March 2017

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY
FOR OPTOMETRISTS AND EYE CARE PROFESSIONALS
PO BOX 106 954, AUCKLAND CITY 1143
Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz
MARCH 2017
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2 NEW ZEALAND OPTICS March 2017

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NEW ZEALAND OPTICS
3

The sad, the bad and the beautiful
EDITORIAL
March sees us welcome the wonderfully
talented Cait Sykes to our pages. A
mum, an editor, a long-time business
journalist and friend, Cait has penned the first of
a series of more general business features we’re
planning that are crafted and tailored specifically
for our industry.
Sadly, the first one couldn’t be more timely as it
tackles theft, which some of you are still reeling
from in what, anecdotally at least, seems to be a
spate of break-ins as thieves focus on brandedsunwear
ranges (see p18). And it’s not just those
in retail hotspots who are being targeted, BTP’s
Jill Stackhouse had her car broken into in a central
city carpark (see story this page).
But enough of the bad, there’s still plenty
to smile about like the amazing group of
young ophthalmologists and researchers
celebrated at this year’s wonderful Excellence
in Ophthalmology awards (p22). It was great to
catch up with all the folk from the ophthalmology
department again and I even managed to capture
my predecessor, Maryanne Dransfield on film
which, after being snapped by her for years, I
thought some of you might appreciate! This year’s
awards evening was a particularly warm occasion
as the Calvin Ring Award was won by Dr Charlotte
Jordan, who’s well-known to many of you having
obtained a first in optometry before moving onto
ophthalmology. What made it so warm, however,
was the close friendship Charlotte has with the
Ring family and department head Professor
Charles McGhee, who stayed with the Rings when
he first arrived in New Zealand so has known
Charlotte (or ‘Charlie J’ as the family call her) since
she was 15. The speech made by Dr Peter Ring’s
daughter, also Charlotte, in honour of her friend
brought a tear to the eye.
For more heart-warming, beautiful behaviour
check out the Christchurch care home initiative
devised by optometrist Tianyuan Qu and his
engineer wife Irene Kong (p8). And if you’re still
debating whether to attend the CCLS conference
in beautiful, sunny Nelson this year, our feature
on p11-15, which includes a revealing look into
what drives some of this year’s keynotes, should
have you rushing to register. Plus, for even more
beauty, we’ve got all the latest on the world of
beautiful frames: check out Kylie’s Minogue’s
photoshoot, this page; General Optical’s MCM
brand on p8; Groovy Glasses stunning refit on
p17; and of course our now regular fashion
update on p26). If you’re in the OIG, make sure
we’re getting all the news from all your frame
brands, so we can include it in our updates!
But if frames aren’t your thing, how about
technology and the latest clinical advances. There’s
the world’s first eye operation by robot (p6) and the
latest thinking on glaucoma from ANZGIG (now
ANZGS) on p23 and the cornea on p25, penned by
our own Dr Graham Reeves and Professor Charles
McGhee, respectively. Thanks guys.
Enjoy.
Lesley Springall, publisher, NZ Optics
Are you a World Master?
Word on the ophthalmic street is
this year’s World Masters Games is
going to be peppered with a heavy
dose of ophthalmic industry representatives.
NZ Optics’ own Nick Griffiths has entered the
squash tournament, there’s a well-known Kiwi
ophthalmologist in the 400m, and apparently
there’s a host of
others both from New
Zealand and Australia
entering. If you are,
we’d love to hear from
you. Just drop us a line
at lesley@nzoptics.co.nz ▀
NOW AVAILABLE IN NEW ZEALAND FROM
Cardinal Eyewear at www.cardinal.co.nz
Zeiss hits our slopes
Zeiss is introducing
snow goggles to
New Zealand and
Australia for the first time.
The international lens
company has been making
and supplying high
quality snow googles to
the European market for
a number of years, but
this year will be the first
time they are available in
Australasia.
Pamela Andrews,
marketing
manager-consumer
products at Zeiss
in Australia, says
they are “incredibly
popular” in Europe,
but haven’t been
introduced into
Australasia until now
because Australia wasn’t
a particularly strong snow market. “But New
Zealand certainly is. They are a great product and
a new range has just been released so we thought
it was the perfect opportunity to bring them to
market here.”
Zeiss Snow Goggles are created especially for
the challenges posed by alpine sports, says the
company, they are robust and light, with 100%
UV protection, a large visual field and improved
contrast vision in both bright sunlight and diffuse
light. “Zeiss Snow Goggles feature many different
models… and are available with easy-to-change
lenses. Several types of mirror coatings and a large
selection of high-performance tints don’t just give
your goggles a fashionable, unique look: they also
Watch out for stolen goods
Trish Orr, from New Zealand high-end frames
distributor BTP International Designz is
asking industry colleagues to keep an eye
out for a significant amount of stock stolen
from her colleague Jill Stackhouse’s car in early
February.
The thieves broke a rear
window in Stackhouse’s car
in a central city carpark in
Auckland during the day and
made off with thousands of
dollars’ worth of stock, despite
the car being alarmed and the
stock being covered with an
old, dark blanket. “Luckily Jill,
wasn’t there, so she was fine,”
says Orr adding, however, that
she was understandably upset,
and even more so when she
discovered the police had little
interest in helping and the
Wilson Carpark team wouldn’t
even look at the security tape
unless the police requested it.
“It’s not been a good start
Jill Stackhouse’s smashed car window
ensure ideal vision in all weather,” says Zeiss. The
goggles also cater for spectacle wearers with a clip
insert for prescription lenses.
There will be point-of-sale material and though
there are no specific trade promotions available
currently, the company is likely to launch
something in the near future, says Andrews.
“The ski season is June through to October, so
we wanted to give people plenty of notice prior to
the season coming into play.”
The goggles will be available for order from 6
March and will be on display at Silmo Sydney
from 9-11 March at the International Convention
Centre in Sydney’s Darling Harbour. For more, see
the ad on p17. ▀
Queen of Pop eyewear
Kylie Minogue has
launched her
first collection of
eyewear on Valentine’s
Day, complete with
sexy photoshoot
showing the collection
from morning to night.
The new range, which
will be sold exclusively
in Specsavers, draws
inspiration from her
glamorous lifestyle,
says the self-styled
Queen of Pop and
international megastar.
The collection is
designed around
three key themes:
modern classics, subtle
bling and reinvented
vintage and includes
several petite styles at
Minogue’s own request. Though the collection has
been designed with women in mind, many can be
worn by men too, say Specsavers. ▀
to the New Year,” admits Orr, who’s now fighting
through the insurance paperwork.
Product taken includes: Porsche, sunglasses and
optical; Vera Wang, sunglasses and optical; Kaos,
optical; Olivier Contini, optical; and Rodenstock,
sunglasses and optical.
BTP is not the only company
to have been hit by the bad
guys, with media reports that
Bell Neuhauser & Matthews
Optometrists in Hamilton
was burgled in late January
after two thieves threw a rock
through the door (it took four
attempts to break it) and made
off with thousands of dollars’
worth of sunglasses. One thief
has already been apprehended
with the help of the company’s
CCTV footage, however, but
police are still looking for the
second man. ▀
For more about theft and
protecting your practice
against shoplifting, see p18.
4 NEW ZEALAND OPTICS March 2017

March 2017 NEW ZEALAND OPTICS
5

News
in brief
CANNABIS QUESTIONED FOR GLAUCOMA
Marijuana has been given the
thumbs down for treating
glaucoma, reports Optometry
Australia. A new report from the
US National Academies of Sciences,
Engineering and Medicine, ‘The
Health Effects of Cannabis and
Cannabinoids: The Current State
of Evidence and Recommendations
for Research’, which reviewed
more than 10,000 scientific papers, concluded there was no
real evidence to support cannabis as an effective treatment for
glaucoma. “Non-randomised studies in healthy volunteers and
glaucoma patients have shown short-term reductions in intraocular
pressure with oral, topical eye-drops and intravenous cannabinoids,
suggesting the potential for therapeutic benefit,” said researchers,
but “a good-quality systemic review identified a single small trial
that found no effect of two cannabinoids, given as an oromucosal
spray, on intraocular pressure…suggesting a limited potential for
cannabinoids in the treatment of glaucoma.”
ARTIFICIAL VISION: ONE STEP CLOSER
Second Sight Medical Products has announced encouraging results
from its initial clinical safety and feasibility trial of its FDA-approved
retinal prosthesis, Orion I. The company’s goal is to develop a visual
cortical prosthesis that can provide artificial vision for individuals
affected by virtually all forms of blindness by using an electrode
array implanted on the surface of the brain over the visual cortex. A
full clinical trial is still to come.
HOYA ACQUIRES 3M DIVISION
Hoya Vision Care has expanded its capabilities by acquiring 3M’s
safety prescription eyewear business. 3M has been supplying
safety prescription eyewear for more than 90 years and has a
strong foothold in the North American market as well as sales in
Latin America, Europe and Asia. “The safety prescription eyewear
business strongly complements Hoya’s existing portfolio, offering
our customers a broader range of products while continuing to
focus on high quality and service,” said Barney Dougher, president
Hoya Vision Care, Americas.
RECORD NUMBER OF ORGAN DONATIONS
The latest figures from Organ
Donation New Zealand (ODNZ) show
there were a total of 61 deceased
organ donors in 2016, a 69%
increase over the past four years.
From these donors, 181 organs were
transplanted, representing a 57%
increase over the same time period,
though only 46% of deceased organ donors donated eye tissue.
ODNZ, however, facilitated a further 60 eye tissue donations from
donors who could not donate organs.
AUSSIE OPHTHALMIC NURSES JOIN FORCES
Supported by RANZCO, the Australian Ophthalmic Nursing
Association are in the process of formalising an Australian
Ophthalmic Nurses Association National Council (AONANC). The
new, national body will represent the whole Australian ophthalmic
nursing community. RANZCO says it believes having a main-pointof-contact
in the ophthalmic nursing community will enable greater
collaboration and engagement between the profession and the
wider eye healthcare community.
FSA RATES CLIMB
The Ministry of Health released new data showing 148,000 more
Kiwis have received a first specialist assessment (FSA) since 2008,
a rise of 37%. Acceptance rates for FSA assessments are also higher
with data showing there were 177,400 FSA referrals between April
and June 2016, of which 87% were accepted.
EMR DATA INTEGRITY QUESTIONED
A US study has uncovered “large inconsistencies” when comparing
symptoms reported in an electronic medical record (EMR)
compared with patient reports on Eye Symptom Questionnaires
(ESQs). Researchers compared symptoms checked off by 162
patients on paper-based questionnaires with information entered
in their electronic clinic charts. Between a quarter and a half of
patients’ data on blurry vision, glare, pain and redness from the
questionnaires didn’t match the EMR. The data suggests that
symptom reporting varies between methods, with patients tending
to report more symptoms on self-reported questionnaires, said
researchers in JAMA Ophthalmology. “These results suggest that
documentation of symptoms based on EMR data may not provide a
comprehensive resource for clinical practice or ‘big data’ research.”
NEW NSAID FOR CATARACTS
Sun Pharma has launched BromSite (bromfenac ophthalmic
solution) 0.075% in the US following several clinical studies
demonstrating a strong safety and efficacy profile in cataract
surgery patients. Approved by the FDA in April 2016, BromSite is
the first nonsteroidal anti-inflammatory drug (NSAID) approved to
prevent ocular pain and treat inflammation in the eye following
cataract surgery.
First by robot
Eye surgeons at University Hospitals Leuven in Belgium have
successfully used a surgical robot to operate on a patient with
retinal vein occlusion. The robot, developed specifically for
purpose by Leuven University (KU Leuven), uses a needle, barely
0.03mm in diameter, to inject a thrombolytic drug into the patient’s
retinal vein to remove blood clots.
Current treatment for retinal vein occlusion, which can lead to
blindness, consists of monthly eye injections that only reduce the
side effects of thrombosis. But researchers from University Hospitals
Leuven and KU Leuven are studying retinal vein cannulation (RVC),
a revolutionary treatment that addresses the cause of retinal vein
occlusion by removing the blood clot in the retinal vein.
RVC is a promising method, say researchers, that requires the
eye surgeon to insert an ultrathin needle into the vein and inject
medicine to dissolve the blood clot. This is challenging as a retinal
vein is only 0.1 mm wide, similar to a human hair. No surgeon can
manually inject a drug into such a thin vein while holding the needle
perfectly still for 10 minutes, they say. “The danger of damaging
the vein or the retina would simply be too high.” Which is why
researchers from KU Leuven’s Department of Mechanical Engineering
embarked on developing a robotic device to allow a surgeon to insert
the needle in a very precise and stable way and, once inserted, can be
held perfectly still by the robot for as long as required.
Thinking eyewear launched
The world of wearable technology reached
another milestone with the launch of
brain-sensing eyewear, designed to
improve cognitive function and concentration.
The rather clumsily-named ‘Smith Lowdown
Mpowered by Muse’ combines Canadian tech
company Interaxon’s Muse brain-sensing technology with Italian
eyewear manufacturer Safilo Group’s Smith Lowdown frames.
Designed for athletes and outdoor enthusiasts, the new “smart”
Smith sunglasses were unveiled at the 2017 Consumer Electronics
Show in Las Vegas in January. The Smith frames integrate
brainwave-sensing technology measuring electroencephalogram,
electrooculography and electromyography technologies as well as
other sensors like three-axis accelerometer, gyro and magnetometer,
a UV and pressure sensor and a temperature gauge.
The brain is central to athletic development and outcomes, not to
mention the quality and value of those outcomes, said the companies
in a joint statement. “By implementing the Muse technology
into Smith glasses [we] have advanced a brain-first approach to
maintaining brain health and performance.”
Interaxon’s Muse brain-sensing technology has been in use for two
years in the company’s Muse meditation headband. The technology
measures brainwave activity during meditation and provides users
with feedback and guidance to help them relax and focus. Interaxon
describes the experience as listening to the sound of waves lapping
against the beach: the more focused you are, the quieter and lighter
the waves sound; the less focused, the more thunderous and stormy.
At the end of each brain-training session, the accompanying app
provides users with feedback and a performance score.
“We’ve been providing superior vision and safety through our
market-leading goggles and helmets for more than 50 years and are
excited to add cognitive training and conditioning to our offering,”
said Thorsten Brandt, general manager of Safilo’s sports and outdoor
lifestyle brands. “Active consumers at all levels intuitively understand
the importance of finding their focus, yet up until now, there
CLs differ in myopia battle
The results of a new study, presented
at the American Academy of
Optometry’s annual meeting late
last year, indicate that certain contact
lenses may be better for treating myopic
patients, particularly children.
CooperVision shared its two-year
interim results from a clinical trial
evaluating its MiSight dual-focus myopia
control 1-day soft contact lens. The
dual-focus lens demonstrated a slowing
in myopia development in children by
59% over two years when compared to
children in the control group wearing a
single vision 1-day contact lens.
www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand
Initial concerns from parents were
also quickly overcome in the study, with
82% of parents rating their children
as ‘extremely happy’ with the overall
experience. Nearly 80% of participating
children, in both the test and control
groups, also said they preferred wearing
contact lenses to glasses.
A Brien Holden Institute study projects
the prevalence of myopia to increase
from approximately two billion people
worldwide in 2010 to almost five billion
people in 2050. (See also p20-21) ▀
“We are extremely proud our robot enables us to perform eye
surgery that was previously impossible to perform safely,” says KU
Leuven Professor Dominiek Reynaerts. “This brings us one step closer
to commercialising this ground-breaking technology.”
The robot is the result of seven years of collaborative research
between the Hospitals’ ophthalmologists and KU Leuven. The current
phase I trial aims to demonstrate it is technically feasible to use a
robotic device to insert a microneedle into the retinal vein and inject
ocriplasmin to dissolve the clot, while a planned phase II trial will
research the clinical impact for patients. ▀
hasn’t been a lot of products that help you up your mental game.
We believe our collaboration with Interaxon is truly unique and
something our customers will love. This is a first in bringing together
innovative products that beautifully blend technology, form and
style.”
Derek Luke, CEO of Interaxon, said the company was excited by
the launch. “Wearers of Lowdown Focus Mpowered by Muse will
be supported to develop a consistent mental training practice,
leading to greater levels of performance and focus whether they’re
competing, studying, parenting or working. Our collaboration with
Safilo has resulted in the first mental performance-enhancing
eyewear on the market and the first device users will wear
throughout the day, increasing the likelihood they will engage in
beneficial exercises more often and consistently.”
The new smart Smiths should be available for purchase later this
year. The Muse technology will eventually be available with Safilo
brands Smith, Carrera and Polaroid. ▀
For general enquiries or classifieds please email info@nzoptics.co.nz
For editorial, please contact Lesley Springall at lesley@nzoptics.co.nz or +64 27 445 3543 or Jai Breitnauer at editor@nzoptics.co.nz or +64 22 424 9322
For all advertising and marketing enquiries, please contact Susanne Bradley
at susanne@nzoptics.co.nz or +64 27 545 4357 in the first instance, or Lesley Springall at lesley@nzoptics.co.nz
To submit artwork, or to query a graphic, please email susanne@nzoptics.co.nz
NZ Optics magazine is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times a year, by New Zealand Optics 2015 Ltd. Copyright is held by
NZ Optics 2015 Ltd. As well as the magazine and the website, NZ Optics publishes the annual New Zealand Optical Information Guide (OIG), a comprehensive listing guide that profiles the
products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The views expressed in this publication are not necessarily
those of NZ Optics 2015 Ltd or the editorial team.
6 NEW ZEALAND OPTICS March 2017

