses. Poster #50 presented at BCLA 2015; Liverpool, UK.<br />
4. Alcon data on file, 2014. CSR for protocol C-13-003. 5. Lally J et al. A new lens care solution provides moisture and comfort with today’s CL’s. Optician<br />
04/01/2011;241(62960):42–46.<br />
© <strong>2018</strong> Novartis. Alcon Laboratories (Australia) Pty. Ltd. ABN 88 000 740 830. Australia Phone: 1800 224 153.<br />
New Zealand Phone: 0800 101 106. 01/18 ALC0803 NP4: A21711744129<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
19
Focus<br />
on Business<br />
Dos and don’ts of online<br />
and social marketing<br />
Your practice is part of a<br />
dynamic community, so<br />
keeping your services top-ofmind<br />
can be a challenge. Mobile<br />
phones have overtaken desktop<br />
computers as the primary device for<br />
web search and people are spending<br />
increasingly more time online,<br />
especially connected to social media.<br />
Thus, marketing your practice has<br />
evolved to include all sorts of digital<br />
aspects, even for more traditional<br />
methods. Sending out recall letters<br />
or still running print and radio ads?<br />
Even loyal patients are likely to<br />
check out your website and do some<br />
comparative online searches now<br />
before responding.<br />
Seek and you shall find<br />
In the early days of Google, Yahoo<br />
and Internet Explorer, it was the wild<br />
west of advertising, occupied mainly<br />
by large corporations using the “spray<br />
and pray” approach, putting out as<br />
many ads as possible. Fast forward 20<br />
years and there has been a massive<br />
shift to local search, especially<br />
given platforms such as Google My<br />
Business, designed to empower small<br />
business owners with tools such as<br />
Google Maps, Google Reviews and<br />
Google Ads, which can be targeted to<br />
your own database.<br />
The physical aspects of your<br />
practice are now well represented<br />
online: Google and Facebook know<br />
your business location and create<br />
a listing for you automatically. This<br />
is taken a step further with health<br />
directory websites looking to play a<br />
role in guiding patients to healthcare<br />
providers.<br />
You need to know what both new<br />
and existing patients experience<br />
when they come to visit your practice.<br />
Explore their patient journey online<br />
and the digital touchpoints they use<br />
to know what prompted them to visit<br />
and how you can better represent<br />
your practice online.<br />
Tips and tricks for online search<br />
Definitely dos<br />
• Ensure your online message is<br />
“click-worthy”. Online searches<br />
will result in clicks to your website<br />
homepage or specific content page.<br />
Ensure your message is clear, looks<br />
good and provides compelling<br />
reasons to visit your practice<br />
• Optimise your Google Maps listing.<br />
New patients often use location as<br />
a deciding factor, so ensure your<br />
images, keywords and address are up<br />
to date<br />
• Acquire some positive Google<br />
Reviews<br />
Definitely don’ts<br />
• When running ads on Google,<br />
avoid depleting your budget by using<br />
common, and therefore expensive,<br />
keywords. Use the Google keyword<br />
search tool instead to identify hot<br />
pockets of search activity related to<br />
brands you sell or a clinical service<br />
you provide<br />
• Don’t be tempted to generate your<br />
own online reviews by staff or family<br />
members. Google knows to look for<br />
irregular or disingenuous activity<br />
and will penalise you by dropping<br />
your Google search ranking<br />
Every post has a purpose<br />
Back in late 2005, Facebook rolled<br />
BY ROBERT SPRINGER*<br />
out across the globe and two years<br />
later, company pages were launched<br />
and businesses started to get to<br />
grips with this new media.<br />
In <strong>2018</strong>, it would be unusual for<br />
a business not to have a Facebook<br />
page. It serves the same purpose<br />
as your website: to represent your<br />
practice online, but with the added<br />
benefit of built-in traffic generating<br />
capabilities. Reaching patients<br />
with your message has become<br />
easier, because of the trust and<br />
transparency that comes with social<br />
media. Every post has a purpose,<br />
to engage and inspire your target<br />
audience.<br />
Tips and tricks for social media<br />
marketing<br />
Definitely dos<br />
• Be interesting to your target<br />
audience: know your audience and<br />
post accordingly<br />
• Create posts that are “boostworthy”.<br />
For only a few dollars you<br />
can ensure your post is seen by<br />
a new audience, generating new<br />
patient prospects<br />
• Assign a dedicated person, even<br />
for a few hours per week, to measure<br />
and monitor<br />
• Post regularly using the<br />
“Goldilocks” rule: not too much, such<br />
that you’ll struggle to come up with<br />
new content, and not too little, with<br />
the minimum being once per month<br />
to keep an active online presence<br />
Definitely don’ts<br />
• Don’t rely heavily on re-posted<br />
content. Facebook rewards you with<br />
greater reach when you post original<br />
content<br />
• Don’t worry about the possible<br />
downsides of comments or online<br />
reviews. The Facebook reviews<br />
module can be inactivated and all<br />
posts can be moderated. This puts<br />
you fully in control of your online<br />
reputation and allows you to capture<br />
the tremendous upside of social<br />
word-of-mouth<br />
• Don’t use your personal Facebook<br />
profile to represent your practice.<br />
Post and comment only with your<br />
practice page<br />
Your digital advantage<br />
The benefit of digital marketing<br />
and consumer online activity is<br />
that it leaves a digital footprint. You<br />
can measure if your methods are<br />
working and this allows you to focus<br />
on specific audiences and techniques<br />
generating the best response. As a<br />
business promoting eye health, the<br />
latest eye care and eyewear, this is a<br />
huge advantage for you. You’ve got a<br />
service that benefits nearly everyone<br />
in your local area, it’s just a matter of<br />
how to get your message out.<br />
ABOUT THE AUTHOR:<br />
Robert Springer<br />
is the technical<br />
director of<br />
OptomEDGE,<br />
an optometryfocused<br />
marketing<br />
agency covering<br />
campaigns,<br />
printed and<br />
digital recalls,<br />
and patient<br />
communications. To get in touch and learn<br />
more, please call: +64 9 889 3179 or email<br />
ask@optomedge.co.nz<br />
In Cameroon with Orbis<br />
BY ANITA GERBER-SETZ*<br />
Orbis is the world’s only accredited<br />
teaching flying eye hospital. It<br />
was set up in 1982 by American<br />
ophthalmologist Dr David Paton who felt<br />
that if people were not able to travel to<br />
increase their knowledge, then the next<br />
best thing would be to travel to where the<br />
knowledge and skills are needed.<br />
Over time, Orbis has evolved from<br />
upskilling ophthalmologists and nurses to<br />
providing hands on training for biomedical<br />
engineers, orthoptists and optometrists.<br />
It organises study symposiums with guest<br />
speakers and, with the advent of the<br />
internet, has also established Cybersight<br />
to enable information to be exchanged<br />
remotely, including triaging of patients for<br />
future programmes and timely advice for<br />
difficult cases.<br />
A core group of staff including nurses,<br />
doctors, anaesthetists, administration<br />
staff, engineers and mechanics fly regularly<br />
with the new MD-10 plane, which replaced the aging DC-10<br />
last year. People like me, and other visiting professionals also<br />
join the team for a week or two to share knowledge and skills<br />
with overseas colleagues.<br />
For this trip, Orbis was again invited by Philémon Yang,<br />
the prime minister of Cameroon, to come for four weeks to<br />
strengthen the clinical and operational capacity of Orbis’<br />
partner hospitals, Yaoundé Central Hospital and Magrabi<br />
ICO Cameroon Eye Institute. The government hospital is<br />
a large hospital with limited resources, while Magrabi is<br />
newly built with better resources, but with doctors who have<br />
limited surgical experience. Cameroon is home to 25 million<br />
people with about 73 ophthalmologists to treat the main<br />
causes of avoidable blindness namely cataract, glaucoma,<br />
onchocerciasis, trachoma with corneal scarring, and refractive<br />
error. Because of the number of people, the scarce resources<br />
and under-qualified staff, screening and referral of eye disease<br />
and access to quality eye care remains a great challenge.<br />
On the ground in Yaoundé<br />
Whilst in Cameroon, I had the opportunity to work on the<br />
Orbis airplane for one week and in the local hospital for one<br />
week. My week on the airplane coincided with world sight day<br />
on 12 October which was very appropriate.<br />
Every Monday is screening day. Patients are chosen according<br />
to the best teaching cases for the widest audience. They are<br />
thoroughly screened and anaesthesia always has the last word<br />
on patient suitability. The screening process also includes<br />
patient education and media consent as well as the relevant<br />
tests and diagnostics for surgery.<br />
While the bulk of the trainees were in the class room at the<br />
front of the plane, one local doctor assisted the surgeon. The<br />
operation was televised via a live feed to the classroom. The<br />
visiting ophthalmologist would talk through the surgery and<br />
take questions as they were operating. The sub-specialties<br />
focused on in my first week were paediatric strabismus under<br />
general anaesthetic and trabeculectomy with MMC and SICS.<br />
While this was happening, anaesthetic and nursing trainees<br />
were participating in learning opportunities at the back<br />
of the plane while admitting patients, administering local<br />
BOOK REVIEW<br />
anaesthetic and caring for patients, post-anaesthesia. The<br />
plane is a very compact place and it is always a hive of activity!<br />
After surgery, patients were driven back to the local<br />
hospital by ambulance and seen post-operatively by the staff<br />
ophthalmologist. The traffic in Yaoundé is alarming to say the<br />
least and there are not too many times in my life where I have<br />
had a police escort to and from my place of work!<br />
My second week in the local hospital was a sober reality<br />
check after the state-of-the-art flying eye hospital. The<br />
local hospital had no recovery area, which meant general<br />
anaesthesia patients had to be recovered in theatre. Working<br />
together, the Orbis recovery room nurses and the local nurses<br />
created a pre and post-operative area which functioned well,<br />
despite no air conditioning!<br />
During the second week, the three sub-specialties the local<br />
doctors wished to have more training in were oculoplastics<br />
and, again, glaucoma and SICS. Our cataract specialist<br />
from Maulana Azad Medical College, India, Dr Ruchi<br />
Goel’s experience with small incision cataract surgery was<br />
phenomenal, having operated on hundreds of Indian patients.<br />
The oculoplastics surgeon, Dr Thomas Johnson from the<br />
University of Miami Miller School of Medicine, was a veteran<br />
of Orbis’ programmes, both on the plane and in local hospitals.<br />
He was well used to teaching with the aid of an interpreter and<br />
the local trainees were like sponges: engaged and enthusiastic,<br />
especially those who worked with us in the operating theatre.<br />
French and English are the official languages in Cameroon with<br />
