Feb 2017

SPECIAL FEATURE: RANZCO
Registrars Drs Verona Botha, Ken Ng and Aaron Wong
FROM ON PAGE 11
Professor Ursula Schmidt-Erfurth from Vienna
gave the retina update lecture. She hopes that
improvements in technology allowing machinelearning
OCT will help us predict visual outcomes
in the future.
Professor Mourits, an ophthalmologist from
Amsterdam who first described the clinical activity
score in thyroid eye disease, gave the Ida Mann
lecture. He explained how in Graves’ orbitopathy
both muscle and fat volumes increase within the
orbit due to activity of orbital fibroblasts.
Peter Savino, clinical professor of ophthalmology
and neurosciences at San Diego’s Shiley Eye
Institute, and Professor Danesh-Meyer convened
the always entertaining neuro-ophthalmology
challenges session. The cases were a mix of the
common and the obscure and served as the
catalyst for sparking audience discussion about
diagnostic dilemmas in neuro-ophthalmology.
The day finished on a high note with the
conference dinner at the hallowed Melbourne
Cricket Ground. Although the dinner included a
tour around the largest cricket stadium by capacity
in the world, many Kiwis preferred not to relive the
pain of the 1981 underarm bowling incident and
the 2015 cricket world cup final.
Day four
The final day of Congress started with a session
on keeping your cool during complicated cataract
surgery. Auckland University Associate Professor
Dipika Patel started by reassuring the audience
that complication rates such as posterior capsule
rupture have improved over the last few decades.
In part, this is due to improvements in equipment
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Jina Han, Professor Charles McGhee, Dr Hannah Kersten and
Samantha Simkin
Drs Graham Wilson, Nick Mantell, Stephen Ng and Justin Mora
and, as Dr Mo Ziaei explained in the
next talk, this includes the treatment of
small pupil and floppy iris. Dr Ormonde
spoke about a dreaded fear for most
cataract surgeons, posterior capsular
rupture with vitreous loss. Professor
McGhee’s express vignettes provided
insights into dealing with iris and
zonular deficiencies. He advocated for
a good understanding of the modern
tool kit and plenty of surgical and wet
lab experience to prepare surgeons
for dealing with these cases. While Dr
Bia Kim spoke of the importance of
pre-operative risk stratification scoring
prior to cataract surgery. A modified risk
stratification score is to be trialed at
Auckland DHB in 2017 so watch this space.
Associate Professor Fiona Costello from
the University of Calgary gave the neuroophthalmology
update lecture and explained how
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Himanshu Wadhwa, A/Prof Dipika Patel, Aki Gokul, Dr Divya Perumal
and Professor Trevor Sherwin
Drs Simon Dean, Andrea Vincent, Michael Merriman, Hannah Kersten and
Andrew Riley
Bayer’s Christie Murzello with Professor Anthony Molteno and
Dr Tahira Malik
Drs Graham Wilson and Shuan Dai
the eyes are in fact the window to the soul (or
perhaps in this case the central nervous system).
Her dual training as a neurologist and neuroophthalmologist
give her a unique insight into how
assessment of the eye can give you important
information about diseases of the brain such as
multiple sclerosis. In particular OCT may play a
bigger role in neurological disease in the future
as more is understood about how the neuronal
structure in the eye reflects changes in the brain.
Dr James Muecke from the South Australia
Institute of Ophthalmology gave the Hollows
lecture and talked about his experience in
working in more than 10 developing countries.
In countries such as Myanmar, cataracts have
become such a problem that nearly one in 10
adults over the age of 40 are blind or severely
visually impaired. The Sight for All charity, which
Dr Muecke chairs, aims to make it possible
for ophthalmologists working in developed
countries to have the same skill and knowledge
as those in developed countries.
The afternoon’s rapid fire session covered
a range of topics including uveitis, ocular
oncology, neuro-ophthalmology and
oculoplastics. Dr Ken Ng spoke about
the unique spectrum of uveitis in elderly
patients presenting to clinics in Auckland.
Drs John Beaumont and Kevin Taylor with OptiMed’s Rob Nyenkamp
Drs Peter Hadden, John Ah-Chan and Ross Neville-Lamb and
Steve McConnell
Old ophthalmology equipment on the
RANZCO museum display
Dr Rachel Niederer discussed risk factors for
choroidal neovascularisation in punctate inner
choroidopathy. Treatment with oral corticosteroids
may help to reduce the risk of choroidal
neovascular membrane development. Dr Hannah
Kersten spoke about eye findings, including
downbeat nystagmus and temporal retinal nerve
fibre layer thinning, in the recently described
neurological syndrome CANVAS (cerebellar ataxia,
neuropathy and vestibular areflexia).
The Congress was brought to a close with the
annual awards for best paper, poster and film. Dr
Elisabeth de Smit won best junior presentation
for her study of the genomic associations of giant
cell arteritis and Associate Professor John Landers
won best senior presentation for presenting the
findings of the Central Australian Ocular Health
Study. The other speakers in the session, including
Samantha Simkin, were highly commended for
their excellent presentations. As always there was
some New Zealand representation within the
prizewinners with Dr Shong Min Voon winning
best film for ‘A Novel Method for Rapid Production
of Basic Diagnostic Ophthalmic Equipment’. ▀
*Dr Aaron Wong is an ophthalmology trainee at the University
of Auckland. He was helped in the writing of this article by Dr
Hannah Kersten, a lecturer and research fellow at the University
of Auckland.
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Matthew Northage and Henri Buhagiar from Abbott flank Tania
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Drs Muhammad Khalid and John Beaumont
Drs Hussain Patel and Mark Donaldson
12 NEW ZEALAND OPTICS February 2017