THE PASSION
REMAINS.
TEN YEARS ON…
In early 2007, our original Port Melbourne lens laboratory and fledgling support office
opened for business, igniting the first sparks of the Specsavers optical revolution.
One year later, we unveiled our very first stores, heralding the opening of an
incredible 150 Australian stores in just nine months and our first six New Zealand
stores. Consumers in both countries were quick to embrace our simple offer of
high quality eye care and affordable, stylish eyewear – allowing our stores not just
to grow but to thrive.
Fast forward to 2017 and we now have 370 Specsavers stores operating across the
two countries with annual sales approaching $800 million in Australia and over
$100 million in New Zealand. Our customer database has grown to over six million
individuals and we dispensed more than 4 million pairs of glasses over the past 12
months alone, at an average of 80,000 pairs every week.
Partnership – underpinning our success
At the very beginning, we set out our stall to optometrists and dispensers
under the banner ‘A Passion for Partnership’. We presented a new, inclusive
business model that was open to all those with ambition and a passion for
service excellence.
Ten years on our passion for partnership remains undimmed. The Partnership
model that pairs an optometrist and an optical dispenser as partners in their own
store has propelled hundreds of optical professionals into business ownership,
creating hundreds of successful, profitable, community practices and thousands
of current jobs. And the Partnership between the Store Partners and Specsavers
grows ever-stronger, underpinned by an unrivalled business support structure.
Back in 2007, we talked to optometrists and dispensers the length and breadth
of Australia and New Zealand about the Specsavers Partnership – and we are still
doing so today. To gain an insight into our plans for the years ahead and to find out
if you are ready for Partnership in a store of your own, talk to us now in confidence
– and spark your very own optical revolution.
To get the conversation started, contact Sinead Convery on
+61 427 754 076 or sinead.convery@specsavers.com
Millward Brown
Research
No.1 for eye tests
2016
Excellence in
Marketing
Award
2016
Retail
Store Design
Award
2016
Retail
Employer
of the Year
2015
Overall
National
Supreme Winner
2015
Franchise
Innovation
Award
2015
NZ Franchise
System of
the Year
2014
Retail
Innovator
of the Year
2014
Roy Morgan
Research
No. 1 for eye tests
2014
FCA Social
Responsibility
Award
2014
March 2017
NEW ZEALAND OPTICS
7

A respectful vision
Optometrist Tianyuan Qu is a naturally
chatty individual, but he makes an extra
effort when his elderly patients arrive at
his Christchurch practice, especially if they come
from a care home, he says. “In Chinese culture, we
believe you should cherish every single moment
with parents and grandparents.”
Good eye care is a key enabler to living an
independent life, but isn’t always readily accessible
to the older segment of the population, says Qu,
quoting studies showing one in every two elderly
people has a vision problem.
Since the February 2011 earthquake, the
population of Christchurch has shifted to the
Visiting a patient at Summerset retirement home
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A breakthrough for sphere lens wearers
Digital Zone Optics
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• Helps ease the accommodative burden without
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• Multiple front-surface aspheric curves
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8 NEW ZEALAND OPTICS March 2017
3
3
suburbs yet most optometry
businesses remain relatively central.
That can mean a drive of 35 minutes
to see an optometrist, with many
patients brought in by a family
member who may only visit once a
week or once a month.
“There are 77,400 elderly people
living in Christchurch, 28% of them
outside the central city. Many local
care home residents have family in
Auckland or Melbourne, and they
don’t have transport to get to a local
practice,” says Qu, emphasising care
home staff do a great job but are stretched
thin. “They cherish their visits from children
and don’t want to fill them in with routine
appointments. They want to have fun.”
Many patients report the same experience
of retirement, he says, “that it really sucks.”
So Qu and his wife, structural engineer Irene
Kong, felt there had to be something they
could do to make the life of their elderly
patients a little better. The result was to bring
eye care services to retirement villages and
care homes to help lift some of the strain.
Qu and Kong joined ‘Live the Dream’, a
nine-week intensive accelerator programme
for social enterprise. With a tool box of
necessary skills, they began contacting the
Tianyuan Qu and Irene Kong
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• Long silicone chains and compatible hydrogen
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ONLY AVAILABLE
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IN AUSTRALIA & NEW ZEALAND
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Why prescribe anything else for your monthly and two-weekly contact lens wearers?
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organisations that could support their endeavour,
including the care homes themselves.
“It was difficult to organise. Care homes are
very busy places and at first it was hard for them
to find the time to accommodate us,” says Qu.
“But now they understand we are taking away a
burden, relieving staff to focus their time on other
activities around the care home.”
Qu and Kong have been to three care homes
in Christchurch since January, Summerset at
Wigram, Anthony Wilding (Ryman Healthcare)
and Woodcote (Ryman), and have seen around 40
patients, as well as operating a service out of the
BizDojo premises in the city. This wouldn’t have
been possible without the support of the local
optometry community, says Qu.
© CooperVision 2017
The Christchurch care home team: (back row) Natasha Louise, Sephy Ming Cheng,
Tianyuan Qu, (front) Shannon Pope, Katarina Marijcarz and Douglas Mullan
“Our team consists of optometrists Douglas
Mullan, Jasmine Seok, Jasmine Zoest, Sephy
Ming Cheng and Katarina Marcijasz, a part IV
optometry student and NZOSS educational
rep., and optical assistants Natasha Louise and
Shannon Pope. Everyone has volunteered their
time. We also have to acknowledge Specsavers
Hornby, Riccarton and Shirley for providing
optometry equipment, and ACG Yoobee design
school for video recording.”
Qu and Kong are really just starting out with
their endeavour, raising awareness and seeking
further help, but they feel this project has a lot of
potential filling a gap in post-quake healthcare
services. ▀
For more, email mobileye.nz@gmail.com
GenOp: a focus
on luxury
Australasia frames distributor General Optical, owned by
VSP Global, has grouped together its luxury frames brands,
some old, some new, into a new luxury frames portfolio. This
means they can be marketed together direct to practices who have
a focus on the finer things.
“Our focus with the luxury brands is to partner exclusively with
stockists who
understand
these brands and
merchandise
them in a way
that is consistent
with each of the
brand’s values,”
says Brad Saffin,
managing
director of VSP
Global Australia.
“Luxury brands
are and have
always been a bit
more exclusive
than traditional
fashion and
lifestyle brands.
To be effective,
it’s important
to merchandise
them consistently
with their brand
values, and in
locations that
are marketing
to their target
audiences.”
Currently the
luxury side of
General Optical’s
range includes Calvin
Klein Collection, Chloé, Etro, Salvatore Ferragamo and, relative
newcomer, MCM.
MCM is about unique luxury, youthful luxury, says Saffin. “Many
old school European houses have great craftsmanship and heritage,
but the results are too conservative for emerging consumers in
Asia. In Asia today it’s all about the young professionals who are the
next generation of consumers. They have different needs and a new
perception of luxury. That’s what MCM is feeding on.”
According to Sung Joo Kim, founder, chair and “chief visionary
officer” of the Korean-based retail group Sungjoo Group, which
bought MCM in 2005, the German-based accessories company’s
success so far has hinged on the understanding of major
developments in the luxury market. “Millennials are ‘born with
computers’, so they have a completely different approach to life and
expect brands to be interactive, luxurious, and functional,” she’s
reported as saying.
Saffin stresses however, this focus on luxury brands is not to the
detriment of the company’s other brands. “We have always had a
robust portfolio of brands to represent all segments of the market,
luxury brands included. It’s important that we maintain diversity in
our portfolio to serve every customer at every price point.”
See associated story on Nike Vision’s latest innovation
collaboration with Zeiss p16. ▀

OPSM appoints NZ head
OPSM has appointed
Samantha Payne
as country director
for New Zealand.
Payne, originally from
the UK, has a corporate
retail background,
including head of
operational excellence,
joint ventures, for Mitre
10 and national sales
and project manager
for Masters Home
Improvement in Australia.
The daughter of an army
father, Payne started her
career as a senior aircraft
Samantha Payne
engineer in the UK Royal
Airforce, which she says taught her a great
deal about how people work and gave her a
real sense of perspective. Working in a tent,
in rough conditions during pressured times
on a Chinook helicopter, you learn quickly
not to sweat the small stuff, she says.
A working mother of four young children,
Payne was interviewed for the OPSM NZ
position just a few days before her fourth
child was born. She began training at
OPSM’s parent company, Luxottica’s head
Epsom: new owner offers CPD
Auckland’s Epsom Eyecare has been bought
by dispensing optician Andy Willmott,
formerly director of Specsavers in Botany.
Willmott has a 30-year background in optometry
and started off in independent practice. He’d
already decided to sell his Specsavers store to
pursue other avenues and hadn’t been considering
buying an independent optometrist when he
discovered the Epsom practice was for sale
following an ad in NZ Optics. “The Epsom Eyecare
practice presented an opportunity to take on a
new challenge.”
The challenge of growing the business was the
office just two months
after the birth, before
moving to New Zealand at
the beginning of January.
A keen amateur artist,
her interest in optics stems
from a late diagnosis
of astigmatism, which
caused her to panic about
her sight, she says. “I can
relate to how life changing
a sight problem can be
and I remember going to
the optometrist in tears
thinking that I wouldn’t be
able to continue with my
art, but the optometrist
was amazing the way she
explained things for me. If we can give our
customers that kind of experience, I would
be really happy”.
Payne says she’s excited about her new
role and about setting a strong direction for
the company in New Zealand focused on
OPSM’s tagline, ‘OPSM loves eyes’.
“I believe OPSM is a real powerhouse,
combining the best technology available
and highly skilled optometrists with an
amazing brand.” ▀
main attraction, he says, adding he’s been going
at full steam since taking over the practice at the
end of last year: installing an OCT; introducing
on-site glazing; re-introducing ortho-k and
myopia control; and kicking off a new marketing
plan. “There isn’t going to be a re-brand, but we
have opened up the window and brightened the
interior.
“This is most definitely a challenge, but it was
the same at Specsavers and in the UK where
I successfully turned an independent practice
around. It will be a long haul to achieve growth,
but plans are already in action.”
Cardinal introduces Jensen,
Rock*Star
New Zealand frame distributor
Cardinal Eyewear has added another
string to its bow with the addition of
Eyespace Eyewear’s brands to its portfolio.
The award-winning British eyewear
company approached Cardinal directly
last year, says Cardinal’s John Wedlake.
“Eyespace have been selling their optical
frame products in the UK and Europe for a
number of years and in 2016 they created
an Export Team with a view to entering
several overseas markets. They identified
Cardinal Eyewear through NZ Optics’
website and, after reviewing Cardinal’s
own website decided we were a very good
match. Both companies are family-run businesses
and we both strongly believe these create the most
positive long-term relationships.”
Cardinal has initially agreed to distribute two of
Eyespace’s brands, its Rock*Star range and its Jensen
range.
Rock*Star are a “funky” range of frames, aimed at
young people, 10 years and up, says Wedlake. “The
modern shapes and small sizes also lend themselves
very well to women with small faces.” Whereas
men’s range Jensen are “instinctively modern…with
In Botany, Wilmott grew his Specsavers’ business
to an 18-strong team, with four consulting
rooms providing up to 1000 eye examinations
each month. He was also heavily involved with
Specsavers’ professional development side,
running bi-annual CPD conferences for dispensing
opticians, optical assistants and optometrists – a
practice he’s going to continue at Epsom. His first
free Epsom CPD event was held on the 20 February
on ortho-k and his next, on 20 March, is on
glaucoma. He says he’s hoping to run monthly CPD
events, offering 12 points a year to local DO’s.
Former owner Jyotika Lal says she sold the
Rock*Star frames now in New Zealand
a European feel and quality.” Wedlake says both
him and his business partner Rose Wedlake were
especially attracted by Jensen’s very light weight
titanium models in its “Jensen Black” range, which
also includes some larger models, up to 60mm in size.
“We have been very impressed because Jensen and
Rock*Star are excellent quality products, priced at a
level to provide good value to the end user.”
Both Rock*Star and Jensen are available now and
the Cardinal team will be showing them to customers
over the next few months. For more, see ad on p4. ▀
business so she could spend more time with her
family. Epsom Eyecare doubled in size under her
management and this was from the company’s
total focus on good old-fashioned service, she says.
“Epsom has the most loyal customer base, one
I will miss, but my family’s needs have to come
first.”
Lal says she’s been surprised by the number of
people who have approached her since learning of
her decision to sell and says she’s now weighing
up several new, exciting opportunities that will
also give her the time she needs to spend with her
family. ▀
Education Series 2017
Seminars
are FREE!
NEXT SEMINAR
Tuesday 23rd May 2017
6.30pm - 8.45pm
Theme:
Diagnostics and
Therapeutics in
Everyday Practice
Venue:
Ellerslie Event Centre
Racecourse, 80 Ascot Ave
Ellerslie, Auckland
Registration:
5.45pm - 6.30pm
Light Meal & Beverages
provided
Eye Institute’s Education Series continues to offer an opportunity for the Optometry Profession to gain exposure
to the latest advances in therapeutics, shared-care management and surgical advances in New Zealand.
You are invited to join us on one or more of the following Seminars and Conferences for the 2017 year.
2nd Seminar
Tuesday 22nd August
6.30pm - 8.45pm
Ellerslie Event Centre
Racecourse, 80 Ascot Ave
Ellerslie, Auckland
REGISTER ONLINE:
BOOK NOW!
for your 2017 CPD Credits
(including Therapeutics)
Optometry Conference
Sunday 5th November
8am - 5pm
Waipuna Hotel & Conference
Centre, 58 Waipuna Road,
Mt Wellington, Auckland
PLUS 1/2 day workshops
Saturday PM 4th November
www.eyeinstitute.co.nz/optometry
Or register by contacting...
Amber Pio
Ph 09 522 2125 | Fax 09 529 1814
professionaleducation@eyeinstitute.co.nz
Dispensing Optician Conference
Sunday 5th November
8am - 5pm
Waipuna Hotel & Conference
Centre, 58 Waipuna Road,
Mt Wellington, Auckland
March 2017
NEW ZEALAND OPTICS
9

Meet the … bio-engineer
Dr Ehsan Vaghefi is known by friends and family as ‘the eye guy’, a
name given to him by his dad, who is also his inspiration. Jai Breitnauer
discovers the man behind the research
Dr Ehsan Vaghefi is a quietly spoken, very private, but
exceptionally passionate man. You get that from
the handshake alone. His office, tucked into a quiet
corner in the School of Optometry and Vision Science at the
University of Auckland, is well-ordered and punctuated with
personal photos – people are clearly important to him.
“My background is in bioengineering and I wanted to use a
novel, bioengineering approach to working with degenerative
eye diseases,” he explains, when asked about his research.
“I began imaging the eye using different modalities during
my PhD and became very passionate about this. It’s an area
where there is little research.”
The central tenant underpinning Dr Vaghefi’s work is the
idea of pre-diagnosis – that if you can find markers or model
the behaviour of parts of the eye under certain conditions, you
will be able to predict the likelihood of a patient developing
a particular eye problem and ultimately prevent potential
blindness.
“My dad went blind when he was five-years old,” explains Dr
Vaghefi. “He had congenital glaucoma, an ultimately treatable
disease that went undiagnosed. He’s a successful man in
his own right and a great dad – but my childhood was very
different from my friends. While they were play fighting with
their dads, I was helping mine with basic tasks like walking
around. It drives me mad that his blindness was preventable.”
When Dr Vaghefi went to university, his parents – both
lawyers – were surprised he chose bio-engineering.
“I said, ‘I want to help people like you, Dad.’ I knew he was
proud of me for wanting to make a difference in this area. He
calls me ‘the eye guy’.”
After he finished his PhD, Dr Vaghefi says the school of
Optometry and Vision Science was the natural place to go.
He felt there was a lot to be done from a bio-engineering
perspective. Clinicians, he says, are doing amazing work, but
there is room for a fresh look at the eye.
“We are seeing similar approaches for other systems in the
body, like cardiovascular. Medicine in this area is predictive
and preventative, but we can’t do this for vision right now.”
Using up-to-the-minute MRI technology, using the
University’s state-of-the-art MRI machine, Dr Vaghefi is
imaging the blood flood in patient’s eyes to find predictive
trends.
“MRI has many benefits. It’s non-invasive and has no depth
limitations, whereas most optical devices are limited to
looking at the surface. MRI can be fine-tuned to image the
same tissue in different ways looking at, for example, water
content then oxygen content.”
Looking at blood flow is a new area of development, which
has opened up MRI’s usefulness for the eye.
“Currently, ophthalmologists use angiography to look at
blood flow, but this has two problems,” explains Dr Vaghefi.
“Firstly, you have to inject a tracer into the blood stream, which
Dr Ehsan Vaghefi
makes this treatment invasive and perhaps not suitable for all.
Secondly, all you can see from this is one moment in the blood
flow, where the tracer enters that tissue. So, for example, you
can see if a leak is present, but you can’t see the quantity of the
leak or the speed of the blood flow.”
Dr Vaghefi has designed a system that solves these
problems. Using iron naturally present in the patient’s own
red blood cells as a marker, he tags them using a neutral
magnetic setup around the patient’s jaw bone area. The
magnetic tag lasts for just a few seconds and doesn’t interfere
with the patient at all, but it does allow Dr Vaghefi and his
team to monitor the blood flow for a few seconds using the
MRI machine, measuring the speed and quantity of the flow
and getting a really good look at where that blood is, and isn’t,
going in the eye. The full scan takes just seven minutes.
“It’s quite simple science really,” he says noting that the
possibility was always there, it just needed a sensitive enough
MRI machine and someone, like himself, to have the idea in
the first place.
“When people think of MRI, they always think of the brain.
But there’s a lot of applications for MRI technology if you think
broadly and from a bio-engineering perspective.”
So what’s the future for his research? Its potential knows
no bounds, says Dr Vaghefi. But for now the team are
concentrating on developing a model for pre-diagnosis of agerelated
macular degeneration (AMD) and have applied for an
HRC grant on the back of a successful pilot study to run a bigger
clinical study on people newly-diagnosed with AMD and in the
later stages of AMD. This study will
look at blood flow patterns to see what
the early warning signs of AMD could
be and also what the blood flow looks
like in later stages when patients are
receiving treatment. It will run for more
than three years.
“It’s very exciting,” says Dr Vaghefi,
who is aiming to launch the research
trial later this year. “I believe the
outcome of this trial will be informative
and unique. As far as I know, we are
the only research group in the world
who has this perspective on AMD. We
are aiming to get in a couple of steps
before vision starts to degrade and if
we can spot AMD here, then maybe we
can prevent it.”
This pre-diagnosis would involve a
simple scan of people with certain risk
factors and allow ophthalmologists to
prescribe preventative lifestyle changes
and medication before AMD damage
has set in. The research will also look
at the relationship between AMD
progression, treatment and blood flow,
giving medical practitioners the ability
to fine tune the way they prescribe and
treat patients suffering AMD related
vision loss.
The same technology can be applied
to other vision damaging conditions as
well, Dr Vasghefi adds. “Imagine going
to a clinic and being told a couple of
years beforehand that you were at risk
of losing your sight for some reason
and then being told what you can do
now to prevent that from becoming a
reality rather than just what they will
do once the symptoms set in. If you
can predict you can prevent. Predicting
pathologies is my big drive. Preventing
eye disease, not just managing it, is the
next big thing.” ▀
It’s green for
glaucoma
World Glaucoma Week (WGW) from 12-18
March kicks off this year with an all-day event
in Times Square, New York, which will be followed
by a host of other inventive events around the globe.
Across Japan, 34 landmark buildings will be illuminated in green with the
‘Light Up in Green for Glaucoma’ campaign to help spread awareness. This will
be complemented by special lectures in Tajimi by Dr Tadahi Nakano and a host
of screening events.
Closer to home, Glaucoma Australia is inviting everyone to ‘Beat Invisible
Glaucoma’ (BIG) by hosting a BIG breakfast to raise funds for glaucoma
awareness and education; the Department of Ophthalmology at the University
of Auckland is hosting a fundraising morning tea; and Glaucoma New Zealand
has been contacting numerous organisations to help drum up awareness.
Thousands of glaucoma awareness initiatives have been held since the first
World Glaucoma Week in 2010. The World Health Organization has identified
glaucoma as the second
leading cause of blindness
in the world with 79.6
million people expected
to have lost their sight
from glaucoma by 2020.
“Enormous efforts will
be needed in the next
decade to overcome
the impact of glaucoma
around the world. New
strategies concerning
glaucoma screening,
diagnosis, treatment
and rehabilitation are
mandatory,” said Maria
Carrasco, WGW managing
director.
In other glaucoma news,
registrations are now
open for the 7th World
Glaucoma Congress
from 28 June to 1 July in
Helsinki, Finland. In 2019
the event will be held
in Melbourne. For more
information, visit: www.
worldglaucoma.org. ▀
For more on the latest
research on glaucoma, see
our story on ANZGIG 2017
on p23.
Light Up in Green for glaucoma in Japan
Partnership reduces
cataract costs
Eye Institute has partnered with Southern Cross to reduce the cost of
cataract procedures.
The Auckland-based Eye Institute has committed to incrementally
decrease the cost of a cataract procedure for Southern Cross members by almost
30% to help make cataract surgery more affordable, both organisations said in a
joint statement at the end of January.
“With a significantly ageing population and stretched health dollars, we have
entered into a long-term agreement with Southern Cross Health Society,” said
Dr David Fitzpatrick-Cockram, Eye Institute CEO. “They wanted to ensure great
value with the best possible outcomes and treatment experiences for their
825,000 plus members. This marries with our commitments to provide high
quality clinical care and exceptional patient service and in doing so maintain a
sustainable sector.”
Southern Cross’ main vehicle for providing members with cost certainty is its
Affiliated Provider programme, where specialists provide procedures at agreed
prices and streamline prior approval and claims processes for members. But this
is contracting, said Geoff
Searle, Southern Cross’
head of provider networks.
“With our increasing
senior population, the
number of cataract
operations is increasing
each year, [so] we need
to be getting the best
possible deal for our
members. Eye Institute
are definitely supporting
us in this by providing
exceptional patient
experience at lower cost
to the patient and in doing
so, helping to keep the
private healthcare sector
affordable for a significant
number of Kiwis.”
Southern Cross Health
Society currently funds
around 9,000 cataract
procedures each year. ▀
Eye Institute CEO, Dr David Fitzpatrick-Cockram and Southern Cross’
Geoff Searle
10 NEW ZEALAND OPTICS March 2017