more people speaking French, so my high school French got a<br />
good work out!<br />
An enormous amount of planning and work goes into<br />
programmes like this, with many people wholeheartedly<br />
contributing. This was an amazing and humbling experience<br />
for me, not least because of the people we were able to help,<br />
but also the spirit of cooperation between local professionals<br />
and Orbis personnel. The teamwork, camaraderie and<br />
dedication, demonstrated time and again by everyone, made<br />
this programme a great success. ▀<br />
*Anita Gerber-Setz, RN, BN, OND, is the Clinical Nurse Manager and passionate<br />
ophthalmic nurse with Christchurch Eye Surgery, which she’d like to thank for<br />
being so supportive of her trip to Cameroon with Orbis<br />
Review of Ophthalmology (third edition) and Case Reviews<br />
of Ophthalmology (second edition)<br />
by Neil J. Friedman, Peter K Kaiser, and William B Trattler<br />
REVIEWED BY DR JINA HAN*<br />
The Review of Ophthalmology, third edition, by Drs Neil<br />
Friedman, Peter Kaiser and William Trattler, has quickly become<br />
one of my favourite textbooks. It is a one-stop comprehensive<br />
review book, richly filled with concise bullet points of key<br />
information.<br />
The 11 chapters cover all subspecialties as well as optics,<br />
pharmacology, embryology, anatomy and pathology. With a<br />
strong clinical focus, it walks the reader through pertinent<br />
symptoms, findings, diagnosis and treatment. The book<br />
is visually well designed with a nice flow and consistent<br />
formatting throughout. The text is in concise bullet points,<br />
which makes the read easy-to-digest and follow. There are high<br />
quality clinical and histological images and large illustrations<br />
are used to demonstrate concepts and anatomy.<br />
New to this edition are clinical scenario-based review<br />
questions at the end of every chapter. These multiple-choice<br />
style questions provide a nice breather from reading factual<br />
information and are helpful to consolidate learning.<br />
Perhaps the most impressive feature of this book are the<br />
generous sections summarising findings of key clinical studies.<br />
These allow the reader to rapidly access up-to-date, evidencebased<br />
treatment and management information across all<br />
subspecialty areas.<br />
With 416 pages in total, and at more or less A4 paper size,<br />
the book is too large to be readily portable. However, the eBook<br />
companion can be viewed on your mobile or laptop and is easily<br />
Anita Gerber-Setz and fellow Orbis, nurse, Elisa from Peru, on their first day operating in Cameroon on the MD-10<br />
accessible to all book<br />
owners through a<br />
unique code supplied<br />
within each cover. The<br />
online version is easy<br />
to navigate and allows the reader to make notes alongside each<br />
section, magnify images to a sufficient resolution full screen<br />
and perform useful searches.<br />
For readers in exam preparation, this book would pair very<br />
well with a question bank. It is also worth pairing this third<br />
edition with its sister book, ‘Case Reviews in Ophthalmology,<br />
second edition’, which contains more than 140 case scenarios<br />
covering the most relevant ocular conditions and basic sciences,<br />
in a similar format to RANZCO’s advanced clinical examinations<br />
(RACE). The eBook companion can be used like flash cards and<br />
there are large photos to highlight the key aspects of diagnosis<br />
for each case.<br />
Overall, both of these texts have a clear clinical focus,<br />
with concise relevant content and high-quality illustrations.<br />
Although these books may be most useful for ophthalmic<br />
trainees preparing for clinical examinations, they would make<br />
an excellent resource for any reader in eye care interested in<br />
reviewing ocular conditions quickly and efficiently.<br />
*Dr Jina Han is a clinical research fellow in cornea and anterior segment diseases<br />
in the Department of Ophthalmology, University of Auckland. She is currently<br />
pursuing her MD on preoperative risk stratification and works closely with the<br />
anterior segment team at the Auckland District Health Board, as well as at the<br />
Eye Institute, Auckland, with Professor Charles McGhee.<br />
20 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
SPARK THERAPEUTICS INC<br />
Luxturna: costly but welcomed<br />
The US Food and Drug Administration (FDA)<br />
has fast-tracked and approved a novel gene<br />
therapy, Luxturna (voretigene neparvovecrzyl),<br />
to treat patients with a rare form of inherited<br />
vision loss that can result in blindness.<br />
The news was welcomed by advocacy group<br />
Retina International and international retina<br />
specialists, including Auckland-based Associate<br />
Professor Andrea Vincent.<br />
“This represents a very exciting milestone in the<br />
treatment of inherited retinal diseases,” said A/<br />
Prof Vincent. “There is a complex surgical procedure<br />
that has been developed to deliver this gene<br />
therapy. Therefore, it is likely at this point, that any<br />
patient would have to travel overseas to receive this<br />
Gene therapy research at Spark Therapeutics<br />
treatment, although expertise exists in Australia.”<br />
Luxturna has been approved in the US for<br />
the treatment of patients with confirmed<br />
biallelic RPE65 mutation-associated retinal<br />
dystrophy that leads to vision loss and may cause<br />
complete blindness. The condition is rare, with<br />
approximately 1,000 to 2,000 patients believed<br />
to suffer from it in the US and just a few in New<br />
Zealand. Only two individuals have been identified<br />
in the New Zealand Database of Inherited Retinal<br />
Diseases, confirmed A/Prof Vincent.<br />
Though the new treatment was welcomed,<br />
many international commentators however, are<br />
questioning the cost of treatment. Manufacturer<br />
Spark Therapeutics announced the cost at a<br />
whopping US$425,000 per eye at the end of last<br />
year, not including surgery costs, reigniting the<br />
cost of medicines debate in the US.<br />
“(In New Zealand) application would have to<br />
be made on a case-by-case basis,” said A/Prof<br />
Vincent. “However, as RPE65 retinal disease<br />
affects very young children, the socioeconomic<br />
cost of supporting and educating severely visually<br />
impaired children for the duration of their life<br />
is not insignificant, and therefore this likely<br />
represents a cost benefit.”<br />
But the cost shouldn’t detract from what is an<br />
incredible scientific breakthrough, she added. “This<br />
is a very exciting advancement for the treatment of<br />
inherited retinal diseases and the lessons learnt from<br />
[the trials] have allowed many other gene therapies<br />
for retinal degenerations to advance more rapidly.”<br />
The RPE65 gene provides instructions for making<br />
an enzyme that is essential for normal vision.<br />
Thus, Luxturna works by delivering a normal copy<br />
of the RPE65 gene directly to retinal cells using<br />
a naturally occurring adeno-associated virus,<br />
which has been modified using recombinant DNA<br />
techniques. These retinal cells then produce the<br />
protein that converts light to an electrical signal in<br />
the retina to restore patient’s vision loss.<br />
“[This] approval marks another first in the field<br />
of gene therapy — both in how the therapy works<br />
and in expanding the use of gene therapy beyond<br />
the treatment of cancer to the treatment of vision<br />
loss,” said FDA commissioner Dr Scott Gottlieb in a<br />
statement. “I believe gene therapy will become a<br />
mainstay in treating, and maybe curing, many of<br />
our most devastating and intractable illnesses.”<br />
Congratulating those involved in Luxturna’s<br />
development, Christina Fasser, president of Retina<br />
International, said the news marks the beginning<br />
of “an exciting and hopeful new era in the<br />
development of treatments.”<br />
More about this incredible new treatment will<br />
be revealed at the Retina International meeting<br />
in Auckland this month (see box) as one of the<br />
keynote speakers is Dr Jean Bennett, a lead<br />
researcher on Luxturna and an ophthalmologist at<br />
the University of Pennsylvania’s Perelman School<br />
of Medicine. Others senior researchers involved<br />
in Luxturna’s development include Dr Bennett’s<br />
husband, Dr Albert Maguire, an ophthalmologist<br />
at The Children’s Hospital of Philadelphia (CHOP)<br />
and Dr Katherine High, president and chief<br />
scientific officer at Spark Therapeutics.<br />
Retina <strong>2018</strong> in Auckland<br />
The 20th Retina International World Congress<br />
is being held in the Owen G Glenn Building at<br />
the University of Auckland from 10-11 <strong>Feb</strong>ruary.<br />
The Congress will bring together some of the<br />
world’s foremost retinal scientists and clinicians<br />
along with global leaders in patient advocacy<br />
and peer support. It is aimed at anyone<br />
interested retinal disorders.<br />
The scientific programme, organised<br />
by Associate Professor Andrea Vincent,<br />
covers two days with a variety of sessions,<br />
including keynote addresses given by leading<br />
international researchers, plenary sessions,<br />
patient-focused sessions and education for<br />
healthcare professionals and scientists.<br />
For more and to register, go to http://<br />
retina<strong>2018</strong>newzealand.com<br />
APVRS 2017 and an<br />
update on Eylea<br />
BY A/PROF PHILIP POLKINGHORNE*<br />
The 11th Asia-Pacific Vitreo-retina Society<br />
(APVRS) Congress was held in December<br />
in Kuala Lumpur, hosted by the Malaysian<br />
Society of Ophthalmology. Enthusiastic hosts,<br />
beautiful Asian food, the latest technology from<br />
sponsoring companies and a scientific programme<br />
to interest all, greeted some 2000 delegates.<br />
The Congress was held in the Malaysian National<br />
Convention Centre, just opposite the Petronas Twin<br />
Towers. James Bond wasn’t in town, but the Tano<br />
lecture delivered by Professor Taraprasad Das from<br />
India on endophthalmitis following cataract surgery,<br />
attracted a large audience. The other named<br />
lectures were equally well-supported, delivering and<br />
sharing a wealth of information with the region. It<br />
is great to go and listen to experts who have clearly<br />
identified problems and can offer some solutions<br />
based on clinically published evidence, modified<br />
by real life experience. Quoting to a patient with<br />
diabetic macular oedema that Eylea will get you<br />
back to driving standard 18 months faster than a<br />
generic anti-VEGF, for example, as demonstrated<br />
by Bayer’s Vivid study, may have great relevance for<br />
your patient.<br />
I also enjoyed the first-hand experience of the<br />
investigators on Bayer’s Clarity Study (the latest<br />
update published in The Lancet in May 2017) who<br />
reported on how aflibercept (Eylea) was superior<br />
to panretinal photocoagulation for proliferative<br />
diabetic retinopathy. Maybe my days hunched over<br />
a laser are coming to an end! Perhaps I can cancel<br />
my scheduled appointments with my chiropractor?<br />
In addition to the named lectures, the Congress<br />
programme included a number of masterclass<br />
sessions covering such topics as the timing of<br />
intervention for eyes that have suffered significant<br />
trauma. There was also a masterclass session on<br />
the surgical management of diabetic eye disease<br />
and assessment of retinopathy of prematurity. This<br />
