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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 />

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distance between these nanocrystals, the<br />

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INFINITE CONTRAST, COMFORT<br />

AND VISUAL CLARITY.<br />

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• Available in grey, the most<br />

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MARKETING MATERIALS<br />

Our bold new point-of-sale materials<br />

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also available. Order yours today at:<br />

youngeroptics.com.au/order-pos<br />

• Window posters (1000mm x 692mm)<br />

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*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>


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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 />

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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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<strong>Feb</strong>ruary<br />

transitions.com<br />

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TRA0003<br />

13


C<br />

M<br />

Y<br />

CM<br />

MY<br />

CY<br />

MY<br />

K<br />

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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NEW ZEALAND OPTICS<br />

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>

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