SPECIAL FEATURE: CCLS 2017
CCLS: A little bit
legendary
BY ANNE MATHESON, CCLS PRESIDENT
Welcome to CCLS 2017, with a new format and some exciting
new speakers.
In 2016, the CCLS Council changed the one-day conference
format with the introduction of an optional workshop the day prior.
The change was well received and paved the way for the Council to
make changes to the format of the traditional three-day conference.
In the past, our larger conference opened on the Thursday evening
and was followed by a full-day on Friday, a half-day on Saturday and
a half-day on Sunday, so attendees could enjoy the city they were
visiting. The downside, however, was people had more time away
from families and costs were higher.
So we’ve revisited the timing for this conference. The opening
function is still on the Thursday night, the 23 March, but now we
have a full-day of conferencing on Friday 24 and Saturday 25 March,
ending at 4.30 pm. So delegates can choose whether to fly home on
Saturday evening or stay an extra night to explore. With about half the
delegates returning home on Saturday and the other half staying on to
enjoy Nelson, I’m delighted to say it’s clear giving people the option of
an extra night has worked.
This year we have a very exciting conference line-up in a very
beautiful place – sunny Nelson. I’m particularly looking forward
to hearing from Dr Marc Bloomenstein from Southern California
who will be discussing inflammation and contact lens intolerance.
I saw him at the Southern Regional Conference (SRC) in Melbourne
a couple of years ago and his delivery is entertaining as well as
educational. I’m also looking forward to hearing from our own
Professor Charles McGhee and his take on Acanthamoeba, because
it’s something we all need on our optometric radars, and Alex Petty
on myopia control because it’s a personal interest. Then of course
we’re very lucky to have Professor Fiona Stapleton join us again from
Australia and Professor Ken Nischal from the Children’s Hospital in
Pittsburg, as well as a host of great local speakers too.
The conference wouldn’t be complete without our legendary
dinner, which is being held on Friday night. In past years, we’ve seen
some amazing costumes and we think the theme “Best-of-British”
gives people lots of scope to have some fun this year too.
So please join us. There are still a few spaces left. CPD points have
been applied for. And I for one look forward to seeing you in Nelson.
To register visit www.contactlens.org.nz for full details.
Renowned speakers’ line-up for 2017
This year promises an exceptional line of up international
and home-grown speakers. International names Dr Marc
Bloomenstein and Professors Ken Nischal and Fiona
Stapleton, back by popular demand, join our own Professors
Charles McGhee and Trevor Sherwin and a host of other local talent
including Dr Trevor Gray, Alex Petty, Grant Watters, Robert Ng, Peter
Walker and Eleisha Dudson, promising to make this CCLS two-day
conference something special.
NZ Optics asked some of the keynotes how they came to be
involved in eye health and what they’re most looking forward to at
this year’s CCLS conference in Nelson.
Professor Charles
McGhee
Professor Charles McGhee
heads up the Ophthalmology
Department at the University of
Auckland, is foundation director
of NZ National Eye Centre and
chair of the ANZ Cornea Society
(see story p23.) At CCLS 2017
he will be presenting on trends
in corneal transplantation,
Acanthamoeba keratitis, iris
abnormalities and keratoconus
management.
Professor Charles McGhee
Why eye health?
It was entirely by serendipity. I was a medical student and I’d taken
a couple of years out to do pathology during a time when I was
thinking of giving up medicine and “going on the road” as part of
a blues-rock band. However, my parents persuaded me to finish
at least the pathology degree. Unfortunately, the professor of
pathology thought I was ‘a bad example to other students’ and had
suggested I should do something else, so when serendipitously the
professor of eye pathology asked me to come and work for him, I
did. He then arranged for me to pursue research at Harvard, after
which I decided to finish both my pathology and medical degrees…
and move into ophthalmology and eye research.
What keeps you interested in eye health?
It’s about trying to address the demand, because the demand
always exceeds the supply. So I’m always looking at better ways or
safer ways to meet demand. But what drives me generally in life,
what wakes me up in the morning and gets me to work after 31
years of doing ophthalmology, is curiosity. I’m always intrigued
by ‘what if’, and so every day I like to think of something new
and I surround myself with young, enthusiastic optometrists,
ophthalmologists and scientists who always challenge the dogma
of what we think we know.
Why not dedicate yourself full-time to research?
I spend about 50% of my week seeing patients and doing surgery
and 50% of my week on research, so I do a very enjoyable, busy,
six-day week. But there’s nothing like seeing someone who has
a complex eye problem, working out what that problem is and
solving it either medically or surgically. I’m very fortunate that
my clinical practice is based around tertiary referrals, so most of
my patients have already seen a number of ophthalmologists and
optometrists, so I typically see the ‘weird and wonderful’ or ‘rare’
cases. That complexity and patient interaction stimulates my
clinical curiosity… and so I’m also fortunate that this challenging
patient base often leads onto clinical research projects.
What are you looking forward to most from CCLS 2017
It always has excellent speakers you can learn from. I believe if
you ever think you’ve ‘learned the lot’, you’re kidding yourself. Also
one of the fantastic things about New Zealand is the networking.
There isn’t a big hierarchy, everyone is happy to be approached
about cases or interests. So one of the things I most enjoy is
people bringing up interesting cases or questions; sometimes even
posing questions that might be worth developing into a research
project. So the personal exchange of ideas and discussion of cases
and problems is probably the biggest thing I get from CCLS.
What’s the one thing you’d like people to take away
from your time at CCLS?
We are still investigating keratoconus. We certainly don’t know
the full story. We have a much better grasp of the aetiology and
the prognosis and the outcomes of corneal transplants, but each
year we chip away at the enigma of keratoconus. It’s 160 years
since it was first described and we still actually don’t know what
is the best management to recommend for every individual. So
it’s worth always considering that there will be other discoveries
and major developments, which may completely change the we
manage keratoconus in the next 20 years.
CONTINUED ON PAGE 12
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11

SPECIAL FEATURE: CCLS 2017
Dr Marc Bloomenstein
American practitioner Dr
Marc Bloomenstein is adjunct
assistant professor at the
Southern California College of
Optometry and Arizona College
of Optometry and director
of optometric services at the
Schwartz Laser Eye Center
in Scottsdale, Arizona. He
will be covering a number of
different topics at CCLS 2017
including inflammation and CL
intolerance, povidone iodine
vs topical ganciclovir for EKC,
advanced corneal cross-linking,
LASIK surgery and Restasis vs
Xiidra for dry eye.
Marc Bloomenstein
What drew you into to eye health and influenced your
journey?
I always knew I wanted to work in the health industry; I wanted to
help people. But I didn’t want to be in a hospital setting. I liked the
idea of working with one organ and the ocular system has always
fascinated me, so optometry seemed a good fit.
I didn’t wear glasses as kid or have a squint and my parents weren’t
in eye care, but I didn’t have great eye exam experiences. I remember
my doctor sitting behind me in the examining room and using
automated eye charts. We didn’t have much interaction. I wanted
more of a relationship with my patients. I also found the surgical side
of things fascinating in optometry school, which has influenced my
practice to be more medically orientated. The anterior segment is
something of a speciality for me.
What are you most looking forward to at CCLS?
First and foremost, the people. I was lucky enough to go to Australia
and everyone was amazing; so engaged and interactive. I’m also
interested in how different people across the globe perceive the
same profession. In Trinidad, for example, I learned that access
to healthcare and treatments we take for granted in the US, like
drops or artificial tears, are not that accessible for doctors and
optometrists there. That informs the way they practise.
What do you hope delegates will take away from your
sessions at CCLS?
I hope they stay awake! A long time ago someone said to me that
if you can have everybody walk out of the room knowing just
one more thing than before they came, then that’s a win. I hope
everyone will be engaged and my talks will feed into their daily
practice, allowing them to approach something differently or be a
little more pro-active for the benefit of their patients.
Professor Ken Nischal
Professor Ken Nischal heads up Paediatric Ophthalmology,
Strabismus and Adult Motility at the Children’s Hospital of
Pittsburgh and is professor of ophthalmology at Pittsburgh
University’s School of Medicine. At CCLS 2017 he will
be tackling blepharokeratoconjunctivitis, penetrating
keratoplasty, acute corneal melt and alternatives to PKP in
children, and congenital corneal opacification.
What inspired you about eye health?
I was a lazy medical student and found it easy to look at the
eye – that’s the truth! However, early on in my training I saw
a child with a tumour in one eye and that really inspired me
to become involved in paediatrics.
Later, during a placement in Oxford, I saw a child with Peters’
anomaly, a clouding of the cornea that results in blindness. I
was told by a senior colleague there was nothing that could be
done. In the UK in 1998, it was deemed that the failure rate of
infant corneal transplants was too high to justrify the trauma.
Months later in Toronto, I saw a five-year-old who’d been born
with the same condition and had a corneal transplant. He
had a level of sight that meant he could lead an indpendent
life. When I got back to the UK, I championed infant corneal
transplants at Great Ormond Street Hospital and by the time I
left in 2011, it was standard practice.
What are you looking forward to at CCLS?
Exchanging ideas and discussing what people are doing
for adults and children. I always learn something at these
events.
What do you hope people will take from your talks?
I am giving several, varied sessions, including a talk about
acute corneal melt in children and how if you wait for the
eye to go quiet, the
damage will have been
done. I recommend
you operate when hot
– that should generate
some good discussion!
I will also be talking
about alternatives
to full thickness
corneal transplants
in children and
blepharoconjunctivitis
– a condition many
wrongly believe children
can’t get. Paediatric
approaches are often
Professor Ken Nishal
very different.
Corneal Lens Corporation (CLC)
2017 is going to be an exciting year for Corneal Lens Corporation. A
new distribution will be announced at the CCLS conference and Paul
Rose has released the Rose K2 Soft lens for irregular corneas, now
available in New Zealand through CLC.
The SMap mapping system has had a number of developments
that enhance the fitting of specialty lenses, the new benchmark in
data collection of the cornea and sclera. Plus, we’ve got a number of
new accessories for the management of dry eye. We look forward to
seeing you at CCLS 2017 on stand 8.
Abbott
Abbott is a proud sponsor of CCLS and will be stationed at booth 7
where Damien Liuzzo and Rachel Haynes will be representing Abbott
ANZ Consumer Eye Health. They will showcase Blink Intensive
Tears Plus gel drop 10ml, which is designed for enhanced ocular
comfort and relief of the symptoms of severe dry eye. Blink Intensive
Tears Plus gel drop’s visco-elastic technology provides maximum
lubrication with minimal blurring. While some eye ointments and
gels are messy and inhibit your vision, Blink Intensive Tears Plus gel
drop’s synergistic action of sodium hyaluronate and polyethylene
glycol formulation adapts to the eye’s natural blinking function and
provides hypotonic long lasting relief and vision acuity. Preservative
free in the eye. Free from Benzalkonium chloride.
Alcon Vision Care
Alcon’s Dailies Total1 water gradient contact lenses provide
outstanding breathability and comfort 1 to meet the demanding
needs of today’s contact lens wearers. Patients can now experience
both the benefits of high oxygen transmissibility and a lubricious
surface gel 2 with the world’s first and only water gradient contact
lens 2 . The unique chemistry of the lens material allows the water
content to increase from 33% at the core to almost 100% at the
outermost surface 2-4 . Dailies Total1 also feature phosphatidylcholine,
which is eluded into the tear film when needed through lipid layer
stabilisation 5 . A modulus of 0.01MPa at the outermost surface allows
the lens to mimic the softness of the corneal epithelial cells 6 . With
exceptional comfort ratings 7 , let your patients experience the lens
that feels like nothing 7 !
References available on request.
CONTINUED ON PAGE 14
sMap3D SPECS + FEATURES
COVERAGE
Single: up to 17mm diameter
Stitched: up to 22mm diameter
FIELD OF VIEW
Single: H22mm x V17mm
Stitched: H22mm x V22mm
MEASUREMENT POINTS
32,400
ANALYZED POINTS
1,000,000+
SHIPPING DIMENSIONS/WEIGHT
Head: 14” x 14” x 12”
(36cm x 36cm x 30cm)
15lb. (6.8kg)
Manipulator: 14” x 13.5” x 7.5”
(36cm x 34cm x 19 cm)
12lb. (5.44kg)
Chinrest: 21” x 10.5” x 3”
(53cm x 27cm x 8cm)
5lb. (2.26kg)
Base: 20” x 14” x 3”
(51cm x 36cm x 8cm)
7lb. (3.2kg)
FOOTPRINT
Width: 9.5” x 13.5” x 6”
(24cm x 34cm x 15cm)
varied width from patient to doctor
Depth: 17” (43cm)
Height: 19”-21” (48cm - 53cm)
[with head fully lowered and fully raised]
WEIGHT
Est. 11lb. (5kg) (head only)
POWER REQUIREMENTS
5V DC 3A
SUPPLIED PC
HP Envy 15” i7
8GB RAM
HIGHLIGHTS
• Fluorescence based structured light
topographer with more than 22mm range
and 360 o scleral coverage
• Under the eyelid scleral measurements
• Over 1 million measurement points with
a 10 micron precision
• Integrated software for fitting and
customizing Europa Scleral lenses with direct
ordering capabilities
• Unbeatable Price
FEATURED MAPS
• Sagittal Elevation
• Texture-mapped image elevation
• Lens Elevation
• Mean curvature
• Simulated fluorescein pattern
• Corneal and Scleral Elevation (Best-fit
sphere)
• Polar display
• Full 3D display
TOOLS
• Principle toricity display at varying diameters
• Distance measurement
• Mean sagittal height at varying diameters
• Lens and sagittal height cross-section display
• Customizable Data tips
• Customizable color scales
• Brightness and contrast adjustments
• Customizable for multiple users
• Online storage
CONTACT LENS FITTING
• Scleral Lenses
- Normal Corneas
- Irregular Corneas
• Customized Soft Lenses
• Customized Back Surfaces
HVID/VVID MEASUREMENT
A Revolution in Scleral Lens Fitting
www.corneal-lens.co.nz
Visionary Optics is the exclusive US Distributor of the sMap3D.
CAUTION: Federal (USA) law restricts this device to sale by or on the order of a licensed practitioner.
www.corneal-lens.co.nz
+64 (0)3 366 6247 | 2 Ballarat Way Wigram 8042 Christchurch New Zealand
12 NEW ZEALAND OPTICS March 2017

UNIQUE WATER GRADIENT
ULTRASOFT
HYDROPHILIC
SURFACE GEL
SILICONE
HYDROGEL
CORE
THIS IS WHY patients
can experience a surface
so soft, it feels like nothing. ** 1
DAILIES TOTAL1 ® contact lenses have an ultrasoft surface,
almost as soft as the corneal epithelial cells. 2–5
The First and Only Water Gradient Contact Lens
>80% 33%
>80%
~0.01
MPa
Contact Lens Cross-Section
Enlarged Water Gradient Surface Modulus
UNIQUE WATER GRADIENT
Features different surface
and core water contents 6 LASTING LUBRICITY
Hydrophilic surface gel
approaches 100% water
LOW SURFACE MODULUS
Modulus of ~0.01 MPa at
the outermost surface 2,4
at the outermost surface †2
Let your patients experience the DAILIES TOTAL1 ® contact lens difference today.
PERFORMANCE DRIVEN BY SCIENCE
*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.
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 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.
6. Thekveli S et al. Cont Lens Anterior Eye 2012;35(Supp1):e14.
See product instructions for wear, care, and safety information.
© 2016 Novartis. Alcon Laboratories (Australia) Pty. Ltd. 10/25 Frenchs Forest Road East, Frenchs Forest, NSW 2086, Australia. Phone: 1800 224 153. 109 Carlton Gore Rd, Newmarket
1023, Auckland, New Zealand. Phone: 0800 101 106. 07/16 ALC0550a NP4:A21601422433
March 2017 NEW ZEALAND OPTICS
13