cluster of talks was aimed at the general retinal<br />
specialist and those just starting out, to let them<br />
know about the latest findings.<br />
There were also sessions for the more<br />
technologically-geeky on new applications on<br />
different devices, artificial intelligence, robotic<br />
developments and software programmes designed<br />
to help with mass screening. There were plenty<br />
of free papers as well, reporting on all manner of<br />
studies from Asia and beyond.<br />
The results of the Planet study into the<br />
management of that variant of age-related macular<br />
degeneration, namely PCV (polypoidal choroidal<br />
vasculopathy) were also presented in Kuala Lumpur.<br />
While this disease is likely to be more prevalent<br />
in Asia as opposed to New Zealand, it is being<br />
increasingly recognised here. Essentially, after two<br />
years, the Planet study demonstrated that Bayer’s<br />
anti-VEGF treatment aflibercept is effective as<br />
a monotherapy for PCV patients and had better<br />
outcomes than a combination therapy of anti-VEGF<br />
and photodynamic therapy.<br />
The Asia Pacific Vitreo-retinal Society is only about<br />
Drs Andrew Thompson and Jim Borthwick with Bayer’s Christie Murzello<br />
(middle) in Kuala Lumpur<br />
a decade old, formed as the result of a conversation<br />
between APVRS secretary-general, Professor Dennis<br />
Lam, and the late Professor Yasuo Tano from Japan.<br />
It is now a fully mature society hosting not only<br />
the annual meeting but supporting colleagues<br />
throughout the region. One APVRS programme I<br />
was especially interested in, was the mentoring<br />
scheme, where experienced VR surgeons team up<br />
with newbies from developing countries to offer<br />
advice and support online. The ability to transfer<br />
images internationally, means a colleague working<br />
by him or herself in more remote regions, for<br />
example, can obtain another opinion from someone<br />
who might have encountered something similar.<br />
Equally, a more experienced colleague’s literary<br />
knowledge may help a colleague who has less<br />
access to a well-resourced library.<br />
The medium-term goal of APVRS is to get onto<br />
an even footing with Euretina and the American<br />
Society of Retinal Specialists. With the growth<br />
of specialists in the region, together with the<br />
encouragement and support of younger colleagues<br />
– as evidenced by the mentoring programme and<br />
travelling scholarships etc. – I think that goal will be<br />
achieved in the very near future.<br />
The next APVRS meeting is in Seoul, South Korea<br />
on 14-16 December <strong>2018</strong> and I would recommend<br />
retinal colleagues attend. ▀<br />
*Dr Philip Polkinghorne is an associate professor in the<br />
Department of Ophthalmology at the University of Auckland,<br />
a visiting lecturer at Otago University and a consultant<br />
ophthalmologist with Auckland Eye and the Greenlane Clinical<br />
Centre. A specialist in retinal, vitreo-retinal and cataract surgery,<br />
he also has subspecialty training in medical and surgical retina<br />
and is active in clinical and basic science research.<br />
Robotic delivery system<br />
for retinal cells<br />
A<br />
team of researchers from Moorfields Eye<br />
Hospital and the UCL Institute of Healthcare<br />
Engineering in the UK have been awarded<br />
£1.1 million to develop a robotic system to replace<br />
damaged retinal cells in people with age-related<br />
macular degeneration (AMD).<br />
The system will be supported by advanced<br />
imaging techniques, such as OCT-A, allowing<br />
surgeons to deliver new retinal cells with precision,<br />
said Professor Lyndon da Cruz, Moorfield’s<br />
ophthalmologist and clinical lead for the project.<br />
LEAVE A LEGACY<br />
OF VISUAL FREEDOM.<br />
TECNIS ®<br />
PRESBYOPIA-CORRECTING IOLs<br />
“Significant<br />
progress<br />
in cellular<br />
therapy<br />
has meant<br />
we are one<br />
step closer<br />
to restoring<br />
sight and improving AMD patients’ quality of life.<br />
However, this cannot be realised without effective<br />
cellular delivery.” ▀<br />
TECNIS is a trademark owned by or licensed to Abbott Laboratories, its subsidiaries or affiliates. All other trademarks are the intellectual property of their respective owners.<br />
AMO Australia Pty. Limited. Level 3, 299 Lane Cove Road, Macquarie Park, NSW 2113. AMO Australia Pty. Limited (Incorporated in Australia) PO Box 401, Shortland Street, Auckland, 1140.<br />
© 2017 Abbott Medical Optics Inc. | www.vision.abbott | PP2016CT1775<br />
AMO20530 Tecnis PICOLs Adv_A4.indd 1<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
21<br />
14/3/17 10:00 am
for optometrists and eye care professionals<br />
with<br />
Professors Charles<br />
McGhee & Dipika Patel<br />
Series Editors<br />
Iris melanoma: a review<br />
BY AMY CLUCAS AND DR JENNIFER COURT*<br />
Iris naevi are common, making up to 63% of<br />
melanocytic iris tumours found in adults 1 .<br />
In contrast, iris melanomas are rare, making<br />
up only 2-8% of all uveal melanomas 2 . Most are<br />
believed to arise from iris naevi, with an estimated<br />
transformation rate of 4% over 10 years, and 11%<br />
over 20 years 3 . Iris melanoma typically display<br />
two patterns of growth, circumscribed or diffuse.<br />
Progress tends to be slow – either locally along the<br />
surface of the iris, locally into the anterior chamber<br />
or invading into the ciliary body 4 . Metastases of<br />
iris melanoma occurs in up to 10% of cases over<br />
20 years and are influenced by factors such as<br />
the cytology of the tumour, increased age of the<br />
patient and angle involvement. This renders the<br />
distinction between naevus and melanoma, and<br />
then the different histological subtypes, clinically<br />
important.<br />
Iris naevi – The ABCDEF Guide 3<br />
Certain clinical features of iris naevi have been<br />
identified as indicators of increased risk for<br />
transformation into iris melanoma. A study done<br />
by Shields et al, which analysed 1611 consecutive<br />
patients with an initial diagnosis of iris naevus,<br />
developed ‘The ABCDEF Guide’ – a mnemonic for<br />
remembering factors predictive of transformation:<br />
A – age < 40 years, B – blood (hyphaema), C – clock<br />
hour inferior, D – diffuse, E – ectropion uveae, F –<br />
feathery margin 3 . While the mnemonic is helpful,<br />
important features are missing such as large size,<br />
nodule formation, elevated intra-ocular pressure<br />
and prominent intralesional vasculature 5 .<br />
The use of sequential photographs via slit lamp<br />
photography is extremely helpful for monitoring<br />
the size and growth of iris lesions. The frequency<br />
at which these photographs should occur depends<br />
on if there are features present which make the<br />
naevi higher risk and whether there is a history<br />
of suspected recent change. Should any changes<br />
in naevi be noticed, referral for ophthalmic<br />
review is advised. Just as patients are educated to<br />
monitor their cutaneous naevi, they should also<br />
be encouraged to monitor their iris naevi for any<br />
obvious changes if possible.<br />
Epidemiology of iris melanoma<br />
The prevalence of iris melanoma is increasing 6 .<br />
The estimated incidence of iris melanoma in New<br />
Zealand is 0.09/100,000 per year 6 , which is slightly<br />
higher than the estimated European incidence<br />
(0.02-0.08/100,000 per year) 7 . This may be<br />
attributed to the higher amount of solar radiation<br />
experienced in New Zealand. The superior part<br />
of the iris, which is better protected from UV<br />
radiation by the upper eyelid, rarely experiences<br />
iris melanoma 6 .<br />
The average age of patients with iris melanoma<br />
is 64 years of age 8 , with an equal distribution<br />
between male and females 9 . Risk factors include<br />
pre-existing iris naevi, fair skin with cutaneous<br />
naevi and non-brown coloured irises 8 . One<br />
study found 4% of patients diagnosed with iris<br />
melanoma had a history of skin melanoma 10 .<br />
Presentation<br />
The most common presentation of iris melanoma<br />
is the sudden rapid growth of a previously<br />
existing pigmented iris lesion. Most of these<br />
tend to be brown in colour (65.6%), but also exist<br />
as amelanotic (9.9%) or multi-coloured (9,9%) 8 .<br />
The shape is most commonly nodular (78.4%) as<br />
Fig 1. Diffuse iris melanoma associated with ectropion uveae and distortion of the pupil<br />
opposed to flat (21.6%) and existing in the inferior<br />
clock face (78.4%) 9 . Common associated features<br />
include a corectopia (the drawing of the pupil from<br />
its usual central position, 62%), ectropion uveae<br />
(44%), intrinsic tumour vessels (43%), hyphaema<br />
(9%) secondary glaucoma and tumour induced<br />
cataract (14%) 5 .<br />
Histology<br />
Iris melanomas can be divided into three broad<br />
histological categories: spindle- cell, epithelioidcell<br />
and mixed – with spindle-cell tumours<br />
being the most common and carrying the best<br />
prognosis 9 . Mixed or epithelioid tumours have<br />
been found to have an estimated eight times<br />
higher risk of mortality 8 .<br />
Management of iris melanoma<br />
The course of management for iris melanoma<br />
depends on many factors, including the size of<br />
the tumour, invasion into the anterior chamber<br />
angle and the presence of melanoma-related<br />
complications such as raised intraocular pressure.<br />
An initial thorough inspection of the lesion is<br />
recommended, followed by an investigation<br />
for involvement of surrounding structures,<br />
including the anterior chamber, angle, lens<br />
and cornea 5 . Diagnostic procedures such as<br />
ultrasound biomicroscopy and anterior segment<br />
optical coherence tomography (OCT) are useful<br />
for differentiating between cystic and solid<br />
lesions 10 , as well as assessing the ciliary body<br />
for involvement. Ultrasound-guided fine-needle<br />
aspiration biopsy to confirm cytology can also play<br />
a role in guiding the course of management.<br />
Watchful waiting<br />
Watchful waiting is an option for lesions that are<br />
slow growing or have been histologically identified<br />
as composed of spindle type-A cells. These<br />
melanomas have a very low risk of local invasion<br />
and metastasis 11 .<br />
Surgical Excision<br />
For lesions identified as being localised and<br />
without evidence of tumour seeding, local<br />
excision via iridectomy or iridocyclectomy is an<br />
appropriate choice of management. For these<br />
patients, the most common post-operative<br />
complaint is glare – experienced in up to 25%<br />
of cases 12 . This can be managed with either a<br />
pupil reconstruction or tinted glasses. Other<br />
complications include incomplete excision of the<br />
lesion, a dislocated lens, cataract progression and<br />
post-operative glaucoma 4 .<br />
Radiotherapy<br />
Radiotherapeutic approaches to iris melanoma<br />
include proton beam therapy and plaque<br />
radiotherapy. Proton beam therapy involves a<br />
highly collimated external beam that uses protons<br />
instead of x-rays 13 . Plaque radiotherapy is a disc<br />
of radioactive material (commonly Iodine 125)<br />
delivering localised trans-corneal radiotherapy to<br />
an iris lesion 14 . Indications for radiotherapy include<br />
residual tumour following surgical excision,<br />
tumour recurrence and diffuse or multifocal<br />
involvement. Radiation-induced side effects<br />
are common. Shields et al reported at five years<br />
following treatment, patients developed cataracts<br />
(70%), corneal conditions (9%) and neovascular<br />