SPECIAL FEATURE: CCLS 2017
CCLS boosts workshop numbers
This year there will be four workshops at the
CCLS conference in Nelson to ensure every
delegate with a special interest is take care
of, but places are limited so you need to sign up
fast, say organisers.
Workshop 1: Choosing and fitting the
right Rose K design for the irregular
cornea
Time: Friday 24 March 2.10 - 3.10pm
Host: Paul Rose, CNZM
Ever taken a history and a topography, diagnosed
an irregular cornea, and then been confused
about which design you should fit? This workshop
will cover how to
choose the correct
Rose K design from
the six different Rose K
designs available, with
particular emphasis
on live fittings of the
corneo-scleral Rose K2XL
design.
Designs for Vision (DFV)
The Rose K workshop will be
given by none other than Paul
Rose himself
Workshop 2: Dry eye
Time: Friday 24 March 2.10 - 3.10pm
Host: Ally Xue
This workshop offers a hands-on approach to dry
eye, with opportunities to discuss diagnoses and
treatment of the condition.
Workshop 3: OCT – front to back
Time: Saturday 25 March 8.00 - 8.45am
Host: Richard Johnson and Dr Chris Murphy
This workshop will cover the use of an OCT in
everyday practice including cornea, anterior
chamber assessment, macular and other retinal
conditions.
Workshop 4: Scleral Lenses – from start
to finish
Time: Saturday 25 March 8.00 - 8.45am
Host: Eleisha Dudson and Andrew Sangster
This scleral workshop will be a detailed and
hands-on discussion on the fitting protocol of
scleral lenses, using case examples and hands on
practical fitting.
For more speciality CLs and myopia control see
p16 and p20.
Designs for Vision (DFV) are looking forward to a big year in 2017, and particularly to making
contact at the CCLS conference where we will be demonstrating the versatile Oculus Easygraph
combination corneal topographer/keratometer, as well as consulting room equipment specials.
The highly successful Icare ic100 tonometer continues to draw interest, along with the Icare
Home for at-home monitoring of IOP. Keeler provides a high quality Symphony slit lamp, while a
more affordable retinal camera is now available in the Volk INview.
We are also anxiously awaiting the newly-upgraded Vistavision digital eye chart system, which
will soon be joining the vast range of DFV’s other ophthalmic products, and should be available on
stand to view. See you in Nelson!
Ophthalmic Instrument Company (OIC)
We look forward to welcoming you onto the OIC stand at the CCLS meeting in Nelson. Among items
on display we will have the Nidek RS-330 DUO, which combines high resolution retinal photography
with optical coherence tomography (OCT); and the Nidek RS-3000 Advanced SLO (scanning laser
ophthalmoscope) OCT, which includes non-invasive OCT angiography.
The latest release from Nidek is the TONOREF3, which is a four-in-one unit that combines
autorefraction and keratometry with IOP and CCT measurement, all in one compact unit. The new
tear film analysis software for the Medmont E300 Corneal Topographer will be being demonstrated,
which perfectly complements our Tearlab Tear Osmolarity Test, which provides objective and
quantitative point-of-care testing to help diagnose dry eye disease. See you in Nelson.
Discover Nelson
Sunny Nelson has a wealth of experiences to
offer the CCLS conference delegate.
Stroll along Wakefield Quay to appreciate
the stunning scenery and take in the Nelson
harbour, which is sheltered from the Tasman
Bay by a natural 13km boulder bank crowned
by Nelson’s historic lighthouse. Or you could
head into the nearby city centre and discover the
impressive Nelson Christ Church Cathedral with
its 35m high tower.
Renowned for its arts scene,
Nelson is home to more than
300 working artists. One
gallery well worth a visit is the
internationally-commended
Hoglund Art Glass studio.
World of WearableArt was
also born in Nelson and you’ll
find the WOW museum just
10 minutes south of the city,
on the way to the airport. The
museum is also host to the
Nelson classic cars gallery.
If you’ve got time to head
out of the city, experience the
scenic Tasman’s Great Taste
Trail, winding beside beaches
and estuaries, past vineyards
and restaurants such as Petite
Fleur at Siefried Estate, art
galleries, craft breweries and delightful cafés.
Drive or join a tour following the wine trail
through historic Moutere village where you can
chat with winemakers or viticulturists at their
cellar door.
For those seeking something more adventurous,
you can enjoy unparalleled views of Abel Tasman
National Park skydiving with Skydive Abel
Tasman.
Enjoy.
NELSON TOURISM
Nelson Seifried
NELSON TOURISM
Distributed by:
phone: 09 443 0072
email: tim@oic.co.nz
Precision Contact Lenses
Precision Contact Lenses is pleased to
once again attend the CCLS conference
in Nelson. Kathryn Steeman, director,
is looking forward to catching up with
clients old and new. Kathryn will be on
hand to share her knowledge of 37 years
of contact lens manufacturing and help
optometrists obtain the best contact lens
fit for their clients. If optometrists have
any tricky design fits you wish to discuss,
Kathryn will be more than glad to talk
over the best options for your clients.
Be it the range of free contact lens trial
lenses available, the variety of contact
lens materials on offer or the need to use
one of many different designs that PCL
supplies. We look forward to seeing you at
stand 16!
Device Technologies
Device Technologies is proudly supporting
CCLS 2017 and will be exhibiting at stand
15. While the Topcon Triton Swept Source
OCTs have become highly ranked in retinal
specialist clinics and exclusive optometry
practices around the world, the demand
for the affordable and space saving
Maestro OCT is ever increasing.
Come and see the Maestro, featuring a
‘one-click wide scan’ including macular-,
RNFL-, GCL- and real-colour fundus photo,
all presented in a single report. The
Maestro’s ‘one minute learning curve’ will
also help staff in today’s busy practice
(anterior scan and networking available).
Plus, discover the Frey VA chart’s great
flexibility, durability and great value.
14 NEW ZEALAND OPTICS March 2017

March 2017 NEW ZEALAND OPTICS
15

Nike & Zeiss: a new
innovation
SPECIALITY CL FORUM BY JACOB BENFIELD*
JURASSIC PARK, CLS AND A CATARACT
As the guest writer for this
issue’s speciality contact lens
forum, I thought I would
tackle a problem I have encountered
a few times and feel may become
more common as we test an aging
population.
First we have to go back, way back,
to my penultimate year at university.
Sitting in a lecture about the history
of contact lenses, I learned all about
dental technician Eugene Hirst
who brought rigid contact lenses
to New Zealand around the Second
World War. We heard how these
lenses, made of PMMA and other
old materials, took off and soon
became common place. We talked
about the challenges of fitting and looking after
patients with hard contact lenses and how more
modern materials had replaced them. Despite
this, we were warned, we would still occasionally
see patients who had been in hard contact lenses
for several decades. They might even be PMMA or
other old materials. These patients were known
affectionately as ‘dinosaurs’.
This leads me today’s patient, a 70-year-old
female – ‘LS’ – who has been in hard contact
lenses for at least 40 years. LS presented to my
practice as a new patient and is a true ‘dinosaur’
– not only is she a full-time wearer but she is
still in PMMA. LS had noticed a reduction in
vision over the past few months particularly in
her right eye, and felt her contact lenses needed
an update or a polish. On examination it was
revealed a cataract was the underlying cause.
It makes sense that these patients who have
been in contact lenses for thirty or forty years
may be coming in with blurry vision more often.
Even if they started lens wear in their twenties
they will at least be getting into their sixties
now, increasing the chance of cataract, macular
degeneration and other pathologies. I discussed
with LS that the cataract was blurring her vision
not the contact lenses and she wanted to have
this dealt with. Having been short-sighted her
whole life she was keen following cataract
surgery to still be slightly short-sighted for
the convenience of reading unaided. This got
me thinking about the effect PMMA has had
on her cornea and the potential effect on her
prescription and final cataract outcome.
PMMA and its effects on the eyes are well
known to optometrists with lack of oxygen
leading to oedema and corneal warpage among
other things. A topography following PMMA wear
shows this warpage (fig 1.) with irregular mires
and an irregular surface. This is immediately
noticeable to patients who switch from their
lenses into spectacles and notice blurry vision.
This patient has spent every waking moment
in PMMA lenses for the past 40 years with no
spectacle wear and hence no obvious blur. Of
course older, less oxygen permeable materials
have been dying off for more cornea-friendly
options such as Boston XO. But even these newer
materials can affect the cornea if the lens is
poorly fitting or if it flexes as it ages. This change
in corneal shape is of course not always bad and
with new designs and materials have started the
orthokeratology revolution.
Back to LS then. After removing the contact
lenses my initial refraction was R -7.50/ -1.50
x 45 (6/12-) and L -5.75/ -2.00 x 155 (6/7.5-). I
advised LS that for the best cataract outcome she
will need to cease contact lens wear and wear
spectacles until her corneas stabilise. I got her
back after one week without contact lenses and
the prescription was now quite different, at R
-7.50/ -4.50 x 80 (6/21) and L -4.50/ -3.00 x 160
(6/9.5+).
At this stage I wasn’t happy to prescribe
spectacles so I got LS back once more a week
later and things were quite similar to the week
before so I gave her a pair of single vision
distance spectacles. This got me thinking about
when was an appropriate time to review LS and
when do we expect her corneas to stabilise?
Fig 1: A topography showing corneal warpage
Further reading made me realise the answer
to this was really ‘how long is a piece of string’.
A study by Wang et al 1 found the average
resolution time of corneal warpage was eight
weeks but this had a standard deviation of
nearly seven weeks! Based on this I got LS back
two months later and her prescription was now
R -4.00/ -4.00 x 80 (6/12) and L -4.50/ -1.00 x 80
(6/7.5-).
The end was in sight! Vision was stabilising,
retinoscopy reflex was good and corneas were
clear on slit lamp. To be safe I got LS back
once more one month later and found the
prescription was stable. Success! I have since
referred LS for private right cataract surgery to
be followed with left cataract surgery to balance
any anisometropia.
There may be nothing too startling about what
occurred with LS, but I think it may be a more
common scenario as long-time PMMA contact
lens patients (dinosaurs) develop age-related
pathologies. To give the best surgical outcome
we, as the optometrists, should be considering
the stability of prescriptions and the stability of
the cornea.
The options for these patients will vary with the
patients’ needs. The first step which will help in
the long-term will be to change these patients
to well-fitting newer materials before problems
occur. The patient may not be keen to change
from a winning formula but just as we change
soft contact lens wearers into silicon hydrogel
it seems sensible to change PMMA wearers
into more modern materials. If you do end up
with a patient like LS though, it is worthwhile
discussing with them that they will have a few
months of potentially average vision to give them
a long-term positive outcome. Once out of rigid
lenses patients, may decide to pursue spectacles
(although we must warn them the prescription
may change quickly) or soft contact lenses but
these of course can be difficult with rigid wearers.
I would be intrigued to find out how other
optometrists deal with this problem particularly
for a patient concerned with the cost of this
process. There doesn’t seem to be any universal
answer but it does seem certain that the
number of patients in rigid lenses whether it be
PMMA or modern materials are increasing in age
and therefore increasing in pathology. Cataracts
can affect these patients and it is our job to deal
with it to give them the best vision. ▀
References
1. Time to Resolution of Contact Lens-Induced Corneal
Warpage Prior to Refractive Surgery1 Wang, Xiaohong
M.D.; McCulley, James P. M.D.; Bowman, R. Wayne M.D.;
Cavanagh, H. Dwight M.D., Ph.D. CLAO Journal: October
2002 - Volume 28 - Issue 4 - pp 169-171
ABOUT THE AUTHOR:
* Guest columnist Jacob Benefield stepped in to help while our
regular speciality lens contributor
Alex Petty focused on establishing
his new practice in Tauranga.
Benefield, an optometrist based in
Palmerston North, splits his time
between Visique Naylor Palmer,
Bruce Little Optometrists and the
glaucoma clinic at Palmerston
North hospital. He too has a special
interest in ortho-k and fitting hard
contact lenses.
For those who missed it, General Optical’s stand
at last year’s Visionz conference was proudly
displaying the latest partnership innovation
between Nike and lens company Zeiss for Nike’s
most recent Vision Running Collection.
Though the companies have been working
together since 1998, last year saw the development
of a completely new construction method which
seamlessly fuses the lens material with the frame to
increase coverage and offer eyewear that is lighter
than the average performance product on the market
today, said the companies in a statement. The new
Nike Vapourwing, Tailwind and Bandit designs were
the result of two-years of collaborative development
between Nike Vision, Zeiss and The Shop, VSP Global’s
innovation lab, which develops technologies for the
physical and digital aspects of eyewear and eye care.
US-based VSP Global is the licensee owner for Nike
Vision, through its global design manufacturer and
distributor, Marchon Eyewear.
“The partnership started from scratch to
manufacture a new lens from a custom mould,”
said Stephen Tripi, Marchon’s marketing director.
“Once developed, the mould was refined using
ultra-precise machinery with diamond-polishing
technology to polish the complex lens shape down
to the nanometer. The end result is a lightweight,
state-of-the-art lens that maximizes coverage
and provides optimum clarity to allow athletes to
perform at the highest level.
“To better serve our athletes, we looked to the
future of sunglass design to incorporate new lens
geometry and materials, as well as fit technology
and design elements that haven’t been used in
the performance eyewear industry before. We
really wanted to elevate athletic performance by
developing a better system of eyewear.”
Leslie Muller, co-lead of The Shop and vice
president, design for Marchon said his team worked
side-by-side with Nike athletes to first understand
the unique eyewear demands of runners. The team
drew design inspiration from nature—known as
biomimicry—and looked at factors like the lattice
structure of bones and tendons as strong, but
lightweight interactions of materials. Collaboration
with Zeiss then led to breakthroughs in lens design
by fusing lens materials into frames, he said.
BOOK REVIEW:
The Retinal Atlas, 2nd Edition
by Bailey Freund, David Sarraf, William Mieler and Lawrence Yannuzzi.
Published by Elsevier 2017.
REVIEWED BY A/PROF ANDREA VINCENT*
It has been a long time since I have been seduced
by a text book. But a quick flick through the pages
of The Retinal Atlas quickly became an absorbing
two hours.
Blame it on our busy lives and the digital
revolution, but we are rapidly becoming attuned
to 30 second soundbites, 140 characters and
e-tocs. Rapid advances in technology are
constantly changing our understanding of eye
diseases and the way in which we perceive and
manage them, so many textbooks have a short
shelf-life. The Retinal Atlas, 2nd Edition, however,
is a textbook which challenges and revolts against
this. As a reference textbook predominantly
consisting of images of retinal disease (and
optic nerve disorders for good measure), this is a
diagnostician’s dream.
The stellar cast of editors and contributors have
ably updated Lawrence Yannuzzi’s 1st Edition.
Short synopses of clinical features, epidemiology
and aetiology (longer than a tweet, but succinct
and concisely written) accompany a feast of
images. All imaging modalities are covered, with
colour codes for image type and fundus photos,
including wide-field, autofluorescence, fluorescein
angiography (FFA), OCT (often with a histological
correlate), ICG, and occasional ancillary images of
ocular or systemic associations. Post-treatment
images are present where relevant. Two pages
describe and illustrate OCT angiography, but FFA
images predominate, with only occasional OCT-A
images – notably in MacTel2 and age-related
macular degeneration (AMD) - present throughout
the book.
Often the ‘art of medicine’ is as simple as
experience and pattern recognition; that gestalt
that allows us to categorise the underlying cause,
eg. vascular vs inflammatory, genetic vs toxicity.
Armed with a book like this, the very clearly
indexed and delineated chapters enable the
Nike Vision Vapourwing sports sunglasses
All styles include responsive comfort, that grips
when the athlete sweats, and flexible arms that
conform to the shape of the wearer’s face for
stability and fit. The eyewear also features advanced
ventilation with an auto-adjusting nose pad that
is said to eliminate fog. Each style also includes an
expanded lens for increased coverage that acts as a
protection barrier and minimises stress-causing light
leaks, allowing the runner’s eyes to stay relaxed and
focused, said the companies.
“For decades, the strict optical 0.09D standards for
sunglasses have constrained designers to use only
simple spheres and torics for the optical surfaces in
their premium products. Zeiss has adapted advanced
freeform design and manufacturing techniques
developed for ophthalmic and precision optics to
achieve 0.06D optical performance for general,
complex-shaped surfaces. This extra freedom has
been exploited by the creative team at Nike and
frame-manufacturer Marchon to simultaneously
optimise the fit, the aerodynamics and the aesthetics
of their new line of premium athletic eyewear
without compromising optical performance,” said
Steve Sprat, lens designer for the project. ▀
See associated story on GenOp’s luxury focus p8.
observer to target
and peruse relevant
images for many
diagnostic dilemmas.
Any eye professional
who looks at the
retina; from the
student, the resident
studying for finals, and the generalist, to the rare
diseases guru can find solace amongst these pages.
Comprehensive sections cover common conditions
such as diabetic retinopathy and AMD. There are
detailed chapters on paediatrics, oncology and
surgical retina and complications. The nematode
section is truly fascinating and indicative of coverage
of more singular entities. One omission, however,
was manifestations of the Zika virus, demonstrating
the speed at which our knowledge grows. Each
chapter ends with a ‘suggested reading’ list, which
is predominantly journal-based and necessary for
further insight into aetiology, diagnostic tests or
management plans.
For those not wholly ready for a complete digital
detox, the book includes an online companion,
which can be viewed on your mobile. The Retinal
Atlas website follows exactly the same format
as the book, with a useful search function, and
is easily navigated. The instructional blurb states
you can view enhanced images, but a quick review
of some topics showed the content to be near
identical. The images are high quality resulting in
some lag downloading them.
The book, however, is truly desirable, (albeit
large at 1173 pages long and weighing 3.5kg), and
likely to develop a patina acquired from regular
perusal from students to experts alike. ▀
*Associate Professor Andrea Vincent heads a team researching the
genetics of retinal and corneal dystrophies, keratoconus, glaucoma
and lid abnormalities at the Department of Ophthalmology at the
University of Auckland. She is also a consultant ophthalmologist
at Greenlane Eye Clinic and Retina Specialists in Auckland, a
section editor for Clinical and Experimental Ophthalmology and a
board member of the Ophthalmic Research Institute of Australia.
16 NEW ZEALAND OPTICS March 2017

Groovy re-fit in Christchurch
Groovy Glasses have been a Christchurch
institution since 1994, but when the
September 2010 earthquake destroyed
their Manchester Street premises, it put their
future in jeopardy. Trudy McBeath and her team
managed to find a temporary location to rent in
High Street, but that was levelled by the February
2011 earthquake. Perhaps a weaker business
owner might have cashed in the insurance policy,
but passionate optometrist Trudy and antiques
dealer husband Dirk McBeath were determined to
re-establish, re-opening in rented premises in Bath
Street six-months later while they searched for a
permanent new home.
“We finally secured a character building in New
Regent Street in 2013 that had been earthquake
strengthened, and have been waiting for a suitable
time to move in,” says Trudy, noting much of the
city centre was, until recently, still a ghost town.
“Christchurch is still very much disrupted by
blocked streets, demolition and construction, so
it has been hard to know when a location will be
disruption-free.”
The beautiful art-deco inspired buildings on
Regent Street offered Trudy the perfect canvas
for her quirky stock. Recently renovated, there
wasn’t much to do to the exterior, but inside Trudy
designed and styled the store herself.
“I’d designed three other interiors for my
business previously and have gained confidence
that I know pretty much what I want and know the
tradesmen who can help me achieve it. I have an
artistic bent and a passion for retro and art deco
design, so I guess things came naturally when
thinking about the fit out.”
The theme to the design is retro with a feminine
twist on one side of the showroom including
dressing tables and Axminster floral carpet, and
a masculine industrial feel to the other side with
pre-loved wooden cabinets and workbenches.
“The general idea was to emulate an optician’s
showroom from the 1920’s with all that lovely old
patina on the furniture and that vintage vibe,”
says Trudy, who describes herself as a child of the
‘60s and says many of her patients are too. “Our
aim is to use genuine vintage pieces of furniture
whenever possible or re-purpose something
vintage to become useful. Too much is thrown
away by our society so a devotion to valuing things
from the past has been a driving force in all my
shop fit-outs.”
This passion for vintage doesn’t extend to
technology, however, as all the company’s optical
equipment and POS systems have been recently
updated.
As well as sticking to her upcycling principles,
Trudy incorporated sensory design into her fit out.
“I wanted not just visual stimulation, but good
music in the showroom (aural stimulation), good
smells like fresh flowers and wood polish, and
tactile stimulation from handling those battered
old wooden surfaces when putting frames down
after trying them on.”
She admits though she’s never heard of sensory
design principles, preferring to put her trust in
instinct, adding that she’s even allowed for a
positive taste sensation by providing mackintosh
toffees for customers to enjoy! ▀
Trudy’s showroom is like stepping back in time
When you experience
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March 2017
NEW ZEALAND OPTICS
17

Tackling that shrinking feeling
Shrinkage is a given in the retail game, but by taking a proactive
approach to minimising theft, businesses can reduce both their
stress levels and financial losses. By Caitlin Sykes
It’s a crime estimated to cost the country
more than a billion dollars annually, and is
increasingly perpetrated by criminal groups
that are well organised and intimidating in their
methods. But it’s not headline-grabbing offences
such as methamphetamine dealing or cybercrime,
it’s shoplifting.
While it may have once been the domain of
bored, opportunistic teenagers up for a lark,
shoplifting today is often a more organised and
menacing business.
Chris Wilkinson, managing director of Wellingtonbased
retail strategy firm First Retail Group,
has spied a number of growing trends among
shoplifters, including increased incidences of
shoplifters travelling to several similar stores to fulfil
specific orders.
“There’s also an increasing incidence of threats
made against staff and this is something that’s a
major concern to businesses,” he says. “We’ve got
people coming into stores and saying things like,
‘you’re all going to stand in the corner while I take
this, and none of you are going to call the police’...
it’s very scary.”
Phil Thomson
heads up Auror, a
crime-intelligence
and prevention
software
platform that
helps retailers
and police work
together to fight
crime. Thomson
says businesses
in the eyecare
and ophthalmic
industries are
facing similar
issues to many
other retailers
Chris Wilkinson
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18 NEW ZEALAND OPTICS March 2017
with respect to shop theft and shrinkage - a
progression toward more organised offending with
groups that are selectively targeting goods, based on
instructions from others, that can be easily on-sold.
“In particular, sunglasses are a known item
targeted by thieves as they are readily convertible,”
he says. “Just last year, one specialty sunglass retailer
in Dunedin had $30,000 worth of stock stolen
overnight from a kiosk in a shopping mall. That’s
not the type of theft conducted out of opportunity
because someone liked a pair of sunnies; it’s because
sunglasses can be easily sold through markets,
online or in person for money or drugs.”
To put this in an international context, according
to the Global Retail Theft Barometer survey last
year, sunglasses were the number four loss category
within apparel and fashion accessories, says
Thomson.
The cost of shoplifting
Greg Harford, general manager of public affairs
at retail trade association Retail NZ, notes these
trends impact businesses in a number of ways.
“We’re seeing an increasing perception among
some in the community – and it’s an incorrect
perception – that shoplifting is a victimless crime
and there are no consequences. Whereas actually
there are very real victims of it.”
Ultimately, as consumers, we’re all victims as losses
wrought by shrinkage impact the price we pay for
goods, he says. “Retail crime is a big issue. There is
some analysis that suggests it costs the economy
about $1.2 billion a year nationally, so that’s a driver
for every retailer to take it pretty seriously.”
At a firm level, the material cost associated with
shrinkage is more keenly felt. Professional retail
businesses such as optometrists are often small,
privately-owned firms that are particularly impacted
by the financial cost of theft, says Harford, and the
violence and intimidation that are increasingly
being associated with theft can be traumatic
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for staff and
members of
the public, and
present a health
and safety risk.
The emotional
impact of theft
on staff may
be even greater
in healthcarerelated
businesses such
as optometrists,
where
relationships with
clients tend to be
Greg Harford
closer than those
in purely transactional retail environments, notes
Wilkinson. “With that intimacy comes an implicit
trust, so it can be very unexpected when you see
that trust violated.”
It’s a sentiment echoed by therapeutic optometrist
Hadyn Treanor, who is co-owner of Auckland-based
Frith & Laird Optometrists.
“We see ourselves more as a community
optometrist, and that people are coming in because
they’re genuinely seeking help and not wanting
to be ‘sold’ to. So to then find out that that person
wasn’t looking for your help and they were actually
after something to take from you, I think that hurts
more than if it was in a purely retail environment.”
Tackling the shoplifting problem
Frith & Laird’s Manurewa-based premises are
located on the first floor of a medical centre, which
Treanor says makes the practice less vulnerable to
shoplifting, although he says the business is still
not exempt. Prior to joining Frith & Laird seven
years ago, however, Treanor worked in a number of
different practice environments, including in a city
centre location with a large sunglass offering where
shoplifters were very much on the radar of staff.
“One of the little things we always did was ensure
the frame and sunglass racks were kept full, so
if something
was taken it
was obvious,”
he says. “But
sometimes the
more organised
[shoplifters]
would have a
dummy frame
they would swap.
So they’d take
the designer
sunglasses down
and the cheap
service station
sunglasses would
Hadyn Treanor
go into the rack
in their place. So you do need to be very vigilant
because when they’re good, they’re very good.”
Dispensing optician and optometry practice
designer Elaine Silk agrees keeping displays tidy
and fully stocked – affording a quick visual check
that nothing’s missing – is one tactic to help fight
shrinkage.
Silk says thinking about preventing shrinkage
when planning a practice layout ultimately
benefits the overall experience for both clients and
employees. She prefers practice designs that are as
open plan as possible, and says a well-considered
layout can eliminate blind spots that staff can’t
manage or watch.
“Stand at your reception and survey your practice.
Then do the same at your dispensing desks. Are
there areas you cannot see? Consider moving any
freestanding frame displays that impede your line-ofsight
through the practice, and create a clear view for
your employees and clients. The potential shoplifter
will know they are far more likely to be seen.”
Mirrors are also a great theft deterrent, she says.
“One bonus when it comes to optometry practice
design is the ability to use lots of mirrors – both for
your clients to appreciate the great eyewear you have
and for the added perk that when consumers can see
A right mess
A good Samaritan who came to investigate a
disturbance at optometrist Peter O’Hagan’s
Paeroa practice late one night got hit in the head
with a brick for his trouble by a burglar fleeing
the scene.
While the incident made news headlines when
it happened in April 2015, thankfully O’Hagan
says the man who was struck made a quick
recovery. But other annoyances linger.
“There’s a bit of evidence that they’d cased
the joint a few days before. They’d come in,
wandered around, made an excuse and left,” he
recalls.
“The stupid thing was they broke in to steal the
$20 that was in the charity box on the counter –
that’s all they took. For all that, we had glass all
through the front [of the practice], and I was up
in the middle of the night taping it up.”
Despite the experience, O’Hagan – who with
his wife, optometrist Heather O’Hagan, also has
practices in Whangamata, Waihi and Te Aroha
– feels his businesses are not an obvious target
for thieves and their security measures have
remained unchanged.
“It was just our turn. We’ve had three robberies
in 34 years, and for us the cost has been in the
mess, not in what they take.”

themselves, they tend to behave more appropriately.”
Wilkinson’s company delivers a crime-prevention
initiative called Eyes On, which helps businesses
in the Capital work with each other and police to
proactively reduce theft. Empowering staff with the
skills to deal effectively with shoplifters is crucial,
he says. The Eyes On initiative includes staff training
programmes such as ‘verbal judo’, which teaches
staff how to diffuse tricky situations using words
and body language.
Auror’s Thomson says taking a proactive approach
to shoplifting prevention through customer
service is also a good tactic. “The very best way
to discourage an offender from stealing is to
shower them
with customer
service. If you
spot someone in a
store that seems
suspicious, they
should become
your number one
service priority
while in the shop.
Ask for their
name, be helpful,
point out specific
glasses, offer to
hold bags, and do
anything else you Elaine Silk
can think of to let
them know that they have your full attention. Often
thieves will leave rather than try to press ahead with
a theft if they know they are being watched.”
Another key is to keep communicating with
the public about the efforts you’re taking with
security; with other retailers to share any shoplifting
intelligence, as well as advice and support; and with
police, says Harford. “There’s sometimes, perhaps,
been the perception that the police won’t come
[when shoplifting is reported], or it’s not worth the
effort. Well it absolutely is because the police can’t
do anything about it if they don’t know about it.
Particularly with today’s software tools, you can now
track patterns of activity and piece them together
and build up potentially quite a dossier against
individuals.”
Theft from inside
When it comes to preventing theft from staff, many
of the same principles apply, says Harford. “It’s
around making sure you’ve got security systems in
place, thoroughly vetting your people, and making
sure they’re aware you are watching what’s going
on – in a positive way, in that you’re keeping an eye
on the store.
“Ideally its about having people working together
so there’s good communication within the store,
and again communicating with police and nearby
retailers because if you find there are a lot of
problems in your store and it’s only in your store
then that might be telling you something.”
Frith & Laird’s Treanor says combating internal theft
can be particularly challenging in small businesses
where responsibilities still inevitably need to be
delegated, but there’s not always the luxury of
having them overseen by a number of staff. Then
again relationships between staff in small firms tend
to be closer so it can be easier to pick up on clues that
theft is occurring, such as staff displaying spending
that’s out of sync with their earnings.
“It’s difficult as a store owner in that you can’t
do everything all the time. You have to give people
responsibility and inevitably it’s the front of house
staff who are handling the money. There has to be
an element of trust but at the same time you have
to be vigilant – things like keeping an eye on how
many bank runs you’re doing to deposit cash, or
looking at how many refunds you’re doing.”
Treanor also says that when hiring, practice
owners should check to see if there are any gaps
in the applicant’s CV. “More often than not, it’s the
employees who you’d almost least expect because
they’ve worked hard to earn your trust so you
start giving them more and more responsibility.
Unfortunately, that’s sometimes when it’s
betrayed.” ▀
A corporate take on shrinkage?
Peter Papatheodorou, loss prevention manager at
Specsavers for Australia and New Zealand, shared
his five top tips for securing your business:
1. Position a designated ‘meet-and-greet’ staff
member close to your store entrance. Not only
does this improve the ‘welcome’ factor for
patients and help capture browsers, it also acts as
a deterrent for external theft
2. Installing a CCTV camera and alarm system
will deter potential theft and provide valuable
evidence to assist police when a theft has been
committed. Make sure the CCTV camera is
highly visible
3. Undertake regular stocktakes. This will
identify missing stock very quickly and alert you
and all staff to what could be either internal or
external risks
4. Establish a clear process for staff to report
shoplifting or theft concerns to management
5. Always do a complete end-of-day reconciliation
and run all available reports, ensuring any card or
cash variances are fully understood
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March 2017
8/02/2017 12:39:03 PM
NEW ZEALAND OPTICS
19