glaucoma (8%) 14 . An additional complication<br />
specific to proton beam therapy is limbal stem cell<br />
deficiency 12 .<br />
A review done by Popovic et al 12 comparing<br />
the radiotherapeutic and surgical management<br />
of iris melanoma found that radiotherapeutic<br />
approaches are now being used more frequently<br />
(proton beam 49.4%, plaque 31.4%) than surgical<br />
resection (19.2%). Other findings included<br />
lower rates of local recurrence and metastatic<br />
development with radiotherapy (0-5%) than<br />
surgery (0-14%, including enucleation). However,<br />
surgical management tended to show lower rates<br />
of cataract and glaucoma development following<br />
treatment and avoids the radiotherapeutic specific<br />
complications such as limbal stem cell deficiency 12 .<br />
Enucleation<br />
Enucleation is reserved as a last resort treatment<br />
for tumours that show aggressive recurrence,<br />
extensive growth and invasion, poor vision<br />
potential and uncontrollably high intraocular<br />
pressure with pain 12,14 .<br />
Summary<br />
Fig 2. Gonioscopy image of an iris melanoma abutting the angle<br />
There is considerable overlap between the<br />
features of iris naevus and melanoma, warranting<br />
monitoring of naevi by patients and their families,<br />
optometrists and ophthalmologists. The use<br />
of radiotherapeutic approaches are becoming<br />
more popular, with studies showing lower rates<br />
of recurrence and metastases compared to local<br />
surgical excision. However, this must be balanced<br />
against the higher rates of common complications<br />
such as cataract, glaucoma and limbal stem cell<br />
deficiency. Given the rarity and heterogeneity of<br />
iris melanoma, there remains a need for more<br />
research regarding its monitoring and optimum<br />
timing for intervention. ▀<br />
References:<br />
1. Shields, Carol L., et al. “Clinical survey of 3680 iris tumors<br />
based on patient age at presentation.” Ophthalmology<br />
119.2 (2012): 407-414.<br />
2. Shields, Carol L., et al. “Clinical spectrum and prognosis<br />
of uveal melanoma based on age at presentation in 8,033<br />
cases.” Retina 32.7 (2012): 1363-1372.<br />
3. Shields, Carol L., et al. “Iris nevus growth into melanoma:<br />
analysis of 1611 consecutive eyes: the ABCDEF guide.”<br />
Ophthalmology 120.4 (2013): 766-772.<br />
4. Conway, R. M., et al. “Primary iris melanoma: diagnostic<br />
features and outcome of conservative surgical treatment.”<br />
British journal of ophthalmology85.7 (2001): 848-854.<br />
5. Shields, Carol L., et al. “Iris melanoma: risk factors for<br />
metastasis in 169 consecutive patients.” Ophthalmology<br />
108.1 (2001): 172-178.<br />
6. Michalova, Kira, et al. “Iris melanomas: are they<br />
more frequent in New Zealand?.” British journal of<br />
ophthalmology 85.1 (2001): 4-5.<br />
7. McGalliard, J. N., and P. B. Johnston. “A study of iris<br />
melanoma in Northern Ireland.” British journal of<br />
ophthalmology 73.8 (1989): 591-595.<br />
8. Khan, Samira, et al. “Clinical and pathologic<br />
characteristics of biopsy-proven iris melanoma:<br />
a multicenter international study.” Archives of<br />
Ophthalmology130.1 (2012): 57-64.<br />
9. Jakobiec, Frederick A., and Glenn Silbert. “Are most iris’<br />
melanomas’ really nevi?: A clinicopathologic study of<br />
189 lesions.” Archives of Ophthalmology99.12 (1981):<br />
2117-2132.<br />
10. Pavlin, Charles J., et al. “Ultrasound biomicroscopy of<br />
anterior segment tumors.” Ophthalmology 99.8 (1992):<br />
1220-1228.<br />
11. Geisse, Lawrence J., and Dennis M. Robertson. “Iris<br />
melanomas.” American journal of ophthalmology 99.6<br />
(1985): 638-648.<br />
12. Popovic, Marko, et al. “Radiotherapeutic and surgical<br />
management of iris melanoma: A review.” Survey of<br />
ophthalmology (2017).<br />
13. Rahmi, Ahmed, et al. “Proton beam therapy for<br />
presumed and confirmed iris melanomas: a review of 36<br />
cases.” Graefe’s Archive for Clinical and Experimental<br />
Ophthalmology 252.9 (2014): 1515-1521.<br />
14. Shields, Carol L., et al. “Iris melanoma management<br />
with iodine-125 plaque radiotherapy in 144 patients:<br />
impact of melanoma-related glaucoma on outcomes.”<br />
Ophthalmology 120.1 (2013): 55-61.<br />
15. Shields, Carol L., et al. “Custom-designed plaque<br />
radiotherapy for nonresectable iris melanoma in 38<br />
patients: tumor control and ocular complications.”<br />
American journal of ophthalmology 135.5 (2003): 648-656.<br />
About the authors<br />
IMAGES COURTESY OF PROFESSOR CHARLES MCGHEE<br />
Fig 3. (a) Iris melanoma with visible incisional biopsy site; (b) following excisional biopsy; (c) following phacoemulsification and insertion of an intraocular lens and artificial iris<br />
Amy Clucas<br />
Dr Jennifer Court<br />
*Amy Clucas is a medical student at the University of Auckland<br />
who developed an interest in ophthalmology on her two-week<br />
attachment last year. She completed a selective in ophthalmology<br />
with the Greenlane Clinical Centre’s eye department and says<br />
she’s looking forward to future experiences in the field.<br />
Dr Jennifer Court trained in ophthalmology in the UK. She is a<br />
cornea and anterior segment fellow at Greenlane Clinical Centre,<br />
Auckland.<br />
22 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
New education evening<br />
Class of 2017 graduates<br />
BY MICHAELLA DOLLING*<br />
We had our first<br />
of, hopefully,<br />
many educational<br />
evenings with local<br />
Hamilton ophthalmologist<br />
Dr Chris Murphy at the<br />
end November. Dr Murphy,<br />
an anterior eye specialist,<br />
informed attendees about<br />
the latest up-to-date<br />
techniques in pterygium,<br />
cataract and corneal crosslinking<br />
procedures and<br />
when, where and who to<br />
refer.<br />
After a lovely dinner and<br />
drinks in Victoria Street<br />
Bistro’s private rooms, Dr<br />
Murphy then ended the<br />
evening with a discussion<br />
about common corneal<br />
dystrophies and answered<br />
any questions we had.<br />
Places were limited for this first evening, but<br />
after great feedback, we will be arranging another<br />
evening this year.<br />
Attendees also received 2.5 CPD points. ▀<br />
New SOVS appointees<br />
The School of Optometry and Vision Science<br />
(SOVS) at the University of Auckland has<br />
announced three new appointments: Dr Sam<br />
Schwarzkopf as an associate professor and Drs<br />
Hannah Kersten and Phil Turnbull as lecturers.<br />
Professor Steven Dakin says it’s wonderful<br />
the School’s two new lecturers, Drs Kersten and<br />
Turnbull, both did their undergraduate degrees<br />
and PhDs at the University of Auckland. Their<br />
appointments, says Dakin, continues a proud<br />
tradition of New Zealand “growing its own” clinical<br />
vision scientists. The SOVS team is also excited to<br />
welcome Associate Professor Sam Schwarzkopf,<br />
who joins them from one of the world’s best<br />
psychology/neuroscience departments at<br />
University College London, says Prof Dakin.<br />
“These exceptionally talented young scientists<br />
will add value to the innovative teaching making<br />
up the BOptom programme and the world-class<br />
eye health research conducted within the School.”<br />
NZ Optics caught up with the new appointees<br />
to learn more about what attracted them to eye<br />
health.<br />
Associate Professor Sam Schwarzkopf<br />
A/Prof Schwarzkopf<br />
became interested<br />
in perceptual<br />
processing,<br />
especially in the<br />
visual domain,<br />
when he first learnt<br />
about neurobiology<br />
in high school,<br />
he says. “In my<br />
first year, in my<br />
neuroscience<br />
degree I read a<br />
A/Prof Sam Schwarzkopf<br />
textbook about<br />
visual perception and started to focus my interest<br />
in this area. I actually convinced my tutors to allow<br />
me to write an essay about it instead of answering<br />
the essay question everybody else had to answer.”<br />
Today, he says, he is driven by the mystery of how<br />
the brain turns sensory inputs into an experience.<br />
“Even though a lot of the general processes are<br />
fairly well studied, we still do not really know<br />
what determines how each person subjectively<br />
experiences the world.”<br />
A/Prof Schwarzkopf, who first visited New<br />
Zealand on his honeymoon, says he is looking<br />
forward to the change of environment his new<br />
appointment brings and he’s exited by New<br />
Zealand’s unique ethnic and cultural mix, which<br />
opens up opportunities of cross-cultural and<br />
population comparisons of perceptual function<br />
which few other countries can offer. “I am<br />
also excited to move back from a psychology<br />
department into a more biologically-oriented<br />
department. In some ways, this is going<br />
back to the roots for me as I was trained as a<br />
neurophysiologist, but of course my research will<br />
continue to have close links to psychology.”<br />
Dr Phil Turnbull<br />
Dr Turnbull, a former graduate from the University<br />
of Auckland optometry programme, says he’s<br />
Dr Chris Murphy (at the back) and attendees from the new Hamilton education evening<br />
Michaella Dolling is a locum optometrist who works in New<br />
Zealand, Australia and further afield. She organised this<br />
inaugural educational evening with Dr Chris Murphy after<br />
realising how much her travels have led her to appreciate both<br />
the ophthalmological talent in Hamilton and Hamilton itself.<br />
thrilled to be able<br />
to continue his<br />
clinical research<br />
career as a SOVS<br />
lecturer. He<br />
completed his<br />
PhD in the field<br />
of myopia with<br />
Dr John Phillips<br />
and, between<br />
feeding his<br />
octopus and squid<br />
research subjects,<br />
Dr Phil Turnbull<br />
pushed for better<br />
awareness of myopia control management and<br />
taught myopia control techniques to optometry<br />
students in the University Eye Clinic. His current<br />
research, however, investigates how new and<br />
emerging technologies, such as eye-tracking,<br />
virtual reality and electroretinography can be used<br />
in optometry and vision science, he says.<br />
“As a clinician scientist, I’m passionate about<br />
optometry, research and evidence-based medicine<br />
and try to infuse this into my teaching to inspire<br />
future optometrists. My class (of 2006) was the<br />
first year to have therapeutics included as part<br />
of the undergraduate degree and [we] have seen<br />
several expansions in the scope of the optometry<br />
profession. I hope my research will be able to<br />
contribute to the literature… help maintain the<br />
healthy outlook for the optometric profession,<br />
improve our understanding of vision science and<br />
benefit the broader community.”<br />
Dr Hannah Kersten<br />
A love of physics<br />
led Dr Hannah<br />
Kersten to do<br />
a Bachelor of<br />
Optometry, where<br />
she developed a<br />
strong interest<br />
in eye health.<br />
After graduating,<br />
she worked in<br />
a community<br />
optometry practice<br />
in Lower Hutt,<br />
before returning<br />
to Auckland to Dr Hannah Kersten<br />
take up a junior optic nerve research fellowship<br />
position in the Department of Ophthalmology.<br />
Since completing her doctoral thesis in 2016,<br />
she’s held a joint position between SOVS and the<br />
ophthalmology department, with her current<br />
research focusing on the identification of potential<br />
retinal and optic nerve biomarkers in early<br />
neurodegenerative disease.<br />
Dr Kersten says she’s excited about her new<br />
role, which allows her to develop an independent<br />
research career and expand her teaching practice,<br />
while contributing to the profession of optometry.<br />
“In addition, I am able to continue in my clinical<br />
role and further develop my areas of clinical<br />
expertise. I hope to solidify existing research<br />
collaborations and form new ones with fellow NZ-<br />
NEC researchers.” ▀<br />
The graduating class of 2017<br />
Entering to the powerful<br />
sound-track of Star Wars<br />
(the good side, that is,<br />
the dark side was reserved for<br />
the University’s professional<br />
teaching staff!), the graduating<br />
optometry class of 2017 entered<br />
Auckland Town Hall, bedecked<br />
in flowing black robes with royal<br />
blue collars. For the first time,<br />
optometry students graduated<br />
in November with their Faculty<br />
of Medical & Health Science<br />
colleagues from nursing and<br />
pharmacy. To herald this, the<br />
guest speaker was optometry’s<br />
own Paul Rose, CNZM.<br />
Inventor of the internationallyrecognised<br />
and sold Rose K<br />
brand of contact lenses for<br />
irregular cornea, Rose provided<br />
an uplifting speech about<br />
entrepreneurialism and being<br />
aware of “those lightbulb<br />
moments” as you never know<br />
where they might take you.<br />
“Innovation is challenging the<br />
status quo, that’s how we move<br />
forward in life.”<br />
After congratulating all the<br />
students on their hard work,<br />
adding that learning is an<br />
exciting journey that never ends,<br />
he reminded all the graduates<br />
to stay passionate about what<br />
they do as then, they will never<br />
be bored.<br />
Graduates were then<br />
presented with their certificates<br />
and prizes were awarded. Class of 2017 School of<br />
Optometry and Vision Science prize winners were:<br />
• Sean Mahendran – the Anna Pritchard Prize for<br />
optical dispensing<br />
• Jing Chen – the Raymond Harry Hawkins Prize for<br />
undergraduate optometry research<br />
• Theantay Keo and Kishan Mistry – first in the<br />
Carla Louise Ngo Sy, Astha Rai, Zhen Lim and Linda Lin<br />
Keynote speaker Paul Rose addresses the 2017 graduates in Auckland’s Town Hall<br />
Hong Low, Sherin Varughese, Sean Mahendran, Rahul Kumar and Eva Woodward<br />
NZCO Prize for project presentation<br />
• Joyce Mathan, Bridget Field and Bianca Davidson<br />
– second in the NZCO Prize for project presentation<br />
• Sharifeh Safdari – Excellence in Clinical<br />
Optometry Prize<br />
• Bianca Davidson – Senior Scholar<br />
• Bianca Davidson – Dean’s Medal ▀<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
23
Style-Eyes<br />
Magical metal makes a<br />
come back<br />
BY COURTNEY ELDER*<br />
Anyone who’s been in the eyewear industry,<br />
or any occupation related to fashion<br />
for that matter, for any length of time,<br />
know styles are cyclical. People who grew up<br />
in the 1950s and 1960s and needed vision<br />
correction more than likely wore cat-eye shapes<br />
or clubmaster styles, and they always tend to<br />
laugh with familiarity when they see these looks<br />
displayed as the latest new thing in their local<br />
optometrists.<br />
Millennials who wore glasses in middle school,<br />
more than likely weren’t thrilled with round<br />
frames that typically had a faux tortoise shell<br />
print on them. But, at the time, there wasn’t much<br />
else to choose from. Imagine their surprise when<br />
they see these exact frames making a comeback<br />
and turning into eyewear’s latest trend!<br />
On a broader scale, bold acetate frames have<br />
been the go-to for the visually impaired for<br />
many years, and while the styles have slightly<br />
changed, the overall feel has not. Maybe you’ve<br />
already started to see the shift, but if you’re<br />
not following eyewear trends closely, get ready<br />
for what will seem like a surprising jump in a<br />
completely opposite direction.<br />
ProDesign Model 1291<br />
who want<br />
outrageous<br />
colors like lime<br />
green or hot<br />
pink can get<br />
exactly what<br />
they want from<br />
ProDesign’s<br />
ProDesign Axiom<br />
collection.<br />
Usually, ProDesign lovers tend to be bold and<br />
it’s not uncommon to encounter them saying<br />
they are on their fifth or sixth pair of these<br />
Danish beauties, so they are also quite possibly<br />
early adopters of this growing metal eyewear<br />
fashion.<br />
DITA<br />
Fashion update<br />
WOOW Wool<br />
WOOW, created by Face á Face in 2012, is celebrating its<br />
fifth anniversary by introducing the new WOOW Wool<br />
collection. The new collection stays true to the fun, upbeat<br />
spirit of the label, combining brightly coloured frames with<br />
vibrant matching patterns adorning the acetate temples,<br />
inspired by the iconic Argyle diamond sock design. All also<br />
feature “frame names” such as ‘Heat Up’ and ‘Be Hot’<br />
inside the temple tips. ‘Be Hot’ has light metal fronts and<br />
acetate temples and comes in two shapes and six colour<br />
combinations. Distributed by Eyes Right Optical,<br />
NZ agent CMI Optical.<br />
Ricky Martin dons Blackfin<br />
Celebrity singer Ricky Martin, wore a pair of<br />
Blackfin sunglasses during the Golden Globes<br />
‘Gold Meets Golden’<br />
after-party, which<br />
brings together<br />
Hollywood stars,<br />
professional athletes,<br />
Olympic champions,<br />
sponsors and rich<br />
listers to help<br />
generate awareness<br />
and support for<br />
sports-related<br />
causes. Distributed<br />
by Beni Vision.<br />
Superlight Airlock II<br />
With minimalistic style and modern designs, the<br />
new Airlock II Collection is crafted from superlight<br />
materials, providing ultimate comfort and<br />
durability to suit all faces, said US manufacturer<br />
Marchon Eyewear. It also features the company’s<br />
unique Dual Compression Mounting system,<br />
providing faster fabrication time and no-notch lens<br />
edges. Distributed by VSP Australia.<br />
William Morris strikes gold<br />
Readers who attended ADONZ in Christchurch<br />
last year had the opportunity to have a close look<br />
at William Morris’ new London Gold Collection.<br />
This elegant, lightweight collection includes nine<br />
exclusive, premium acetate styles, in retro inspired<br />
shapes with modern details. Acetate fronts are<br />
blended with gold metal finishes while stainless<br />
steel temples make them light weight and<br />
extremely durable, said the company. “To give the<br />
frames an exceptionally beautiful and long-lasting<br />
sheen, we use up to four layers of fine metals and<br />
then coat in a natural white palladium metal (to<br />
increase) the strength and durability of the stainless<br />
steel.” Distributed by Phoenix Eyewear. ▀<br />
Retro shapes are coming back into mainstream fashion<br />
Metal’s making a return<br />
For years, optical professionals touted the<br />
strength and durability of acetate frames and<br />
when this functional aspect blended in with the<br />
ability to choose from a variety of unique colors<br />
and designs, it’s no surprise plastic became the<br />
popular choice.<br />
But today, eyewear manufacturers across the<br />
globe seemed to have finally cracked the code<br />
when it comes to metal frames and are now<br />
starting to offer styles that vastly outperform the<br />
lifespan of their zyl counterparts and bring bold<br />
looks of their own.<br />
Here’s a few of my top picks today.<br />
Mykita<br />
Berlin designers have an edgy interpretation of metal frames<br />
Luxury eyewear shops around the world often<br />
boast that Mykita is one of their best-selling<br />
brands due to its clean design and incredible<br />
flexibility. When wearing glasses goes beyond<br />
just a fashion statement and wearers place an<br />
emphasis on all-day comfort, perceptions about<br />
metal frames seem to shift.<br />
From bold sunglasses to the ability to combine<br />
beautiful colors for a pretty and delicate look,<br />
this German eyewear company takes its craft<br />
seriously. Offering frames suitable for men,<br />
women and children, Mykita has begun to<br />
revolutionise the future of fashionable frames.<br />
ProDesign<br />
A staple for many optometrists and patients<br />
alike, the selection from ProDesign continues to<br />
show us that the future of fashion is in metals.<br />
People who are looking for elegant frames with<br />
intricate leaf work on the temples or those<br />
Genuine gold adds to the detailed metal work<br />
Tracing back to its Italian roots of high quality<br />
and luxury, Dita also seems to be on the<br />
forefront of fashion, using elegant finishes and<br />
materials to make metals feel truly sublime.<br />
People who love craftsmanship sometimes<br />
simply don’t get it when it comes to acetate<br />
frames.<br />
But with Dita, each hinge itself is made using<br />
over 40 pieces, often crafted from 14K gold. Just<br />
like other boutique eyewear brands, patients<br />
certainly get what they pay for (and pay for what<br />
they get) when it comes to this brand. But, just<br />
like the fans of ProDesign, die-hard lovers of Dita<br />
don’t seem to flinch at the price point.<br />
Part of the company’s strategy, that seems to<br />
really work, comes from morphing supple metals<br />
into retro shapes that strike a chord with anyone<br />
who has a penchant for vintage eyewear. Dita<br />
isn’t afraid to go big and bold with its metal<br />
collection and is certainly at the forefront of<br />
today’s metal eyewear collections.<br />
A time and a place<br />
The craftsmanship and creative designs displayed<br />
in today’s metal frames shouldn’t be underplayed,<br />
yet at the same time, it’s not like plastic styles are<br />
going by the wayside either. Plenty of eyewear<br />
manufacturers rely on bold and dark frames as<br />
staple pieces, but the increasing appeal of metal<br />
frames just can’t be ignored.<br />
As a glasses wearer of 20+ years and a gal who<br />
has always adored her plastic frames, I actually<br />
happily added a metal frame to my collection<br />
last year. It took some time getting used to<br />
nosepads, but it’s infused an entirely new<br />
element to my style that allows me to change<br />
things up when I want to. If it wasn’t for the<br />
new and innovative styles that I see from various<br />
brands across the world, I doubt I would’ve<br />
strayed from my tried and true acetates.<br />
*Courtney Elder has more<br />
than 10 years of optical<br />
experience and loves wearing<br />
fashionable eyewear in<br />
Portland, OR, USA. Today<br />
she owns a content creation<br />
company with her husband.<br />
Visit www.author-eyes.com for<br />
more info.<br />
Kosby tech now in NZ<br />
Little Peach have introduced the high-tech<br />
eyewear brand, Kosby, to New Zealand. Kosby<br />
eyewear incorporate a unique, and now<br />
patented, spring hinge, that springs both in and<br />
outwards to ensure both a comfortable and tight<br />
fit, that’s been rigorously tested to ensure it doesn’t<br />
come lose, says David Bearpark from Little Peach.<br />
Stars and their Eyes…<br />
Paul Holmes<br />
In 1973, at the age of 23, the late broadcaster<br />
and keen amateur pilot Sir Paul Holmes had a<br />
near-fatal accident injuring his optic nerve and<br />
causing permanent vision loss in his right eye.<br />
Close friend, Richard Griffin recalls fondly<br />
the white-knuckle moments flying with newly<br />
licensed, amateur, one-eyed pilot Sir Paul (with<br />
just 17 hours solo behind him). “He’d got over<br />
Egmont in a whiteout and he said, “F***, I think I<br />
just missed that mountain.”<br />
Sir Paul had lost his stereopsis since becoming<br />