Focus
on Business
BDO: Protecting business
secrets from cyber threats
A
company was busily preparing
its tender document for a
major project – unaware
spying eyes from a foreign country
were watching through a cybersecurity
infiltration of their network.
Leon Fouche, BDO’s Australasian
leader in cyber-security, says this
does not only happen in movies. This
is a real cyber threat happening to
New Zealand companies – a threat
to which no entity – even small scale
clinical practices – is immune.
According to Leon, BDO has
been involved in cyber intrusion
investigations similar to this. In one of
these investigations, a BDO client was
going through a large merger and
acquisition process when they alerted
BDO that a foreign body had been in
their network for a number of months
before they became aware of it.
The company was able to clean the
intruder – which had been looking
for information to advantage its own
tender – out of the network.
The potential disaster was
contained, but this and other forms of
cyber-crime are already costing New
Zealand millions of dollars.
Internet security company Netsafe,
in its 2015 report, estimated cybercrime
as totalling between $250m
and $400m annually. New Zealand
law does not require companies to
report cyber-crime, so many don’t.
Few admit to a breach that could
damage their brand, business and
customer trust.
Netsafe reported 8,570 cyber
attacks in New Zealand last year,
costing $13.4m – with the biggest
attack costing the target just over
$2m. But that only covers known
breaches. Netsafe estimates that’s
only about 4% of all cyber-crime.
I take Fouche’s warnings very
seriously. His long list of cybersecurity
credentials includes
establishing and running a cybersecurity
programme for the
Australian Government’s hosting of
the G20 summit in 2014. His view
of cyber-crime is that there are only
two kinds of companies in the world
– those who have experienced a data
breach and those who don’t know
they’ve already been breached.
But most alarming is that whilst
this is a big problem, so many
companies just accept it as a fact of
life and don’t do much about it. Yet
a cyber breach can not only damage
a business – it can close it. This point
is most pertinent to optometrists as
you are in a business that is founded
on trust, and if you lose the trust of
your customers because your data
and their privacy has been breached,
it can be fatal.
It may be easy to be lulled into a
false sense of security because you
don’t think optometry is a line of
business that one of the four main
kinds of hackers would target –
activists making a political or social
point; cyber-criminals for whom
money is the motivation; statesponsored
hackers seeking a political
or commercial edge; and those who
use disgruntled employees or human
error to gain access to a company’s
network and data.
Yet, as Fouche warns, it is not
only large multinational companies
that are at risk. Indeed, two recent
BY DAVID PEARSON*
examples prove that any New
Zealand entity is susceptible to these
attacks. In July 2016, Fairfax Media
reported that Hunting and Fishing’s
website had been targeted by
hackers who were seeking customer
information. As a result their website
was shutdown including all online
trading activity. As of the end of
September, they were still offline as
they have been unable to guarantee
the security of customer details,
including payment information. At
the other end of the scale, a small
Wairarapa business was the target of
a crypto-ransomware attack, where
the hacker attempts to encrypt
valuable files and demand a ransom
in return for decrypting them.
One of the best defences against
crypto-ransomware attacks is
ensuring your staff are vigilant when
receiving unsolicited emails with
suspicious attachments. This is the
most common method of infiltrating
a business and antivirus software
won’t always keep pace with the
latest methods used by the hackers.
An employee who opens a suspicious
attachment can unknowingly
release one of these viruses into the
company’s network.
BDO had a specific incidence of this,
where one of our optometry clients
had exactly that happen to them.
Luckily BDO’s in-house IT specialist
was able to recover their data with
minimal disruption to the business. A
potentially destructive event became
nothing more than a minor headache.
This was largely due to the ongoing
relationship we have with the client
and the backup processes that we
had previously implemented for them
in case of this type of event occurring.
The threat is now at the point
where cyber insurance is just as
important as building, general
liability or professional indemnity
insurance. Equally important is the
implementation of robust backup
procedures, appropriate malware
and antivirus protection and keeping
network infrastructure up-to-date. As
noted above, staff are an important
line of defence and password
strength is also key to this. The more
complex the password, including
upper and lowercase letters, numbers
and symbols, the more exponentially
difficult it becomes for a hacker to
crack. Finally, the maintenance of
current software protection versions
is essential as with all technologies,
the pace of change is significant. ▀
Written in conjunction with Leon
Fouche – National Leader of Cyber
Security, Brisbane.
ABOUT THE AUTHOR:
* David Pearson is managing partner with
BDO Central and has a speciality interest in
advisory services to the optometry sector.
For more
information
contact David at
david.pearson@
bdo.co.nz or visit
www.bdo.nz
Myopia Control – is it the new
standard of care?
One measure of how significant the discussion around
myopia control has become was illustrated by the
American Academy of Optometry holding a joint
AAO/ARVO symposium on the first morning of its November
2016 annual conference titled ‘Control vs Correction of
Early Myopia: Has the Standard of Care Changed?’. This
question reflects the current state of evidence supporting
the use of optical
and pharmacological
interventions to
reduce the progression
of myopia and
environmental
interventions to reduce
the incidence of new
cases of myopia. It
challenges practitioners
to consider whether
simply correcting myopia
by prescribing glasses
or contact lenses for
children and adolescents
showing progression is a
sufficient management
option or should advice
regarding myopia
control also be provided
to the patients and their
caregivers from the
onset.
High myopia, often
taken as a refraction
greater than -6DS, has
long been recognised
as being associated with sight-threatening conditions
including myopic maculopathy, retinal detachment, cataract
and glaucoma. However, this threshold is arbitrary and even
low to moderate degrees of myopia increase the risk of such
conditions developing. Furthermore, while high myopia has
been considered to be more genetic than environmental in
origin, the rapid increase in prevalence of myopia in East
and Southeast Asia over the last few decades has revealed a
new pattern of development of high myopia 1 . In this pattern,
high myopia develops at around 11 years of age, due to the
onset of common (or school) myopia at 6-7 years of age,
associated with a relatively high progression rate of -1D per
year or greater. This form of rapidly progressing common
myopia appears to be associated with the adoption of an
intensive and prolonged education system. While the current
“epidemic” of myopia is commonly associated with Asian
countries and states, a similar association between extensive
academic education and myopia was also noted over 150
years ago in Germany by the ophthalmologist, Hermann
Cohn 2 .
While a few dioptres of myopic refractive error may even
be considered quite useful once presbyopia has developed,
the aim of myopia control is to identify early signs of myopic
progression in children and adolescent patients and offer an
appropriate myopia control option with the aim of reducing
the rate of progression, and hence the final degree of myopia
developed in adulthood. The overall aim is to reduce the
future risk of loss of sight due to myopic maculopathy and
associated conditions. Current evidence-based myopia
control options, which have been shown in controlled studies
to reduce myopia progression, can be divided into optical
(orthokeratology, peripheral/dual focus modifying soft contact
lenses, progressive addition spectacles lens and executivestyle
bifocals) and pharmacological (low concentration/dose
atropine) methods.
Optical control
BY ANDREW COLLINS*
Myopia is now considered an “epidemic” by many commentators
Optical interventions for myopia were traditionally based on
the concept of managing accommodative demand and/or lag
associated with near work and so under-correction of myopia
was often promoted. However, when tested in a randomised
clinical trial (RCT) under-correction actually resulted in a
small, but significant increase in myopia progression relative
to the control group who wore their full refractive correction.
Conversely, myopia correction with progressive addition
lenses (PAL) has been shown to slow myopia progression
by 11-13% in a number of RCT studies, although the clinical
benefit has been considered to be too small to promote as
a clinical intervention. Interestingly, a larger reduction in
myopia progression (39-51%) has been demonstrated in a
RCT using executive-style bifocal spectacle wear, either with
or without base-in prism incorporated in the near segments.
In fact, the observation has been made across a number of
spectacle-based myopia control studies that there appears to
be a positive relationship between the size of near segment
or zone, and the magnitude of the treatment effect. This
observation has led to an alternative hypothesis that such
spectacle lenses may be producing their reduction in myopia
progression by the near segment altering peripheral retinal
defocus when the wearer is looking through the distance
portion of the lens.
The role of peripheral retinal defocus in the control
of refractive development is supported by a number of
experiments in animal models of myopia. In these models,
manipulation of the retinal focal plane so that it lies behind
the retina (hyperopic defocus) promotes a compensatory
axial elongation of the eye, resulting in the development
of a myopic refractive error. Conversely, relative peripheral
myopic defocus (image plane in front of the retina) slows axial
elongation and myopia development, even when the foveal
region is experiencing hyperopic defocus.
These findings have led to a number of optical solutions,
including novel spectacle lens designs, intended to produce
relative peripheral myopic defocus with the aim of reducing
myopia progression. A one-year trial of peripheral defocuscontrolling
spectacle lenses demonstrated that a sub-group of
6 to 12-year-old children with a parental history of myopia did
display significantly less progression (0.29D less) with one lens
design, however, the effect was not statistically significant
across all participants. One possible explanation for the overall
lack of a significant effect is that with spectacles the eyes can
move behind the lens altering the optical effectiveness of the
peripheral defocus-control. For example, when the principal
of peripheral defocus-control was incorporated into a contact
lens correction, a 34% reduction of myopia progression was
found in a similar age group of children 3 .
Further evidence for the potential of optical control of
myopia progression with a novel contact lens design has been
provided by the local research of Drs Nicola Anstice and John
Phillips at the School of Optometry and Vision Science. These
researchers trialled a dual-focus soft contact lens design
where the central distance correction zone was surrounded by
a concentric addition zone to produce simultaneous myopic
retinal defocus. Myopia progression in adolescent children
was reduced by at least 30% in the eye wearing the dualfocus
treatment lens during the first 10 months of the study 4 .
This lens design provided the basis for the CooperVision
MiSight lens which is currently undergoing worldwide clinical
trials (see p6).
Orthokeratology (ortho-k) is typically utilised to correct
myopia by flattening the corneal epithelium overnight to
reduce the effective corneal power during waking hours. A
secondary effect has been identified in several longitudinal
studies where ortho-k has been shown to significantly reduce
myopia progression by up to 45%. As ortho-k lenses flatten the
central cornea, while leaving the peripheral cornea relatively
steeper, the production of relative peripheral myopic defocus
has been suggested as the potential mechanism for the
reduction of myopia progression effect.
A retrospective audit of clinical records from the public
Myopia Control Clinic at the University of Auckland shows
both dual-focus soft contact lens wear and ortho-k were
equally efficacious in controlling myopia progression, with
rates of progression following treatment falling to about 1/10
of the pre-treatment rates in young adolescent patients 5 .
The authors concluded that clinicians, on the basis of current
evidence, should be offering contact lens-based methods of
myopia control to patients at-risk of progression.
Pharmacological control
The ability of atropine to reduce the progression of axial
myopia has been recognised for nearly 150 years. However,
with the commercially available topical 1% concentration,
the side-effects of mydriasis, photophobia and cycloplegia
have limited its use as a myopia intervention. Meta-analysis
of recent RCT studies has convincingly demonstrated that
atropine eye drops in high dose (1% and 0.5%), moderatedose
(0.1%) and low dose (0.01%) can slow the progression of
myopia in children 6 . The demonstration in a number of trials
that the low dose 0.01% atropine has comparable clinical
efficacy, but minimal side effects, when compared to the
higher doses, has led to its use in myopia control by a number
of practitioners in New Zealand. Furthermore, a lower degree
20 NEW ZEALAND OPTICS March 2017

of myopia rebound has been found when ceasing
treatment with low dose 0.01% atropine (-0.72D)
when compared to 1.0% atropine (-1.15D).
Experience from the Myopia Control Clinic
suggests that the requirement for low-dose
0.01% atropine to be made up by a compounding
pharmacy monthly, and associated cost, is the
main impediment to this treatment being used
more widely for myopia control.
Outdoor activity and myopia control
It is now well-established that spending increased
time outdoors lowers the risk of developing
myopia in children 1 . This is not a simple
substitution effect and can counter the risk of
developing myopia associated with increased
periods of near work and the presence of parental
myopia. A meta-analysis of the epidemiological
evidence found that every additional hour per
week of outdoor activity reduced the odds of
myopia developing by 2%. However, outdoor
activity does not appear to reduce the progression
rate of myopia once developed.
While trials in East Asia involving structured
outdoor activities either during or after school
have demonstrated this reduction in myopia
incidence over the period of one to two years,
other studies have shown that compliance
with incentivised but voluntary programmes
of outdoor activity decreases quickly within
one year. One answer to the issue of decreased
compliance with outdoor activity programmes
over time may be to change the indoor lighting
environment in schools. In Northeast China,
an intervention trial showed that increasing
the average school room desktop illumination
from less than 100 lux, to approximately 500
lux, resulted in a statistically significantly lower
incidence of myopia (4% vs 10%) when compared
to the non-modified lighting group after one
year. While this is relatively early evidence
from one trial and requires further replication,
intervening by changing the lighting conditions
of the indoor school environment may prove to
be an effective public health measure against
myopia development in the long term.
The AAO conference symposium posed the
question as to whether the standard of care for
early myopia has changed given the evidence for
effective myopia control interventions available
to practitioners. The symposium concluded that
while it might still be too soon to definitively
say this is so, particularly with issues around the
availability of low dose 0.01% atropine for the
treatment of myopia progression, practitioners
should be making their patients and caregivers
aware of the options now available to control
myopia progression and the potential benefit
of reducing the final myopic refraction of the
patient as an adult. A second session on myopia
control at the AAO conference concluded with
a presentation from a practitioner who has
successfully set up a practice which specialises
in myopia control in the USA. More locally, the
February 2017 edition of NZ Optics reported
on the opening of practice in Tauranga which
will concentrate on the more secondary care
aspects of optometry including myopia control.
The advent of both evidence-based optical and
pharmacological methods of myopia control
provides an excellent opportunity to optometrists
to provide up-to-date eye care which will
potentially have long-term ocular health benefits
to the patient. The interest in, and presentations
on myopia control, at the AAO conference made
it clear that this is an important area of ongoing
development for both practitioners and optical
companies in the near future. ▀
References
1. Rose, K.A., A.N. French, and I.G. Morgan, Environmental
Factors and Myopia: Paradoxes and Prospects for
Prevention. Asia Pac J Ophthalmol (Phila), 2016. 5(6): p. 403-
410.
2. Schaeffel, F., Myopia-What is Old and What is New?
Optom Vis Sci, 2016.
3. Sankaridurg, P.R. and B.A. Holden, Practical applications
to modify and control the development of ametropia. Eye
(Lond), 2014. 28(2): p. 134-41.
4. Anstice, N.S. and J.R. Phillips, Effect of Dual-Focus Soft
Contact Lens Wear on Axial Myopia Progression in Children.
Ophthalmology, 2011. 118(6): p. 1152-61.
5. Turnbull, P.R., O.J. Munro, and J.R. Phillips, Contact lens
methods for clinical myopia control. Optom Vis Sci, 2016.
6. Huang, J., et al., Efficacy Comparison of 16 Interventions
for Myopia Control in Children: A Network Meta-analysis.
Ophthalmology, 2016. 123(4): p. 697-708.
About the author:
* Andrew Collins is a
senior tutor and registered
optometrist who has
worked in the Department
of Optometry and Vision
Science at the University of
Auckland since 1994. He is
currently enrolled in a parttime
PhD researching the
role of light exposure in the
development of myopia.
Kilsgaard joins DEG
Jacob Kilsgaard
SAFETY,
DRIVEN BY VISION.
Confidence behind the wheel with Rodenstock Road driving glasses.
See better. Look perfect.
GREATER SAFETY COMES FROM
1. UNRESTRICTED FIELD OF VISION FOR RAPID CHANGE OF FOCUS.
2. LESS GLARE AND MORE CONTRAST.
3. EXCELLENT NIGHT VISION.
4. SAFE ASSESSMENT OF DISTANCES.
Without Rodenstock Road: Restricted peripheral vision with conventional
progressive lenses.
Danish company Kilsgaard Eyewear has
joined the Design Eyewear Group (DEG)
to help grow its international sales.
“The Kilsgaard brand has an elegant,
minimalistic and innovative expression and is a
perfect match to the brand portfolio of Design
Eyewear Group,” said Lars Flyvholm, CEO of
Design Eyewear Group. “Kilsgaard Eyewear will
right away benefit from our strength in sales
and distribution, while we clearly will benefit
from their straightforward business model and
their strong relations to the fashion scene.”
Kilsgaard Eyewear was founded in 2008 by
Jacob Kilsgaard, who will now supervise design and
brand development as a creative consultant for
DEG, added Flyvholm. “The close relation to Jacob
will ensure the future development of the brand.”
Headquartered in Denmark, the Design Eyewear
Group emerged from three design companies:
Danish companies ProDesign and Inface, and
With Rodenstock Road: Perfect overview of traffic and rapid change of focus
between dashboard, GPS and mirrors thanks to optimal fields of vision.
For more information speak to your Rodenstock Account Manager or visit www.rodenstock.com.au
Kilsgaard joins DEG brands like WOOW, distributed in ANZ by Eyes Right Optical
French eyewear firm, Face à Face, which also owns
the popular WOOW brand. The company’s strategy
is to develop and market a portfolio of individual
designer brands to customers worldwide. It
currently has an international annual turnover
of more than 400 million Danish Krone ($79.4
million). ▀
COMING SOON
March 2017
NEW ZEALAND OPTICS
21

NZ ophthalmology research celebrated
Dr Charlotte Jordan, winner of the 2017 Calvin Ring prize, flanked by her parents, Annette Jones
and Peter Jordan, and good friend Charlotte Ring
Himanshu Wadhwa with summer student awardees Sunny Li, William Cook and Joevy Lim
Drs David Fitzpatrick-Cockram and Rasha Altaie
Summer students awardees Ye Li, Ji Soo Kim, Michael Wang and Lize Angelo
Professor Trevor Sherwin (R) presenting the William MacKenzie Medal to Jeremy Mathan
Drs Stuti Misra and Jie Zhang with Jina Han and Samantha Simkin
Dr Peter Ring, Professor Colin Green and Alison Ring
Jasha Morarji and Maryanne Dransfield
Maree McInerney, Dr Hussain Patel and Tina Fitness
Dr Dean Corbett, Dr Stephen Best and Professor Trevor Sherwin
Hutokshi Chinoy, Maree McInerney and Dr Mark Donaldson
Frazer Coutinho, Dr James Slater and Salim Ismail
The 2017 Excellence in Ophthalmology & Vision Research
awards evening, celebrating the best of the country’s
young ophthalmology researchers, was an upbeat and
warm affair.
Professor Charles McGhee, the Maurice Paykel Chair
of Ophthalmology at the University of Auckland, was
an amusing MC, peppering the evening with interesting
personal anecdotes about the award winners and others they
have worked with in the department.
He also outlined the department’s annual activities noting
the steep rise in the number of papers published from one
publication a year in 1999 to 1.6 papers a week in 2016; the
many special people and organisations whose donations
have made the growth of the department and its rising
reputation for excellent ophthalmology research possible;
and the staff, research fellows and others behind the scenes
whose dedication to the students and the department result
in evenings such as this.
PhD presentation – Samantha Simkin
Samantha Simkin presented her thought-provoking PhD
study into neonatal and infant eye screening.
The two main aims of her PhD were to determine the
efficacy of telemedicine retinopathy of prematurity
(ROP) screening and to identify the prevalence of ocular
abnormalities, including retinal haemorrhages in a New
Zealand newborn population.
Results for ROP showed that of the 1285 newborns
screened, 83 had Type 1 ROP with no new ROP or retinal
problems detected after six months, demonstrating the
effectiveness of the telemedicine programme. In the study’s
other results, retinal haemorrhages were shown to be
associated with delivery modality, while ocular abnormalities
were identified at a significantly higher rate, 15%, compared
with other established screening programmes in New
Zealand (0.1% for hearing and 0.2% for the heel prick test),
raising the question of whether all newborns should be
screened in the future in New Zealand.
Calvin Ring Undergraduate Award –
Dr Charlotte Jordan
The Calvin Ring Undergraduate Award was a full-on family
affair this year, with Dr Peter Ring handing his presentation
duties to daughter Charlotte Ring as the awardee, Dr
Charlotte Jordan, has been one of her closest friends since
they were both in their teens. She is also the only recipient
to have actually known Dr Calvin Ring before he died in 1998
after a long and internationally distinguished ophthalmology
career.
Named after Dr Ring’s father, the Calvin Ring Prize
recognises the best all-round undergraduate medical student
in clinical ophthalmology. The annual award was established
to encourage interest and awareness of ophthalmology
among medical students in memory of Dr Calvin Ring
who believed that ophthalmology in Auckland needed
an academic focus. Selection for the award is based on
excellence in examination, clinical knowledge and diagnostic
and management skills in ophthalmology.
In a moving and occasionally amusing presentation,
Charlotte Ring praised her friend “Charlie J” or “CJ’s”
22 NEW ZEALAND OPTICS March 2017