monocular. “He couldn’t calculate distance from<br />
about 10 feet up. So, when you were coming in<br />
for landing, the last 10 feet were just a bit of a<br />
mystery, really. He used to drop it anywhere and<br />
sometimes it was perfect and sometimes it was<br />
hair-raising,” said Griffin in media reports.<br />
“We had four emergency landings and took out<br />
two fences. On one occasion, we took a fence with<br />
us without crashing. I still can’t believe that. I<br />
looked out to one side and there was the top wire<br />
The new hinge technology was developed over<br />
more than five years by two French optometrists, Guy<br />
Azoulay and Francis Kessous, and is now incorporated<br />
into their brand-new collection made from highquality<br />
stainless steel and acetate.<br />
“Coupled with a timeless, stylish look, Kosby frames<br />
are also extremely lightweight, making them some<br />
of the most comfortable frames on<br />
the market,” said Bearpark. “This<br />
highly technical brand collection is<br />
aimed primarily at men and women<br />
over the age of 35, who are happy<br />
to spend a little more if they can see<br />
quality and added value. We expect<br />
Kosby to become a major player in<br />
the independent optical market very<br />
quickly.” ▀<br />
For more see the ad on p8 and<br />
contact Little Peach (details in your<br />
<strong>2018</strong> OIG)<br />
of a fence trailing along. Paul said, “Jesus, we’ve got<br />
to be more careful.”<br />
Along with surviving a colourful radio and<br />
television career in the public eye, several plane,<br />
car and helicopter crashes, Sir Paul also endured<br />
several health battles. In an interview, he said “If<br />
you want to get through an experience, you’ve just<br />
got to grit your teeth and get through it.” He was<br />
knighted in 2013 two weeks before his death. ▀<br />
24 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
Chalkeyes presents…<br />
Seeing vs perceiving<br />
What every eye care practitioner should know about visual-perceptual processing problems. By Dr Sandra Tosta*<br />
In the world of optics, what an individual<br />
sees is of utmost importance and eye care<br />
professionals are impeccably trained to<br />
recognise and treat dysfunctions and anomalies<br />
related to the eye. The visual system, however,<br />
includes not just the eyes, but also the brain.<br />
Even when the eyes are functioning perfectly, the<br />
brain can have difficulty processing the visual<br />
information it receives. When this happens, what<br />
an individual “sees” can become like an optical<br />
illusion and a variety of difficulties ranging from<br />
reading problems to physical symptoms can result.<br />
Swirled print distortion suffered by some people with visual<br />
perception processing problems<br />
A common, but often mis – or unidentified<br />
condition<br />
Since 1980, research has repeatedly documented<br />
the presence of, and difficulties associated with, a<br />
little known perceptual processing problem known<br />
as Irlen Syndrome. Irlen Syndrome is a problem<br />
with how the brain interprets visual information.<br />
The condition affects 12-14% of the general<br />
population and up to 46% of individuals with<br />
reading and learning difficulties. It is characterised<br />
by a variety of physical symptoms exacerbated by<br />
environmental factors such as lighting, especially<br />
bright lights and fluorescents, and computer<br />
screens, iPhones, white paper, white boards,<br />
high-contrast and visually-intensive activities.<br />
Unfortunately, eye care professionals are unfamiliar<br />
with the warning signs of Irlen Syndrome. As a<br />
result, many individuals with this condition go<br />
unidentified and never receive proper intervention<br />
for their visual-perceptual processing problems.<br />
Drs Ricardo and Marcia Guimaraes are<br />
ophthalmologists at the largest eye hospital in<br />
Brazil and researchers at the country’s second<br />
largest university. According to their research,<br />
the basic difference between the current<br />
optometric assessments and those required to<br />
identify visual-perceptual processing disorders<br />
is, “besides checking the static abilities granted<br />
by the parvocellular system and related to visual<br />
acuity (special resolution, refraction, intraocular<br />
pressure, biomicroscopy and fundoscopy, cover<br />
testing, OCT, etc.), it is necessary to also consider<br />
the performance of the eye under dynamic<br />
conditions.” Thus, the absence of a dynamic<br />
assessment protocol means Irlen Syndrome is not<br />
picked up during standard optometric exams.<br />
How to tell if Irlen Syndrome might be<br />
part of the problem<br />
Individuals with Irlen Syndrome will often<br />
complain of light sensitivity associated with<br />
sunlight, bright lighting, fluorescent lights,<br />
headlight and glare. They may also have reading<br />
problems, as reading becomes inefficient and they<br />
Irlen specs: the coloured-lenses help with visual processing<br />
Ongoing research by Drs Adam Anderson and Eve De Rosa at Cornell<br />
University’s shows over-active brain function when Irlen Syndrome<br />
sufferers wear a blank lens that normalizes when proper precisiontinted<br />
coloured filters are worn<br />
may need to re-read for comprehension or build<br />
breaks into reading. High-contrast (black print<br />
on white paper) and visually-intensive activities,<br />
create high levels of stress for the brain that<br />
trigger physical symptoms which may include<br />
headaches and migraines. Brain imaging, both<br />
SPECT scans and fMRI, of individuals with this<br />
condition shows over-activity, complex brain<br />
patterns and non-normalised functioning. This<br />
results in a variety of issues, including difficulties<br />
reading because of a lack of print stability,<br />
issues with glare or discomfort from the white<br />
background on the printed page, problems with<br />
depth perception and physical symptoms, such as<br />
headaches, nausea, dizziness, brain fog, anxiety,<br />
strain and fatigue.<br />
What we know about Irlen Syndrome<br />
Over 100 scientific studies on the topic have<br />
established a hereditary component of the<br />
disorder 1-3 , a number of biochemical markers for<br />
problems associated with Irlen Syndrome 4-6 , and<br />
differences in brain function between individuals<br />
with and without the condition 7-11 . Precisiontinted<br />
coloured filters have been found to<br />
normalise abnormal brain activity and eliminate<br />
issues with print clarity and stability, physical<br />
symptoms, and light sensitivity associated with<br />
the condition 12-21 . Although originally thought<br />
to be associated solely with reading problems,<br />
research has linked visual processing difficulties<br />
to a range of other disorders, including ADHD<br />
(attention deficit hyperactivity disorder), ASD<br />
(autism spectrum disorders), learning disabilities,<br />
anxiety and certain emotional and psychological<br />
issues 22-24 . Visual processing challenges also<br />
overlap with other neurological conditions, such<br />
as migraines and tourette’s 8, 25 .<br />
How eye care professionals can help: the<br />
need for comprehensive care<br />
While binocular and accommodative anomalies<br />
may occur in conjunction with Irlen Syndrome,<br />
they are not considered to be the underlying<br />
physiological basis of the condition 26-29 . As such,<br />
comprehensive care of individuals suffering from<br />
Irlen Syndrome needs to include assessment<br />
and correction of eye-related dysfunctions and<br />
anomalies by an eye care professional before any<br />
assessment for Irlen Syndrome. Specific assessment<br />
and intervention for the neurologic dysfunction<br />
related to Irlen Syndrome ensures that both eyeand<br />
brain-related issues are being addressed.<br />
A short pre-screening questionnaire can help<br />
identify individuals who might be at risk for<br />
Irlen Syndrome and most eye-care professionals<br />
can be trained to both identify and address Irlen<br />
Syndrome in their clients. ▀<br />
For more information about Irlen Syndrome,<br />
visit www.irlen.com or contact Sarah Bycroft, the<br />
national director for Irlen NZ, on 09 414 4484 or<br />
sarah@irlen.nz.<br />
References:<br />
1. Loew, S.J., & Watson, K. (2012). A prospective genetic marker<br />
of the visual perception disorder Meares–Irlen syndrome.<br />
Perceptual and Motor Skills, 114(3), 870-882.<br />
2. Robinson, G.L., Foreman, P.J., & Dear, K.G.B. (2000). The familial<br />
incidence of symptoms of Scotopic sensitivity/Irlen syndrome:<br />
comparison of referred and mass-screened groups. Perceptual<br />
and Motor Skills, 91, 707-724.<br />
3. Robinson, G.L., Foreman, P.J., Dear, K.G.B., and Sparkes, D.<br />
(2004). The Family Incidence of a Visual-Perceptual Subtype of<br />
Dyslexia. Nova Science Publishers, 27-40.<br />
4. Robinson, G.L., Roberts, T.K., McGregor, N.R., Dunstan, R.H.,<br />
& Butt, H. (1999) . Understanding the causal mechanisms of<br />
visual processing problems: a possible biochemical basis for<br />
Irlen Syndrome? Australian Journal of Learning Disabilities,<br />
4(4), 21-29.<br />
5. Robinson, G.L., McGregor, N.R., Roberts, T.K., Dunstan, R.H., &<br />
Butt, H. (2001). A biochemical analysis of people with chronic<br />
fatigue who have Irlen syndrome: speculation concerning<br />
immune system dysfunction. Perceptual and Motor Skills, 93,<br />
486-504.<br />
6. Sparks, D.L., Robinson, G.L., Dunstan, H., & Roberts, T.K. (2003).<br />
Plasma cholesterol levels and Irlen Syndrome: preliminary<br />
study of 10- to 17-yr., old students. Perceptual and Motor Skills,<br />
97, 745-752.<br />
7. Chouinard, B.D., Zhou, C.I., Hrybouski, S., Kim, E.S., Cummine,<br />
J. (2012). A functional neuroimaging case study of Meares-Irlen<br />
syndrome/visual stress (MISViS) Brain Topography, 25 (3), pp.<br />
293-307.<br />
8. Huang, J., Zong, X., Wilkins, A., Jenkins, B., Bozoki, A., Cao, Y.<br />
(2011). fMRI evidence that precision ophthalmic tints reduce<br />
cortical hyperactivation in migraine. Cephalagia, 31(8):925-36.<br />
9. Lewine, J.D., Irlen, H.L., & Orrison, W.W. (1996). Visual evoked<br />
magnetic fields in Scotopic sensitivity syndrome. (Available<br />
from New Mexico Institute of Neuroimaging. The New Mexico<br />
Regional Field Medical Center: Albuquerque, NM).<br />
10. Riddell, P. M., Wilkins, A. and Hainline, L. (2006) The effect of<br />
colored lenses on the visual evoked response in children with<br />
visual stress. Optometry and Vision Science, 83 (5). pp. 299-305.<br />
11. Yellen, A. (2010). Irlen syndrome: a case study. Los Angeles<br />
Psychologist, May-June,16-18.<br />
12. Bouldoukian, J., Wilkins, A.J., & Evans, Bruce J.W. (2002).<br />
Randomised controlled trial of the effect of coloured overlays on<br />
the rate of reading of people with specific learning difficulties.<br />
Ophthalmological and Physiological Optics, 22, 55-60.<br />
13. IMAIZUMI, S., HIBINO, H., & KOYAMA, S. (2016). Effect of<br />
Colored Overlays on Reading Comfort in People with and<br />
without Meares-Irlen Syndrome. International Journal of<br />
Affective Engineering, 15(1), 21-28.<br />
14. Kim, J. H., Seo, H. J., Ha, S. G., & Kim, S. H. (2015). Functional<br />
Magnetic Resonance Imaging Findings in Meares-Irlen<br />
Syndrome: A Pilot Study. Korean Journal of Ophthalmology,<br />
29(2), 121-125.<br />
15. Nobel, J., Orton, M., Irlen, S., & Robinson, G. (2004). A controlled<br />
field study of the use of coloured overlays on reading<br />
achievement. Australian Journal of Learning Disabilities, 9(2)<br />
14-22.<br />
16. Park, S.H., Kim, S., Cho, Y.A., Joo, C. (2012). The Effect of Colored<br />
Filters in Patients with Meares-Irlen Syndrome. J Korean<br />
Ophthalmol Soc. 2012 Mar;53(3):452-459.<br />
17. Huang, J., Zong, X., Wilkins, A., Jenkins, B., Bozoki, A., Cao, Y.<br />
(2011). fMRI evidence that precision ophthalmic tints reduce<br />
cortical hyperactivation in migraine. Cephalagia, 31(8):925-36.<br />
18. Loew, S. J., Rodríguez, C., Marsh, N. V., Jones, G. L., Núñez, J. C.,<br />
& Watson, K. (2015). Levels of Visual Stress in Proficient Readers:<br />
Effects of Spectral Filtering of Fluorescent Lighting on Reading<br />
Discomfort. The Spanish journal of psychology, 18, E58.<br />
19. Robinson, G.L., & Conway, R.N.F. (2000). Irlen lenses and adults:<br />
a small scale study of reading speed, accuracy, comprehension<br />
and self-image. Australian Journal of Learning Disabilities, 5,<br />
4-13.<br />
20. Whiting, P., Robinson, G.L., & Parrot, C.F. (1994). Irlen coloured<br />
filters for reading: a six year follow up. Australian Journal of<br />
Remedial Education, 26, 13-19.<br />
21. Kim, J. H., Seo, H. J., Ha, S. G., & Kim, S. H. (2015). Functional<br />
Magnetic Resonance Imaging Findings in Meares-Irlen<br />
Syndrome: A Pilot Study. Korean Journal of Ophthalmology,<br />
29(2), 121-125.<br />
22. Loew, S. J., & Watson, K. (2013). The prevalence of symptoms<br />
of scotopic sensitivity/Meares-Irlen syndrome in subjects<br />
diagnosed with ADHD: Does misdiagnosis play a significant<br />
role?. Hrvatska revija za rehabilitacijska istraživanja,<br />
49(Supplement), 64-72.<br />
23. Irlen, H. (1991). Reading by the Colors. New York: Avery Press.<br />
24. Irlen, H. (2010) The Irlen Revolution: A Guide to Changing Your<br />
Perception and Your Life. New York: SquareOne Publishers.<br />
25. Ludlow, A. K., & Wilkins, A. J. (2016). Atypical Sensory<br />
behaviours in children with Tourette’s Syndrome and in<br />
children with Autism Spectrum Disorders. Research in<br />
Developmental Disabilities, 56, 108-116.<br />
26. Evans, B.J.W., Patel, R., Wilkins, A.J., Lightstone, A., Eperjesi, F.,<br />
Speedwell, L., & Duffy, J. (1999). A review of the management of<br />
323 consecutive patients seen in a specific learning disabilities<br />
clinic. Ophthalmological and Physiological Optics, 19(6), 454-<br />
466.<br />
27. Evans, B. J. W., Wilkins, A. J., Brown, J., Busby, A., Wingfield,<br />
A., Jeanes, R., & Bald, J. (1996). A preliminary investigation<br />
into the aetiology of Meares-Irlen syndrome. Ophthalmic and<br />
Physiological Optics, 16(4), 286-296.<br />
28. Evans, B. J. W., Wilkins, A. J., Busby, A., & Jeanes, R. (1996).<br />
Optometric characteristics of children with reading difficulties<br />
who report a benefit from coloured filters. In C. M. Dickinson,<br />
I. J., Murray, & D. Garden (Eds.), John Dalton’s colour legacy (pp.<br />
709-715). London : Taylor and Francis.<br />
29. Scott, L., McWhinnie, H., Taylor, L., Stevenson, N., Irons, P.,<br />
Lewis E., Evans, M., Evans, B., & Wilkins, A. (2002). Coloured<br />
overlays in schools: orthoptic and optometric findings.<br />
Ophthalmological and Physiological Optics, 22, 156-165.<br />
*Sandra Tosta, PhD, is head of research for the Perceptual<br />
Development Corporation at the Irlen Institute’s international<br />
headquarters. She holds a Bachelor of Science in Human<br />
Development from Cornell University and a PhD in Educational<br />
Psychology from the University of California, Los Angeles<br />
(UCLA). As a senior researcher at the Hypothesis Group for<br />
nearly a decade, she focused on research related to children<br />
and education. She has authored a variety of papers on Irlen<br />
Syndrome and related topics. For more information about the<br />
Irlen Institute and the Irlen Method, please visit www.irlen.com.<br />
FLEYE Copenhagen is the first eyewear brand to blend<br />
carbon fibres and natural wood in one glasses frame.<br />
For the Carbon Wood Collection<br />
we have constructed the frame<br />
front with 23 paper-thin layers of<br />
carbon fibre and 1 layer of wood,<br />
taking innovative eyewear design<br />
to a completely new level. Flexible<br />
beta-titanium temples and acetate<br />
tips ensures optimal comfort for<br />
the wearer.<br />
For more information please<br />
contact your local New Zealand<br />
Sales rep, Tracey Dobson.<br />
E-mail: tracey@fleye.com.au,<br />
Tel. no. +64 21 655573<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
25
VOSO in Tonga<br />
Volunteer Opthalmic Services Overseas (VOSO) spent<br />
a week in Tonga at the end of last year at the Vaiola<br />
Hospital in Nukuʻalofa. The VOSO team was led by<br />
VOSO chair Dr Andrew Riley and included Dr Hussain Patel,<br />
VOSO secretary Kylie Dreaver and trustee Hywel Bowen. The<br />
team was based at the hospital and was fortunate in having<br />
the opportunity to meet the King of Tonga, King Tupou VI.<br />
VOSO worked closely with local staff, including Dr Duke<br />
Mataka, whom VOSO supported to come from Fiji to work<br />
with the team.<br />
The surgeons set a record for the number of surgical<br />
procedures performed in a week’s trip to Tonga, and the<br />
newly donated autorefractor was a great asset to train<br />
staff and better manage unusual refraction cases, reported<br />
Dreaver. The most memorable case was an undiagnosed<br />
diabetic patient, who initially presented with septicaemia<br />
then developed red eye. As he had had uveitis previously, he<br />
was treated with steroids, but was diagnosed by the VOSO<br />
team with orbital cellulitis and suspected endogenous<br />
endophthalmitis, she said.<br />
“It has been nine years since I last went to Tonga on a<br />
VOSO trip and I was blown away by the changes. The new<br />
building was clean, tidy, well-equipped and air-conditioned.<br />
The staff could do and manage so much more than before.<br />
In fact, their scope of practice is greater than mine! I take my<br />
hat off to Dr Andrew Riley who has been volunteering and<br />
heading the trips to Tonga for the last consecutive 11 years.”<br />
VOSO supplied 100 surgical kits for IOLs; 800 recycled<br />
glasses, including sunglasses; a donated chair and stand;<br />
plus lots of other optometric equipment that will be used<br />
in the Hospital’s eye department and outlying clinics. The<br />
donated glasses were processed by the Lions Club and the<br />
surgical equipment was purchased with funds raised at Dine<br />
by Donation at Merediths in November. The month was<br />
fully-booked and raised an amazing $11,377, said Dreaver.<br />
Sadly, though, there will be no more Dine by Donations as<br />
Merediths has been sold.<br />
VOSO is on the lookout for more ophthalmologist<br />
volunteers, so if you would like to get involved, please visit:<br />
www.voso.org.nz ▀<br />
Some of the VOSO 2017 team, including chair Dr Andrew Riley (third from right), Kylie Dreaver (centre, behind)<br />
and Hywel Bowen (centre, front)<br />
MORE CLASSIFIEDS ON PAGE 28<br />
LOCUM<br />
OPTOMETRIST<br />
Paterson Burn Optometrists is looking for an experienced TPA<br />
qualified Optometrist to join our team on a locum basis. This position<br />
is flexible and requires you to provide cover at any of our Waikato<br />
branches during extremely busy periods and covering staff holidays.<br />
DISPENSING OPTICIAN/<br />
OPTICAL ASSISTANT CAMBRIDGE<br />
This is an exciting fixed-term opportunity offering you a great<br />
working environment, state-of-the art equipment, continuous<br />
support and professional development opportunities.<br />
To be successful in this role you will have experience as a<br />
Dispensing Optician / Optical Assistant, be confident, enthusiastic<br />
and have a friendly, natural and consultative approach to selling.<br />
This position is a fixed-term 12-month contract covering maternity<br />
leave with the possibility of a permanent position within the<br />
group. This position is full-time, based in Cambridge and requires<br />
some Saturday work.<br />
DISPENSING OPTICIAN/<br />
OPTICAL ASSISTANT HAMILTON<br />
Paterson Burn Optometrists Hamilton is looking for an enthusiastic<br />
Dispensing Optician/Optical Assistant/Visual Therapist. The ideal<br />
candidate will have previous experience working in the Visual<br />
Therapy field or have a strong interest in working with children.<br />
In this role, you will be working closely with our Optometrists with<br />
special interests in children’s vision, be responsible for running<br />
visual therapy block courses with patients while still being part of<br />
the dispensing team.<br />
The successful applicant will need to be confident with engaging<br />
communication skills and experienced in the optical industry.<br />
Ongoing training will be provided. This position is full-time<br />
including some Saturdays.<br />
DISPENSING OPTICIAN/<br />
PRACTICE MANAGER NEWMARKET<br />
Paterson Burn Newmarket is looking for a Dispensing Optician/<br />
Practice Manager to take control of the day-to-day running of the<br />
practice while providing the best visual solutions available to our<br />
patients.<br />
The successful applicant will need to be confident with engaging<br />
communication skills and experienced in the industry. Ongoing<br />
managerial training will be provided.<br />
This position is full-time with some Saturdays and some public<br />
holidays required.<br />
DISPENSING OPTICIAN/<br />
OPTICAL ASSISTANT<br />
Gates Optometrists is looking for a<br />
fashion forward Dispensing Optician /<br />
Optical Assistant to join our shiny new practice!<br />
If you love good quality fashion eyewear, believe in exceptional<br />
customer service and enjoy working with the newest technology,<br />
then this is for you! Take a virtual tour of the practice through https://<br />
gatesoptometrists.co.nz/ and imagine yourself working there!<br />
This position is full-time, based at the Gates Optometrists practice<br />
in Hamilton and requires some Saturday work.<br />
Experience as a Dispensing Optician or Optical Assistant is<br />
preferred.<br />
If you are interested in any of these roles and would like to become a<br />
part of one of the largest independent optometry practice groups in<br />
New Zealand, please email your CV and cover letter to<br />
sandri@patersonburn.co.nz or call 09 9035406.<br />
OPTOMETRIST<br />
REQUIRED<br />
Optik Eyecare Pukekohe is looking for a TPA qualified optometrist<br />
to join our team on a nine month fixed contract to cover<br />
maternity leave.<br />
We are an independent optometry practice in Pukekohe, South<br />
Auckland providing excellent eye care in our purpose built<br />
building.Our practice is clinically orientated, with a strong<br />
support team, and has excellent technology, including an OCT.<br />
You will be part of an Optometrist team of three. It’s a full-time<br />
position but part-time could be considered for the right applicant.<br />
We expect this contract to start mid June <strong>2018</strong>.<br />
In the first instance please forward your CV to Laurraine at<br />
admin@optik.co.nz<br />
OPTOMETRIST<br />
WANTED<br />
CANBERRA<br />
Fantastic opportunity for an enthusiastic graduate optometrist to<br />
join an established independent optometry practice in Canberra<br />
CBD. You will be interested in full scope optometry, have great<br />
people skills and work well in a team. Our practice includes retinal<br />
imaging and corneal topography as well as E-Eye IPL treatment.<br />
You will be supported by an experienced and friendly team who are<br />
fashion forward and passionate in delivering exceptional service.<br />
Applications to info@thecanberraoptometrist.com.au<br />
Refer your low vision patients to Naomi Meltzer,<br />
optometrist specialising in low vision rehabilitation.<br />