dedication and work effort, having not
only studied optometry, being a dedicated
ophthalmology researcher and medical student,
but also a mum to two young children and wife to
Auckland ophthalmologist Dr Shanu Subbiah.
“I’m in awe of you and your dedication to
your career,” she said. “Not only have you been
awarded this and other accolades during your
medical studies, but you were also awarded the
senior prize in optometry during your optometry
degree for which you achieved first class honours
and then continued on to do your PhD. I couldn’t
be more proud…”
William MacKenzie Medal –
Jeremy Mathan
The newly appointed Professor Trevor Sherwin
kept the evening upbeat with an amusing look at
the William McKenzie Medal awardee, medical
student Jeremy Mathan’s rather casual email
pitch – “Hi Trevor” – to come and work in the
department.
Mathan is already an accomplished presenter
“with a David Attenborough tilt to him,” said
Professor Sherwin, having won a number of
awards for his presentations despite being
so early into his career. Mathan has already
published three papers: ‘Autonomous corneal
repair using autologous corneal repair using
In-vitro adult stem cell expansion’; ‘Analysis
of glaucoma subtypes and corresponding
demographics in a New Zealand population’;
and ‘Sphere-forming cells from peripheral
cornea demonstrate the ability to repopulate
the ocular surface’. He has also been involved in
the Aotearoa Research into Keratoconus (ARK)
study, looking at the epidemiologic, demographic
and basic clinical characteristics of people with
keratoconus managed by optometrists in New
Zealand.
The William MacKenzie Medal is awarded
annually for early excellence in eye research.
Arthur Thomas Paterson Scholarship –
Dr Divya Perumal
Dr Stephen Best presented the Arthur Thomas
Paterson Post-graduate Scholarship, noting every
one of the registrars who has won this prize since
it the first was awarded in 1994, has been one of
his registrars at some stage.
The award was established to assist newly
qualified Kiwi ophthalmologists to continue their
post-graduate studies overseas and thus return
to New Zealand with new skills to serve the
populace. Unfortunately this year’s award winner,
Dr Divya Perumal, had already left to take up a
glaucoma fellowship with Manchester Royal Eye
Hospital in the UK, so was not present to receive
her award on the night.
Summer Studentships
Associate Professor Jennifer Craig presented the
awards for the summer students:
Lise Angelo, whose study was titled:
‘Confirming a novel therapeutic target in human
retina for the treatment of chronic inflammatory
disease’ (Betty Bennett Summer Studentship)
William Cook: ‘Rocket science and ‘super’
vision’, which assessed the reproducibility and
comparability of ocular higher order and corneal
aberrations
Darina Khun: ‘The effect of semifluorinated
alkanes on tear fluid dynamics’
Joevy Lim and Ji Soo Kim: ‘Effects of pressure
and heat on corneal biomechanics’, to determine
if different modes of meibomian gland
dysfunction treatment using heat alters the
biomechanical parameters of the cornea (Eye
Insitute Summer Studentship)
Charisse Kuo: ‘Investigation of corneal
epithelium matrix production in healthy and
keratoconic corneas’
ANZGIG (now ANZGS) 2017
The Stamford Plaza on a sweltering Brisbane
summer weekend was the setting for the
2017 Australia and New Zealand Glaucoma
Interest Group (ANZGIG) meeting. This was
a great chance to catch up with colleagues,
discuss challenging cases, learn the latest results
from some high-quality glaucoma research
taking place in Australasia and hear about the
inspirational work of invited speaker Professor
Keith Martin from the Department of Clinical
Neurosciences at Cambridge University. It was
also timed to coincide with the Association for
Research in Vision and Ophthalmology (ARVO)
Asia conference across the river at the Brisbane
Convention Centre for those who wanted to get
their CPD points for the year off to a flying start!
Cases, driving and genetics
The two-day ANZGIG conference commenced on 4
February with a collection of cases. Dr Jo Koppens
from Auckland presented an interesting case of
normal tension glaucoma leading to a discussion
of the possible protective effect of statins in
glaucoma. Other cases included the challenges
of managing patients with nanophthalmic eyes
and raised IOP, highlighting the high-risk of
complications of any sort of ocular surgery.
The second session addressed an issue that
many ophthalmologists struggle with - glaucoma
and safety to drive. Given the ageing population
with many people still driving into their 80s this
is going to be an increasingly common situation.
Loss of a driving licence can have a severe
detrimental effect on quality-of-life through
loss of independence leading to isolation and
depression, with secondary effects on other
members of the family.
Dr Jim Stewart outlined the situation in New
Zealand, with our option to refer the decision to
the chief medical examiner of the Land Transport
Safety Authority if we feel a further opinion is
required, and the potential use of a practical
driving exam by an occupational therapist.
Professor Joanne Wood from the Queensland
University of Technology, a world expert on
driving and visual impairment, highlighted it was
unclear if current Australian visual standards
(which are similar to NZ) were suitable and the
Estermann visual field may not test the most vital
areas or in a way that is relevant to driving.
Professor Wood undertook some very
interesting research comparing patients with
moderate to severe glaucoma with age-matched
controls using an on-road assessment with a
trained instructor in a dual-control car. She found
the patients with glaucoma had only slightly
lower overall safety scores than the controls,
but had twice as many critical errors where the
instructor had to intervene. None of the standard
visual field measures were strongly correlated
with driving safety. She suggested tests involving
motion sensitivity may have better predictive
value. In her research, combining visual field
scores with tests of cognition and strength
showed a better correlation to the driving score.
The other factor making it difficult to determine
the effect of glaucoma on driving was that the
“normal” controls made a high number of driving
errors!
The biggest discussion at the AGM of ANZGIG
was changing the name as there was a feeling
that we should transition from being a “Group” to
a “Society” (having started out as a “Club”!). After
a near unanimous vote it was decided that in
future this group will be known as the Australia
New Zealand Glaucoma Society (ANZGS).
The Lowe Lecture was delivered by Professor
Martin of the University of Cambridge and was
titled ‘Beyond IOP’. He discussed the ongoing
need to develop better ways to protect patients
heading towards significant visual loss. He
outlined the early use of stem cells and the
growth factors they release which were found
to be protective but cause reactive gliosis. He
described newer techniques whereby genes are
introduced into retinal ganglion cells (RGCs) using
viral vectors. This research has reached human
clinical trials, initially testing technique safety
on blind eyes. Further trials on neuroprotective
agents are likely and in the future we may be
combining strategies to replace and regenerate
RGCs.
Professor Martin was followed by Professor
Jamie Craig from Melbourne who updated us
on advances in glaucoma genetics. He broadly
grouped the glaucoma phenotypes into those
where there was a single gene mutation causing
severe disease such as myocilin, which makes up
a very small proportion of glaucoma cases, and
compared this with the more common situation
BY DR GRAHAM REEVES*
Drs Jay Meyer, Nicholas Johnston and Graham Reeves at ANZGIG in
Brisbane
where individuals are born with a “bad hand” of
genes that individually only increase the risk of
glaucoma slightly, but together contribute a risk
up to five times greater. Professor Craig said he
sees a future where genetic analysis may allow us
to better understand an individuals’ risk profile
so we can better personalise their treatment.
Already through The Australian and New Zealand
Registry of Advanced Glaucoma, researchers
are using genetic profiles to help screen family
members of those patients with severe glaucoma.
False irides, vascular factors and MIGS
The second day started with another set of
challenging cases, the most notable being a
patient who had undergone surgery in India
of angle-supported iris implants to change the
colour of her eyes and then suffered recurrent
episodes of anterior uveitis with raised intraocular
pressure. She refused treatment for a
Ye Li: ‘Is keratoconus a stem cell disorder?’
TECNIS ®
Sunny Li: ‘The cornea: wound healing and
changes after cataract surgery’ (Tom Cat Summer
Studentship)
Micah Rapata (absent): ‘Characterisation of the
inherited maculopathies from the NZ Inherited
Retinal Disease Database’ (Ombler Trust Summer
Studentship)
Michael Wang (last year’s William MacKenzie
Medal winner): ‘Clinical and microbiological
profile of Pseudomonas aeruginosa keratitis at
Greenlane Clinical Centre’ (NZAO Education and
Research Fund)
Kenny Wu (absent): ‘Quantification of laserinduced
choroidal neovascular lesions in a mouse
model of AMD’ ▀
LEAVE A LEGACY
OF VISUAL FREEDOM.
PRESBYOPIA-CORRECTING IOLs
long period before finally consenting to having
one explanted. Audience members shared their
experiences with similar patients and advised it
may be necessary to enlist a psychiatrist to help
engage with these patients as there is often an
element of body dysmorphic disorder that makes
rational discussion of the implant risks very
difficult.
Professor Stuart Graham from Sydney gave
the Gillies Lecture discussing the importance of
vascular factors in glaucoma, including research
into patients with nocturnal blood pressure drops.
So-called “big dippers”, whose blood pressure
drops more than 10% overnight, have a three
times greater risk of glaucoma progression.
The only recommended remedy is to make sure
any systemic hypertension is not over-treated
and avoid beta-blocker use, which may further
compromise optic nerve head perfusion. Professor
Graham also discussed the controversy about
whether obstructive sleep apnoea is relevant in
glaucoma. His conclusion was there are probably
several different disease processes involved in the
pathophysiology of glaucoma and postulated that
future genetic testing may allow better distinction
of phenotypes and so guide us in individualising
treatment.
Professor Bill Morgan from Perth added to the
vascular discussion with his work on venous
pulsation and disc haemorrhages, providing
further evidence of the importance of looking
for haemorrhages to identify patients who are
progressing.
The final session covered minimally invasive
glaucoma surgery (MIGS) with a collection of
experts sharing their experience with different
devices and offering advice in terms of patient
selection and technical tips. This was finished with
some very informative and entertaining videos
from Dr Graham Lee of Brisbane, complete with
music appropriate for the sticky situations he
demonstrated!
Overall this was a great conference with
enlightening and entertaining speakers and I look
forward to next years’ instalment in Sydney. ▀
* Dr Graham Reeves is based at the Manukau Superclinic and
Eye Institute and has a special interest in the diagnosis and
management of glaucoma.
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. 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. © 2017 Abbott Medical Optics Inc. | www.AbbottMedicalOptics.com | PP2016CT1775
AMO20468 Tecnis Symfony Adv NZ-Optics.indd 1
March 2017
4/1/17 10:59 am
NEW ZEALAND OPTICS
23

with
Prof Charles McGhee
& A/Prof Dipika Patel
Series Editors
Atypical infectious keratitis
– a rising scourge
ASSOCIATE PROFESSOR DIPIKA PATEL
& PROFESSOR CHARLES McGHEE*
Corneas may be infected by a myriad of
pathogens, and in temperate countries such
as New Zealand, bacterial infections account
for the majority of cases of infectious keratitis.
All forms of infectious keratitis have one thing in
common – their potential to cause devastating
visual loss.
Although relatively uncommon, corneal
infections with atypical microbial pathogens
(eg. Acanthamoeba, fungal, microsporidia, nontuberculous
mycobacteria) are notoriously difficult
to diagnose and treat, often resulting in poor visual
outcomes.
The past decade has seen a rise in the incidence of
atypical infectious keratitis. An outbreak of fusarium
keratitis was described in Singapore in 2005 and
was linked to the use of ReNu with MoistureLoc. In
2006, an increase in the incidence of Acanthamoeba
keratitis was linked to the use of AMO Complete
MoisturePlus. Although product recalls led to a
dramatic drop in cases of fusarium keratitis, the
incidence of acanthamoeba keratitis continues to
rise, the cause of which remains uncertain. Indeed,
recent data from Greenlane Clinical Centre indicates
that the number of cases of Acanthamoeba keratitis
presenting annually has doubled in the period 2009-
2016 compared to 2001-2009.
Risk factors
Taking a detailed history is crucial when it comes
to raising suspicion of an atypical corneal infection.
The vast majority of cases of Acanthamoeba
keratitis occur in contact lens wearers and is typically
associated with swimming, using hot-pools/hottubs
or showering with contact lenses in situ. Risk
factors also include washing contact lenses in tap
water, particularly if sourced from a water tank.
A major red flag for fungal infection is trauma
involving vegetable matter. Other risk factors
include recent travel to a tropical country, chronic
ocular surface disease or systemic immune
deficiency, and poor contact lens hygiene.
Non-tuberculous mycobacterial corneal
infections are rare and are usually preceded by a
surgical intervention (most commonly LASIK), or
corneal trauma.
silmoparis.com
24 NEW ZEALAND OPTICS March 2017
SHOW
Fig 1. Slit lamp biomicroscopy images of atypical infectious keratitis showing (a) corneal epitheliopathy (arrows) in a patient with Acanthamoeba keratitis, (b) a dense
stromal infiltrate in severe fungal keratitis, and (c) a focal stromal infiltrate (arrow) with intact overlying epithelium in a case of microsporidium keratitis.
Fig 2. In vivo confocal microscopy images of the cornea showing (a) double walled cysts (arrows) in Acanthamoeba keratitis,
(b) branching lines in fusarium keratitis and (c) diffuse fine hyper-reflective spots in microsporidium keratitis.
Up until 2003, microsporidial keratitis was
primarily observed in immunocompromised
individuals. There was subsequently an increase
in reported cases of microsporidia keratitis in
immunocompetent individuals in South East Asia.
Risk factors include contact lens wear and trauma
with exposure to contaminated water or soil.
Diagnosis
Clinical signs alone are usually unreliable in
distinguishing the causative
organism. In the case of
atypical corneal infections,
this is attributed to the
great variability in clinical
presentation. Studies report
that over 90% of cases of
Acanthamoeba keratitis
are initially misdiagnosed
as viral, fungal or
bacterial keratitis. Corneal
epitheliopathy (fig 1a)
occurs early in the course of
the disease and may have
a dendritiform appearance
similar to that observed
in herpetic keratitis.
Subepithelial infiltrates may
mimic adenoviral keratitis.
Other presentations include
ring-shaped or focal stromal
infiltrates and corneal melt
or perforation. The presence
of radial keratoneuritis is
virtually pathognomonic
for Acanthamoeba keratitis,
as it occurs rarely in
other keratitis, but this
sign is also uncommon
in acanthamoeba and is
usually only observed early
in the course of the disease.
The stromal keratitis
caused by fungal infection
(fig 1b) usually resembles
bacterial keratitis. Features
that are thought to aid
in distinguishing fungal
keratitis include stromal infiltrates with feathery
edges, and satellite stromal infiltrates. In some
cases, the overlying epithelium may remain intact
despite extensive stromal involvement.
In non-tuberculous mycobacterium keratitis, the
infiltrates have may have an unusual, focal, waxy or
“cracked windshield” appearance and may develop
satellite lesions or a ring infiltrate.
Microsporidial keratitis often mimics herpetic
keratitis, presenting with multifocal epitheliopathy,
or stromal infiltrates (fig 1c) with surrounding
corneal oedema and keratic precipitates.
For patients who are on empirical treatment for
presumed bacterial keratitis, if there is not at least
some sign of improvement within the first four to
seven days, viral or atypical causes of the keratitis
should be actively considered and the temptation
to use corticosteroids should be actively avoided.
Investigation
Tissue sampling and culture remain imperative
in the diagnosis of infectious keratitis. Atypical
pathogens are often fastidious, requiring
specialised culture systems and some cultures may
take days to weeks to become positive.
The difficulty in isolating the causative organism
in atypical keratitis is reflected by the observation
that only 30 to 40% of cultured cases among
patients with Acanthamoeba or fungal keratitis
have a positive culture.
In culture negative cases where there is a lack of a
favourable clinical response, a repeat corneal scrape
is recommended and, in some cases, a corneal
biopsy may be required.
In vivo confocal microscopy (IVCM) is a rapid,
non-invasive technique that enables imaging of
the living human cornea at the cellular level. IVCM
is a useful adjunctive tool when Acanthamoeba
or fungal keratitis are suspected. However, the
resolution limits of this instrument (approaching
one micron) preclude its use in detecting bacterial
or viral infections. IVCM has a sensitivity and
specificity of approximately 90% for the detection
of fungi or Acanthamoeba.
On IVCM imaging, Acanthamoeba cysts may appear
as double-walled cysts, signet rings, and bright spots
(fig 2a). However, inflammatory cells also appear as
similar bright spots, and may easily be confused with
Acanthamoeba cysts leading to erroneous diagnosis.
The presence of double-walled cysts, signet rings
should therefore always be sought.
Fungal hyphae characteristically appear as bright
linear branching structures on IVCM images (fig 2b).
Microsporidia may be diagnosed on IVCM by the
presence of diffuse punctate hyper-reflective inter
and intracellular dots (fig 2c).
Conclusion
Atypical corneal infections pose significant diagnostic
challenges, particularly due to the wide variability
in presentation, overlapping clinical signs, and
difficulties in isolating causative organisms. Early
detection of these cases is crucial and relies on
having a high level of suspicion based on the history,
clinical signs and response to treatment. In particular,
the temptation to start corticosteroids should be
avoided if there is uncertainty in the diagnosis. ▀
References
Patel DV, Rayner S, McGhee CN. Resurgence of Acanthamoeba
keratitis in Auckland, New Zealand: a 7-year review
of presentation and outcomes. Clin Exp Ophthalmol.
2010;38(1):15-20
Patel DV, McGhee CN. Acanthamoeba keratitis: a
comprehensive photographic reference of common and
uncommon signs. Clin Exp Ophthalmol. 2009;37(2):232-8
Kheir WJ, Sheheitli H, Abdul Fattah M, Hamam RN.
Nontuberculous Mycobacterial Ocular Infections: A Systematic
Review of the Literature. Biomed Res Int. 2015;2015:164989.
Garg P. Microsporidia infection of the cornea--a unique and
challenging disease. Cornea. 2013 Nov;32 Suppl 1:S33-8.
Garg P.Fungal, Mycobacterial, and Nocardia infections and the
eye: an update. Eye (Lond). 2012 Feb;26(2):245-51.
About the authors:
* Associate professor Dipika Patel is based in the Department
of Ophthalmology at the University of Auckland. Her research
interests include anterior segment imaging and investigating
potential therapeutic applications for corneal stem cells.
* Professor Charles McGhee is head of the Department of
Ophthalmology at the University of Auckland, and senior
ophthalmic surgeon at Auckland City Hospital. Prof McGhee’s
clinical interests
include corneal
diseases such as
keratoconus, corneal
dystrophies, corneal
transplantation,
cataract surgery and
complex anterior
A/Prof Patel
Prof McGhee
segment surgery
following trauma.