For appointments and information<br />
low vision<br />
services<br />
Phone (09) 520 5208 or 0800 555 546 Email info@lowvisionservices.nz<br />
www.lowvisionservices.nz<br />
To advertise in NZ Optics’ classified<br />
pages contact:<br />
Susanne Bradley at<br />
susanne@nzoptics.co.nz<br />
A cause for<br />
optimism<br />
Contact lens (CL) company, CooperVision has bundled its<br />
offerings together to create a series of initiatives designed<br />
to drive contact lens profitability and inspire loyalty among<br />
practices’ patients.<br />
Wittily described as its “Optomism mission”, the company says it’s<br />
passionate about its new business proposition, which it hopes will<br />
make practice owners more optimistic about their future. “Contact<br />
lenses can sometimes be overlooked as a profitable opportunity.<br />
CooperVision has developed numerous tools, techniques and<br />
products to help drive best business practice where both glasses and<br />
contact lenses are for all patients.”<br />
Specifically, CooperVision’s initiatives include: its exclusive optometryonly<br />
and house brands, Ascend, Liberty and Softview; its ‘See Both<br />
Ways’ promotional package to encourage higher CL and glasses<br />
sales; its speedy delivery service; and its comfort guarantee, amongst<br />
other services designed to assist both the optometrist and patient in<br />
adopting contact lenses within their eye care plan, said the company.<br />
“The CooperVision Agents of Optomism aim to restore optimism in<br />
optometry to help you transform your contact lens business… (giving)<br />
you the tools, techniques and products you need to help transform your<br />
contact lens business and generate measurable growth.” ▀<br />
Win a holiday<br />
with Transitions<br />
Transitions: offering optometrists the chance to win a holiday<br />
Transitions Optical is kicking off <strong>2018</strong> with a Transitions<br />
XtraActive campaign giving eyecare professionals on both<br />
sides of the Tasman the opportunity to win a holiday.<br />
The promotion builds upon the current ‘Which Transitions lens<br />
are you?’ campaign which challenges consumers to question which<br />
of Transitions’ three technologies is the best match for their needs:<br />
Transitions Signature, Transitions XtraActive or Transitions Vantage.<br />
While Transitions Signature remains the most popular, Transitions<br />
XtraActive offers unmatched benefits not offered by any other<br />
photochromic lens currently on the market, said Stuart Cannon,<br />
Transitions Optical general manager for Asia Pacific. “Not only is it<br />
the darkest lens, it also activates in the car, filters more harmful blue<br />
light both indoors and outdoors, and offers protection from harsh<br />
artificial light and bright sunlight for light-sensitive eyes.”<br />
For every pair of Transitions XtraActive ordered between 29<br />
January and 30 March, eyecare professionals have the opportunity<br />
to win themselves a luxury holiday for two to Nusa Dua staying at<br />
the exclusive Ritz-Carlton Bali resort for seven nights. Valued at up<br />
to $9,000, it includes a $1,000 Visa Gift Card and return flights from<br />
the winner’s nearest capital city.<br />
“Transitions also offer a ‘Love Them or Exchange Them’ guarantee as<br />
reassurance for patients and eyecare professionals, said Cannon. “If<br />
your patient is in doubt, they can try Transitions XtraActive risk-free; if<br />
they don’t love their lenses they can exchange for a clear pair of lenses.”<br />
For more information and to enter the competition entry visit www.<br />
transitions.com/win-a-holiday ▀<br />
26 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>
PUT DOWN YOUR<br />
ROOTS IN REGIONAL NZ<br />
PERMANENT ROLES IN YOUR CHOICE OF REGIONAL LOCATION<br />
Multiple opportunities available across both the North and South Islands to suit your career aspirations<br />
Specsavers’ growing New Zealand store network offers a variety of roles catering<br />
to different development needs and are available for optometrists at all stages of<br />
their career.<br />
Joining one of our regional New Zealand stores provides an ideal opportunity to<br />
firmly establish yourself within a community while progressing your clinical skills.<br />
You will be equipped with the latest ophthalmic equipment and presented with<br />
a range of interesting conditions across a high-volume patient base – all with the<br />
support of an experienced dispensing and pre-testing team, the mentorship of the<br />
store partners, and access to an exemplary professional development program.<br />
Or if you’re ready to move into practice ownership, our regional New Zealand stores<br />
present an attractive business venture. With average annual sales running at $2.4<br />
million per store, and Support Office training and assistance available every step of<br />
the way, there’s no better time to uncover the leader within you.<br />
Ask us about the opportunities we have waiting for you – contact Chris Rickard<br />
on 027 579 5499 or via chris.rickard@specsavers.com<br />
VIEW ALL THE OPPORTUNITIES AVAILABLE ON SPECTRUM-ANZ.COM<br />
Voted by New Zealanders<br />
Reader’s Digest<br />
Quality Service<br />
Award<br />
2017<br />
Best Talent<br />
Development<br />
Program<br />
2017<br />
Best Customer<br />
Service in NZ<br />
Optometry<br />
2017<br />
Millward Brown<br />
Research<br />
No.1 for eye tests<br />
2016<br />
Excellence in<br />
Marketing<br />
Award<br />
2016<br />
Retail<br />
Store Design<br />
Award<br />
2016<br />
Retail<br />
Employer<br />
of the Year<br />
2015<br />
Overall<br />
National<br />
Supreme Winner<br />
2015<br />
Franchise<br />
Innovation<br />
Award<br />
2015<br />
NZ Franchise<br />
System of<br />
the Year<br />
2014<br />
Retail<br />
Innovator<br />
of the Year<br />
2014<br />
<strong>Feb</strong>ruary <strong>2018</strong><br />
NEW ZEALAND OPTICS<br />
27
MORE CLASSIFIEDS ON PAGE 26<br />
OPTOMETRIST<br />
6-12 MONTH CONTRACT<br />
Grant & Douglas Optometry<br />
& Eyewear is looking for an Optometrist to join our team on a<br />
6-12 month fixed-term contract to cover maternity leave.<br />
We are an independent optometry practice providing excellent<br />
eye care with a personalised service. We have two locations;<br />
Hastings and Havelock North, within a 10-minute drive of each<br />
other. Our practices are busy, modern and well equipped enabling<br />
full scope clinical optometry. You will be supported by a friendly,<br />
experienced and professional team.<br />
Starting ASAP! We operate Monday to Friday only. No weekends!<br />
If you would like the opportunity to enjoy the lovely climate and<br />
lifestyle of Hawkes Bay then please email your application to<br />
Anna Byers: abyers@grantanddouglas.co.nz<br />
OPTOMETRIST REQUIRED<br />
ASHBURTON<br />
Our team at Ashburton Eyecare is looking for a TPA qualified<br />
optometrist with skills in all areas of the patient journey.<br />
We pride ourselves on the development of long-term patient<br />
relationships, so this may be ideal for a person who has had<br />
enough of the corporate world.<br />
Great inter-personal communication skills and an understanding<br />
of the importance of the patient experience are essential.<br />
Applicants must have a sound knowledge of both contact lens<br />
and spectacle lens options plus dispensing skills would be useful.<br />
This is a full time position with an option for partnership and/or<br />
ownership in the near future.<br />
Applications to eyeguy@xtra.co.nz<br />
EQUIPMENT<br />
FOR SALE<br />
Near new SC-1600 Nidek SC-<br />
1600 Smart LCD Acuity Chart<br />
with Remote $3200 + gst (or<br />
near offer)<br />
Keeler All Pupil II Wireless<br />
Binocular Indirect<br />
Ophthalmoscope with<br />
charger $2200 + gst (or near<br />
offer)<br />
Both in excellent working<br />
condition. Further discount<br />
offered if purchased<br />
together. Email Keaton at<br />
k_daya1@hotmail.com if<br />
interested for further details.<br />
For all your optical and ophthalmic needs<br />
nzowa.org.nz<br />
OPTOMETRIST WANTED<br />
NEW PLYMOUTH<br />
Judd Opticians require a full-time optometrist<br />
to join the dynamic team in the heart of New<br />
Plymouth city.<br />
Please contact Andrew on 027 458 1421 or email<br />
info@juddopticians.co.nz for further information.<br />
DISPENSING OPTICIAN OR<br />
OPTICAL ASSISTANT PART-TIME ROLE<br />
We are on the hunt for that special someone to join the team in<br />
our busy Lower and Upper Hutt practices.<br />
Experience in the industry is essential but we don’t require a formal<br />
qualification. We’re looking for a person with a passion for fashion<br />
eyewear, a commitment to providing exceptional customer service<br />
and a high-level of professionalism and team spirit.<br />
If this sounds like you, please email us confidentially at<br />
nburbery@visique.co.nz with your CV and cover letter.<br />
ZEISS HUMPHREY MATRIX FOR SALE<br />
Matrix for sale. In good condition, approx 5 years old and in good<br />
working order. Only selling as we have upgraded. Asking price<br />
$7,000 or sensible offer. Please contact Tracy on<br />
0272 555 305 for more information.<br />
DREAM OF<br />
TRAVELLING<br />
At OPSM, we are passionate about opening eyes to<br />
the unseen. Our advanced technology enables us to look<br />
deeper to ensure we give the best care to every customer.<br />
OPSM in New Zealand is looking to expand their Locum<br />
Optometrist network.<br />
LOCUM OPTOMETRISTS – NEW ZEALAND<br />
As a locum you will be your own boss, you will have<br />
the flexibility to set your own hours and will be exposed<br />
to lots of different patients and locations across New<br />
Zealand all while gaining lots of skills and experience.<br />
We are looking for Optometrists who share our passion, are<br />
willing to learn quickly and want to join our customer focussed<br />
teams in making a difference to how people see the world.<br />
WHAT’S ON OFFER:<br />
• Great working environment<br />
• Fantastic locum rates $$<br />
• Accommodation and flights<br />
• Latest technology<br />
• Luxury brands<br />
• New friends and having fun<br />
JOIN OUR TEAM<br />
For a chance to be your own boss and part of an amazing<br />
team, contact us for a confidential, no obligation chat.<br />
CONTACT:<br />
Jonathan Payne<br />
Jonathan.Payne@opsm.co.nz<br />
OPSM.CO.NZ/CAREERS<br />
WE SEE YOUR<br />
FUTURE WITH US<br />
At OPSM, we are passionate about opening eyes to<br />
the unseen. Our advanced technology enables us to look<br />
deeper to ensure we give the best care to every customer.<br />
OPTOMETRISTS<br />
NORTH & SOUTH ISLAND, NEW ZEALAND<br />
Our New Zealand business is looking for passionate<br />
Optometrists to join the team.<br />
• Thames, Thames-Coromandel<br />
• Lower Hutt, Wellington<br />
• Mt Maunganui, Tauranga<br />
• Dunedin, Otago<br />
When you join OPSM, you work within a team who<br />
are committed to providing the best possible eyecare<br />
solution with exceptional customer service. You will work<br />
with world class technology including our exclusive<br />
Optos Daytona ultrawide digital retina scanner. You<br />
will have many opportunities for continuing professional<br />
development and can enjoy career flexibility through<br />
our extensive store network. You can also make a<br />
real difference in the way people see the world by<br />
participating in our OneSight outreach program.<br />
JOIN OUR TEAM<br />
Start your journey with us today!<br />
Recent graduates are very welcome to apply.<br />
CONTACT:<br />
NZ – Jonathan Payne<br />
Jonathan.Payne@opsm.co.nz<br />
OPSM.CO.NZ/CAREERS<br />
28 NEW ZEALAND OPTICS <strong>Feb</strong>ruary <strong>2018</strong>