The art of cornea in Brisbane
BY PROFESSOR CHARLES MCGHEE*
This year’s highly successful and well-attended
Australia and New Zealand Cornea Society
(ANZCS) conference was held in Brisbane on
the day before the commencement of the ARVO-
Asia conference. The venue was the beautiful
Queensland Gallery of Modern Art (GOMA) at
Southbank and the one-day conference attracted
almost 100 ophthalmologists, eye-bankers and
those interested in cornea and visual sciences.
The programme was fast-paced but with ample
time for discussion. It covered the whole gamut
of corneal disease in one day – rather than
over the normal annual two-day meeting – so
delegates could also attend ARVO-Asia. Sessions
were divided into sections that included updates,
new investigations, state-of-the-art techniques,
controversies and the annual Doug Coster Lecture.
The principal guest speakers were Dr Mike
Straiko (USA) and Professor Shigeru Kinoshita
(Japan).
The global trend towards Descemet’s membrane
endothelial keratoplasty (DMEK) was highlighted
by a number of speakers, but particularly in
a beautifully presented “DMEK masterclass”
presented by Dr Straiko. It was quite clear that in
the USA and Australasia, however, the majority
of endothelial keratoplasties are still successfully
carried out using the DMEK forerunner, Descemet’s
stripping automated endothelial keratoplasty
(DSAEK). The majority of tissue for DSAEK is now
being prepared by eye banks.
A simple, small, central descemetorhexis without
a transplant, ie. allowing the defect to heal by
sliding of peripheral endothelium, potentially
enhanced by application of Rho-kinase (ROCK)
inhibitors, was highlighted by Dr Greg Maloney
(NSW). Dr Maloney also introduced the audience
to the osteo-odonto keratoprosthesis (OOKP)
programme currently being established in Sydney,
illustrated by the first few treated cases.
Professor Stephanie Watson (Sydney) presented the
compelling advantages of contributing to a corneal
collagen crosslinking (CXL) registry for keratoconus,
the increasingly well-established treatment for early,
progressive keratoconus. While Dr Con Petsoglou
(Sydney) discussed the major development of the
Australian Ocular BioBank in Sydney.
In a landmark Doug Coster Lecture, Professor
Kinoshita discussed the long journey from early
laboratory studies, via animal models, to upcoming
human trials of endothelial cell transplantation
and the utility of ROCK inhibitors. In an academic
tour-de-force Professor Kinoshita outlined
the immediate clinical horizon for endothelial
dysfunction using cultured endothelial cells and
topical agents. In a unique time of rapid changes
in lamellar endothelial keratoplasty, it is now
entirely conceivable that treatment by injection of
cultured cells and application of topical agents will
supplant more invasive surgical techniques within
a decade.
Professor Kinoshita continued in a separate
lecture to highlight the medical and surgical
management of potentially devastating ocular
surface disorders such as Stevens-Johnson
syndrome (SJS).
Dr Graeme Pollock (Melbourne) provided
an annual update of Australasian Eye Banks’
(EBAANZ) activity while his colleague Dr Prema
Finn highlighted key elements of DMEK tissue
selection.
One of the annual highlights of the conference,
the Australian Corneal Graft Registry annual
report, was delivered by Flinders University
research associate Dr Miriam Keane.
The meeting ended with a clinical movie
competition and a new section with interactive
live polling of controversial topics. As always
the mood was upbeat, informal, interactive and
extremely cordial. The fabulous GOMA location
at Southbank, was convivial and refreshing. The
conference dinner in the long gallery was a wellattended
and a most-enjoyably-friendly ending to
a cutting-edge conference. ▀
* Professor Charles McGhee is Maurice Paykel Chair of
Ophthalmology at the University of Auckland and a consultant
ophthalmologist. His clinical interests include corneal disease
and transplantation, and complex anterior segment surgery.
He is the present chair of the ANZ Cornea Society.
Dr Graeme Pollock and Professors Shigeru Kinoshita and Charles
McGhee at the ANZCS dinner
ANZCS diary dates
RANZCO’S Cornea Special Interest Group,
chaired by Professor Charles McGhee, met the
evening before the conference to discuss the
development of the society and to review the
constitution and location of future conferences.
It was provisionally agreed that the ANZCS
conference would rotate to Sydney (2018),
Adelaide (2019), Perth (2020) and Auckland/
Queenstown (2021) to continue this highly
collaborative cornea and eyebank meeting
originally developed by Professor Douglas Coster
in the 1980’s.
Clarity awards
Greerton
DIAGNOSTIC
OCULUS
Oculus Easygraph
Combination Corneal Topographer
and built-in Keratometer
• Extremely high resolution (22.000 measuring points)
• Short measuring time - fraction of a second
• Non-contact measuring
Visique Greerton’s winning team: Tony Simpson, Brenton Clark, Keith Miller, Deanna Black and
Rachel McDonald
Clarity 20/20 presented Visique Greerton in Tauranga with its
Excellence Award for Achievement for signing up more than
1,000 of their patients to Clarity’s “Peace of Mind” insurance
cover.
“We see Clarity as an important tool for us to ensure we retain our
patients. It also offers us a distinct advantage in our local market
by giving our practice a unique point of difference,” said Visique
Greerton director Keith Miller upon receipt of the award. “Clarity not
only helps to build relationships with our patients, but it enables us
to reward our patients for buying premium products by offering the
second year (cover) for free instead of offering discounts.”
Making a claim is very straight-forward and the glasses are
repaired and returned quickly, added Greerton dispensing optician
Tony Simpson. “Using the Clarity interface is quick and very easy,
the temporary save feature means no admin work is done in front
of the patient. We are extremely happy that many patients have
left satisfied having made a claim, especially one gentleman that
damaged his glasses within an hour of collection having sat on them
in the car!”
Matt Marquis, Clarity’s New Zealand sales development manager, says
Clarity has a simple phiilosophy pitch for practices, “sell more glasses,
more often by offering patients the peace of mind they want.” ▀
$9,990+GST+Freight, for month of March 2017 only
SURGICAL
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ODMA update
ODMA 2017 will feature a strong educational focus, say
organisers, including revamped Masterclasses and Spotlight
Seminars, with CPD points for delegates from both sides of
the ditch.
Running from 7-9 July in Sydney, ODMA’s Vison Summit on the
Friday includes Professor John Marshall, the Frost Professor of
Ophthalmology at University College London, in association with
Moorfield’s Eye Hospital, and inventor of the excimer laser; Dr
Rolando Toyos from the US who developed the use of intense pulsed
light (IPL) for dry eye disease; and Associate Professor Paul Chew from
Singapore, who invented and commercialised the Glaucoma MP3
Therapy Laser.
ODMA has confirmed that all the major equipment and lens
companies will exhibit and have so far been joined by frame and
sunglass brands like Tom Ford, Jono Henessy, Face à Face, Lafont and
Salvatore Ferragamo to name a few. ▀
For more information, visit www.odma2017.com.au
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March 2017
NEW ZEALAND OPTICS
25

Style-Eyes
Gender diversity and
eyewear
How would you feel if people refused to
acknowledge who you are and talked
to you like your own identity didn’t
matter?
In the past few years, transgender, gendernon-conforming
and non-binary people have
had a lot more presence in the media and
popular culture. While this exposure has
sometimes lead to greater understanding,
often this doesn’t feed through to the everyday
experiences of our transgender friends.
When I was studying to become an optical
dispenser last year, a transgender friend
told me a story about a recent experience of
shopping for glasses. She is a transwoman
and while browsing for new specs, the shop
assistant made an assumption about her
gender. My friend was looking at the practice’s
selection of women’s eyewear when the
assistant approached without even asking how
she was and told her that the men’s eyewear
was on the other side of the shop. She left
feeling insulted and upset.
How can you make trans and gendernon-conforming/non-binary
people feel
safe and welcome in your shop?
A lesson for all of us who deal with the public is
to never assume anyone’s gender.
Appearances, clothing and accessory choices,
mannerisms and more may make us read
people as men or women because most of
us have spent our whole lives living with an
understanding that there are only two genders.
However, we are beginning to understand there
are many genders, not just men and women.
We need to compassionately approach every
stranger we deal with as an individual.
Here’s what we’ve done in some of the
shops where I’ve worked
• We don’t separate frames by conventional
gender.
• If anyone asks, I tell them that all of our
frames are unisex.
• If anyone is uncomfortable with that or
still confused, I tell them that there are some
BY JO EATON
frames that are more conventionally feminine
and masculine and, if they like, I can help
them find the right frame to suit their style
and personality.
• I try to use non-gendered language when
referring to a group of people. Instead of
saying, “How are you guys doing today?” I say,
“How are you all today?”
• Be considerate when entering people’s data
into your practice software. Many practices
collect titles and gender. If your software
allows this, perhaps you could turn off the
mandatory collection of this information.
I asked another friend - bespectacled
transgender woman and musician, Simona
- what she would recommend and she said,
“The idea that glasses or clothing - fashion - is
gendered is something we need to unlearn.
Anybody should be able to come into a shop and
look at any piece to try on. It’s the staff’s job not
to judge about the gender of both the customer
or the merchandise. When we do that, we stop
focusing on identity and gender altogether and
the store becomes a place where people are free
to look at whatever they want.”
Get talking with your colleagues
There are plenty of great resources online that
you can share with your colleagues.
For a quick 101 about gender and
terminology, I’d direct you to http://tiny.cc/
gender101. It’s a fact sheet called ‘Inclusive
Language Guide Respecting people of intersex,
trans and gender diverse experience’ and is by
the National LGBTI Health Alliance in Australia.
If you would like to learn more start with
this video, ‘An Introduction to Judith Butler’s
Gender Troubles: www.youtube.com/
watch?v=Z7M6kD5Qt5M
Use it to start discussions about what most
of us have been brought up to believe about
gender.
Want to talk about this? I’d be happy to hear
from you. Email me at jo@eyeheartglasses.
com ▀
Stars and their eyes:
Johnny Depp
The 53-year-old Hollywood actor Johnny
Depp is one of the most recognisable faces
of stage and screen – and not in the least
part because of his infamous tinted glasses. As it
turns out, they’re not just a style choice.
“I’m blind as a bat in my left eye,” admitted
the Pirates of the Caribbean star in a Rolling
Stone interview in 2013. He is also myopic in
his right eye. Depp says he’s suffered from sight
problems since birth and has had to rely heavily
on prescription glasses.
“Everything is just very, very blurry. I’ve
never had proper vision,” he explained, noting
that when he is acting a role, like Edward
Scissorhands, it’s not always possible to
wear glasses and he often can only see a few
centimetres in front of his face.
* Jo Eaton is a native Wellingtonian, now working as a
qualified DO in Melbourne. She runs eyewear fashion blog,
eyeheartglasses.com
Fashion update
As Europe’s fashion houses gear up for the northern hemisphere’s spring/
summer season, New Zealand is benefitting with an influx of versatile, up
to the minute styles.
Fleye
On display at Munich’s OPTIfair in January, Fleye
revealed its innovative new designs inspired by
the Canadian interior and furniture designer, Zoë
Mowat.
“With her intuitive exploration of color and
texture [she] adds a touch of ‘Modern Bauhaus’
to the Fleye SS17 collection,” said the Fleye team.
The Copenhagen-based fashion eyewear brand
has gone for an art deco meets industrial theme,
with beautiful angular detail set in metallic and
hardwearing frames.
Distributed direct from Fleye Australia (see the
2017 OIG for contact).
Jono Hennessy
Closer to home, Australian brand Jono Hennessy
has released a selection of new and exclusive styles
in anticipation of Silmo Sydney. Also combining
acetate and bold, colourful prints with quality
metal framework and design, many of these
limited edition styles are produced using pure fabric
laminated in cellulose acetate with an interlayer
formulation developed with Mazzuchelli in Italy in
the 1980’s. Distributed by Phoenix Eyewear.
MORE CLASSIFIEDS ON PAGE 28
WORK AS YOUR
OWN BOSS
At OPSM, we are passionate about opening eyes to
the unseen. Our advanced technology enables us to look
deeper to ensure we give the best care to every customer.
OPSM in New Zealand is looking to expand their Locum
Optometrist network.
LOCUM OPTOMETRISTS – NEW ZEALAND
As a locum you will be your own boss, you will have
the flexibility to set your own hours and will be exposed
to lots of different patients and locations across New
Zealand all while gaining lots of skills and experience.
We are looking for Optometrists who share our passion, are
willing to learn quickly and want to join our customer focussed
teams in making a difference to how people see the world.
WHAT’S ON OFFER:
• Great working environment
• Fantastic locum rates $$
• Accommodation and flights
• Latest technology
• Luxury brands
• New friends and having fun
JOIN OUR TEAM
For a chance to be your own boss and part of an amazing
team, contact us for a confidential, no obligation chat.
CONTACT:
Hirdesh Nair
hirdesh.nair@opsm.co.nz or call +64 21 523 282
Robbie Singh
robbie.singh@luxottica.com.au or call +64 21 750 847
OPSM.CO.NZ/CAREERS
Radley from Inspecs
The London-based fashion accessories firm
revealed its new collection in February, which
focuses on little luxuries and stable pieces that
can morph from work into the weekend. Using
prints lifted directly from the Radley design
palette, expect “floral torts, layered berry
tones and vintage inspired caramel,” says the
London team. Distributed by Phoenix Eyewear.
Blackfin
Also going for an industrial look with a splash
of colour, the Blackfin Lamina PLUS range is
making its debut. The brand’s usual, high-end
titanium frames have been accentuated with
acetate – a new material for Blackfin – offering
a quirky and lively take on classic designs.
The acetate is ultra thin and hand-worked to
offer a style note without compromising on
quality, says the promotional material. The
name PLUS will now be used by Blackfin to
describe all models in which their hallmark
titanium is combined with other materials to
add diversity and choice. Distributed in New
Zealand by Beni Vision.
26 NEW ZEALAND OPTICS March 2017
LX21_OPSM_NZ_LOCUMADVERT.indd 1
10/2/17 3:47 pm

PALMERSTON NTH
& SHIRLEY
OPPORTUNITIES
AVAILABLE TODAY!
ISLANDS
THE BEST OF BOTH WORLDS.
OPPORTUNITY KNOCKS IN
WELLINGTON & CHRISTCHURCH
As 2017 gathers pace, so too do the opportunities for optometrists at all stages
of their careers in and around both Wellington and Christchurch.
A total of seven Specsavers stores are available for you to choose from – and we have multiple positions available, depending on your experience.
We have graduate positions, full-time roles, locum opportunities – and we can even discuss the pathway to partnership if you believe you are ready to
look at store ownership.
Whatever your situation, there has never been a better time to talk to our team about what roles are available now and what is in the pipeline. While 2016
was another year of strong growth for Specsavers stores across New Zealand, 2017 promises just as much for those looking to develop their careers.
Talk to us now and we can tell you about great rates of pay and our unrivalled professional development program.
Contact Chanelle Coates on 0800 717 350 or chanelle.coates@specsavers.com
SEE OUR PALMERSTON NORTH AND SHIRLEY OPPORTUNITIES ON SPECTRUM-BLOG.COM
Millward Brown
Research
No.1 for eye tests
2016
Excellence in
Marketing
Award
2016
Retail
Store Design
Award
2016
Retail
Employer
of the Year
2015
Overall
National
Supreme Winner
2015
Franchise
Innovation
Award
2015
NZ Franchise
System of
the Year
2014
Retail
Innovator
of the Year
2014
Roy Morgan
Research
No. 1 for eye tests
2014
FCA Social
Responsibility
Award
2014
March 2017
NEW ZEALAND OPTICS
27

MORE CLASSIFIEDS ON PAGE 26
DISPENSING OPTICIAN
HAVELOCK NORTH
Grant & Douglas Optometry & Eyewear is seeking a
qualified dispensing optician (or someone currently in
training to be a dispensing optician).
We are a busy independent practice providing excellent
eyecare and eyewear solutions tailored to our customers'
individual needs.
The role will be based mainly in our Havelock North
practice but may require occassional work in our
Hastings practice.
This is a great opportunity for a confident, versatile
individual with the following attributes:
• Experience in customer service with a proven track
record for a high level of customer satisfaction
• Excellent communication and sales skills
• Shows initiative, is reliable and honest
• Strong computer literacy
• Good standard of personal presentation
• Able to work cohesively and productively within
a team.
Monday-Friday, approx 30-40 hours per week (negotiable).
Please email your CV and cover letter outlining your
skills and experience to Anna Byers
abyers@grantanddouglas.co.nz
FULL-TIME OPTOMETRIST WANTED
We have an opportunity for a therapeutically qualified optometrist to
become part of our Total Eyecare team. You need to be competent in full
scope optometry as our private practices embrace all aspects of clinical
work including diabetic retinal screening and myopia control. We are well
equipped with anterior and posterior cameras, topography, automated
Zeiss visual fields and Cirrus HD-OCT. You’ll have the support of experienced
colleagues and opportunities for professional development.
We are looking for a motivated optometrist with a good sense of
humour and someone who works well as part of a team.
Please send your CV to jane@totaleyecare.co.nz
All enquiries will be treated in confidence.
PRACTICE FOR SALE -
CHRISTCHURCH
Unique opportunity to acquire long established practice in the busy
Riccarton suburb of Christchurch. The spacious premises are fitted out
to a high specification custom design and have an excellent high profile
location on Riccarton Road opposite Westfield Mall. The client base is
large, extremely loyal and appreciates the individual and personal clinical
service that the practice offers alongside high quality optical dispensing.
With scope for further growth this practice offers an exceptional
opportunity to practice your own brand of independent optometry.
For a confidential discussion email Julia Saulsbury:
js.visoncare@xtra.co.nz
OCULUS PENTACAM FOR SALE
Still under warranty, less than two years old, just serviced Jan 2017.
Topcon table & 21’’ computer & software licensing key included.
Comes with extra cataract & refractive software packages. Was
used for Capital Vision Research Trust WELKS study.
If interested, please contact Rachel at Capital Vision Research Trust
on 022 394 9980 or info@capitalvision.nz
All offers considered.
PART-TIME OPTOMETRIST WANTED
SILVERDALE
OPSM Optometrists in Silverdale is a privately owned (franchise)
practice/store with a supportive and experienced team. We are
seeking a caring optometrist to join our friendly team and work
around 18 hours per week (including Sundays) or alternatively to
just do Sundays (10am to 5 pm).
Competitive salary package and generous product allowances for
the right candidate.
To apply, please email your CV and cover letter to
tracy.kendall-jones@opsm.co.nz
All applications will be treated with the utmost confidentiality.
NEED TO REPLACE
YOUR LETTER CHART?
AcuityKit has a comprehensive range of digital eyecharts for eyecare
professionals. Ideal for low vision and domiciliary work.
Visit our website www.acuitykit.com or email john@acuitkit.com
CHOOSE YOUR
AUSSIE ADVENTURE
WE SEE YOUR
FUTURE WITH US
At OPSM, we are passionate about opening eyes to
the unseen. Our advanced technology enables us to look
deeper to ensure we give the best care to every customer.
At OPSM, we are passionate about opening eyes to
the unseen. Our advanced technology enables us to look
deeper to ensure we give the best care to every customer.
OPTOMETRISTS
QUEENSLAND AND NORTHERN TERRITORY
WITH ATTRACTIVE SALARY PACKAGES
We are looking for Optometrists who share our passion
and want to make a difference to how people see the
world. Whether you like the city, the surf or the outback,
we’ve got the role for you with our teams in:
• Bundaberg
• Darwin
• Katherine
• Mackay
• Mt Isa
• Toowoomba
• Townsville
JOIN OUR TEAM
You can look to take on a fixed period role or even
consider a more permanent move - who knows, you might
fall in love with the place. Depending on the location,
salary packages up to 175K including superannuation,
accommodation, annual return flights to visit family and
friends and relocation support for the right candidate.
Start your journey with us today! Graduates or recent
graduates are very welcome to apply.
CONTACT:
Brendan Philp
brendan.philp@luxottica.com.au or call +61 418 845 197
Kim Shepherd
kim.shepherd@opsm.com.au or call +61 408 763 575
OPSM.COM.AU/CAREERS
OPTOMETRISTS
NORTH & SOUTH ISLAND, NEW ZEALAND
Our New Zealand business is looking for passionate
Optometrists to join the team.
• Whangarei – full time
• Wellington Float – full time
• Thames – full time
• Dunedin – full time
• The Plaza – full time
• Napier/Hastings – 32 hours per week
When you join OPSM, you work within a team who
are committed to providing the best possible eyecare
solution with exceptional customer service. You will work
with world class technology including our exclusive
Optos Daytona ultrawide digital retina scanner. You
will have many opportunities for continuing professional
development and can enjoy career flexibility through
our extensive store network. You can also make a
real difference in the way people see the world by
participating in our OneSight outreach program.
JOIN OUR TEAM
Start your journey with us today! Recent graduates are
very welcome to apply.
CONTACT:
Hirdesh Nair
hirdesh.nair@opsm.co.nz or call +64 21 523 282
Robbie Singh
robbie.singh@luxottica.com.au or call +64 21 750 847
OPSM.CO.NZ/CAREERS
LX21_OPSM_NZOpticsAU_Advert_A4.indd 1
12/1/17 7:47 am
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11/1/17 11:07 am
C
M
Y
CM
MY
CY
MY
K
Thinking of selling your practice - we have buyers
Considering buying - we’ll give you all the options
OpticsNZ specialises in optometry practice sales,
we've helped dozens of Optometrists buy and sell their practices
For more information contact Stuart Allan on: 03 546 6996
027 436 9091 stu@opticsnz.co.nz www.opticsnz.co.nz
• Locum Service
• Recruitment Services
• Practice Brokering
• Business Consultants
28 NEW ZEALAND OPTICS March 2017